Obstetrics-Maternal And Child Health Nursing Practice Test

SITUATION : Aling Martha, a 32 year old fish vendor from baranggay matahimik came to see you at the prenatal clinic. She brought with her all her three children. Maye, 1 year 6 months; Joy, 3 and Dan, 7 years old. She mentioned that she stopped taking oral contraceptives several months ago and now suspects she is pregnant. She cannot remember her LMP.

1. Which of the following would be useful in calculating Aling Martha's EDC?

A. Appearance of linea negraB. First FHT by fetoscopeC. Increase pulse rateD. Presence of edema

2. Which hormone is necessary for a positive pregnancy test?

A. ProgesteroneB. HCGC. EstrogenD. Placental Lactogen

3. With this pregnancy, Aling Martha is a

A. P3 G3B. PrimigravidaC. P3 G4D. P0 G3

4. In explaining the development of her baby, you identified in chronological order of growth of the fetus as it occurs in pregnancy as

A. Ovum, embryo, zygote, fetus, infantB. Zygote, ovum, embryo, fetus, infantC. Ovum, zygote, embryo, fetus, infantD. Zygote, ovum, fetus, embryo, infant

5. Aling Martha states she is happy to be pregnant. Which behavior is elicited by her during your assessment that would lead you to think she is stressed?

A. She told you about her drunk husbandB. She states she has very meager income from sellingC. She laughs at every advise you give even when its not funnyD. She has difficulty following instructions

6. When teaching Aling Martha about her pregnancy, you should include personal common discomforts. Which of the following is an indication for prompt professional supervision?

A. Constipation and hemorrhoidsB. BackacheC. Facial edemaD. frequent urination

7. Which of the following statements would be appropriate for you to include in Aling Martha's prenatal teaching plan?

A. Exercise is very tiresome, it should be avoidedB. Limit your food intakeC. Smoking has no harmful effect on the growth and development of fetusD. Avoid unnecessary fatigue, rest periods should be included in you schedule

8. The best advise you can give to Aling Martha regarding prevention of varicosities is

A. Raise the legs while in upright position and put it against the wall several times a dayB. Lay flat for most hours of the day

C. Use garters with nylon stockingD. Wear support hose

9. In a 32 day menstrual cycle, ovulation usually occurs on the

A. 14th day after menstruationB. 18th day after menstruationC. 20th day after menstruationD. 24th day after menstruation

10. Placenta is the organ that provides exchange of nutrients and waste products between mother and fetus. This develops by

A. First monthB. Third monthC. Fifth monthD. Seventh month

11. In evaluating the weight gain of Aling Martha, you know the minimum weight gain during pregnancy is

A. 2 lbs/wkB. 5 lbs/wkC. 7 lbs/wkD. 10 lbs/wk

12. The more accurate method of measuring fundal height is

A. MillimeterB. CentimeterC. InchesD. Fingerbreadths

13. To determine fetal position using Leopold's maneuvers, the first maneuver is to

A. Determine degree of cephalic flexion and engagementB. Determine part of fetus presenting into pelvisC. Locate the back,arms and legsD. Determine what part of fetus is in the fundus

14. Aling Martha has encouraged her husband to attend prenatal classes with her. During the prenatal class, the couple expressed fear of pain during labor and delivery. The use of touch and soothing voice often promotes comfort to the laboring patient. This physical intervention is effective because

A. Pain perception is interruptedB. Gate control fibers are openC. It distracts the client away from the painD. Empathy is communicated by a caring person

15. Which of the following could be considered as a positive sign of pregnancy ?

A. Amenorrhea, nausea, vomitingB. Frequency of urinationC. Braxton hicks contractionD. Fetal outline by sonography

SITUATION : Maternal and child health is the program of the department of health created to lessen the death of infants and mother in the Philippines.

