Mcn Midterm

Immaculate Conception College-Albay Daraga, Albay MIDTERM EXAMINATION Subject: NCM 101 (Maternal & Newborn Nursing) Instructor: Paul Jhon A. Vergara, RN

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. Keep your answer sheet clean. Do not make any unnecessary markings on your answer sheet. SRICTLY NO ERASURES. 1.

2.

3.

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.” Jaivin, a student nurse, is asked by a patient, “What determines if my baby’s lungs are mature?” Jaivin’s correct response is: A. Fern test B. Nitrazine test C. Phosphatidylglycerol test D. Lecithin-sphingomyelin ratio The L/S ratio that indicates fetal lung maturity is: A. 2:1 B. 2:2 C. 1:2 D. 1:1

4. 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

B. 2nd trimester C. 3rd trimester D. 4th trimester 10. At A. B. C.

20 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

11. 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 12. Pregnancy tests are based on detecting the presence of what hormone in the urine or blood serum of a pregnant woman? A. Human Placental Lactogen B. Estrogen C. Human Chorionic Gonadotropin D. Progesterone 13. What condition(s) can lead to a false-positive result on pregnancy test? A. Hydatidiform mole B. Psychotropic drug therapy C. Women taking oral contraceptives D. All of the above 14. Which of the following is NOT a positive sign of pregnancy? A. Positive pregnancy test B. Audible fetal heart tones C. Fetal movements felt by an examiner D. Fetal outline by ultrasound 15. In preparation for birth, the fetal head descends into the pelvis during the late part of the pregnancy. This phenomenon is referred to as: A. Quickening B. Lightening C. Labor D. Parturition

16. For a primigravida, the phenomenon described in item no. 15 usually takes place during the: A. 34th week B. 36th week C. 38th week D. 40th week

5.

The portion of the uterus whose significant characteristic is to stretch during childbirth is the: A. Corpus B. Fundus C. Cervix D. Internal os

6.

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

17. The extreme softening of the lower uterine segment in pregnancy is known as: A. Chadwick’s sign B. Goodell’s sign C. Hegar’s sign D. Ballotement

7.

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

18. The purplish hue of the vagina in pregnancy is termed

8.

9.

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 The immunoglobulin described in item no. 8 crosses the placenta during the: A. 1st trimester

as: A. B. C. D.

Chadwick’s sign Goodell’s sign Hegar’s sign Ballotement

19. Softening of the cervix in pregnancy is referred to as: A. Chadwick’s sign B. Goodell’s sign C. Hegar’s sign D. Ballottement 20. Suppression of the follicle-stimulating hormone causes what presumptive symptom of pregnancy? A. Nausea and vomiting B. Amenorrhea C. Melasma D. Striae gravidarum

21. The primary purpose of the mucous plug (operculum) is to: A. Prevent infection in the fetus B. Prevent entry of bacteria into the vagina C. Prevent cervical dilation D. Prevent amniotic fluid seepage

22. During pregnancy, the vaginal pH becomes highly acidic making the vagina resistant to bacterial invasion. However, this change in vaginal pH favors the growth of what specific microorganism? A. Döderlein’s bacillus B. Lactobacillus shirota C. Lactobacillus acidophilus D. Candida albicans 23. A vaginal candidiasis is manifested by the following EXCEPT: A. Itching B. Greenish-yellow frothy vaginal secretions C. Burning sensation D. Cream cheese-like discharge 24. A pregnant woman asks the nurse if the reddish streaks on her abdomen will disappear after pregnancy. The nurse’s best response will be: A. “Yes. That is only transient and will completely disappear after you give birth.” B. “Yes. That is only a result of overproduction of pigment hormones.” C. “No. Those reddish streaks will be permanent.” D. “No. It will be permanent but it will lighten and become barely noticeable.” 25. Which of the following is NOT caused by the increased production of melanocyte-stimulating hormone during pregnancy? A. Striae gravidarum B. Melasma C. Linea nigra D. Chloasma 26. During a prenatal visit, a pregnant woman complains of nasal stuffiness. What will you advise this client for the relief of nasal congestion? A. Oral antihistamine B. Oral decongestant C. Cold compression D. Saline nasal drops 27. A pregnant woman comes to the clinic complaining of lightheadedness, faintness, and palpitations while lying down. The nurse based on these data suspects: A. Supine hypotension syndrome B. Orthostatic hypotension C. Shock D. Physiologic anemia 28. To prevent the occurrence of vena cava syndrome, the nurse must instruct a pregnant woman to: A. Lie on her right side B. Lie on her left side C. Elevate her legs while lying down D. Lie on her back 29. What are the two hormones responsible for decreasing gastric motility (peristalsis) during pregnancy? 1. Estrogen 2. Progesterone 3. Relaxin 4. hCG A. 1 and 3 B. 1 and 4 C. 2 and 3 D. 2 and 4 30. What condition is chiefly attributed to cause nausea and vomiting in pregnant women? A. Hyperglycemia B. Decreased serum estrogen C. Decreased serum progesterone D. Increased serum hCG

31. Because of the pressure exerted by the gravid uterus to the urinary bladder, pregnant women usually experience urinary frequency during the: A. 1st trimester B. 2nd trimester C. 3rd trimester D. 4th trimester 32. The return of urinary frequency near the end of pregnancy is a result of: A. Dieresis caused by resolution of edema B. Hyperfunction of the kidneys C. Descent of the fetal head into the pelvis which exerts pressure to the bladder D. Hyposecretion of ADH by the pituitary gland

