PREGESTATIONAL CONDITIONS

1. Type 2
A. Follicle stimulating hormone C. cortisol
D. HPL
B. Glycogen

2. Which of the following are the risk factors of developing Gestational Diabetes Mellitus (GDM)?
A. marked obesity C. history of poor obstetric outcomes
D. all of the above
B. history of GDM

3. A 34-year-old female is currently 16 weeks pregnant. You're collecting the patient's health history. She has the
following health history: gravida 5, para 4, BMI 28, hypertension, depression, and family history of Type 2 diabetes.
Select below all the risk factors in this scenario that increases this patient’s risk for developing gestational diabetes?
A. 34-years-old D. BMI 28 G. Family history of Type 2
B. 16 weeks pregnant E. Hypertension DM
C. Gravida 5, para 4 F. Depression
M – MATERNAL AGE >25,
O - OBESE OR OVERWIEGHT
M- MACROSOMIA (fetal) previous babies greater than 9lbs
M- MULTIPLE pregnancies
A- A HISTORY
4. When do most patients tend to develop gestational diabetes during pregnancy?
A. usually during the 1-3 month of pregnancy C. usually during the 1-2 trimester of pregnancy
B. usually during the 2-3 month of pregnancy D. usually during the 2-3 trimester of pregnancy

5. You're providing an educational class for pregnant women about gestational diabetes. You discuss the role of insulin
in the body. Select all the CORRECT statements about the role and function of insulin:
A. "Insulin is a type of cell that provides glucose to the body from the blood."
B. "Insulin is a hormone secreted by the beta cells of the pancreas."
C. "Insulin influences cells by causing them to uptake glucose from the blood."
D. "Insulin is a protein that helps carry glucose into the cell for energy."

6. A 36-year-old pregnant female is diagnosed with gestational diabetes at 28 weeks gestation. You’re educating the
patient about this condition. Which statement by the patient demonstrates they understood your teaching about
gestational diabetes?
A. “Once I deliver the baby, it will go away, and I will not need any further testing.”
B. “It is important I try to get my fasting blood glucose around 70-95 mg/dL and <140 mg/dL 1 hour after meals.”
normal blood glucose level; 70-95 mg/dL fasting and <140mg/dL 1 hour after meals.
C. “There are no risks or complications related to gestational diabetes other than hyperglycemia.”
D. “I’m at risk for delivering a baby that is too small for its gestational age due to this condition.”

7. Fill-in the blank: When a woman develops gestational diabetes it is during a time in the pregnancy when insulin
sensitivity is _____________. This is majorly influenced by hormones such as estrogen, progesterone,
_______________ and _______________.
A. high; prolactin and human chorionic gonadotropin (hCG)
B. low; estriol and human placental lactogen (hPL)
C. high; human chorionic gonadotropin (hCG) and cortisol
D. low; human placental lactogen (hPL) and cortisol – when a woman develops gestational diabetes it is during a
time in the pregnancy when insulin sensitivity is LOW, majorely influenced by hormones such as ESTROGEN,
PROGESTERONE, HUMAN PLACENTAL LACTOGEN (hPL) and CORTISOL

8. Your patient is 36 weeks pregnant and has gestational diabetes. Which lab result below is euglycemic?
A. Blood glucose 55 mg/dL - HYPOglycemic C. Blood glucose 148 mg/dL- slightly
B. Blood glucose 82 mg/dL HYPERglycemic
D. Blood glucose 325 mg/dL- HYPERglycemic

Euglycemic means normal blood glucose level. Normal blood glucose level is about 70-140 mg/dL.

9. A patient has gestational diabetes and is currently 34 weeks pregnant. Which assessment findings below should you
immediately report to the physician? Select all that apply:
A. Blood glucose 129 mg/dL C. Proteinuria E. Negative glycosuria
B. Blood pressure 190/102 D. Linea nigra
 Preeclampsia is a potential complication of gestational diabetes, it can cause hypertension (option B) and protein in
the urine (option C). Option A is normal finding during pregnancy, option E is a normal finding (abnormal finding
would be positive glycosuria … meaning there is glucose leaking in the urine)

10. A patient is 35 weeks pregnant. She has gestational diabetes and uncontrolled hyperglycemia. Her current blood
glucose is 290 mg/dL. You administer insulin per physician’s order and recheck the blood glucose level per protocol.
It is now 135 mg/dL. Which statement by the patient requires you to notify the physician?
A. “It burns when I urinate.” C. “I feel tired.”
B. “My back is hurting.” D. “I feel the baby kick about 10 times an hour.”
Gestational diabetes places a patient at risk for urinary tract infections because the glucose can leak into the urine
leading to infection (remember bacteria thrive in glucose). This scenario tells us the patient has at risk for glycosuria
(glucose in the urine). The physician should be notified if the patient reports burning on urination so urine analysis
can be performed. All the other options are normal findings in a pregnancy at this stage.