16. What is the goal of this program?

A. Promote mother and infant health especially during the gravida stageB. Training of local hilotsC. Direct supervision of midwives during home deliveryD. Health teaching to mother regarding proper newborn care

17. One philosophy of the maternal and child health nursing is

A. All pregnancy experiences are the same for all womanB. Culture and religious practices have little effect on pregnancy of a womanC. Pregnancy is a part of the life cycle but provides no meaningD. The father is as important as the mother

18. In maternal care, the PHN responsibility is

A. To secure all information that would be needing in birth certificateB. To protect the baby against tetanus neonatorum by immunizing the mother with DPTC. To reach all pregnant womanD. To assess nutritional status of existing children

19. This is use when rendering prenatal care in the rural health unit. It serves as a guide in Identification of risk factors

A. Underfive clinic chartB. Home based mother's recordC. Client list of mother under prenatal careD. Target list of woman under TT vaccination

20. The schedule of prenatal visit in the RHU unit is

A. Once from 1st up to 8th month, weekly on the 9th monthB. Twice in 1st and second trimester, weekly on third trimesterC. Once in each trimester, more frequent for those at riskD. Frequent as possible to determine the presence of FHT each week

SITUATION : Knowledge of the menstrual cycle is important in maternal health nursing. The following questions pertains to the process of menstruation

21. Menarche occurs during the pubertal period, Which of the following occurs first in the development of female sex characteristics?

A. MenarcheB. Accelerated Linear GrowthC. Breast developmentD. Growth of pubic hair

22. Which gland is responsible for initiating the menstrual cycle?

A. OvariesB. APGC. PPGD. Hypothalamus

23. The hormone that stimulates the ovaries to produce estrogen is

A. GnRHB. LHC. LHRFD. FSH

24. Which hormone stimulates oocyte maturation?

A. GnRHB. LHC. LHRFD. FSH

25. When is the serum estrogen level highest in the menstrual cycle?

A. 3rd dayB. 13th day

C. 14th dayD. End of menstrual cycle

26. To correctly determine the day of ovulation, the nurse must

A. Deduct 14 days at the mid of the cycleB. Subtract two weeks at cycle's endC. Add 7 days from mid of the cycleD. Add 14 days from the end of the cycle

27. The serum progesterone is lowest during what day of the menstrual cycle?

A. 3rd dayB. 13th dayC. 14th dayD. End of menstrual cycle

28. How much blood is loss on the average during menstrual period?

A. Half cupB. 4 tablespoonC. 3 ouncesD. 1/3 cup

29. Menstruation occurs because of which following mechanism?

A. Increase level of estrogen and progesterone levelB. Degeneration of the corpus luteumC. Increase vascularity of the endotheliumD. Surge of hormone progesterone

30. If the menstrual cycle of a woman is 35 day cycle, she will approximately

A. Ovulate on the 21st day with fertile days beginning on the 16th day to the 26th day of her cycleB. Ovulate on the 21st day with fertile days beginning on the 16th day to the 21th day of her cycleC. Ovulate on the 22st day with fertile days beginning on the 16th day to the 26th day of her cycleD. Ovulate on the 22st day with fertile days beginning on the 14th day to the 30th day of her cycle

SITUATION : Wide knowledge about different diagnostic tests during pregnancy is an essential arsenal for a nurse to be successful.

31. The Biparietal diameter of a fetus is considered matured if it is atleast

A. 9.8 cmB. 8.5 cmC. 7.5 cmD. 6 cm

32. Quickening is experienced first by multigravida clients. At what week of gestation do they start to experience quickening?

A. 16thB. 20thC. 24thD. 28th

33. Before the start of a non stress test, The FHR is 120 BPM. The mother ate the snack and the practitioner noticed an increase from 120 BPM to 135 BPM for 15 seconds. How would you read the result?

