FOCUS ON MATERNITY EXAM 100QUESTIONS WITH CORRECT
ANSWERS
A home care nurse is instructing a client with hyperemesis gravidarum about measures to ease
the nausea and vomiting. The nurse tells the client to: - CORRECT ANSWER✅✅✅Eat
carbohydrates such as cereals, rice, and pasta
Low-fat foods and easily digested carbohydrates such as fruit, breads, cereals, rice, and pasta
provide important nutrients and help prevent a low blood glucose level, which can cause nausea.
Soups and other liquids should be taken between meals to avoid distending the stomach and
triggering nausea. Sitting upright after meals reduces gastric reflux. Additionally, food portions
should be small and foods with strong odors should be eliminated from the diet, because food
smells often incite nausea.
Test-Taking Strategy: Use the process of elimination and focus on the client's diagnosis and the
subject, ways to ease and prevent nausea and vomiting. Knowing that foods high in fat may be
difficult to digest will assist you in eliminating this option. Next eliminate the option that
involves consuming primarily soups and fluids at meals, recalling that liquids will cause
distention of the stomach. To select from the remaining options, recall that lying down after
meals can cause gastric reflux; this will direct you to the correct option. Review measures to ease
and prevent nausea and vomiting if you had difficulty with this question.
A nurse is caring for a client with preeclampsia who is receiving a magnesium sulfate infusion to
prevent eclampsia. Which finding indicates to the nurse that the medication is effective? -
CORRECT ANSWER✅✅✅The client experiences diuresis within 24 to 48 hours.
Magnesium sulfate is effective in preventing seizures (eclampsia) if diuresis occurs within 24 to
48 hours of the start of the infusion. As part of the therapeutic response, renal perfusion is
increased and the client is free of visual disturbances, headache, epigastric pain, clonus (the rapid
rhythmic jerking motion of the foot that occurs when the client's lower leg is supported and the
foot is sharply dorsiflexed), and seizure activity. Hyperreflexia indicates cerebral irritability.
Clonus is normally not present. The therapeutic magnesium level is 4 to 8 mg/dL (1.64 to 3.29
mmol/L). Reflexes range from 1+ to 2+ but should not be absent.
A client with preeclampsia who is receiving magnesium sulfate in an intravenous infusion
exhibits signs of magnesium toxicity. The nurse immediately prepares for the administration of: -
CORRECT ANSWER✅✅✅Calcium gluconate
,Calcium gluconate is the antidote to magnesium sulfate because it antagonizes the effects of
magnesium at the neuromuscular junction. It should be readily available whenever magnesium is
administered. Vitamin K is the antidote in cases of hemorrhage induced by the administration of
oral anticoagulants such as warfarin sodium (Coumadin). Protamine sulfate is the antidote in
cases of hemorrhage induced by the administration of heparin. Naloxone hydrochloride is
administered to treat opioid-induced respiratory depression.
A nurse instructs a pregnant client about foods that are high in folic acid. Which item does the
nurse tell the client is the best source of folic acid? - CORRECT ANSWER✅✅✅Lima beans
The best sources of folic acid are liver; kidney, pinto, lima, and black beans; and fresh dark-
green leafy vegetables. Other good sources of folic acid are orange juice, peanuts, refried beans,
and peas. Milk is high in calcium. Chicken and steak are high in protein.
A nurse is providing instructions to a mother of an infant with seborrheic dermatitis (cradle cap)
about treatment of the condition. The nurse tells the mother to: - CORRECT
ANSWER✅✅✅Apply oil to the affected area on the infant's scalp
Seborrheic dermatitis, a chronic inflammation of the scalp or other areas of the skin, is
characterized by yellow, scaly, oily lesions. It sometimes results when parents do not wash over
the anterior fontanel carefully for fear that they will hurt the infant. Treatment includes the
application of oil (e.g., mineral oil) to the area to help soften the lesions followed by gentle
removal of the scaly lesions with a comb before the head is shampooed. The nurse should teach
the mother how to shampoo the scalp and explain that she will not damage the fontanel with
normal gentle shampooing. The scalp should be rinsed well to remove all soap, which could
cause irritation.
A nurse is monitoring a client who was given an epidural opioid for a cesarean birth. The nurse
notes that the client's oxygen saturation on pulse oximetry is 92%. The nurse first: - CORRECT
ANSWER✅✅✅Instructs the client to take several deep breaths
If the client has been given an epidural opioid, the nurse should monitor the client's respiratory
status closely. If the oxygen saturation falls below 95%, the nurse instructs the client to take
several deep breaths to increase the level. Although the finding would be documented, action is
required to increase the oxygen saturation level. It is not necessary to contact the health care
,provider. If the deep breaths fail to increase the oxygen saturation level, the health care provider
is notified and may prescribe oxygen.
