Silvestri: Saunders Comprehensive Review for the NCLEX-RN®
Examination, 5th Edition
Maternity
Test Bank
MULTIPLE CHOICE
1. The nurse is assisting in conducting a prenatal session with a group of expectant
parents. One of the expectant parents asks, “How does the milk get secreted from the
breast?” The best response by the nurse should be:
1. “Testosterone stimulates the secretion of milk, which is called lactogenesis.”
2. “Oxytocin stimulates the secretion of milk, which is called lactogenesis.”
3. “Prolactin stimulates the secretion of milk, which is called lactogenesis.”
4. “Progesterone stimulates the secretion of milk, which is called lactogenesis.”
ANS: 3
Rationale: Prolactin stimulates the secretion of milk, which is called lactogenesis.
Oxytocin stimulates contractions during birth and stimulates postpartum contractions
to compress uterine vessels and control bleeding. Testosterone is produced by the
adrenal glands in the female and induces the growth of pubic and axillary hair at
puberty. Progesterone stimulates the secretions of the endometrial glands, causing
endometrial vessels to become highly dilated and tortuous in preparation for possible
embryo implantation.
Test-Taking Strategy: Knowledge regarding the functions of the various hormones
in the female reproductive system is required to answer this question. Note the
relationship between the secretion of milk and the hormone prolactin in the correct
option. If you had difficulty with this question, review the functions of the various
hormones of the female reproductive system.
PTS: 1
DIF: Level of Cognitive Ability: Applying
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal
child nursing care (4th ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
2. A nurse implements a teaching plan for a pregnant client who is newly diagnosed
with gestational diabetes mellitus. Which statement, if made by the client, indicates a
need for further education?
1. “I need to stay on the diabetic diet.”
2. “I will perform glucose monitoring at home.”
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
, Test Bank 2
3. “I need to avoid exercise because of the negative effects on insulin production.”
4. “I need to be aware of any infections and report signs of infection immediately
to my health care provider.”
ANS: 3
Rationale: Exercise is safe for the client with gestational diabetes mellitus and is
helpful in lowering the blood glucose level. Dietary modifications are the mainstay
of treatment, and the client is placed on a standard diabetic diet. Many women are
taught to perform blood glucose monitoring. If the woman is not performing the
blood glucose monitoring at home, then it will be performed at the clinic or health
care provider’s office. Signs of infection need to be reported to the health care
provider.
Test-Taking Strategy: Use the process of elimination, noting the strategic words
“need for further education.” These words indicate a negative event query and the
need to select the incorrect option. Noting these strategic words, including the word
“avoid,” in the correct option will assist in answering the question. If you had
difficulty with this question, review the teaching points for a client with gestational
diabetes mellitus.
PTS: 1
DIF: Level of Cognitive Ability: Evaluating
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.).
St. Louis: Mosby.
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
3. A client has been seen in the clinic and has been diagnosed with endometriosis. The
client asks the nurse to describe this condition. The best response by the nurse
should be:
1. “It causes the cessation of menstruation.”
2. “It is also known as primary dysmenorrhea.”
3. “It is pain that occurs during ovulation.”
4. “It is the presence of tissue outside the uterus that resembles the endometrium.”
ANS: 4
Rationale: Endometriosis is defined as the presence of tissue outside the uterus that
resembles the endometrium in both structure and function. The response of this
tissue to the stimulation of estrogen and progesterone during the menstrual cycle is
identical to that of the endometrium. Primary dysmenorrhea refers to menstrual pain
without identified pathology. Mittelschmerz refers to pelvic pain that occurs midway
between menstrual periods, and amenorrhea is the cessation of menstruation for at
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
, Test Bank 3
least three cycles or 6 months in a woman who has an established a pattern of
menstruation. Amenorrhea can be caused by a variety of causes.
Test-Taking Strategy: Use the process of elimination. Note the relationship between
the diagnosis and the correct option. If you had difficulty with this question and are
unfamiliar with this disorder, review the description of endometriosis.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child
nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
4. A client calls the physician’s office to schedule an appointment because a home
pregnancy test was performed and the results were positive. The nurse determines
that the home pregnancy test identified the presence of which of the following in the
urine?
1. Estrogen
2. Progesterone
3. Human chorionic gonadotropin (hCG)
4. Follicle-stimulating hormone (FSH)
ANS: 3
Rationale: In early pregnancy, hCG is produced by trophoblastic cells that surround
the developing embryo. This hormone is responsible for positive pregnancy tests.
The other options are not hormones found in urine that indicate pregnancy.