A. AbnormalB. Non reactiveC. ReactiveD. Inconclusive, needs repeat

34. When should the nurse expect to hear the FHR using a fetoscope?

A. 2nd weekB. 8th weekC. 2nd monthD. 4th month

35. When should the nurse expect to hear FHR using doppler Ultrasound?

A. 8th weekB. 8th monthC. 2nd weekD. 4th month

36. The mother asks, What does it means if her maternal serum alph feto protein is 35 ng/ml? The nurse should answer

A. It is normalB. It is not normalC. 35 ng/ml indicates chromosomal abberationD. 35 ng/ml indicates neural tube defect

37. Which of the following mothers needs RHOGAM?

A. RH + mother who delivered an RH - fetusB. RH - mother who delivered an RH + fetusC. RH + mother who delivered an RH + fetusD. RH - mother who delivered an RH - fetus

38. Which family planning method is recommended by the department of health more than any other means of contraception?

A. Fertility Awareness MethodB. CondomC. Tubal LigationD. Abstinence

39. How much booster dose does tetanus toxoid vaccination for pregnant women has?

A. 2B. 5C. 3D. 4

40. Baranggay pinoybsn.tk has 70,000 population. How much nurse is needed to service this population?

A. 5B. 7C. 50D. 70

SITUATION : Reproductive health is the exercise of reproductive right with responsibility. A married couple has the responsibility to reproduce and procreate.

41. Which of the following is ONE of the goals of the reproductive health concept?

A. To achieve healthy sexual development and maturationB. To prevent specific RH problem through counselingC. Provide care, treatment and rehabilitationD. To practice RH as a way of life of every man and woman

42. Which of the following is NOT an element of the reproductive health?

A. Maternal and child health and nutritionB. Family planningC. Prevention and management of abortion complication

D. Healthy sexual development and nutrition

43. In the international framework of RH, which one of the following is the ultimate goal?

A. Women's health in reproductionB. Attainment of optimum healthC. Achievement of women's statusD. Quality of life

44. Which one of the following is a determinant of RH affecting woman's ability to participate in social affairs?

A. Gender issuesB. Socio-Economic conditionC. Cultural and psychosocial factorsD. Status of women

45. In the philippine RH Framework. which major factor affects RH status?

A. Women's lower level of literacyB. Health service delivery mechanismC. Poor living conditions lead to illnessD. Commercial sex workers are exposed to AIDS/STD.

46. Which determinant of reproductive health advocates nutrition for better health promotion and maintain a healthful life?

A. Socio-Economic conditionsB. Status of womenC. Social and gender issuesD. Biological, Cultural and Psychosocial factors

47. Which of the following is NOT a strategy of RH?

A. Increase and improve contraceptive methodsB. Achieve reproductive intentionsC. Care provision focused on people with RH problemsD. Prevent specific RH problem through information dessemination

48. Which of the following is NOT a goal of RH?

A. Achieve healthy sexual development and maturationB. Avoid illness/diseases, injuries, disabilities related to sexuality and reproductionC. Receive appropriate counseling and care of RH problemsD. Strengthen outreach activities and the referral system

49. What is the VISION of the RH?

A. Attain QUALITY OF LIFEB. Practice RH as a WAY OF LIFEC. Prevent specific RH problemD. Health in the hands of the filipino

SITUATION : Baby G, a 6 hours old newborn is admitted to the NICU because of low APGAR Score. His mother had a prolonged second stage of labor

50. Which of the following is the most important concept associated with all high risk newborn?

A. Support the high-risk newborn's cardiopulmonary adaptation by maintaining adequate airwayB. Identify complications with early intervention in the high risk newborn to reduce morbidity and mortalityC. Assess the high risk newborn for any physical complications that will assist the parent with bondingD. Support mother and significant others in their request toward adaptation to the high risk newborn

51. Which of the following would the nurse expect to find in a newborn with birth asphyxia?

A. Hyperoxemia

B. AcidosisC. HypocapniaD. Ketosis

52. When planning and implementing care for the newborn that has been successfully resuscitated, which of the following would be important to assess?