A client who delivered a healthy newborn 11 days ago calls the clinic and tells the nurse that she
is experiencing a white vaginal discharge. The nurse tells the client: - CORRECT
ANSWER✅✅✅That this is a normal postpartum occurrence
For the first 3 days following childbirth, lochia consists almost entirely of blood, with small
particles of decidua and mucus, and is called lochia rubra because of its red color. The amount of
blood decreases by about the fourth day, and which time the lochia changes from red to pink or
brown-tinged; this stage is called lochia serosa. By about the 11th day, the erythrocyte
component of lochia has decreased and the discharge becomes white or cream-colored. This final
stage is known as lochia alba. Lochia alba contains leukocytes, decidual cells, epithelial cells,
fat, cervical mucus, and bacteria. It is present in most women until the third week after childbirth
but may persist for as long as 6 weeks. Lochia alba is a normal finding during the postpartum
course, and no intervention is required, so the other options are incorrect.
A rubella antibody screen is performed in a pregnant client, and the results indicate that the client
is not immune to rubella. The nurse tells the client that: - CORRECT ANSWER✅✅✅A
rubella vaccine must be administered after childbirth
A prenatal rubella antibody screen is performed in every pregnant woman to determine whether
she is immune to rubella, which can cause serious fetal anomalies. If she is not immune, rubella
vaccine is offered after childbirth to keep her from contracting rubella during subsequent
pregnancies. The vaccine is a live virus, and defects might occur in the fetus if the vaccine were
administered during pregnancy or if the mother were to become pregnant soon after it was
administered. Administering a rubella vaccine immediately places the fetus at risk. Telling the
client that she does not need to be concerned about being exposed to rubella is incorrect, because
the possibility of exposure, which could be harmful to the fetus, does exist.
A nurse is monitoring a client who delivered a healthy newborn 12 hours ago. The nurse takes
the client's temperature and notes that it is 38° C (100.4° F). The most appropriate nursing action
would be to: - CORRECT ANSWER✅✅✅Encourage the intake of oral fluids
A temperature of 38° C (100.4° F) is common during the 24 hours after childbirth. It may be the
result of dehydration or normal postpartum leukocytosis. If the increased temperature persists for
, longer than 24 hours or exceeds 38° C, infection is a possibility, and the fever is reported to the
health care provider or nurse midwife. Because the client delivered her baby just 12 hours ago,
the most appropriate nursing action is to encourage the intake of oral fluids.
A nurse is assessing the uterine fundus of a client who has just delivered a baby and notes that
the fundus is boggy. The nurse massages the fundus, and then presses to expel clots from the
uterus. To prevent uterine inversion during this procedure, the nurse: - CORRECT
ANSWER✅✅✅Simultaneously provides pressure over the lower uterine segment
After massaging a boggy fundus until it is firm, the nurse presses the fundus to expel clots from
the uterus. The nurse must also keep one hand pressed firmly just above the symphysis (over the
lower uterine segment) the entire time. Removing the clots allows the uterus to contract properly.
Providing pressure over the lower uterine segment prevents uterine inversion. Having the client
void before uterine assessment will not prevent uterine inversion. Telling the woman to bear
down while the nurse performs fundal message and asking the client to take slow, deep breaths
during fundal assessment also will not prevent uterine inversion.
A nonstress test is performed, and the health care provider documents "accelerations lasting less
than 15 seconds throughout fetal movement." The nurse interprets these findings as: -
CORRECT ANSWER✅✅✅Nonreactive
A reactive nonstress test is a normal, or negative, result and indicates a healthy fetus. The result
requires two or more fetal heart rate accelerations of at least 15 beats/min lasting at least 15
seconds from the beginning of the acceleration to the end, in association with fetal movement,
during a 20-minute period. A nonreactive test is an abnormal test, showing no accelerations or
accelerations of less than 15 beats/min or lasting less than 15 seconds during a 40-minute
observation. An inconclusive result is one that cannot be interpreted because of the poor quality
of the fetal heart rate recording.
A stillborn infant was delivered a few hours ago. After the birth, the family remains together,
holding and touching the baby. Which statement by the nurse is appropriate? - CORRECT
ANSWER✅✅✅"This must be hard for you."