11. A baby is born at 37 weeks gestation to a mother with gestational diabetes. As the nurse you know at birth that the
newborn is at risk for? Select all that apply.
A. Hyperglycemia D. Jaundice
B. Hypoglycemia E. Hyperthermia
C. Respiratory distress

The newborn is at risk for hypoglycemia and respiratory distress. When a baby of a mom, who has gestational
diabetes, is still in utero there is constant highly supply of glucose. This causes the baby to increase its fats stores
(producing a large baby) and create a lot of insulin to deal with the high glucose it’s receiving from mom. BUT once
the baby leaves the utero, the glucose supply decreases but the baby still has a lot of insulin on board. This can lead
to a drop of blood glucose (hypoglycemia) at birth. In addition, uncontrolled gestational diabetes can affect lung
maturity in babies and increases the newborn’s risk of respiratory distress at birth.

12. You’re teaching a pregnant mother with gestational diabetes about the signs and symptoms of hyperglycemia. What
are the signs and symptoms you will include in your education to the patient? Select all that apply.
A. Sweating C. Frequent hunger E. Anxiety
B. Confusion D. Polydipsia F. Frequent urination

REMEMBER the 3Ps for HYPERGLYCEMIA: Polyphagia (frequent hunger), Polydipsia (frequent thirst), Polyuria
(frequent urination). Sweating, confusion, and anxiety are signs and symptoms of HYPOglycemia (low blood
glucoses)
13. When are most pregnant patients tested for gestational diabetes?
A. 6-12 weeks gestation C. 24-28 weeks gestation
B. 12-20 weeks gestation D. 34-36 week gestation

14. You educate a pregnant patient with gestational diabetes that she should try to have a blood glucose level of
______________ 1 hour after a meal.
A. <70 mg/dL B. <250 mg/dL C. >160 mg/dL D. <140 mg/dL

15. You’re discharging a patient who just gave birth to a baby at 39 weeks gestation. The patient had gestational
diabetes throughout her pregnancy. Her blood glucose levels have now returned to normal. When should the
patient first follow-up with her physician for blood glucose testing?
A. 1-3 years
B. 6-12 weeks postpartum
C. 1 year postpartum
D. Not applicable since this condition has resolved and only occurs during pregnancy

Patients who’ve had gestational diabetes are at high risk for developing Type 2 diabetes. She should first
follow-up with her physician at 6-12 weeks postpartum for initial blood glucose testing. After this, she should
follow up 1-3 years for blood glucose testing since there is a high risk of her developing Type 2 diabetes

16. The goal to be maintained in the antepartum management of diabetic woman is:
A. Check the blood glucose regularly.
B. Eat a balanced diet.
C. Maintain balance between insulin and glucose during pregnancy.
D. Quit smoking and drinking alcohol
17. Alcohol is a potent teratogen to the fetus. These will result to which of the following?
A. mental retardation C. intoxication
B. malnutrition D. all of the above

18. The following are maternal effects of cocaine and crack, except:
A. seizures C. meconium aspiration
B. hallucinations D. heart problems

19. Which of the following are the signs and symptoms of heroin addiction to newborn?
A. fist sucking, irritability, shrill high pitch cry C. bloodshot eyes, catlike cry
B. altered brain dev’t, late appearing reflexes D. bigger head, insomnia

20. It is an immunoglobulin given to prevent maternal sensitization in Rh incompatibility:

A. RhoGAM C. Folic acid
B. Zidovudine D. All of the above

21. The following nursing interventions are necessary to prevent transmission of HIV virus, except:
A. Avoid contact with body fluids.
B. Dispose blood and blood products properly.
C. Do proper hand washing as necessary.
D. Ensure confidentiality and give nonjudgmental care.