Test-Taking Strategy: Knowledge regarding the changes caused by placental
hormones in early pregnancy will direct you to the correction option, “human
chorionic gonadotropin (hCG)”. Remember that hCG is responsible for positive
pregnancy tests. If you are unfamiliar with this pregnancy test, review this content.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child
nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Nursing Process—Assessment
5. The nurse is teaching a pregnant client about the physiological effects and hormonal
changes that occur during pregnancy. The client asks the nurse about the purpose of
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
, Test Bank 4
estrogen. The nurse bases the response on which of the following purposes of
estrogen?
1. It maintains the uterine lining for implantation.
2. It stimulates metabolism of glucose and converts the glucose to fat.
3. It prevents the involution of the corpus luteum and maintains the production of
progesterone until the placenta is formed.
4. It stimulates uterine development to provide an environment for the fetus and
stimulates the breasts to prepare for lactation.
ANS: 4
Rationale: Estrogen stimulates uterine development to provide an environment for
the fetus and stimulates the breasts to prepare for lactation. Progesterone maintains
the uterine lining for implantation and relaxes all smooth muscle. Human placental
lactogen stimulates the metabolism of glucose and converts the glucose to fat; it is
antagonistic to insulin. Human chorionic gonadotropin prevents involution of the
corpus luteum and maintains the production of progesterone until the placenta is
formed.
Test-Taking Strategy: Knowledge regarding the functions of various hormones
related to pregnancy will direct you to the correct option. Remember that estrogen
stimulates uterine development to provide an environment for the fetus and
stimulates the breasts to prepare for lactation. If you had difficulty with this question
or are unfamiliar with these hormones, review this content.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child
nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
6. A client is seen in the health care clinic with a diagnosis of mild anemia. The anemia
is believed to be a result of her menstrual period. The client asks the nurse how
much blood is lost during a menstrual period. The nurse bases the response on which
of the following amounts of blood lost during this time?
1. 40 mL
2. 60 mL
3. 80 mL
4. 100 mL
ANS: 1
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
Examination, 5th Edition
Maternity
Test Bank
MULTIPLE CHOICE
1. The nurse is assisting in conducting a prenatal session with a group of expectant
parents. One of the expectant parents asks, “How does the milk get secreted from the
breast?” The best response by the nurse should be:
1. “Testosterone stimulates the secretion of milk, which is called lactogenesis.”
2. “Oxytocin stimulates the secretion of milk, which is called lactogenesis.”
3. “Prolactin stimulates the secretion of milk, which is called lactogenesis.”
4. “Progesterone stimulates the secretion of milk, which is called lactogenesis.”
ANS: 3
Rationale: Prolactin stimulates the secretion of milk, which is called lactogenesis.
Oxytocin stimulates contractions during birth and stimulates postpartum contractions
to compress uterine vessels and control bleeding. Testosterone is produced by the
adrenal glands in the female and induces the growth of pubic and axillary hair at
puberty. Progesterone stimulates the secretions of the endometrial glands, causing
endometrial vessels to become highly dilated and tortuous in preparation for possible
embryo implantation.
Test-Taking Strategy: Knowledge regarding the functions of the various hormones
in the female reproductive system is required to answer this question. Note the
relationship between the secretion of milk and the hormone prolactin in the correct
option. If you had difficulty with this question, review the functions of the various
hormones of the female reproductive system.
PTS: 1
DIF: Level of Cognitive Ability: Applying
REF: Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). Maternal
child nursing care (4th ed.). St. Louis: Mosby.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
2. A nurse implements a teaching plan for a pregnant client who is newly diagnosed
with gestational diabetes mellitus. Which statement, if made by the client, indicates a
need for further education?
1. “I need to stay on the diabetic diet.”
2. “I will perform glucose monitoring at home.”
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
, Test Bank 2
3. “I need to avoid exercise because of the negative effects on insulin production.”
4. “I need to be aware of any infections and report signs of infection immediately
to my health care provider.”
ANS: 3
Rationale: Exercise is safe for the client with gestational diabetes mellitus and is
helpful in lowering the blood glucose level. Dietary modifications are the mainstay
of treatment, and the client is placed on a standard diabetic diet. Many women are
taught to perform blood glucose monitoring. If the woman is not performing the
blood glucose monitoring at home, then it will be performed at the clinic or health
care provider’s office. Signs of infection need to be reported to the health care
provider.
