Maternal & Child Practice Exam 2 completed at approximately 6 weeks. Use of a female
condom protects thereproductive system from the
1. For the client who is using oral contraceptives, the introduction of semen or spermicides into the vagina
nurse informs the client about the need to take the pill and may be used after childbirth. Oral contraceptives
at the same time each day to accomplish which of the may be started within the first postpartum week to
following? ensure suppression of ovulation . For the couple who
has determined the female’s fertile period, using the
A. Decrease the incidence of nausea rhythm method, avoidance of intercourse during this
B. Maintain hormonal levels period, is safe and effective.
C. Reduce side effects
D. Prevent drug interactions 4. For which of the following clients would the nurse
expect that an intrauterine device would not be
Rationale: Regular timely ingestion of oral recommended?
contraceptives is necessary to maintain hormonal levels
of the drugs to suppress the action of the hypothalamus A. Woman over age 35
and anterior pituitary leading to inappropriate secretion B. Nulliparous woman
of FSH and LH. Therefore, follicles do not mature, C. Promiscuous young adult
ovulation is inhibited, and pregnancy is prevented. The D. Postpartum client
estrogen content of the oral site contraceptive may
cause the nausea, regardless of when the pill is taken. Rationale: An IUD may increase the risk of pelvic
Side effects and drug interactions may occur withoral inflammatory disease, especially in women with more
contraceptives regardless of the time the pill is taken than one sexual partner, because of the increased risk
of sexually transmitted infections. An UID should not be
2. When teaching a client about contraception. Which of used if the woman has an active or chronic pelvic
the following would the nurse include as the most infection, postpartum infection, endometrial hyperplasia
effective method for preventing sexually transmitted or carcinoma, or uterine abnormalities. Age is not a
infections? factor in determining the risks associated with IUD use.
Most IUD users are over the age of 30. Although there
A. Spermicides is a slightly higher risk for infertility in women who have
B. Diaphragm never been pregnant, the IUD is an acceptable option
C. Condoms as long as the risk-benefit ratio is discussed. IUDs may
D. Vasectomy be inserted immediately after delivery, but this is not
recommended because of the increased risk and rate of
Rationale: Condoms, when used correctly and expulsion at this time.
consistently, are the most effective contraceptive
method or barrier against bacterial and viral sexually 5. A client in her third trimester tells the nurse, “I’m
transmitted infections. Although spermicides kill sperm, constipated all the time!” Which of the following should
they do not provide reliable protection against the the nurse recommend?
spread of sexually transmitted infections, especially
intracellular organisms such as HIV. Insertion and A. Daily enemas
removal of the diaphragm along with the use of the B. Laxatives
spermicides may cause vaginal irritations, which could C. Increased fiber intake
place the client at risk for infection transmission. Male D. Decreased fluid intake
sterilization eliminates spermatozoa from the ejaculate,
but it does not eliminate bacterial and/or viral Rationale: During the third trimester, the enlarging
microorganisms that can cause sexually transmitted uterus places pressure on the intestines. This coupled
infections. with the effect of hormones on smooth muscle
relaxation causes decreased intestinal motility
3. When preparing a woman who is 2 days postpartum (peristalsis). Increasing fiber in the diet will help fecal
for discharge, recommendations for which of the matter pass more quickly through the intestinal tract,
following contraceptive methods would be avoided? thus decreasing the amount of water that is absorbed.
As a result, stool is softer and easier to pass. Enemas
A. Diaphragm could precipitate preterm laborand/or electrolyte loss
B. Female condom and should be avoided. Laxatives may cause preterm
C. Oral contraceptives labor by stimulating peristalsis and may interfere with
D. Rhythm method the absorption of nutrients. Use for more than 1 week
can also lead to laxative dependency. Liquid in the diet
Rationale: The diaphragm must be fitted individually to helps provide a semisolid, soft consistency to the stool.
ensure effectiveness. Because of the changes to the Eight to ten glasses of fluid per day are essential to
reproductive structures during pregnancy and following maintain hydration and promote stool evacuation.
delivery, the diaphragm must be refitted, usually at the 6. Which of the following would the nurse use as the
6 weeks’ examination following childbirth or after a basis for the teaching plan when caring for a pregnant
weight loss of 15 lbs or more. In addition, for maximum teenager concerned about gaining too much weight
effectiveness, spermicidal jelly should be placed in the during pregnancy?