CONCEPT: GESTATIONAL CONDITIONS

22. Mrs. Villamor, 14 weeks pregnant come to the clinic complaining of persistent vomiting. She was diagnosed to have
hyperemesis gravidarum. As a nurse, you have a knowledge that this is a complication of nausea and vomiting that is
common:
A. during the first trimester C. during the third trimester
B. beyond the first trimester D. all of the above

23. The following are nursing interventions you can give to Mrs. Villamor:
I. Taking a cracker biscuit half hour before getting out of bed
II. Sips of hot water
III. Eat foods rich in protein
IV. Avoid intake of greasy and spicy foods
V. Drink a cup of clear coffee

A. I, II, and III C. I, III, IV, and V

B. I, II, III, and IV D. all of the above

24. A 6-week AOG mother is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will
often result in:
A. Bowel perforation C. Miscarriage
B. Electrolyte imbalance D. PIH

25. The following symptoms are common in an ectopic pregnancy: light vaginal bleeding and pelvic pain.
I. Sharp lower right or abdominal pain radiating to shoulder
II. Concealed bleeding from site of rupture
III. Uterine perforation – rapture in fallopian tube
IV. Painless bright-red vaginal bleeding – placenta previa
V. Painful dark red vaginal bleeding – abruptio placenta

A. I and II only C. I, II, III, IV and V only

B. I, II, and III only D. all of the above

26. Mrs. Hierro, 17 weeks pregnant, was admitted to the hospital due to H-mole pregnancy. The following are signs and
symptoms you can probably see in Mrs. Hierro:
I. Fundus larger for the III. Presence of PIH VI. Generalized edema
period of gestation IV. Palpable fetal parts
II. Uterine perforation V. Painful labor

A. I, II, and III only C. I, II, III, IV, and V only

B. I, II, III, and IV only D. all of the above
27. The following is/are true in Placenta Previa:
I. painless bright-red vaginal bleeding III. soft uterus in the latter part of pregnancy
IV. Uterine perforation
II. painful dark-red vaginal bleeding V. signs of infection may be present

A. I, II, and III only B. I, III, and IV C. I, III, and V

D. all of the above

28. Karen, 10 weeks pregnant come to the hospital due to vaginal bleeding, cramping and backache. Internal
examination revealed a closed cervix. As a nurse you have a knowledge that this is what kind of abortion?
A. threatened C. complete
D. incomplete
B. imminent or inevitable

29. The nurse notifies the physician that a client has been admitted in her 36th week of pregnancy. The client has severe
bleeding, severe abdominal pain, a hard fundus, and is demonstrating signs of shock. She was diagnosed to have
abruptio placenta. In addition to notifying the physician, the nurse also prepares the patient next for:
A. a high-forceps delivery C. an immediate delivery
D. the administration of oxytocin
B. the insertion of a fetal monitor

30. Nurses must realize that the abdominal pain associated with abruptio placenta initially may be caused by:
A. Hemorrhagic shock C. concealed hemorrhage
D. blood in the uterine muscle
B. Inflammatory reactions

the blood cannot escape from behind the placenta, thus the abdomen becomes boardlike and painful because of
the entrapment

31. One of the following signs and symptoms are seen in pregnant mothers with gestational hypertension:
A. systolic BP increase of 30 mmHg, proteinuria 1+ or 2+
B. BP of 160/110 mmHg or above on two, proteinuria 3+ or 4+
C. BP of 140/90 mmHg but has no proteinuria or edema
D. Any of the above

32. Magnesium Sulfate (MgSo4) is one of the medication given to pre-eclamptic clients. As a nurse you have the idea
that the action of the medication is :
A. a peripheral vasodilator used to decrease hypertension
B. a muscle relaxant to prevent seizures
C. an antipyretic to prevent high grade fever
D. thrombotic agent to prevent bleeding

33. During a prenatal interview, a client tells the nurse, “My mother told me she had toxemia during her pregnancy and
almost died!” Which of the following questions should the nurse ask in response to this statement?
A. “Does your mother have a cardiac condition?”
B. “Did your mother tell you what she was toxic from?”
C. “Does your mother have diabetes now?”
D. “Did your mother say whether she had a seizure or not?”

34. A patient, 32 weeks pregnant with severe headache, is admitted to the hospital with preeclampsia. In addition to
obtaining baseline vital signs and placing the client on bed rest, the physician ordered the following four items.
Which of the orders should the nurse perform first?
A. Assess deep tendon reflexes. C. Assess baseline weight.
B. Obtain complete blood count. D. Obtain routine urinalysis

The nurse can make a preliminary assessment of the severity of the pre-eclampsia. For example, if the reflexes are
E2, the client would be much less likely to become eclamptic than a client who has E4 reflexes with clonus.

