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2 | Page A. Having some pink striae but starting to fade B. Tender breast, some milk expressed C. Fundus 6cm below the umbilicus on palpation D. With creamy, yellow vaginal discharge 14. In the postpartum period, you should instruct your client to perform which of the following exercises to strengthen her pelvis floor muscles? A. Kegel exercises B. lung exercise C. push-up D. sit-ups 15. Another nursing focus is the monitoring of postpartum clients for possible complications. Postpartum hemorrhage is one of the primary causes of maternal mortality associated with child bearing. Which among the following T’s is the most frequent cause of postpartum hemorrhage? A. Tissue B. Trauma C. Tone D. Thrombin SCENARIO: As the fetus grows, body organ systems develop from specific tissue layers. Knowing these is helpful to know because coexisting congenital disorders found in newborns usually arise from the same germ layer. 16. Which among the Germ layers that forms the brain and spinal cord? A. Ectoderm B. Mesoderm C. Endoderm D. Epidermis 17. Heart is the muscle at the center of the circulatory system that pumps blood around the body as it beats. The nurse is aware that it is from which germ layer? A. Ectoderm B. Mesoderm C. Endoderm D. Epidermis 18. The trachea and esophagus arise from the same germ layer which makes it common for a birth anomaly such as fistula to occur between them. Which germ layer it arises from? A. Ectoderm B. Mesoderm C. Endoderm D. Epidermis 19. Krizzia, a pregnant client, is currently working in a company. She tells the nurse that she has to work because her husband’s income is not enough to sustain their everyday needs. She asks the nurse how she can prevent fetal teratogens. A. Avoid any room where smoker gathers B. Refrain from drinking alcohol C. Ask employer for a statement on hazardous substances at work site D. AOTA SCENARIO: There is a 1.47% increase of population in the Philippines in 2022. Family Planning Health program was held in a hospital where topics about contraceptives is discussed. Nurse Totimar is on duty and she encountered the following questions: 20. Jana went to the clinic and confirmed with the nurse about the use of diaphragm. She should be instructed to leave it in place after coitus for at least how many hours? A. 1 hour B. 6 hours C. 12 hours D. 24 hours 21. A 38 year old female, with 4 children, came to the clinic and inquired about her options for contraception methods. She also stated that she smokes a pack of cigarettes a day. The nurse advised her to avoid: A. Oral contraceptives B. IUD C. Cervical cap D. Diaphragm 22. Carla, a 19-year-old working student, was trembling. She told the nurse she forgot to take her prescribed active contraceptive pills for two consecutive days. She started crying and asked the nurse what to do. The nurse should instruct: A. Ignore it, take one now and use other contraceptive such as spermicide for a month B. Take two pills now then continue tomorrow with your usual schedule C. Throw out the rest of the pack and start a new pack of pills D. Let’s inform the physician. 23. Carol consults the nurse because her 16-year-old daughter asks her how she can avoid the pressure of unwanted sex? The nurse should not suggests: A. Tell the daughter to discuss it with her partner which sexual activities will permit or not B. Be certain that her partner understands that when she say “NO”, she means it C. Avoid being in a high-pressure situations such as a party with known drug use D. Tell her daughter that accepting drugs is fine if she is with her close friends 24. The nurse is teaching the client about a natural family planning method which is the basal body temperature method. The woman does not need any further teaching when she states that: A. “Sa araw ng ovulation ko ay tataas ng 1°C ang temperature ko” B. “Iche-check ko ang temperature ko sa umaga pagkatapos ko mag exercise” C. “Kapag bumaba po ang temperature ko tapos kinabukasan biglang tumaas, dapat hindi ako makipagtalik hanggang dalawang araw pagkatapos ito tumaas” D. “Kapag paiba-iba ang oras ng gising ko, makakaapekto ito sa BBT method” 25. The mucus of the uterine cervix changes in structure and consistency each month during a menstrual cycle. Which assessment of cervical mucus suggests that the woman is about to ovulate? I. Scant cervical mucus II. (+) Spinnbarkeit III. Highly viscous cervical mucus IV. (+) Ferning A. i, ii, iii, iv B. ii, iii, iv C. i, ii, iv D. ii, iv SCENARIO: Nurse Lilian is working in Guimaras Primary Health Care where routine laboratory tests is done for pregnant client. She knows that Routine laboratory tests are performed to identify conditions that may increase the probability of complications during pregnancy. The following questions apply: 26. Maryrose, a 22-week pregnant client, is scheduled for an amniocentesis. Which of the following nursing instructions should be given to the client? A. Position the patient in a sitting position to better access the fluid B. Void immediately before the procedure C. Drink 2-3 full glasses of water prior to the amniocentesis and void after the procedure D. X-ray will be used to guide the procedure 27. Judy, a 23-year old primigravida is scheduled for an alpha- fetoprotein test. She asks the nurse for the indication of the test and what the medical professional is trying to detect. The nurse correctly answers: A. Kidney defects B. Respiratory Defects C. Cardiac Defects D. Chromosomal Defects 28. Judy, still being anxious, feels sorry and says it is her first time. She is curious on how AFP is being obtained? A. Cervical secretions B. Chorionic villi blood sample C. Maternal blood sample D. Abdominal ultrasound