dome and around the rim. However, spermicidal jelly
should
This not be
study source wasinserted into
downloaded the vagina until
by 100000889438651 involution
from is on 01-30-2025 05:21:07
nursinghero.com A. GMT
10 pounds
-06:00 per trimester
https://www.nursinghero.com//study-files/23686708
, B. 1 pound per week for 40 weeks The Doppler intensifies the sound of the fetal pulse rate
C. ½ pound per week for 40 weeks so it is audible. The uterus has merely risen out of the
D. A total gain of 25 to 30 pounds pelvis into the abdominal cavity and is not at the level of
the umbilicus. The fetal heart rate at this age is not
Rationale: To ensure adequate fetal growth and audible with a stethoscope. The uterus at 12 weeks is
development during the 40 weeks of a pregnancy, a just above the symphysis pubis in the abdominal cavity,
total weight gain 25 to 30 pounds is recommended: 1.5 not midway between the umbilicus and the xiphoid
pounds in the first 10 weeks; 9 pounds by 30 weeks; process. At 12 weeks the FHR would be difficult to
and 27.5 pounds by 40 weeks. The pregnant woman auscultate with a fetoscope. Although the external
should gain less weight in the first and second trimester electronic fetal monitor would project the FHR, the
than in the third. During the first trimester, the client uterus has not risen to the umbilicus at 12 weeks.
should only gain 1.5 pounds in the first 10 weeks, not 1
pound per week. A weight gain of ½ pound per week 10. When developing a plan of care for a client newly
would be 20 pounds for the total pregnancy, less than diagnosed with gestational diabetes, which of the
the recommended amount. following instructions would be the priority?
7. The client tells the nurse that her last menstrual A. Dietary intake
period started on January 14 and ended on January 20. B. Medication
Using Nagele’s rule, the nurse determines her EDD to C. Exercise
be which of the following? D. Glucose monitoring
A. September 27 Rationale: Although all of the choices are important in
B. October 21 the management of diabetes, diet therapy is the
C. November 7 mainstay of the treatment plan and should always be
D. December 27 the priority. Women diagnosed with gestational diabetes
generally need only diet therapy without medication to
Rationale: To calculate the EDD by Nagele’s rule, add control their blood sugar levels. Exercise, is important
7 days to the first day of the last menstrual period and for all pregnant women and especially for diabetic
count back 3 months, changing the year appropriately. women, because it burns up glucose, thus decreasing
To obtain a date of September 27, 7 days have been blood sugar. However, dietary intake, not exercise, is
added to the last day of the LMP (rather than the first the priority. All pregnant women with diabetes should
day of the LMP), plus 4 months (instead of 3 months) have periodic monitoring of serum glucose. However,
were counted back. To obtain the date of November 7, those with gestational diabetes generally do not need
7 days have been subtracted (instead of added) from daily glucose monitoring. The standard of care
the first day of LMP plus November indicates counting recommends a fasting and 2-hour postprandial blood
back 2 months (instead of 3 months) from January. To sugar level every 2 weeks.
obtain the date of December 27, 7 days were added to
the last day of the LMP (rather than the first day of the 11. A client at 24 weeks gestation has gained 6 pounds
LMP) and December indicates counting back only 1 in 4 weeks. Which of the following would be the priority
month (instead of 3 months) from January. when assessing the client?
8. When taking an obstetrical history on a pregnant A. Glucosuria
client who states, “I had a son born at 38 weeks B. Depression
gestation, a daughter born at 30 weeks gestation and I C. Hand/face edema
lost a baby at about 8 weeks,”the nurse should record D. Dietary intake
her obstetrical history as which of the following?
Rationale: After 20 weeks’ gestation, when there is a
A. G2 T2 P0 A0 L2 rapid weight gain, preeclampsia should be suspected,
B. G3 T1 P1 A0 L2 which may be caused by fluid retention manifested by
C. G3 T2 P0 A0 L2 edema, especially of the hands and face. The three
D. G4 T1 P1 A1 L2 classic signs of preeclampsia are hypertension, edema,
9. When preparing to listen to the fetal heart rate at 12 and proteinuria. Although urine is checked for glucose
weeks’ gestation, the nurse would use which of the at each clinic visit, this is not the priority. Depression
following? may cause either anorexia or excessive food intake,
leading to excessive weight gain or loss. This is not,
A. Stethoscope placed midline at the however, the priority consideration at this time. Weight
umbilicus gain thought to be caused by excessive food intake
B. Doppler placed midline at the suprapubic would require a 24-hour diet recall. However, excessive
region intake would not be the primary consideration for this
C. Fetoscope placed midway between the client at this time.
umbilicus and the xiphoid process
D. External electronic fetal monitor placed at 12. A client 12 weeks’ pregnant come to the emergency
the umbilicus department with abdominal cramping and moderate
vaginal bleeding. Speculum examination reveals 2 to 3
Rationale: At 12 weeks gestation, the uterus rises out of cms cervical dilation.The nurse would document these
thestudy
This pelvis and
source was is palpable
downloaded by above the symphysis
100000889438651 findings
pubis. on 01-30-2025
from nursinghero.com as which
05:21:07 of the following?