A. Muscle flaccidityB. HypoglycemiaC. Decreased intracranial pressureD. Spontaneous respiration

SITUATION : Nurses should be aware of the different reproductive problems.

53. When is the best time to achieve pregnancy?

A. Midway between periodsB. Immediately after menses endC. 14 days before the next period is expectedD. 14 days after the beginning of the next period

54. A factor in infertility maybe related to the PH of the vaginal canal. A medication that is ordered to alter the vaginal PH is:

A. Estrogen therapyB. Sulfur insufflationsC. Lactic acid douchesD. Na HCO3 Douches

55. A diagnostic test used to evaluate fertility is the postcoital test. It is best timed

A. 1 week after ovulationB. Immediately after mensesC. Just before the next menstrual periodD. Within 1 to 2 days of presumed ovulation

56. A tubal insufflation test is done to determine whether there is a tubal obstruction. Infertility caused by a defect in the tube is most often related to a

A. Past infectionB. Fibroid TumorC. Congenital AnomalyD. Previous injury to a tube

57. Which test is commonly used to determine the number, motility and activity of sperm is the

A. Rubin testB. Huhner testC. Friedman testD. Papanicolau test

58. In the female, Evaluation of the pelvic organs of reproduction is accomplished by

A. BiopsyB. CystoscopyC. CuldoscopyD. Hysterosalpingogram

59. When is the fetal weight gain greatest?

A. 1st trimesterB. 2nd trimesterC. 3rd trimesterD. from 4th week up to 16th week of pregnancy

60. In fetal blood vessel, where is the oxygen content highest?

A. Umbilical arteryB. Ductus VenosusC. Ductus areteriosusD. Pulmonary artery

61. The nurse is caring for a woman in labor. The woman is irritable, complains of nausea and vomits and has heavier show. The membranes rupture. The nurse understands that this indicates

A. The woman is in transition stage of laborB. The woman is having a complication and the doctor should be notifiedC. Labor is slowing down and the woman may need oxytocinD. The woman is emotionally distraught and needs assistance in dealing with labor

SITUATION : Cynthia, a 32 year old primigravida at 39-40 weeks AOG was admitted to the labor room due to hypogastric and lumbo-sacral pains. IE revealed a fully dilated, fully effaced cervix. Station 0.

62. She is immediately transferred to the DR table. Which of the following conditions signify that delivery is near?

I - A desire to defecateII - Begins to bear down with uterine contractionIII - Perineum bulgesIV - Uterine contraction occur 2-3 minutes intervals at 50 seconds duration

A. I,II,IIIB. I,II,III,IVC. I,III,IVD. II,III,IV

63. Artificial rupture of the membrane is done. Which of the following nursing diagnoses is the priority?

A. High risk for infection related to membrane ruptureB. Potential for injury related to prolapse cordC. Alteration in comfort related to increasing strength of uterine contractionD. Anxiety related to unfamiliar procedure

64. Cynthia complains of severe abdominal pain and back pain during contraction. Which two of the following measures will be MOST effective in reducing pain?

I - Rubbing the back with a tennis ballII- EffleurageIII-ImageryIV-Breathing techniques

A. II,IVB. II,IIIC. I,IVD. I,II

65. Lumbar epidural anesthesia is administered. Which of the following nursing responsibilities should be done immediately following procedure?

A. Reposition from side to sideB. Administer oxygenC. Increase IV fluid as indicatedD. Assess for maternal hypotension

66. Which is NOT the drug of choice for epidural anesthesia?

A. SensorcaineB. XylocaineC. EphedrineD. Marcaine

SITUATION : Helen, a 24 year old G4P3 at full term gestation is brought to the ER after a gush of fluid passes through here vagina while doing her holiday shopping.

67. She is brought to the triage unit. The FHT is noted to be 114 bpm. Which of the following actions should the nurse do first?

