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1. Which statement by the client indicates she understands how her newly inserted
progestin-release intrauterine system (IUS) works? Select all that apply.
A) "It keeps my cervical mucus thick."
B) "I can expect to see a decrease in menstrual bleeding."
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C) "It prevents the release of an egg from the ovary."
D) "It secretes a spermicide to immobilize and kill sperm."
E) "It provides protection against sexually transmitted abirb.com/test
infections."

2. The nurse is collecting the health history on a newly pregnant 37-year-old client. This
client is at increased risk for which gene-mediated complication of the pregnancy?
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A) Trisomy
B) Neural tube defect
C) Cystic fibrosis abirb.com/test
D) Tay-Sachs disease

3. The nurse is reviewing a client's history. Which findingsabirb.com/test

would indicate increased risk
for postpartum hemorrhage? Select all that apply.
A) Previous history of postpartum hemorrhage
B) Current diagnosis of low-lying placenta abirb.com/test
C) Premature rupture of membranes in current pregnancy
D) Oxytocin augmentation of labor in previous pregnancy
E) Polyhydramnios in current pregnancy
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4. The nurse assesses a client for signs of hypovolemic shock. What signs indicate the
presence of hypovolemic shock? Select all that apply. abirb.com/test
A) Restlessness
B) Tachypnea
C) Urine output of 20 mL/hr
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D) Back pain
E) Increased fundal height

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5. At 32 weeks' gestation a woman is diagnosed with a mild placental abruption. The fetus
is active and the vaginal bleeding and uterine pain have decreased. The nurse will
implement which interventions in the care of this client? Select all that apply.
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A) Assess blood pressure
B) Place an external fetal monitor
C) Initiate IV fluids
D) Insert a Foley catheter abirb.com/test
E) Administer oxygen

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6. The nurse is reviewing a client's health history. Which risk factors for placental
abruption exist during this pregnancy? Select all that apply.
A) Previous pregnancy was 12 years ago
B) Postpartum hemorrhage with previous delivery abirb.com/test
C) Maternal age 36
D) Maternal cigarette smoking
E) Chronic hypertension abirb.com/test

7. At 16 weeks' gestation laboratory tests are drawn as a follow-up to the first-trimester

integrated screening. The results are in the chart (above).abirb.com/test
Based on these findings, what
procedure would the health care provider recommend for this client? Select all that
apply.
A) Amniocentesis abirb.com/test
B) Chorionic villi sampling
C) Biophysical profile
D) Percutaneous umbilical blood sampling
E) Nuchal translucency scan abirb.com/test

8. The nurse is educating a client about an upcoming a biophysical profile. What behaviors
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of the fetus will be assessed by ultrasound examination? Select all that apply.
A) Fetal breathing movement
B) Fetal activity
C) Fetal cardiac response abirb.com/test

D) Fetal muscle tone

E) Fetal renal function
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9. The nurse is caring for a client at 30 weeks' gestation with a diagnosis of placental
abruption. The client has a weekly biophysical profile ordered. The nurse reviews the
results of the day's biophysical profile (below). What is the recommended management
for this client? abirb.com/test

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A) If cervix is favorable, induce labor today abirb.com/test

B) Repeat the biophysical profile today
C) Cesarean delivery today
D) Repeat biophysical profile in 2 days
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10. The nurse is caring for Lisa, who is 36 hours post-cesarean birth, due to a complete
placental abruption. The infant was stillborn. At the beginning of the shift, the nurse
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observes the client in bed, dressed in a gown, with the bed covers on the floor, and
mumbling. The client is pale and cool to touch. The radial pulse is 52 and weak.
Suddenly the client says, "They stole my baby." The nurse asks the client, "What is your
name", and the client responds "Susan," and then says "Get out of my house." Based on
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this interaction, what is the nurse's priority action?
A) Assess for hypovolemic shock
B) Assess for postpartum depression abirb.com/test
C) Assess for postpartum psychosis
D) Assess for postpartum hemorrhage

