Maternal & Newborn Nursing Exam

IMMACULATE CONCEPTION COLLEGE-ALBAY Daraga, Albay NCM 101 (Maternal & Newborn Nursing) by Paul Jhon A. Vergara, RN PRELIMINARY EXAMINATION Name:______________________________

Block:____

INSTRUCTIONS: Read each item carefully. Choose the best response to each question and shade the circle of the corresponding letter in the separate answer sheet provided. 1. The structures that form the female external genitalia are collectively termed as the: A. Vagina B. Perineum C. Gonads D. Vulva 2. The small erectile structure in the female external genitalia which is the center of sexual arousal and orgasm in female is called the: A. Vagina B. Prepuce C. Clitoris D. Hymen

3. To help improve sperm survival in the vagina, the pH of the secretions from both Skene’s and Bartholin’s glands are normally: A. Acidic B. Alkaline C. Neutral D. None of the above 4. The structure that is sometimes cut (episiotomy) during childbirth to enlarge the vaginal opening is the: A. Fourchette B. Labia majora C. Labia minora D. Hymen 5. The functions of the ovaries are the following EXCEPT: A. Produce, mature, and discharge ova B. Produce oxytocin C. Produce estrogen D. Produce progesterone 6. In which part of the fallopian tube does fertilization usually occurs? A. Interstitial B. Isthmus C. Ampulla D. Infundibulum

7. Which part of the cervix is at the level of the ischial spine? A. Internal os B. External os C. Anterior os D. Posterior os 8. The layer of the uterine wall that grows and thickens each menstrual cycle in preparation for implantation is the: A. Endometrium B. Myometrium C. Perimetrium D. Epimetrium

9. Which of the following is not a function of the vagina? A. Organ of intercourse B. Conveys sperm to the cervix C. Serves as the birth canal D. Contracts during labor

10. The layer of the uterine wall that contracts during labor is the: A. Endometrium B. Myometrium C. Perimetrium D. Epimetrium

11. Ordinarily, the body of the uterus is positioned: A. B. C. D.

Tipped slightly forward Tipped backward Bent sharply forward Bent sharply backward

12. A positional deviation of the uterus in which the fundus is tipped forward is termed: A. Anteversion B. Retroversion C. Anteflexion D. Retroflexion 13. What microorganism, that is part of the normal vaginal flora, is responsible for making the usual pH of the vagina acidic? A. Candida albicans B. Döderleins bacillus C. Chlamydia trachomatis D. Hemophilus ducreyi 14. What is the primary purpose why the vaginal pH is acidic? A. To reduce odor B. To increase sperm survival C. To maintain sterility of the vaginal canal D. To prevent infection 15. What type of pelvis is the most favorable for labor and delivery? A. Android B. Gynecoid C. Platypelloid D. Anthropoid 16. What are the two types of pelvis that are favorable for labor and delivery? 1. Android 2. Gynecoid 3. Platypelloid 4. Anthropoid A. 2 and 1 B. 2 and 3 C. 2 and 4 D. 1 and 3

17. The distance between the sacral prominence and the posterior surface of the lower margin of the symphysis pubis is the: A. Diagonal conjugate B. True conjugate C. Obstetrical conjugate D. Ischial tuberosity diameter

18. When obtaining a client’s diagonal conjugate, the nurse knows that the adequate size for childbirth is: A. > 11 cm B. < 11 cm C. > 12.5 cm D. < 12.5 cm

19. A client has a diagonal conjugate measuring 13 cm, the nurse estimates the client’s true conjugate is approximately: A. 10.5-11 cm B. 11-11.5 cm C. 11.5-12 cm D. 12-12.5 cm 20. The following are body structures involved in menstruation EXCEPT: A. Hypothalamus B. Pituitary gland C. Ovaries D. Adrenal cortex

21. What condition stimulates the hypothalamus to release GnRH? A. Low serum level of progesterone B. High serum level of progesterone C. Low serum level of estrogen D. High serum level of estrogen

22. What are the two gonadotropic hormones produced by the anterior pituitary gland? 1. Luteinizing hormone 2. Follicle stimulating hormone 3. Human chorionic gonadortopin 4. Luteinizing hormone-releasing hormone A. 3 and 2 B. 3 and 4 C. 1 and 2 D. 1 and 3 23. Which of these statements are true regarding FSH? 1. Responsible for ovulation 2. Stimulates maturation of ovum 3. Active during first half of menstrual cycle 4. Most active at the midpoint of the cycle A. 1 and 3 B. 1 and 4 C. 2 and 3 D. 2 and 4 24. Which of these statements are true regarding LH? 1. Responsible for ovulation 2. Stimulates maturation of ovum 3. Active during first half of menstrual cycle 4. Most active at the midpoint of the cycle A. 1 and 3 B. 1 and 4 C. 2 and 3 D. 2 and 4 25. For a woman having a 30-day cycle, ovulation would occur on: A. Day 13 B. Day 14 C. Day 15 D. Day 16

26. After ovulation, the corpus luteum forms and is filled with a bright-yellow fluid called lutein. Lutein is high in what specific hormone? A. Oxytocin B. Estradiol C. Estrogen D. Progesterone 27. What do you call the vague pain on either right or left lower quadrant that is sometimes felt by a woman during ovulation? A. Dysmenorrhea B. Spinnbarkeit C. Mettelschmerz D. Dyspareunia

