1. Mrs.
Villarosa, G4 P3 is admitted to the prenatal clinic at eight and one half
months gestation with a diagnosis of placenta previa partialis. Chief complaint is
vaginal bleeding without contractions. Which action should the nurse perform
initially?
a. Anticipate and set up for emergency LSTCS
b. Elevate the foot of the bed. check cervical dilatation, check vital signs
c. Assess the amount and character of bleeding
d. Check the FHT, anticipate and set up for oxygen therapy
2. In the 5th month of pregnancy, ultrasonography is performed on a client. The
results indicate that the fetus is small for gestational age and there is evidence of
placenta previa partialis. The client asks the nurse if this condition will warrant an
abdominal delivery/cesarean section. Your response would be:
a. The client is financially disadvantaged
b. Definitely, because you will
c. Your doctor will tell you more about this
d. Don't worry, I'm sure you will deliver vaginally
e. it would be early to tell since placental migration bleed profusely if vaginal
delivery would still be possible as pregnancy progresses be permitted
3. Mrs. Villarosa G2P1 presents to the Obstetrical Unit with complaints of moderate
vaginal bleeding and severe abdominal pain. Examination reveals: FH - 34
centimeters, frequency of contractions is every 1.5 minutes, duration 60 seconds,
strong with increasing resting tone. Fetal monitoring shows late decelerations.
Which of the following nursing assessments is consistent with the development
of abruptio placenta?
a. The client has had prenatal care
b. All of the above
c. The client is HIV positive
d. The client admits to using cocaine (readings)
4. Mrs. Villarosa, amenorrheic for two months is diagnosed to have ectopic
pregnancy based on the sign and symptoms of sudden, severe low quadrant
pain radiating to the shoulder, Cullen sign and minimal external vaginal bleeding.
Which of the following actions would be implemented?
a. Performing abdominal scrub in preparation for CS
b. All of the choices
c. Monitoring of vital signs
d. Repositioning of the client to the left
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5. A 32 year old woman presents to the emergency department with abdominal pain
and vagina bleeding. Her last menstrual period was 8 weeks ago and her
pregnancy test is positive. On examination she is tachycardic and hypotensive
and her abdominal examination findings reveal peritoneal signs, a bedside
abdominal ultrasound shows free fluid within the abdominal cavity. The decision
is made to take the patient to the operating room for emergency exploratory
laparotomy. Which of the following is the most likely diagnosis?
a. Torsed ovarian corpus luteum cyst
b. Missed abortion
c. Hydatidiform mole
d. Incomplete abortion
e. Ruptured ectopic pregnancy
6. Mrs. Villarosa, a thirty year old G2P1, receives a diagnosis of complete H. mole
which was treated by thorough evacuation with suction curettage. Which of the
following discharge health instructions needs further teaching?
a. Avoid pregnancy for 6 months
b. Report for regular follow up check ups
c. Take highly nutritious foods particularly those in rich in iron
d. Do not fail to take contraceptive methods
7. Mrs. Villarosa at 33 weeks gestation complains of vaginal bleeding. The nurse
assessing the client is aware that an abruptio placenta is not accompanied by
which of the following assessment findings. EXCEPT.
a. Lack of uterine irritability
b. Uterine tenderness upon palpation
c. Soft abdomen upon palpation
d. No complaint of abdominal pain
8. A 26 year old woman whose last menstrual period (LMP) was 2 ½ months ago
develops bleeding, uterine cramps, and passed tissue per vagina. Two hours
later, she is still bleeding heavily. The bleeding is most likely due to which of the
following?
a. Retained products of conception
b. Systemic coagulopathy
c. Ruptured uterus
d. Bleeding hemorrhoids
e. Vaginal lacerations
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9. G3P2 Maxine at 16 weeks gestation was admitted to the maternity unit for a
McDonald cerclage procedure. When asked about the purpose of this procedure,
the client needs no further teaching if Maxine explained that this procedure is to:
a. Reinforce an incompetent cervix permanently
b. Evaluate cephalopelvic disproportion
c. Reinforce incompetent cervix temporarily
d. Dilate the cervix
10. A 20 year old primigravida at 14 weeks gestation visits the clinic with symptoms
of slight reddish vaginal bleeding and an occasional uterine cramp. The
pregnancy test is positive. The patient states that no tissue has been passed.
The nurse should explain to the patient that these symptoms are indicative of a
type of abortion termed:
a. Missed abortion
b. Incomplete abortion
c. Inevitable abortion
d. Spontaneous abortion
e. Threatened abortion
11. A 29 y/o, G3P2, 35 weeks gestation presents for prenatal care. She complains of on
and off scanty vaginal bleeding not associated with other signs and symptoms. Your
impression is placenta previa. The simplest, most precise and safest method to
confirm your diagnosis is which of the following?
a. Computed tomography
b. Double set-up examination
c. Magnetic resonance imaging
d. Sonography
12. A 26 year old woman whose last menstrual period (LMP) was 2 ½ months ago
develops bleeding, uterine cramps, and passes tissue per vagina. Two hours
later, she is still bleeding heavily. What is the most likely diagnosis?