33. What hormone is secreted by the corpus luteum functions to inhibit uterine activity, thus preventing premature labor? A. Estrogen B. hCG C. Human placental lactogen D. Relaxin 34. The psychological task during the second trimester is: A. Accepting the baby B. Accepting the pregnancy C. Preparing for parenthood D. Preparing for childbirth 35. What is the common emotional reaction expectant parents during the first trimester? A. Anticipatory role-playing B. Impatience C. Ambivalence D. Narcissism

by the

36. A pregnant client tells the nurse that her husband is also having morning sickness like hers. The nurse knows that the client’s husband is experiencing: A. Vena cava syndrome B. Supine hypotension syndrome C. Copy cat syndrome D. Couvade syndrome 37. To prevent breast discomfort, what kind of bra will you instruct a pregnant client to wear? A. Firm, supportive bra with wide straps B. Firm, supportive bra with narrow straps C. Loose, push-up bra with wide straps D. Loose, push-up bra with narrow straps 38. What would you instruct a pregnant woman on what to use for washing her breasts? A. Antibacterial soap and water B. Mild soap and water C. Water only D. Diluted hydrogen peroxide solution 39. Which conditions are contraindications to tub bathing? 1. Ruptured membranes 2. Increased leukorrhea 3. Vaginal bleeding 4. Hemorrhoids A. 1 and 3 B. 1 and 4 C. 2 and 3 D. 2 and 4 40. A pregnant woman asks the nurse what is the best exercise during pregnancy. The nurse correctly responds by saying that it is: A. Swimming B. Jogging C. Boxing D. Walking 41. Which of the following would be a favorable sleeping position for a pregnant woman? A. Prone B. Supine C. Modified trendelenburg D. Modified Sims’

42. A nurse teaching a primigravid client about prevention of constipation in pregnancy. Which statement if made by the client indicates the need for further teaching by the nurse? A. “I need to drink at least 8 oz of fluids in a day.” B. “I have to move my bowel regularly.” C. “I need to exercise regularly.” D. “I should avoid roughage in my diet.” 43. Mineral oil should be avoided as a laxative for pregnant women because it interfere with the absorption of: A. Water-soluble vitamins B. Fat-soluble vitamins C. Iron D. Calcium 44. The following are benefits of Kegel exercises EXCEPT: A. Helps relieve back pain B. Strengthens perineal muscles C. Reduces the possibility of stress incontinence D. Helps strengthen urinary control 45. Which of the following will be helpful in reducing the pressure on rectal veins in a pregnant woman having hemorrhoids? A. Knee-chest position for 10-15 minutes daily B. Prone position for 10-15 minutes daily C. Semi-Fowler’s position for 10-15 minutes daily D. High-Fowler’s position for 10-15 minutes daily 46. A client asks the nurse about ways to prevent varicosities. Which of the following will the nurse NOT include in the teaching plan? A. Avoid leg crossing B. Avoid constrictive knee-high hose C. Avoid use of elastic support stockings D. Avoid bending the knees while sitting

_________ 53.

Stand at the foot of the client, facing her, and place both hands flat on her abdomen.

_________ 54.

Explain the procedure.

_________ 55.

Place fingers on both sides of the uterus approximately 2 inches above the inguinal ligaments, pressing downward and inward in the direction of the birth canal. Allow fingers to be carried downward.

_________ 56.

Palpate the sides of the uterus. Hold the left hand stationary on the left side of the uterus while the right hand palpates the opposite side of the uterus from top to bottom. Then hold the right hand steady, and repeat palpation using the left hand on the left side.

_________ 57.

Instruct the client to empty her bladder.

_________ 58.

Palpate the superior surface of the fundus. Determine consistency, shape, and mobility.

_________ 59.

Gently grasp the lower portion of the abdomen just above the symphysis pubis between the thumb and index finger and try to press the thumb and index finger together. Determine any movement and whether the part is firm or soft.

_________ 60.

Position the woman supine with knees slightly flexed. Place a small pillow or rolled towel under one side.

EXCELSIOR!

47. The nurse, teaching a pregnant woman about the use of an elastic support stockings, determines that the client understood her instructions if the client stated: A. “I will have to wear them before going to bed at night.” B. “I should put them on after taking a shower.” C. “I must wear them after having breakfast.” D. “I need to wear them before arising in the morning.” 48. A normal physiologic change that occurs during pregnancy is an increased vaginal discharge. Which of these client instructions will NOT be helpful in reducing moisture in the vulvar area? A. Sleeping at night without underwear B. Douching C. Daily bath or shower D. Wearing cotton underpants 49. Which of the following exercises helps to prevent and relieve backache in pregnancy? A. Pelvic rocking B. Tailor sitting C. Kegel exercises D. Squatting 50. Which of the following medications is considered safe and effective for the relief of back pain during pregnancy? A. Aspirin (Aspilets) B. Acetaminophen (Tylenol) C. Ketoprofen (Orudis) D. Oxaprozin (Daypro) For items 51 to 60, arrange the following steps in performing the Leopold’s maneuver in chronological order. Assign an order number for each step using numbers 1 to 10 (1 being the first step and 10 as the last). Write the assigned order number on the corresponding item number on the separate answer sheet provided. STRICTLY NO ERASURES. _________ 51.

Face the client and place the palms of each hand on either side of the abdomen.

_________ 52.

Wash your hands using warm water.

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