GMT -06:00
https://www.nursinghero.com//study-files/23686708
condom protects thereproductive system from the
1. For the client who is using oral contraceptives, the introduction of semen or spermicides into the vagina
nurse informs the client about the need to take the pill and may be used after childbirth. Oral contraceptives
at the same time each day to accomplish which of the may be started within the first postpartum week to
following? ensure suppression of ovulation . For the couple who
has determined the female’s fertile period, using the
A. Decrease the incidence of nausea rhythm method, avoidance of intercourse during this
B. Maintain hormonal levels period, is safe and effective.
C. Reduce side effects
D. Prevent drug interactions 4. For which of the following clients would the nurse
expect that an intrauterine device would not be
Rationale: Regular timely ingestion of oral recommended?
contraceptives is necessary to maintain hormonal levels
of the drugs to suppress the action of the hypothalamus A. Woman over age 35
and anterior pituitary leading to inappropriate secretion B. Nulliparous woman
of FSH and LH. Therefore, follicles do not mature, C. Promiscuous young adult
ovulation is inhibited, and pregnancy is prevented. The D. Postpartum client
estrogen content of the oral site contraceptive may
cause the nausea, regardless of when the pill is taken. Rationale: An IUD may increase the risk of pelvic
Side effects and drug interactions may occur withoral inflammatory disease, especially in women with more
contraceptives regardless of the time the pill is taken than one sexual partner, because of the increased risk
of sexually transmitted infections. An UID should not be
2. When teaching a client about contraception. Which of used if the woman has an active or chronic pelvic
the following would the nurse include as the most infection, postpartum infection, endometrial hyperplasia
effective method for preventing sexually transmitted or carcinoma, or uterine abnormalities. Age is not a
infections? factor in determining the risks associated with IUD use.
Most IUD users are over the age of 30. Although there
A. Spermicides is a slightly higher risk for infertility in women who have
B. Diaphragm never been pregnant, the IUD is an acceptable option
C. Condoms as long as the risk-benefit ratio is discussed. IUDs may
D. Vasectomy be inserted immediately after delivery, but this is not
recommended because of the increased risk and rate of
Rationale: Condoms, when used correctly and expulsion at this time.
consistently, are the most effective contraceptive
method or barrier against bacterial and viral sexually 5. A client in her third trimester tells the nurse, “I’m
transmitted infections. Although spermicides kill sperm, constipated all the time!” Which of the following should
they do not provide reliable protection against the the nurse recommend?
spread of sexually transmitted infections, especially
intracellular organisms such as HIV. Insertion and A. Daily enemas
removal of the diaphragm along with the use of the B. Laxatives
spermicides may cause vaginal irritations, which could C. Increased fiber intake
place the client at risk for infection transmission. Male D. Decreased fluid intake
sterilization eliminates spermatozoa from the ejaculate,
but it does not eliminate bacterial and/or viral Rationale: During the third trimester, the enlarging
microorganisms that can cause sexually transmitted uterus places pressure on the intestines. This coupled
infections. with the effect of hormones on smooth muscle
relaxation causes decreased intestinal motility
3. When preparing a woman who is 2 days postpartum (peristalsis). Increasing fiber in the diet will help fecal
for discharge, recommendations for which of the matter pass more quickly through the intestinal tract,
following contraceptive methods would be avoided? thus decreasing the amount of water that is absorbed.
As a result, stool is softer and easier to pass. Enemas
A. Diaphragm could precipitate preterm laborand/or electrolyte loss
B. Female condom and should be avoided. Laxatives may cause preterm
C. Oral contraceptives labor by stimulating peristalsis and may interfere with
D. Rhythm method the absorption of nutrients. Use for more than 1 week
can also lead to laxative dependency. Liquid in the diet
Rationale: The diaphragm must be fitted individually to helps provide a semisolid, soft consistency to the stool.
ensure effectiveness. Because of the changes to the Eight to ten glasses of fluid per day are essential to
reproductive structures during pregnancy and following maintain hydration and promote stool evacuation.
delivery, the diaphragm must be refitted, usually at the 6. Which of the following would the nurse use as the
6 weeks’ examination following childbirth or after a basis for the teaching plan when caring for a pregnant
weight loss of 15 lbs or more. In addition, for maximum teenager concerned about gaining too much weight
effectiveness, spermicidal jelly should be placed in the during pregnancy?