4 | Page walking B. Bed Rest helps in conserving enough energy for the upcoming labor C. Bed Rest prevents premature labor from occurring D. Bed Rest helps in increasing amount of oxygen receive by the fetus 48. Regina, a 22-year-old gravid client, told the nurse her concern and said “Napapansin ko po na parang napapadalas ang pagbabara ang ilong ko. Wala naman po akong allergy”. The nurse knows that it is due to: A. Increased progesterone levels B. Increased estrogen levels C. Increased hCG levels D. Increased testosterone levels 49. It is noted in Regina’s assessment that she is having a mild feeling of shortness of breath. The nurse’s recalls in her maternal and child nursing class that it is due to the diaphragm being displaced by increasing size of the uterus. The following are the respiratory changes during pregnancy except: A. Vital capacity does not decrease and has no change during pregnancy B. Gravid client develops chronic respiratory alkalosis fully compensated by a chronic metabolic acidosis C. Tidal volume is increased up to 40% as a woman draws in deeper breaths D. Residual volume is increased up to 20% because of the pressure from the diaphragm 50. Luna, a 9th week pregnant client, is experiencing morning sickness. All of the following is related to the normal nausea and vomiting in early pregnancy. Which is not included? I. Due to Increasing hCG levels II. Due to decreasing glucose levels being used by growing fetus III. It usually subsides after the first 3 trimester IV. Eating a snack before bedtime may help in preventing nausea V. Notify physician if vomits more than once daily A. i, ii, v B. i only C. i, ii, iii, iv, v D. i, ii, iv, v 51. Marga’s pre-pregnancy weight is 68 kilograms and she is 5 ’4’’ in height. She is advised to gain how much additional weight in her pregnancy? A. 25 - 35 lbs B. 15 - 25 lbs C. 28 - 40 lbs D. 25 - 42 lbs 52. Genesis went together with her BFF, Cassy, who is also pregnant with a pre-pregnancy weight of 121 lbs with 5’7 in height. In Cassy’s case, she is to gain weight how much additional weight, as advised, in her pregnancy? A. 25 - 35 lbs B. 15 - 25 lbs C. 28 - 40 lbs D. 25 - 42 lbs 53. Marga asks if she is taking enough vitamins for the growth and health of her baby and raised a concern about folic acid. The Recommended amounts of folic acid daily to be taken during pregnancy is? A. 0.4 mg daily B. 40 µg daily C. 400 mg daily D. 4 g daily 54. Marga is concerned about her weight and how she will be able to achieve the recommended gain in her entire pregnancy. She asks the nurse about nutrition advice. The nurse should include: A. Obtain simple carbohydrates because it is easily digestible B. Consume sugar substitutes to maintain glucose levels C. Consume less than 1,500 calories per day to help regulate the weight gain D. Advise to consume protein-rich foods 55. Lisa is communicating about the nutrition of the pregnant woman. She wants to gather information that will give the most accurate nutrition history about the patient. She will ask: A. How do you feel after you eat in each meal? B. What foods should you include in an ideal food plate? C. Can you tell me what you ate yesterday? D. In your opinion, are you eating nutritious food? How do you say so? 56. The patient is taking prescribed oral iron supplements religiously. She was informed that it contributes to her constipation. The nurse advised the pregnant client to: A. Use mineral oil to relieve constipation B. Enemas can be done because it is natural. It only uses water C. Docusate sodium may be taken if dietary measures fail D. Dulcolax may be taken if regular bowel evacuation fail 57. Nutrition must always form part of the health education for all pregnant mothers. When counseling a pregnant woman about nutrition, nurse Nicole makes sure to: A. Recommend that she weighs herself once a week B. Tell her to eat double the amount of food that she takes before her pregnancy C. Inform her that only very anemic women need iron/folate supplements D. Ask per participating mothers what they eat in a day to determine if her diet is adequate 58. Four babies are in the newborn nursery. The nurse that is at highest risk for developing cold stress syndrome is? A. Infant with Rh incompatibility B. Infant with neural tube defect C. Infant born with diabetic mother D. Infant born after 41st week of pregnancy 59. As the nurse is assessing the newborn with a high risk. What of the following assessment would lead the nurse to suspect cold stress syndrome? A. Erythema toxicum B. Acyocyanosis C. Blood glucose of 50mg/dL 60. Another neonate, Lucy, born at 28 weeks of gestation, develops respiratory distress syndrome. The doctor prescribed surfactant immediately after birth. The nurse knows it is administered: A. Intravenous B. Intramuscular C. Endotracheally D. Orally 61. Oxygen administration is necessary for Lucy to maintain the correct PO2 and pH levels following surfactant administration. However, a possible complication of oxygen therapy in neonate like Lucy, since she is a preterm baby is: A. Bronchopulmonary dysplasia B. Cystic Fibrosis C. Laryngomalacia D. Croup 62. The nurse heard about the news of increasing hazing in brotherhood, fraternity or sorority. The law that prohibits this is: A. RA 7610 B. RA 10630 C. RA 11053 D. RA 10354 Situation: A current initiative of the Department of Health (DOH) is the program called essential intrapartal Newborn (EINC). This provides meaningful measures to be undertaken by healthcare professionals in doing immediate intrapartal maternal care and newborn care management and the following condition apply. 63. Nurse Nicole is a member of the birthing team when Michelle gave birth to her first born. Inside the delivery room Nicole assisted the attending obstetrician. To address the concerns of keeping the baby warm, her first step in obtaining thermal protection for the newborn is to. A. Dry the baby thoroughly after the cord has been cut B. Dry the baby thoroughly immediately after giving birth C. Cover the baby with a clean, dry cloth after the cord has been cut D. Cover the baby with clean, dry cloth, immediately after birth 64. After providing necessary drying and warmth and support to the newborn. Nurse Michelle observed other details as

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