28. The proliferative phase is also called the: A. Estrogenic phase B. Follicular phase C. Postmenstrual phase D. All of the above

29. The secretory phase is also called the: A. Progestational phase B. Luteal phase C. Premenstrual phase D. All of the above 30. The structure in the fetus that carries oxygenated blood from the umbilical vein to the inferior vena cava is the: A. Ductus arteriosus B. Ductus venosus C. Foramen ovale D. Pulmonary artery 31. While discussing the growth and development of the fetus, you were asked by the patient, “During what time in my pregnancy is my baby most vulnerable?” as a nurse your best response is: A. “As your baby is forming in the first 2 months because organ development takes place at this time.” B. “Throughout your pregnancy.” C. “Near the end of your pregnancy.” D. “Halfway through your pregnancy: around 20 weeks or 5 months.” 32. An adolescent girl asks the nurse at a clinic if the “test for virginity” is an intact hymen. The correct response is: A. “Evidence of bleeding with a first sexual encounter indicates virginity.” B. “No, this is a common myth. The hymen may be torn during exercise, the use of tampons, masturbation, or other activities.” C. “Yes, an intact hymen isn’t seen in sexually active and parous women.” D. “Why are you asking this question? Are you sexually active?” 33. The area in the female between the vagina and the anus is known as the: A. Vestibule B. Mons pubis C. Perineum D. Labia majora 34. Gabriel, a student nurse, is asked by a patient, “What determines if my baby’s lungs are mature?” Gabriel’s correct response is: A. Fern test B. Nitrazine test C. Phosphatidylglycerol test D. Lecithin-sphingomyelin ratio 35. The L/S ratio that indicates fetal lung maturity is: A. 2:1 B. 2:2 C. 1:2 D. 1:1

36. At about 24th week of pregnancy the fetus starts producing surfactant. The function of surfactant is to: A. Lubricate the fetus B. Cushion the fetus C. Increase the surface tension in the alveoli D. Prevent collapse of the alveoli

37. The portion of the uterus whose significant characteristic is to stretch during childbirth is the: A. Corpus B. Fundus C. Cervix D. Internal os 38. The usual site for implantation of the zygote is: A. Low in the uterus, in the anterior surface B. Low in the uterus, in the posterior surface C. High in the uterus, in the anterior surface D. High in the uterus, in the posterior surface 39. When teaching a pregnant woman the position to maximize uterine perfusion, the nurse instructs the client to lie: A. Supine B. Prone C. On her right side D. On her left side

40. Which of these conditions can lead to oligohydramnios? A. Disturbance in kidney function B. Esophageal atresia C. Anencephaly D. Diabetes mellitus 41. The fetal heart starts to beat at: A. 18th day B. 20th day C. 22nd day D. 24th day 42. The fetal heart beat can be heard using a Doppler at: A. 6th-8th week B. 8th-10th week C. 10th-12th week D. 12th-14th week 43. The fetal heart sounds are audible with an ordinary stethoscope at the end of: A. 12th week B. 16th week C. 20th week D. 24th week

44. Which of the following immunoglobulins crosses the placenta to provide the fetus a temporary passive immunity against diseases for which the mother has antibodies? A. IgA B. IgG C. IgM D. IgE 45. The immunoglobulin described in item no. 44 crosses the placenta during the: A. 1st trimester B. 2nd trimester C. 3rd trimester D. 4th trimester

46. The umbilical arteries carry: A. Oxygenated blood to the placenta B. Oxygenated blood to the fetus C. Deoxygenated blood to the placenta D. Deoxygenated blood to the fetus

47. The umbilical vein carries: A. Oxygenated blood to the placenta B. Oxygenated blood to the fetus C. Unoxygenated blood to the placenta D. Unoxygenated blood to the fetus

48. The black or greenish and sticky stool of a newborn is called: A. Wharton’s jelly B. Transition stool C. Vernix caseosa D. Meconium

49. Hydramnios is a condition wherein the amniotic fluid is: A. >2,000 mL B. <2,000 mL C. >300 mL D. <300 mL 50. At A. B. C.

12 weeks age of gestation, the fundus is: Just above the symphysis pubis At the level of the umbilicus Midway between the symphysis pubis and the umbilicus D. At the level of the xiphoid process

For items 51-60 write your answer in the space provided in the separate answer sheet.

51. A client’s last menstrual period is from May 23-26, 2009. Using Nagele’s rule, what is this patient’s EDD?

52. A client’s last menstrual period is from February 25, 2009. Using Nagele’s rule, what is this patient’s EDD?

53. A nurse measures the fundal height of a client and notes that it is 27 cm, based on the McDonald’s rule, the client’s age of gestation is how many weeks? 54-60. Fill in the blanks to complete the fetal circulation. PLACENTA → OXYGENATED BLOOD → 54___ → 55___ →INFERIOR VENA CAVA → RIGHT ATRIUM → 56____ → 57_ ___ → LEFT VENTRICLE → AORTA → CIRCULATION → UNOXYGENATED BLOOD → VENA CAVA → RIGHT ATRIUM → RIGHT VENTRICLE → __ 58_____ → 59_____ → AORTA → DESCENDING AORTA → 60_____ → PLACENTA