a. Inevitable abortion
b. Premature labor
c. incomplete abortion
d. Twin pregnancy
e. Threatened abortion
13. Mrs, Zexy Lucero, 25 years old, G1PO, in the first trimester of pregnancy arrives
at a health care clinic and reports that she has been experiencing vaginal
bleeding. A threatened abortion is suspected, and Nurse Zasha instructs her
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regarding management of care. Which statement made by Mrs. Lucero indicates
no need for further instruction? (Select all that apply)
“I will maintain strict bed rest throughout the remainder of te pregnancy
“I will avoid sexual intercourse unti the bleeding has stopped.and for 2
weeks following the last evidence ot bleeding”
“I will count the number of perineal pads used on a daily basis and note
the amount and color of blood on the pad”
“I will watch for the evidence of the passage of tissue”
14. Ms. Lexy Lucero, 18 years old, an FEU nursing student as a competent maternity
care provider should be able to identify early signs of abortion in order to be able
to save a product of conception. Which of the following represents an incomplete
abortion? (Select all that apply)
Severe uterine cramps
Passage of fetus, placenta, embryonic sac
Mild abdominal pain
Profuse vaginal bleeding
15. Mrs. Lexy Lucero, 34 year old, G1PO comes to the emergency room with
abdominal cramping and vaginal bleeding. History revealed two missed
menstrual periods. Incomplete abortion is considered by Nurse Zasha. Which of
the following statements by Nurse Zasha is most appropriate? (Select all that
apply)
"You'll still be able to have children after this is over."
"Would you like to speak with a hospital counselor?"
"Did you really want to be pregnant now?"
"D and C will be done to clean out your womb."
"This must be difficult for you, I'm sorry."
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16. Mrs. Zexy Lucero, 32-year-old female, G1P0, presents to the emergency
department with abdominal pain and vaginal bleeding. Her last menstrual
period was 8 weeks ago and her pregnancy test is positive. On assessment
she is tachycardic and hypotensive. Abdominal examination findings shows
peritoneal signs, a bedside abdominal ultrasound reveals free fluid within the
abdominal cavity. Which of the following diagnosis if made by Nurse Zasha
needs further instructions? (Select all that apply)
Missed abortion
Incomplete abortion
Ruptured ectopic pregnancy
Torsed ovarian corpus luteal cyst
Hydatidiform mole
17. Ms. Zexy Lucero, 19-year-old, G1PO, 12 weeks AOG is expecting her first child.
She has vaginal bleeding and an enlarged-for-dates uterus, In addition, no fetal
heart sounds are heard. Ultrasound shown below revealed a snow storm pattern.
Which of the following statements if made by Nurse Zasha needs further
instructions? (Select all that apply)
Hysterectomy is contraindicated as primary therapy for molar pregnancy in
women who have completed childbearing.
Partial or incomplete hydatidiform mole has a higher risk of developing
into choriocarcinoma than complete mole.
The most common chromosomal make up or a partial or incomplete H.
mole is 46, xx of paternal origin.
Vaginal bleeding is a common symptom of hydatidiform mole.
Older maternal age is not a risk factor for hydatidiform mole.
18. Mrs. Zexy Lucero, 34-year-old, G2 31 weeks' gestation with a known
placenta previa presents to the hospital with vaginal bleeding. On assessment,
she has normal vital signs and the fetal heart rate tracing is 140 beats per minute
with accelerations and no decelerations. No uterine contractions are
demonstrated on external tocometer. Heavy vaginal bleeding is noted. Which of
the following steps should be questioned by Nurse Zasha in the management of
Mrs. Lucero? (Select all that apply)
Induce labor
Administer intramuscular terbutaline
Administer methylergonovine
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Admit and stabilize the patient
Perform cesarean delivery
19. Mrs. Zexy Lucero, 34-year-old, G2P1, 31 weeks AOG presents to the Obstetrical
Unit with complaints of vaginal bleeding earlier in the day that resolved on its
own. She refutes any leakage of fluid or uterine contractions and informs good
fetal movement, In her last pregnancy, she had a low transverse cesarean
delivery for breech presentation at term. She denies any medical problems, Vital
signs are normal and electronic external monitoring reveals a reactive fetal heart
rate tracing and no uterine contractions. Which of the following are inappropriate
steps in the management of this patient? (Select all that apply).
Perform an amniocentesis to rule out infection
Send her home. since the bleeding has completely resolved and she is
experiencing good fetal movement
Perform a sterile speculum examination
Perform a sterile digital examination
Perform an ultrasound examination
20. Mrs. Zexy Lucero, 34-year-old, 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 inappropriate for Mrs. Lucero? (Select all
that apply)
Mrs. Lucero will gain less than 25 pounds during the pregnancy.
Mrs. Lucero will have normal blood glucose throughout the pregnancy.
Mrs. Lucero will deliver a baby that is appropriate for gestational age.
Mrs. Lucero will deliver after 37 weeks' gestation.
21. Mrs. Zexy Lucero, 34-year old, 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, which of the following should be done by
Nurse Zasha? (Select all that apply)
Encourage the client to eat a high-fiber diet.
Teach the client deep breathing exercises.
Decorate the room with pictures of family.
Restrict the fluid intake of the client
Perform passive range of motion exercises.
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22. Mrs. Zexy Lucero, 34-year-old, G6P5005, 24 weeks' gestation, has been
admitted to the hospital for placenta previa. Nurse Zasha is developing the plan
of care. Which of the following is an inappropriate long-term goal for Mrs. Zexy?
(Select all that apply)
Mrs. Lucero will be symptom-free until at least 37 weeks' gestation.
Mrs. Lucero will have a reactive nonstress test on day 2 of hospitalization.
Mrs. Lucero will call her children shortly after admission.
Mrs. Lucero will state an understanding of the need for complete bed rest.
23.
24. Mrs. Zexy Lucero, 34-year-old, G2P1 at 36 weeks' gestation is diagnosed with
placenta previa. Nurse Zasha gave instructions about the cause of her vaginal
bleeding. Nurse Zasha determines that her teaching has been ineffective when
Mrs. Zexy says that the bleeding results from which of the following? (Select all
that apply)
Increased platelet levels.
A large-for-gestational-age fetus.
Exposure of maternal blood sinuses.
Diminished clotting factors.
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