35. When counseling a preeclamptic client about her diet, what should the nurse encourage the woman to do?
A. Restrict sodium intake. –not recommended B. Increase intake of fluids. –no need to increase
 C. Eat a well-balanced diet.
D. Avoid simple sugars –also no need

36. The nurse is evaluating the effectiveness of bed rest for a client with mild preeclampsia. Which of the following
signs/symptoms would the nurse determine is a positive finding?
A. Weight loss. –not a positive sign C. Decrease in plasma protein. –decrease in serum
B. 2 proteinuria. – losing protein. Should be is a sign of pathology. An increase in serum
evaluate a 0-to-trace amount of protein is a protein would be a positive sign.
positive sign. D. 3 patellar reflexes.—3 reflexes are pathological.
Normal reflexes are 2

37. A 32-week-gestation client was last seen in the prenatal client at 28 weeks’ gestation. Which of the following
changes should the nurse bring to the attention of the certified nurse midwife?
A. Weight change from 128 pounds to 138 pounds. – a weight gain of 10lbs in a four week period is worrisome.
The recommended weight gain during the second and third trimester is approximately 1 lb per week.
B. Pulse rate change from 88 bpm to 92 bpm. –the pulse rate normally increases slightly during pregnancy
C. Blood pressure change from 120/80 to 118/78. –a slight drop in BP is normal during pregnancy
D. Respiratory rate change from 16 rpm to 20 rpm. –the respiratory rate normally increases during pregnancy

38. A 24-week-gravid client is being seen in the prenatal clinic. She states, “I have had a terrible headache for the past 2
days.” Which of the following is the most appropriate action for the nurse to perform next?
A. Inquire whether or not the client has allergies. C. Assess the woman’s fundal height.
B. Take the woman’s blood pressure. D. Ask the woman about stressors at work.

39. A nurse remarks to a 38-week-gravid client, “It looks like your face and hands are swollen.” The client responds,
“Yes, you’re right. Why do you ask?” The nurse’s response is based on the fact that the changes may be caused by
which of the following?
A. Altered glomerular filtration. –altered related to the development of preeclampsia,
glomerular filtration leads to protein loss and bot of cardiac failure.
subsequently to fluid retention, which can lead C. Hepatic insufficiency. -- same
to swelling in the face and hands D. Altered splenic circulation.—monitoring women
B. Cardiac failure. –monitoring women for the for the appearance of swollen and puffy face is
appearance of swollen hands and puffy face is related to the development of preeclampsia,
not altered splenic circulation.

40. A client has severe preeclampsia. The nurse would expect the primary health care practitioner to order tests to
assess the fetus for which of the following?
A. Severe anemia. C. Craniosynostosis.
B. Hypoprothrombinemia. D. Intrauterine growth restriction.

41. A client with 4 protein and 4 reflexes is admitted to the hospital with severe preeclampsia. The nurse must closely
monitor the woman for which of the following?
A. Grand mal seizure. –clients with severe C. Explosive diarrhea.—are not at risk for explosive
preeclampsia are high risk for seizures diarrhea
B. High platelet count. –clients with severe D. Fractured pelvis—are not risk for fractured
preeclampsia should be monitored for a drop in pelvis
platelets

42. The nurse is grading a woman’s reflexes. Which of the following grades would indicate reflexes that are slightly
brisker than normal?
A. 1. B. 2. C. 3. D. 4.

43. A client with mild preeclampsia, who has been advised to be on bed rest at home, asks why it is necessary. Which of
the following is the best response for the nurse to give the client?
A. “Bed rest will help you to conserve energy for your labor.”
B. “Bed rest will help to relieve your nausea and anorexia.”
C. “Reclining will increase the amount of oxygen that your baby gets.”
D. “The position change will prevent the placenta from separating.”
44. In anticipation of a complication that may develop in the second half of pregnancy, the nurse teaches an 18-week
gravid client to call the office if she experiences which of the following?
A. Headache and decreased output. C. Hemorrhoids and vaginal discharge.
B. Puffy feet. D. Backache.

45. Which of the following clients is at highest risk for developing a hypertensive illness of pregnancy?
A. G1P0000, age 44 with history of diabetes C. G3P1102, age 25 with history of scoliosis.
mellitus. D. G3P1011, age 20 with history of celiac disease.
B. G2P0101, age 27 with history of rheumatic fever.