Test-Taking Strategy: Use the process of elimination, noting the strategic words
“need for further education.” These words indicate a negative event query and the
need to select the incorrect option. Noting these strategic words, including the word
“avoid,” in the correct option will assist in answering the question. If you had
difficulty with this question, review the teaching points for a client with gestational
diabetes mellitus.
PTS: 1
DIF: Level of Cognitive Ability: Evaluating
REF: Lowdermilk, D., Perry, S., & Cashion, K. (2010). Maternity nursing (8th ed.).
St. Louis: Mosby.
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
3. A client has been seen in the clinic and has been diagnosed with endometriosis. The
client asks the nurse to describe this condition. The best response by the nurse
should be:
1. “It causes the cessation of menstruation.”
2. “It is also known as primary dysmenorrhea.”
3. “It is pain that occurs during ovulation.”
4. “It is the presence of tissue outside the uterus that resembles the endometrium.”
ANS: 4
Rationale: Endometriosis is defined as the presence of tissue outside the uterus that
resembles the endometrium in both structure and function. The response of this
tissue to the stimulation of estrogen and progesterone during the menstrual cycle is
identical to that of the endometrium. Primary dysmenorrhea refers to menstrual pain
without identified pathology. Mittelschmerz refers to pelvic pain that occurs midway
between menstrual periods, and amenorrhea is the cessation of menstruation for at
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
, Test Bank 3
least three cycles or 6 months in a woman who has an established a pattern of
menstruation. Amenorrhea can be caused by a variety of causes.
Test-Taking Strategy: Use the process of elimination. Note the relationship between
the diagnosis and the correct option. If you had difficulty with this question and are
unfamiliar with this disorder, review the description of endometriosis.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child
nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
4. A client calls the physician’s office to schedule an appointment because a home
pregnancy test was performed and the results were positive. The nurse determines
that the home pregnancy test identified the presence of which of the following in the
urine?
1. Estrogen
2. Progesterone
3. Human chorionic gonadotropin (hCG)
4. Follicle-stimulating hormone (FSH)
ANS: 3
Rationale: In early pregnancy, hCG is produced by trophoblastic cells that surround
the developing embryo. This hormone is responsible for positive pregnancy tests.
The other options are not hormones found in urine that indicate pregnancy.
Test-Taking Strategy: Knowledge regarding the changes caused by placental
hormones in early pregnancy will direct you to the correction option, “human
chorionic gonadotropin (hCG)”. Remember that hCG is responsible for positive
pregnancy tests. If you are unfamiliar with this pregnancy test, review this content.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child
nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Nursing Process—Assessment
5. The nurse is teaching a pregnant client about the physiological effects and hormonal
changes that occur during pregnancy. The client asks the nurse about the purpose of
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
, Test Bank 4
estrogen. The nurse bases the response on which of the following purposes of
estrogen?
1. It maintains the uterine lining for implantation.
2. It stimulates metabolism of glucose and converts the glucose to fat.
3. It prevents the involution of the corpus luteum and maintains the production of
progesterone until the placenta is formed.
4. It stimulates uterine development to provide an environment for the fetus and
stimulates the breasts to prepare for lactation.
ANS: 4
Rationale: Estrogen stimulates uterine development to provide an environment for
the fetus and stimulates the breasts to prepare for lactation. Progesterone maintains
the uterine lining for implantation and relaxes all smooth muscle. Human placental
lactogen stimulates the metabolism of glucose and converts the glucose to fat; it is
antagonistic to insulin. Human chorionic gonadotropin prevents involution of the
corpus luteum and maintains the production of progesterone until the placenta is
formed.
Test-Taking Strategy: Knowledge regarding the functions of various hormones
related to pregnancy will direct you to the correct option. Remember that estrogen
stimulates uterine development to provide an environment for the fetus and
stimulates the breasts to prepare for lactation. If you had difficulty with this question
or are unfamiliar with these hormones, review this content.
PTS: 1
DIF: Level of Cognitive Ability: Understanding
REF: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child
nursing (3rd ed.). St. Louis: Saunders.
OBJ: Client Needs: Physiological Integrity
TOP: Content Area: Maternity/Antepartum
MSC: Integrated Process: Teaching and Learning
6. A client is seen in the health care clinic with a diagnosis of mild anemia. The anemia
is believed to be a result of her menstrual period. The client asks the nurse how
much blood is lost during a menstrual period. The nurse bases the response on which
of the following amounts of blood lost during this time?
1. 40 mL
2. 60 mL
3. 80 mL
4. 100 mL
ANS: 1
Elsevier items and derived items © 2011, 2008, 2005, 2002 by Saunders, an imprint of Elsevier Inc.