A. Monitor FHT ever 15 minutesB. Administer oxygen inhalationC. Ask the charge nurse to notify the ObstetricianD. Place her on the left lateral position

68. The nurse checks the perineum of Helen. Which of the following characteristic of the amniotic fluid would cause an alarm to the nurse?

A. GreenishB. ScantlyC. ColorlessD. Blood tinged

69. Helen asks the nurse. "Why do I have to be on complete bed rest? I am not comfortable in this position." Which of the following response of the nurse is most appropriate?

A. Keeping you on bed rest will prevent possible cord prolapseB. Completed bed rest will prevent more amniotic fluid to escapeC. You need to save your energy so you will be strong enough to push laterD. Let us ask your obstetrician when she returns to check on you

70. Helen wants to know how many fetal movements per hour is normal, the correct response is

A. TwiceB. ThriceC. Four timesD. 10-12 times

71. Upon examination by the obstetrician, he charted that Helen is in the early stage of labor. Which of the following is true in this state?

A. Self-focusedB. Effacement is 100%C. Last for 2 hoursD. Cervical dilation 1-3 cm

SITUATION : Maternal and child health nursing a core concept of providing health in the community. Mastery of MCH Nursing is a quality all nurse should possess.

72. When should be the 2nd visit of a pregnant mother to the RHU?

A. Before getting pregnantB. As early in pregnancyC. Second trimesterD. Third trimester

73. Which of the following is NOT a standard prenatal physical examination?

A. Neck examination for goiterB. Examination of the palms of the hands for pallorC. Edema examination of the face hands, and lower extremetiesD. Examination of the legs for varicosities

74. Which of the following is NOT a basic prenatal service delivery done in the BHS?

A. Oral/Dental check upB. Laboratory examinationC. Treatment of diseases

D. Iron supplementation

75. How many days and how much dosage will the IRON supplementation be taken?

A. 365 days / 300 mgB. 210 days / 200 mgC. 100 days/ 100mgD. 50 days / 50 mg

76. When should the iron supplementation starts and when should it ends?

A. 5th month of pregnancy to 2nd month post partumB. 1st month of pregnancy to 5th month post partumC. As early in pregnancy up to 9th month of pregnancyD. From 1st trimester up to 6 weeks post partum

77. In malaria infested area, how is chloroquine given to pregnant women?

A. 300 mg / twice a month for 9 monthsB. 200 mg / once a week for 5 monthsC. 150 mg / twice a week for the duration of pregnancyD. 100 mg / twice a week for the last trimester of pregnancy

78. Which of the following mothers are qualified for home delivery?

A. Pre termB. 6th pregnancyC. Has a history of hemorrhage last pregnancyD. 2nd pregnancy, Has a history of 20 hours of labor last pregnancy.

79. Which of the following is not included on the 3 Cs of delivery?

A. Clean SurfaceB. Clean HandsC. Clean EquipmentsD. Clean Cord

80. Which of the following is unnecessary equipment to be included in the home delivery kit?

A. Boiled razor bladeB. 70% Isopropyl AlcoholC. FlashlightD. Rectal and oral thermometer

SITUATION : Pillar is admitted to the hospital with the following signs : Contractions coming every 10 minutes, lasting 30 seconds and causing little discomfort. Intact membranes without any bloody shows. Stable vital signs. FHR = 130bpm. Examination reveals cervix is 3 cm dilated with vertex presenting at minus 1 station.