46. The nurse has assessed four primigravid clients in the prenatal clinic. Which of the women would the nurse refer to
the nurse midwife for further assessment?
A. 10 weeks’ gestation, complains of fatigue with nausea and vomiting.
B. 26 weeks’ gestation, complains of ankle edema and chloasma.
C. 32 weeks’ gestation, complains of epigastric pain and facial edema.
D. 37 weeks’ gestation, complains of bleeding gums and urinary frequency

47. A client’s 32-week clinic assessment was: BP 90/60; TPR 98.6ºF, P 92, R 20; weight 145 lb; and urine negative for
protein. Which of the following findings at the 34-week appointment should the nurse highlight for the certified
nurse midwife?
A. BP 110/70; TPR 99.2ºF, 88, 20. C. Urine protein trace; BP 88/56.
B. Weight 155 lb; urine protein 2. D. Weight 147 lb; TPR 99.0ºF, 76, 18.

48. A nurse is caring for a 25-year-old client who has just had a spontaneous first trimester abortion. Which of the
following comments by the nurse is appropriate?
A. “You can try again very soon.” C. “At least you weren’t very far along.”
B. “It is probably better this way.” D. “I’m here to talk if you would like.”

49. A hospitalized gravida’s blood work is hematocrit 30% and hemoglobin 10 gm/dL. In light of the laboratory data,
which of the following meal choices should the nurse recommend to this patient?
A. Chicken livers, sliced tomatoes, and dried apricots.
B. Cheese sandwich, tossed salad, and rice pudding.
C. Veggie burger, cucumber salad, and wedge of cantaloupe.
D. Bagel with cream cheese, pear, and hearts of lettuce

50. A woman has just been admitted to the emergency department subsequent to a head-on automobile accident. Her
body appears to be uninjured. The nurse carefully monitors the woman for which of the following complications of
pregnancy?
A. Placenta previa. C. Placental abruption.
B. Transverse fetal lie. D. Severe preeclampsia.

51. A 25-year-old client is admitted with the following history: 12 weeks pregnant, vaginal bleeding, no fetal heart beat
seen on ultrasound. The nurse would expect the doctor to write an order to prepare the client for which of the
following?
A. Cervical cerclage. C. Nonstress testing.
B. Amniocentesis. D. Dilation and curettage

52. A client’s admitting medical diagnosis is third-trimester bleeding: rule out placenta previa. Each time the nurse
enters the client’s room, the woman asks: “Please tell me, do you think the baby will be all right?” Which of the
following is an appropriate nursing diagnosis for this client?
A. Hopelessness related to possible fetal loss.
B. Anxiety related to unidentified diagnosis.
C. Situational low self-esteem related to blood loss.
D. Potential for altered parenting related to inexperience.

53. Which of the following long-term goals is appropriate for a client, 10 weeks’ gestation, who is diagnosed with
gestational trophoblastic disease (hydatiform mole)?
A. Client will be cancer-free 1 year from diagnosis.
B. Client will deliver her baby at full term without complications.
C. Client will be pain-free 3 months after diagnosis.
D. Client will have normal hemoglobin and hematocrit at delivery.

54. Which of the following findings should the nurse expect when assessing a client, 8 weeks’ gestation, with gestational
trophoblastic disease (hydatiform mole)?
 A. Protracted pain. C. Dark brown vaginal bleeding.
B. Variable fetal heart decelerations. D. Suicidal ideations.

55. Which of the following findings should be reported to the primary health care practitioner when assessing a first-
trimester gravida suspected of having gestational trophoblastic disease (hydatiform mole)?
A. Hematocrit 39%. C. White blood cell count 8000/mm3.
B. Grape-like clusters passed from the vagina. D. Hypertrophied breast tissue.

56. Which finding should the nurse expect when assessing a client with placenta previa?
A. Severe occipital headache. C. Previous premature delivery.
B. History of renal disease. D. Painless vaginal bleeding

57. A nurse is caring for four prenatal clients in the clinic. Which of the clients is high risk for placenta previa?
A. Jogger with low body mass index. C. Registered professional nurse.
B. Smoker carrying fraternal triplets. D. Police officer on foot patrol

58. A woman has been diagnosed with a ruptured ectopic pregnancy. Which of the following signs/symptoms is
characteristic of this diagnosis?
A. Dark brown rectal bleeding. C. Sharp unilateral pain.
B. Severe nausea and vomiting. D. Marked hyperthermia.

59. A client, G2P1001, telephones the gynecology office complaining of left-sided pain. Which of the following questions
by the triage nurse would help to determine whether the one-sided pain is due to an ectopic pregnancy?
A. “When did you have your pregnancy test done?”
B. “When was the first day of your last menstrual period?”
C. “Did you have any complications with your first pregnancy?”
D. “How old were you when you first got your period?”