Therapeutic communication helps the mother, father, and other family members express their
feelings and emotions. "This must be hard for you" is a caring and empathetic response, focused
ANSWERS
A home care nurse is instructing a client with hyperemesis gravidarum about measures to ease
the nausea and vomiting. The nurse tells the client to: - CORRECT ANSWER✅✅✅Eat
carbohydrates such as cereals, rice, and pasta
Low-fat foods and easily digested carbohydrates such as fruit, breads, cereals, rice, and pasta
provide important nutrients and help prevent a low blood glucose level, which can cause nausea.
Soups and other liquids should be taken between meals to avoid distending the stomach and
triggering nausea. Sitting upright after meals reduces gastric reflux. Additionally, food portions
should be small and foods with strong odors should be eliminated from the diet, because food
smells often incite nausea.
Test-Taking Strategy: Use the process of elimination and focus on the client's diagnosis and the
subject, ways to ease and prevent nausea and vomiting. Knowing that foods high in fat may be
difficult to digest will assist you in eliminating this option. Next eliminate the option that
involves consuming primarily soups and fluids at meals, recalling that liquids will cause
distention of the stomach. To select from the remaining options, recall that lying down after
meals can cause gastric reflux; this will direct you to the correct option. Review measures to ease
and prevent nausea and vomiting if you had difficulty with this question.
A nurse is caring for a client with preeclampsia who is receiving a magnesium sulfate infusion to
prevent eclampsia. Which finding indicates to the nurse that the medication is effective? -
CORRECT ANSWER✅✅✅The client experiences diuresis within 24 to 48 hours.
Magnesium sulfate is effective in preventing seizures (eclampsia) if diuresis occurs within 24 to
48 hours of the start of the infusion. As part of the therapeutic response, renal perfusion is
increased and the client is free of visual disturbances, headache, epigastric pain, clonus (the rapid
rhythmic jerking motion of the foot that occurs when the client's lower leg is supported and the
foot is sharply dorsiflexed), and seizure activity. Hyperreflexia indicates cerebral irritability.
Clonus is normally not present. The therapeutic magnesium level is 4 to 8 mg/dL (1.64 to 3.29
mmol/L). Reflexes range from 1+ to 2+ but should not be absent.
A client with preeclampsia who is receiving magnesium sulfate in an intravenous infusion
exhibits signs of magnesium toxicity. The nurse immediately prepares for the administration of: -
CORRECT ANSWER✅✅✅Calcium gluconate
,Calcium gluconate is the antidote to magnesium sulfate because it antagonizes the effects of
magnesium at the neuromuscular junction. It should be readily available whenever magnesium is
administered. Vitamin K is the antidote in cases of hemorrhage induced by the administration of
oral anticoagulants such as warfarin sodium (Coumadin). Protamine sulfate is the antidote in
cases of hemorrhage induced by the administration of heparin. Naloxone hydrochloride is
administered to treat opioid-induced respiratory depression.
A nurse instructs a pregnant client about foods that are high in folic acid. Which item does the
nurse tell the client is the best source of folic acid? - CORRECT ANSWER✅✅✅Lima beans
The best sources of folic acid are liver; kidney, pinto, lima, and black beans; and fresh dark-
green leafy vegetables. Other good sources of folic acid are orange juice, peanuts, refried beans,
and peas. Milk is high in calcium. Chicken and steak are high in protein.
A nurse is providing instructions to a mother of an infant with seborrheic dermatitis (cradle cap)
about treatment of the condition. The nurse tells the mother to: - CORRECT
ANSWER✅✅✅Apply oil to the affected area on the infant's scalp
Seborrheic dermatitis, a chronic inflammation of the scalp or other areas of the skin, is
characterized by yellow, scaly, oily lesions. It sometimes results when parents do not wash over
the anterior fontanel carefully for fear that they will hurt the infant. Treatment includes the
application of oil (e.g., mineral oil) to the area to help soften the lesions followed by gentle
removal of the scaly lesions with a comb before the head is shampooed. The nurse should teach
the mother how to shampoo the scalp and explain that she will not damage the fontanel with
normal gentle shampooing. The scalp should be rinsed well to remove all soap, which could
cause irritation.
A nurse is monitoring a client who was given an epidural opioid for a cesarean birth. The nurse
notes that the client's oxygen saturation on pulse oximetry is 92%. The nurse first: - CORRECT
ANSWER✅✅✅Instructs the client to take several deep breaths
If the client has been given an epidural opioid, the nurse should monitor the client's respiratory
status closely. If the oxygen saturation falls below 95%, the nurse instructs the client to take
several deep breaths to increase the level. Although the finding would be documented, action is
required to increase the oxygen saturation level. It is not necessary to contact the health care
,provider. If the deep breaths fail to increase the oxygen saturation level, the health care provider
is notified and may prescribe oxygen.
