Chapter 12: Nursing Management During Pregnancy (Chapter Worksheet)

Which of the following is not true about breast-feeding? a. Breast-fed infants experience more obesity and allergies b. Breast milk is perfectly suited to the infant's nutritional needs c. Breast milk contains maternal antibodies to stimulate infant's immunity d. Breast-feeding enhances maternal bonding and attachment

a. Breast-fed infants experience more obesity and allergies because based on research, breast-feeding prevents childhood and adult obesity and infants who are breast-fed experience fewer allergies versus those that are bottle-fed. Responses "B," "C," and "D" are all true statement about breast-feeding. These responses represent the advantages of breast-feeding.

Which of the following would be considered risk factors for psychologic well-being in pregnancy? Select all that apply: a. Limited support system and network of friends and family b. Introverted personality at any point in the pregnancy c. Ambivalence any time during the pregnancy d. High levels of stress due to family discord e. History of previous high-risk pregnancy with complications f. Depression prior to pregnancy and on medication

a. Limited support system and network of friends and family d. High levels of stress due to family discord e. History of previous high-risk pregnancy with complications f. Depression prior to pregnancy and on medication because all of these factors will influence the pregnancy outcome in a negative way and the ability to cope with them might become challenging. These factors would be "red flags" in a client's history and counseling and education might be needed during this pregnancy. Responses "B" and "C" are both normal emotions that are universally experienced by most pregnant women. They would not indicate a problem.

The nurse is preparing her teaching plan for a woman who has just had her pregnancy confirmed. Which of the following should be included in it? Select all that apply. a. Prevent constipation by taking a daily laxative b. Balance your dietary intake by increasing your calories by 300 daily c. Continue your daily walking routine just as you did before this pregnancy d. Tetanus, measles, mumps, and rubella vaccines will be given to you now e. Avoid tub baths now that you are pregnant to prevent vaginal infections f. Sexual activity is permitted as long as your membranes are intact g. Increase your consumption of milk to meet your iron needs

b. Balance your dietary intake by increasing your calories by 300 daily c. Continue your daily walking routine just as you did before this pregnancy e. Avoid tub baths now that you are pregnant to prevent vaginal infections f. Sexual activity is permitted as long as your membranes are intact all of these are sound recommendations for a healthy pregnancy. Pregnant women are to avoid taking medications so the nurse would not recommend a daily laxative. Increasing fluids, exercise and fiber in the diet are better choices to prevent constipation. The vaccinations shown are contraindicated for pregnant women by the CDC. Adverse outcomes could result if given while pregnant. Milk does not provide a good source of iron. Typically, iron and folic acid are supplemented in prenatal vitamins and good food sources to prevent anemia include meats, cereals, cooked beans, spinach, broccoli, and wheat germ.

The nurse teaches the pregnant client how to perform Kegel exercises as a way to accomplish which of the following? a. Prevent perineal lacerations b. Stimulate labor contractions c. Increase pelvic muscle tone d. Lose pregnancy weight quickly

c. Increase pelvic muscle tone Kegel exercises help to tighten and strengthen pelvic floor muscles to improve tone. They can help prevent stress incontinence in women after childbirth. These exercises don't strengthen the perineal area on the outside to prevent lacerations, but rather the internal pelvic floor muscles. Kegel exercises have nothing to do with the start of labor for postdate infants. A drop in progesterone levels and an increase in prostaglandins, not exercise, augment labor. Kegel exercises don't burn calories.

Which of the following biophysical profile findings indicate poor oxygenation to the fetus? a. Two pockets of amniotic fluid b. Well-flexed arms and legs c. Nonreactive fetal heart rate d. Fetal breathing movements noted

c. Nonreactive fetal heart rate A nonreactive fetal heart rate is one of the biophysical profile findings that indicate poor oxygenation to the fetus.

During a clinic visit, a pregnant client at 30 weeks' gestation tells the nurse, "I've had some mild cramps that are pretty irregular. What does this mean?" The cramps are probably: a. The beginning of labor in the very early stages b. An ominous finding indicating that the client is about to have a miscarriage c. Related to over hydration of the woman d. Braxton Hicks contractions, which occur throughout pregnancy

d. Braxton Hicks contractions, which occur throughout pregnancy The uterus is constantly contracting throughout pregnancy, but the contractions are irregular and not usually felt by the woman, nor do they cause dilation of the cervix. Braxton Hicks contractions are not the start of early labor, since there aren't any measurable cervical changes. They are normal throughout the pregnancy, not an ominous sign of an impending abortion. A woman's hydration status is not related to Braxton Hicks contractions; they occur regardless of her fluid status.

A pregnant client's last normal menstrual period was on August 10. Using Nagele rule, the nurse calculates that her estimated due date (EDD) will be which of the following? a. June 23 b. July 10 c. July 30 d. May 17

d. May 17 Using Nagele rule, 3 months are subtracted and 7 days are added, plus 1 year from the date of the last menstrual period.

Practicing good oral hygiene is important for all women throughout their pregnancy. As a nurse providing anticipatory guidance for pregnant women, what condition can result from periodontal disease if good dental care isn't practiced? a. Post-dates pregnancy b. Large for gestational age infant c. Advanced reproductive cancer d. Preterm or low-birth-weight infant

d. Preterm or low-birth-weight infant because infections within the mouth caused by poor oral hygiene spread into the maternal circulatory system and cross into the fetal circulation which inhibits growth and development of the fetus. Their uterine environment is compromised and early birth is a risk. Response "A" is incorrect due to maternal infections which tend to create a hostile environment resulting in an early birth, not a prolonged gestation. Response "B" is incorrect because just the opposite happens with the fetal growth becoming compromised due to infections. Response "C" is incorrect because research has not established an association between periodontal disease and the etiology of any reproductive cancer yet.

Anticipatory guidance regarding sexual activity during pregnancy includes which of the following? Select all that apply: a. Sexual activity is contraindicated throughout pregnancy b. Most women don't desire intimacy after the first trimester c. Sexual activity may continue up until the end of the second trimester d. Sexual intercourse is prohibited if a history of preterm labor exists e. Women's sexual desire may change throughout the pregnancy f. Couples can try a variety of positions of comfort during pregnancy

e. Women's sexual desire may change throughout the pregnancy f. Couples can try a variety of positions of comfort during pregnancy since sexual desire changes throughout pregnancy based on hormones, energy levels, relationship, body image, fears of hurting the fetus, and cultural beliefs. Various positions of comfort for the woman are usually tried for most couples desiring intimacy. Responses "A" through "D" are incorrect because unless there is a medical reason why sexual intercourse isn't permitted, sexual activity may be continued throughout a healthy pregnancy.