60. A woman, 8 weeks pregnant, is admitted to the obstetric unit with a diagnosis of threatened abortion. Which of the
following tests would help to determine whether the woman is carrying a viable or a nonviable pregnancy?
A. Luteinizing hormone level. C. Hysterosalpinogram.
B. Endometrial biopsy. D. Serum progesterone level

61. A woman with a diagnosis of ectopic pregnancy is to receive medical intervention rather than a surgical interruption.
Which of the following intramuscular medications would the nurse expect to administer?
A. Decadron (dexamethasone). C. Pergonal (menotropins).
B. Amethopterin (methotrexate). D. Prometrium (progesterone).

62. The nurse is caring for a client who was just admitted to the hospital to rule out ectopic pregnancy. Which of the
following orders is the most important for the nurse to perform?
A. Assess the client’s temperature. C. Obtain urine for urinalysis and culture.
B. Document the time of the client’s last meal. D. Report complaints of dizziness or weakness.

63. A gravid client is admitted with a diagnosis of third-trimester bleeding. The nurse must carefully monitor for a
change in which of the following vital signs?
A. Temperature. B. Pulse. C. Respirations. D. Blood pressure

64. A gravid client, G6P5005, 24 weeks’ gestation, has been admitted to the hospital for placenta previa. Which of the
following is an appropriate long-term goal for this client?
A. The client will state an understanding of need for complete bedrest.
B. The client will have a reactive nonstress test on day 2 of hospitalization.
C. The client will be symptom-free until at least 37 weeks’ gestation.
D. The client will call her children shortly after admission.

65. A 12-week-gravid client presents in the emergency department with abdominal cramps and scant dark red bleeding.
What should the nurse assess this client for?
A. Shortness of breath. C. Hyperreflexia and clonus.
B. Enlarging abdominal girth. D. Fetal heart dysrhythmias.

66. A client, 32 weeks’ gestation with placenta previa, is on total bed rest. The physician expects her to be hospitalized
on bed rest until her cesarean section, which is scheduled for 38 weeks’ gestation. To prevent complications while in
the hospital, the nurse should do which of the following? Select all that apply.
A. Perform passive range of motion exercises. C. Decorate the room with pictures of family.
B. Restrict the fluid intake of the client. D. Encourage the client to eat a high-fiber diet.
 E. Teach the client deep breathing exercises.

67. A client, G8P3406, 14 weeks’ gestation, is being seen in the prenatal clinic. During the nurse’s prenatal teaching
session, the nurse will emphasize that the woman should notify the obstetric office immediately if she notes which
of the following?
A. Change in fetal movement. C. Swelling of feet and ankles.
B. Signs and symptoms of labor. D. Appearance of spider veins.

68. A woman, G4P0210 and 12 weeks’ gestation, has been admitted to the labor and delivery suite for a cerclage
procedure. Which of the following long-term outcomes is appropriate for this client?
A. The client will gain less than 25 pounds during the pregnancy.
B. The client will deliver after 37 weeks’ gestation.
C. The client will have a normal blood glucose throughout the pregnancy.
D. The client will deliver a baby that is appropriate for gestational age

69. In analyzing the need for health teaching in a client, G5P4004 with gestational diabetes, the nurse should ask which
of the following questions?
A. “How old were you at your first pregnancy?” C. “Is your partner diabetic?”
B. “Do you exercise regularly?” D. “Do you work outside of the home?”

70. A gravid client, 27 weeks’ gestation, has been diagnosed with gestational diabetes. Which of the following therapies
will most likely be ordered for this client?
A. Oral hypoglycemic agents. C. Regular insulin injections.
B. Diet control with exercise. D. Inhaled insulin.

71. A client has just done a fetal kick count assessment. She noted 6 movements during the last hour. If taught correctly,
what should be her next action?
A. Nothing because further action is not C. Redo the test during the next one-half hour.
warranted. D. Drink a glass of orange juice and redo the test.
B. Call the doctor to set up a nonstress test.

72. A nurse who is caring for a pregnant diabetic should carefully monitor the client for which of the following?
A. Urinary tract infection. C. Metabolic alkalosis.
B. Multiple gestation. D. Pathological hypotension.

73. A gestational diabetic, who requires insulin therapy to control her blood glucose levels, telephones the triage nurse
complaining of dizziness and headache. Which of the following actions should the nurse take at this time?
A. Have the client proceed to the office to see her physician.
B. Advise the client to drink a glass of milk and then call back.
C. Instruct the client to inject herself with regular insulin.
D. Tell the client immediately to telephone her medical doctor.