81. On the basis of the data provided above, You can conclude the pillar is in the

A. In false laborB. In the active phase of laborC. In the latent phase of laborD. In the transitional phase of labor

82. Pitocin drip is started on Pilar. Possible side effects of pitocin administration include all of the following except

A. DiuresisB. HypertensionC. Water intoxicationD. Cerebral hemorrhage

83. The normal range of FHR is approximately

A. 90 to 140 bpmB. 120 to 160 bpmC. 100 to 140 bpmD. 140 to 180 bpm

84. A negative 1 [-1] station means that

A. Fetus is crowningB. Fetus is floatingC. Fetus is engagedD. Fetus is at the ischial spine

85. Which of the following is characteristics of false labor

A. Bloody showB. Contraction that are regular and increase in frequency and durationC. Contraction are felt in the back and radiates towards the abdomenD. None of the above

86. Who's Theory of labor pain that states that PAIN in labor is cause by FEAR

A. BradleyB. SimpsonC. LamazeD. Dick-Read

87. Which sign would alert the nurse that Pillar is entering the second stage of labor?

A. Increase frequency and intensity of contractionB. Perineum bulges and anal orifice dilatesC. Effacement of internal OS is 100%D. Vulva encircles the largest diameter of presenting part

88. Nursing care during the second stage of labor should include

A. Careful evaluation of prenatal historyB. Coach breathing, Bear down with each contraction and encourage patient.C. Shave the perineumD. Administer enema to the patient

SITUATION : Baby boy Jose was delivered spontaneously following a term pregnancy. Apgar scores are 8 and 9 respectively. Routine procedures are carried out.

89. When is the APGAR Score taken?

A. Immediately after birth and at 30 minutes after birthB. At 5 minutes after birth and at 30 minutes after birthC. At 1 minute after birth and at 5 minutes after birthD. Immediately after birth and at 5 minutes after birth

90. The best way to position a newboarn during the first week of life is to lay him

A. Prone with head slightly elevatedB. On his back, flatC. On his side with his head flat on bedD. On his back with head slightly elevated

91. Baby boy Jose has a large sebaceous glands on his nose, chin, and forehead. These are known as

A. MiliaB. LanugoC. HemangiomasD. Mongolian spots

92. Baby boy Jose must be carefully observed for the first 24 hours for

A. Respiratory distressB. Duration of cryC. Frequency of voidingD. Range in body temperature

93. According to the WHO , when should the mother starts breastfeeding the infant?

A. Within 30 minutes after birthB. Within 12 hours after birthC. Within a day after birthD. After infant's condition stabilizes

94. What is the BEST and most accurate method of measuring the medication dosage for infants and children?

A. WeightB. HeightC. NomogramD. Weight and Height

95. The first postpartum visit should be done by the mother within

A. 24 hoursB. 3 daysC. a weekD. a month

96. The major cause of maternal mortality in the Philippines is

A. InfectionB. HemorrhageC. HypertensionD. Other complications related to labor,delivery and puerperium

97. According to the WHO, what should be the composition of a commercialized Oral rehydration salt solution?

A. Potassium : 1.5 g. ; Sodium Bicarbonate 2.5g ; Sodium Chloride 3.5g; Glucose 20 g.A. Potassium : 1.5 g. ; Sodium Bicarbonate 2.5g ; Sodium Chloride 3.5g; Glucose 10 g.A. Potassium : 2.5 g. ; Sodium Bicarbonate 3.5g ; Sodium Chloride 4.5g; Glucose 20 g.A. Potassium : 2.5 g. ; Sodium Bicarbonate 3.5g ; Sodium Chloride 4.5g; Glucose 10 g.

98. In preparing ORESOL at home, The correct composition recommnded by the DOH is

A. 1 glass of water, 1 pinch of salt and 2 tsp of sugarB. 1 glass of water, 2 pinch of salt and 2 tsp of sugarC. 1 glass of water, 3 pinch of salt and 4 tsp of sugarD. 1 glass of water, 1 pinch of salt and 1 tsp of sugar

99. Milk code is a law that prohibits milk commercialization or artificial feeding for up to 2 years. Which law provides its legal basis?

A. Senate bill 1044B. RA 7600C. Presidential Proclamation 147D. EO 51

100. A 40 year old mother in her third trimester should avoid?

A. TravelingB. ClimbingC. SmokingD. Exercising