A client who delivered a healthy newborn 11 days ago calls the clinic and tells the nurse that she
is experiencing a white vaginal discharge. The nurse tells the client: - CORRECT
ANSWER✅✅✅That this is a normal postpartum occurrence
For the first 3 days following childbirth, lochia consists almost entirely of blood, with small
particles of decidua and mucus, and is called lochia rubra because of its red color. The amount of
blood decreases by about the fourth day, and which time the lochia changes from red to pink or
brown-tinged; this stage is called lochia serosa. By about the 11th day, the erythrocyte
component of lochia has decreased and the discharge becomes white or cream-colored. This final
stage is known as lochia alba. Lochia alba contains leukocytes, decidual cells, epithelial cells,
fat, cervical mucus, and bacteria. It is present in most women until the third week after childbirth
but may persist for as long as 6 weeks. Lochia alba is a normal finding during the postpartum
course, and no intervention is required, so the other options are incorrect.
A rubella antibody screen is performed in a pregnant client, and the results indicate that the client
is not immune to rubella. The nurse tells the client that: - CORRECT ANSWER✅✅✅A
rubella vaccine must be administered after childbirth
A prenatal rubella antibody screen is performed in every pregnant woman to determine whether
she is immune to rubella, which can cause serious fetal anomalies. If she is not immune, rubella
vaccine is offered after childbirth to keep her from contracting rubella during subsequent
pregnancies. The vaccine is a live virus, and defects might occur in the fetus if the vaccine were
administered during pregnancy or if the mother were to become pregnant soon after it was
administered. Administering a rubella vaccine immediately places the fetus at risk. Telling the
client that she does not need to be concerned about being exposed to rubella is incorrect, because
the possibility of exposure, which could be harmful to the fetus, does exist.
A nurse is monitoring a client who delivered a healthy newborn 12 hours ago. The nurse takes
the client's temperature and notes that it is 38° C (100.4° F). The most appropriate nursing action
would be to: - CORRECT ANSWER✅✅✅Encourage the intake of oral fluids
A temperature of 38° C (100.4° F) is common during the 24 hours after childbirth. It may be the
result of dehydration or normal postpartum leukocytosis. If the increased temperature persists for
, longer than 24 hours or exceeds 38° C, infection is a possibility, and the fever is reported to the
health care provider or nurse midwife. Because the client delivered her baby just 12 hours ago,
the most appropriate nursing action is to encourage the intake of oral fluids.
A nurse is assessing the uterine fundus of a client who has just delivered a baby and notes that
the fundus is boggy. The nurse massages the fundus, and then presses to expel clots from the
uterus. To prevent uterine inversion during this procedure, the nurse: - CORRECT
ANSWER✅✅✅Simultaneously provides pressure over the lower uterine segment
After massaging a boggy fundus until it is firm, the nurse presses the fundus to expel clots from
the uterus. The nurse must also keep one hand pressed firmly just above the symphysis (over the
lower uterine segment) the entire time. Removing the clots allows the uterus to contract properly.
Providing pressure over the lower uterine segment prevents uterine inversion. Having the client
void before uterine assessment will not prevent uterine inversion. Telling the woman to bear
down while the nurse performs fundal message and asking the client to take slow, deep breaths
during fundal assessment also will not prevent uterine inversion.
A nonstress test is performed, and the health care provider documents "accelerations lasting less
than 15 seconds throughout fetal movement." The nurse interprets these findings as: -
CORRECT ANSWER✅✅✅Nonreactive
A reactive nonstress test is a normal, or negative, result and indicates a healthy fetus. The result
requires two or more fetal heart rate accelerations of at least 15 beats/min lasting at least 15
seconds from the beginning of the acceleration to the end, in association with fetal movement,
during a 20-minute period. A nonreactive test is an abnormal test, showing no accelerations or
accelerations of less than 15 beats/min or lasting less than 15 seconds during a 40-minute
observation. An inconclusive result is one that cannot be interpreted because of the poor quality
of the fetal heart rate recording.
A stillborn infant was delivered a few hours ago. After the birth, the family remains together,
holding and touching the baby. Which statement by the nurse is appropriate? - CORRECT
ANSWER✅✅✅"This must be hard for you."
Therapeutic communication helps the mother, father, and other family members express their
feelings and emotions. "This must be hard for you" is a caring and empathetic response, focused
