[单项选择]A primigravida at 36 weeks’ gestation tells the nurse that she has moderate breast tenderness. The nurse teaches the client with some suggestions for relief measures. Which of the following statements by the client suggests the nurse that the client needs further instructions
A. "I should wear a supportive bra at all times. "
B. "I should clean my nipples with soap. "
C. "I should change my sleeping positions. "
D. "I should clean up the colostrum with water. "

[单项选择]A multigravida at 37 weeks’ gestation tells the nurse that she has frequent heartburn. The nurse teaches the client with suggestions for obtaining relief from the heartburn. Which of the following statements by the patient indicates that she has understood the nurse’s instructions
A. "I can take a teaspoon of baking soda in water occasionally. "
B. "I should eat only three large meals and drink plenty of fluids. "
C. "It’s all right for me to have a fried hamburger and fries. "
D. "I should eat smaller, more frequent meals with fluids. "

[单项选择]A primigravida at 34 weeks’ gestation is diagnosed with hydramnios. After delivery of the neonate, a priority for the nurse is to assess the neonate for which problem
A. Kidney disorders.
B. Cardiac defects.
C. Diabetes mellitus.
D. Esophageal atresi

[单项选择]A primigravida at 28 weeks’ gestation is admitted with a diagnosis of preterm labor. The client’s contractions are occurring every 15 to 20 minutes, lasting 25 seconds. The membranes are intact. What should the nurse do
A. Request assistance from the neonatal resuscitation team.
B. Place the client on bed rest on her left side.
C. Obtain equipment for an amniotomy.
D. Prepare terbutaline in an intravenous solution of normal salin

[单项选择]A 34-year-old client at 32 weeks’ gestation tells the nurse that her baby will be sick because she saw a dead dog on the road yesterday. What’s the best response by the nurse
A. "Your baby will be fine. That’s just superstition. "
B. "Don’t worry. We’ll make sure your baby is okay. "
C. "I can see that you are concerned. Let’s talk about what’s bothering you. "
D. "Perhaps so. Your baby should be seen by a physician as soon as it’s born. "

[单项选择]A 30-year-old primigravida tells the nurse that her hemorrhoids have become itchy and painful. The nurse instructs the client about relief measures. From which of the following statements by the client would the nurse suspect that the client needs further instructions
A. "I should sit in a warm sitz bath daily. "
B. "I can use a topical ointment for relief. "
C. "I should apply an ice pack at night. "
D. "I should decrease my fluid intake. "

[单项选择]A client in a psychiatric clinic unit tells the nurse, "I don’t think I can face going home tomorrow. " The nurse replies, "Do you want to talk more about it" The nurse is using which of the following techniques
A. Presenting reality.
B. Making observations.
C. Restating.
D. Explorin

[单项选择]A multigravida at 36 weeks’ gestation visits the emergency department because her boyfriend has beaten her severely. What should the nurse do first
A. Contact the authorities.
B. Ensure the client’s safety.
C. Identify a support person.
D. Photograph the client’s injuries.

[单项选择]A 35-year-old multigravida at 16 weeks gestation tells the nurse that she has had frequent mood swings during this pregnancy. What would be the nurse’s best suggestion to the client
A. Seek professional counseling.
B. Keep her feelings to herself.
C. Try to avoid fatigue and stress.
D. Decrease her narcissistic behaviors.

[单项选择]The nurse has a client at 30 weeks’ gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her neonate
A. Encourage breas-feeding so that she can get her rest and get healthier.
B. Encourage breast-feeding because it’s healthier for the neonate.
C. Encourage breast-feeding to facilitate bonding.
D. Discourage breast-feeding because HIV can be transmitted through breast milk.

[单项选择]A primigravida client with acquired immunodeficiency syndrome (AIDS) is in labor at term. In preparing her nursing care plan, the nurse should include which of the following nursing diagnoses
A. Risk for fetal or maternal injury related to the crisis of childbearing.
B. Risk for infection related to suppressed immune status.
C. Risk for deficient fluid volume related to dehydration.
D. Risk for fetal injury related to uteroplacental insufficiency.

[单项选择]At what gestational age would a primigravida expect to feel "quickening"
A. 12 weeks.
B. 16 to 18 weeks.
C. 20 to 22 weeks.
D. By the end of the 26th week.

[单项选择]A primigravida in labor for 13 hours clenches her fists, tightens her muscles, and screams during every contraction. Her reaction to labor seems exaggerated compared to the contraction pattern recording from the electronic fetal monitor (EFM). What’s the nurse’s best response
A. Explain to the client that the EFM shows mild contractions, so she should just relax and let the contractions work.
B. Take over as her coach because her husband isn’t helping her properly.
C. Ignore her reactions, realizing that this is her first time in labor and her reactions will soon match the intensity of contractions shown on the EFM.
D. Palpate her abdomen to determine the intensity of labor contractions as they’re taking plac

[单项选择]The nurse is caring for a primigravida who is scheduled for a fetal acoustic stimulation test (FAST). The nurse should explain to the client that the primary purpose of this test is to（）
A. induce contractions.
B. induce fetal heart rate accelerations.
C. shorten the contraction stress test.
D. determine fluid volume.

[单项选择]A 21-year-old primigravida has an emergency cesarean delivery under general anesthesia because of unanticipated fetal distress. One postoperative intervention is to assist her to turn every 2 hours. Which of the following conditions is this intervention intended to prevent
A. Pressure ulcers.
B. Muscular stiffness.
C. Respiratory complications.
D. Venous stasis.

[单项选择]A 19-year-old primigravida is admitted to the labor and delivery unit in labor. She’s 2 cm dilated and 50% effaced, and the fetal head is at 0 station. She’s having moderately strong 40-second contractions every 5 minutes. She seems rather anxious and becomes very tense during each contraction. When the client asks for pain relief, what should the nurse do next ？（）
A. Determine the source of her anxiety and institute interventions to help her relax.
B. Immediately check the physician’s order and give her the analgesic ordered.
C. Inform her that the neonate’s head isn’t down far enough just yet but that, as soon as it is, medication will be given.
D. Tell her that her contractions are only moderately strong and that she should wait until later to take medication.

[单项选择]Mrs. Wilson, a primigravida, was admitted to the hospital at 12 weeks’ gestation. She is complaining of abdominal cramping, exhibits bright red vaginal spotting without cervical dilation. The nurse determines that the client is most likely experiencing which of the following types of abortion
A. Complete.
B. Threatened.
C. Inevitable.
D. Misse

[单项选择]A 23-year-old primigravida client has a normal vaginal delivery. The next day, the nurse assesses the client’s lochia for color, amount, and the presence of clots. Which of the following best describes lochia on the first postpartum day
A. Dark red (loehia rubra), large amount, with many clots.
B. Pink (lochia serosa), moderate amount, no clots.
C. White (lochia alba), scant amount, no clots.
D. Dark red (lochia rubra), moderate amount, with a few small clots.