74. A diabetic client is to receive 5 units regular and 15 units NPH insulin at 0800. In order to administer the medication
appropriately, what should the nurse do?
A. Draw 5 units regular in one syringe and 15 units NPH in a second syringe and inject in different locations.
B. Draw 5 units regular first and 15 units NPH second into the same syringe and inject.
C. Draw 15 units NPH first and 5 units regular second into the same syringe and inject.
D. Mix 5 units regular and 15 units NPH in a vial before drawing the full 20 units into a syringe and inject

75. An insulin-dependent diabetic woman will require higher doses of insulin as which of the following pregnancy
hormones increases in her body?
A. Estrogen. C. Human chorionic gonadotropin.
B. Progesterone. D. Human placental lactogen.

76. A client has just been diagnosed with gestation diabetes. She cries, “Oh no! I will never be able to give myself
shots!!” Which of the following responses by the nurse is appropriate at this time?
A. “I am sure you can learn for your baby.”
B. “I will work with you until you feel comfortable giving yourself the insulin.”
C. “We will be giving you pills for the diabetes.”
D. “If you follow your diet and exercise you will probably need no insulin.”
77. A 30-year-old gravida, G3P1101, 6 weeks’ gestation, states that her premature baby boy, born 8 years ago, died
shortly after delivery from an infection secondary to spina bifida. Which of the following interventions is most
important for this client?
A. Grief counseling. C. Infection control counseling.
B. Nutrition counseling. D. Genetic counseling.

78. A gravid woman, who is 42 weeks’ gestation, has just had a 20-minute nonstress test (NST). Which of the following
results would the nurse interpret as a reactive test?
A. Moderate fetal heart baseline variability.
B. Maternal heart rate accelerations to 140 bpm lasting at least 20 seconds.
C. Two fetal heart accelerations of 15 bpm lasting at least 15 seconds.
D. Absence of maternal premature ventricular contractions.

79. An obese gravid woman is being seen in the prenatal clinic. The nurse will monitor this client carefully throughout
her pregnancy because she is high risk for which of the following complications of pregnancy?
A. Placenta previa. C. Abruptio placentae.
B. Gestational diabetes. D. Chromosomal defects

80. An obese client is being seen by the nurse during her prenatal visit. Which of the following comments by the nurse is
appropriate at this time?
A. “We will want you to gain the same amount of weight we would encourage any pregnant woman to gain.”
B. “To have a healthy baby we suggest that you go on a weight reduction diet right away.”
C. “To prevent birth defects we suggest that you gain weight during the first trimester and then maintain your
weight for the rest of the pregnancy.”
D. “We suggest that you gain weight throughout your pregnancy but not quite as much as other women.”

81. A 39-year-old, 16-week-gravid woman has had an amniocentesis. Before discharge, the nurse teaches the woman to
call her doctor if she experiences any of the following side effects? Select all that apply.
A. Fever or chills. D. Rash or pruritus.
B. Lack of fetal movement. E. Vaginal bleeding.
C. Abdominal pain.

82. A lecithin:sphingomyelin (L/S) ratio has been ordered by a pregnant woman’s obstetrician. Which of the following
data will the nurse learn from this test?
A. Coagulability of maternal blood.
B. Maturation of the fetal lungs.
C. Potential for fetal development of erythroblastosis fetalis.
D. Potential for maternal development of gestational diabetes.

83. The laboratory reported the L/S ratio results from an amniocentesis as 1:1. How should the nurse interpret the
result?
A. The baby is premature. C. The infant has kernicterus.
B. The mother is high risk for hemorrhage. D. The mother is high risk for eclampsia.

84. A woman is to receive RhoGAM at 28 weeks’ gestation. What action must the nurse take before giving the injection?
A. Validate that the baby is Rh negative. C. Verify the identity of the woman.
B. Assess that the direct Coombs’ test is positive. D. Reconstitute the globulin with sterile water

85. A nurse is about to inject RhoGAM into an Rh-negative mother. Which of the following is the preferred site for the
injection?
A. Deltoid. B. Dorsogluteal. C. Vastus lateralis. D. Ventrogluteal.

86. A woman is recovering at the gynecologist’s office following a late first-trimester spontaneous abortion. At this time,
it is essential for the nurse to check which of the following?
A. Maternal rubella titer. C. Maternal blood type.
B. Past obstetric history. D. Cervical patency.