dome and around the rim. However, spermicidal jelly
should
This not be
study source wasinserted into
downloaded the vagina until
by 100000889438651 involution
from is on 01-30-2025 05:21:07
nursinghero.com A. GMT
10 pounds
-06:00 per trimester
https://www.nursinghero.com//study-files/23686708
, B. 1 pound per week for 40 weeks The Doppler intensifies the sound of the fetal pulse rate
C. ½ pound per week for 40 weeks so it is audible. The uterus has merely risen out of the
D. A total gain of 25 to 30 pounds pelvis into the abdominal cavity and is not at the level of
the umbilicus. The fetal heart rate at this age is not
Rationale: To ensure adequate fetal growth and audible with a stethoscope. The uterus at 12 weeks is
development during the 40 weeks of a pregnancy, a just above the symphysis pubis in the abdominal cavity,
total weight gain 25 to 30 pounds is recommended: 1.5 not midway between the umbilicus and the xiphoid
pounds in the first 10 weeks; 9 pounds by 30 weeks; process. At 12 weeks the FHR would be difficult to
and 27.5 pounds by 40 weeks. The pregnant woman auscultate with a fetoscope. Although the external
should gain less weight in the first and second trimester electronic fetal monitor would project the FHR, the
than in the third. During the first trimester, the client uterus has not risen to the umbilicus at 12 weeks.
should only gain 1.5 pounds in the first 10 weeks, not 1
pound per week. A weight gain of ½ pound per week 10. When developing a plan of care for a client newly
would be 20 pounds for the total pregnancy, less than diagnosed with gestational diabetes, which of the
the recommended amount. following instructions would be the priority?
7. The client tells the nurse that her last menstrual A. Dietary intake
period started on January 14 and ended on January 20. B. Medication
Using Nagele’s rule, the nurse determines her EDD to C. Exercise
be which of the following? D. Glucose monitoring
A. September 27 Rationale: Although all of the choices are important in
B. October 21 the management of diabetes, diet therapy is the
C. November 7 mainstay of the treatment plan and should always be
D. December 27 the priority. Women diagnosed with gestational diabetes
generally need only diet therapy without medication to
Rationale: To calculate the EDD by Nagele’s rule, add control their blood sugar levels. Exercise, is important
7 days to the first day of the last menstrual period and for all pregnant women and especially for diabetic
count back 3 months, changing the year appropriately. women, because it burns up glucose, thus decreasing
To obtain a date of September 27, 7 days have been blood sugar. However, dietary intake, not exercise, is
added to the last day of the LMP (rather than the first the priority. All pregnant women with diabetes should
day of the LMP), plus 4 months (instead of 3 months) have periodic monitoring of serum glucose. However,
were counted back. To obtain the date of November 7, those with gestational diabetes generally do not need
7 days have been subtracted (instead of added) from daily glucose monitoring. The standard of care
the first day of LMP plus November indicates counting recommends a fasting and 2-hour postprandial blood
back 2 months (instead of 3 months) from January. To sugar level every 2 weeks.
obtain the date of December 27, 7 days were added to
the last day of the LMP (rather than the first day of the 11. A client at 24 weeks gestation has gained 6 pounds
LMP) and December indicates counting back only 1 in 4 weeks. Which of the following would be the priority
month (instead of 3 months) from January. when assessing the client?
8. When taking an obstetrical history on a pregnant A. Glucosuria
client who states, “I had a son born at 38 weeks B. Depression
gestation, a daughter born at 30 weeks gestation and I C. Hand/face edema
lost a baby at about 8 weeks,”the nurse should record D. Dietary intake
her obstetrical history as which of the following?
Rationale: After 20 weeks’ gestation, when there is a
A. G2 T2 P0 A0 L2 rapid weight gain, preeclampsia should be suspected,
B. G3 T1 P1 A0 L2 which may be caused by fluid retention manifested by
C. G3 T2 P0 A0 L2 edema, especially of the hands and face. The three
D. G4 T1 P1 A1 L2 classic signs of preeclampsia are hypertension, edema,
9. When preparing to listen to the fetal heart rate at 12 and proteinuria. Although urine is checked for glucose
weeks’ gestation, the nurse would use which of the at each clinic visit, this is not the priority. Depression
following? may cause either anorexia or excessive food intake,
leading to excessive weight gain or loss. This is not,
A. Stethoscope placed midline at the however, the priority consideration at this time. Weight
umbilicus gain thought to be caused by excessive food intake
B. Doppler placed midline at the suprapubic would require a 24-hour diet recall. However, excessive
region intake would not be the primary consideration for this
C. Fetoscope placed midway between the client at this time.
umbilicus and the xiphoid process
D. External electronic fetal monitor placed at 12. A client 12 weeks’ pregnant come to the emergency
the umbilicus department with abdominal cramping and moderate
vaginal bleeding. Speculum examination reveals 2 to 3
Rationale: At 12 weeks gestation, the uterus rises out of cms cervical dilation.The nurse would document these
thestudy
This pelvis and
source was is palpable
downloaded by above the symphysis
100000889438651 findings
pubis. on 01-30-2025
from nursinghero.com as which
05:21:07 of the following?
GMT -06:00
https://www.nursinghero.com//study-files/23686708