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11. While reviewing standard obstetric care with a newly pregnant client, the nurse informs
her that pregnant women are screened for which complication during the second
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A) Gestational diabetes
B) Preeclampsia
C) Preterm labor
D) Ectopic pregnancy abirb.com/test

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12. The charge nurse is reviewing the clients admitted to labor and delivery. Which client is
at greatest risk for a postpartum hemorrhage after birth?
A) A woman on magnesium sulfate for the past 36 hours for preeclampsia and
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receiving oxytocin to induce labor
B) A primigravida in spontaneous labor with twins at 28 weeks' gestation with intact
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C) A 42-year-old woman with five children, who is admitted for a primary cesarean
birth for a breech presentation
D) A primiparous woman who progressed to 7cm dilation but is being prepared for a
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13. A postpartum hemorrhage emergency is called for a woman who gave birth 45 minutes
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ago. Which medications does the nurse anticipate will be administered in this situation?
Select all that apply.
A) Oxytocin
B) Misoprostol abirb.com/test

C) Methylergonovine maleate
D) Magnesium sulfate
E) Morphine sulfate abirb.com/test

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14. The nurse receives the client with the below transfer notes. Which risk factors for
postpartum hemorrhage are present in this client? Select all that apply.

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A) Maternal age
B) Induction of labor with oxytocin abirb.com/test
C) Large-for-gestational age infant
D) Failure to progress in the second stage
E) Hypertensive disorders
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15. After a postpartum hemorrhage the provider orders methylergonovine maleate 0.2 mg
PO every 6 hours. The nurse takes the medication to the abirb.com/test
client. The client refuses to take
the medication and tells the nurse, "It makes my uterus cramp really bad and it hurts too
much." Which action by the nurse is best in this situation?
A) Offer the client pain medication with the methylergonovine maleate.
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B) Document the client's refusal in the medication administration record.
C) Tell the client she might bleed again without the methylergonovine maleate.
D) Hide the pill in the client's food.
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16. The nurse examines a woman at 34 weeks' gestation who presents to labor and delivery
with vaginal bleeding and back pain. Which finding would lead to a diagnosis of
placental abruption?
A) Uterus is soft with no contractions. abirb.com/test
B) Second trimester sonogram showed the placenta covering the cervical os.
C) Fetus is in a breech position.
D) Onset of vaginal bleeding was sudden and painful. abirb.com/test

17. The nurse is performing a nonstress test (NST) on a client at 36 weeks' gestation. The
fetal heart rate is between 134 and 140, except for the three times the fetus moved.
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When the fetus moved the heart rate increased to between 155 and 170. The test was
completed in 20 minutes. How would the nurse document the results of this client's
NST. abirb.com/test
A) Baseline fetal heart rate 134 to 140, with accelerations, nonstress test reactive
B) Fetal heart rate 124 to 175, good movement, nonstress test positive
C) Nonreactive nonstress test, fetus tolerating activity without problems
D) Negative nonstress test. Fetal heart rate and activityabirb.com/test
within normal limits

18. What characteristic of fetal heart rate is illustrated in the abirb.com/test

image below?

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A) Variability
B) Acceleration
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C) Deceleration
D) Tachycardia

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19. The nurse performs a nonstress test (NST) on a client at 36 weeks' gestation. What
criteria does the nurse look for on the tracing to determine that the NST is reactive?
A) Presence of 2 accelerations in 20 minutes
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B) Presence of 2 decelerations in 60 minutes
C) Presence of 2 accelerations per hour
D) Presence of 2 contractions during a 20 minute window
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20. At 16 weeks' gestation laboratory tests are drawn as a follow-up to the first trimester
integrated screening. The results are noted in the chart (below). Based on these results,
the client is at higher risk of having a baby with:
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A) Down syndrome.
B) open neural tube defect.
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C) trisomy 18.
D) fetal adrenal insufficiency.

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Answer Key
1. A, B
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2. A
3. A, B, E
4. A, B, C
5. A, B, C abirb.com/test
6. C, D, E
7. A, B
8. A, B, D
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9. B
10. A
11. A
12. A abirb.com/test
13. A, B, C
14. B, D
15. A
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16. D
17. A
18. A
19. A abirb.com/test
20. A

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