87. It is discovered that a 28-week-gestation gravid is leaking amniotic fluid. Before the client is sent home on bed rest,
the nurse teaches her which of the following?
A. Perform a nitrazine test every morning upon awakening.
B. Immediately report any breast tenderness to the primary health care practitioner.
C. Abstain from engaging in vaginal intercourse for the rest of the pregnancy.
D. Carefully weigh all of her saturated peripads.
88. A nurse is interviewing a prenatal client. Which of the following factors in the client’s history should the nurse
highlight for the health care practitioner?
A. That she is eighteen years old. C. That she eats peanut butter every day.
B. That she owns a cat and a dog. D. That she works as an airline pilot.

89. Which of the following nursing diagnoses would be most appropriate for a 15-year-old woman who is in her first
trimester of pregnancy?
A. Sleep pattern disturbance related to discomforts of pregnancy.
B. Knowledge deficit related to care of infants.
C. Anxiety related to fear of labor and delivery.
D. Ineffective individual coping related to developmental level

90. Nurses working in obstetric clinics know that, in general, teen pregnancies are high risk because of which of the
following?
A. High probability of chromosomal anomalies. C. High numbers of postterm deliveries.
B. High oral intake of manganese and zinc. D. High number of late prenatal care registrants.

91. A 14-year-old woman is seeking obstetric care. Which of the following vital signs must be monitored very carefully
during this woman’s pregnancy?
A. Heart rate. B. Respiratory rate. C. Blood pressure. D. Temperature

92. A 16-year-old woman is being seen for the first time in the obstetric office. Which of the following comments by the
young woman is highest priority for the nurse to respond to?
A. “My favorite lunch is a burger with fries.” C. “On weekends we go out and drink a few beers.”
B. “I’ve been dating my new boyfriend for 2 weeks.” D. “I dropped out of school about 3 months ago.”

93. A 14-year-old woman is seeking obstetric care. Which of the following is an appropriate nursing care goal for this
young woman?
A. Bring her partner to all prenatal visits. C. Continue her education.
B. Terminate the pregnancy. D. Undergo prenatal chromosomal analysis.

94. A nurse works in a clinic with a high adolescent pregnancy population. The nurse provides teaching to the young
women in order to prevent which of the following high risk complications of pregnancy?
A. Preterm birth. C. Macrosomic babies.
B. Gestational diabetes. D. Polycythemia.

95. A 15-year-old client is being seen for her first prenatal visit. Because of this client’s special nutritional needs, the
nurse evaluates the client’s intake of:
A. Protein and magnesium. C. Carbohydrates and zinc.
B. Calcium and iron. D. Pyroxidine and thiamine.

96. A woman with a history of congestive heart disease is 36 weeks pregnant. Which of the following findings should the
nurse report to the primary health care practitioner?
A. Presence of striae gravidarum. C. 4-pound weight gain in a month.
B. Dyspnea on exertion. D. Patellar reflexes 2.

97. A woman enters the prenatal clinic accompanied by her partner. When she is asked by the nurse about her reason
for seeking care, the woman looks down as her partner states, “She says she thinks she’s pregnant. She constantly
complains of feeling tired. And her vomiting is disgusting!” Which of the following is the priority action for the nurse
to perform?
A. Ask the woman what times of the day her fatigue seems to be most severe.
B. Recommend to the couple that they have a pregnancy test done as soon as possible.
C. Continue the interview of the woman in private.
D. Offer suggestions on ways to decrease the vomiting.

98. A client has been admitted with a diagnosis of hyperemesis gravidarum. Which of the following lab values would be
consistent with this diagnosis?
A. pO2 90, pCO2 35, HCO3 19 mEq/L, pH 7.30. C. pO2 60, pCO2 50, HCO3 28 mEq/L, pH 7.30.
B. pO2 100, pCO2 30, HCO3 21 mEq/L, pH 7.50. D. pO2 90, pCO2 45, HCO3 30 mEq/L, pH 7.50.

99. A client has been admitted with a diagnosis of hyperemesis gravidarum. Which of the following orders written by the
primary health care provider is highest priority for the nurse to complete?
A. Obtain complete blood count. C. Check admission weight.
B. Start intravenous with multivitamins. D. Obtain urine for urinalysis.
100. The nurse suspects that a client is third spacing fluid. Which of the following signs will provide the nurse with the
best evidence of this fact?
A. Client’s blood pressure. C. Client’s weight.
B. Client’s appearance. D. Client’s pulse rate