NUR 106 Module A Practice Questions

1 Amenorrhea 2 Breast changes 3 Urinary frequency

A client in her 10th week of pregnancy exhibits presumptive signs of pregnancy. Which clinical findings may the nurse determine upon assessment? Amenorrhea Breast changes Urinary frequency Abdominal enlargement Positive urine pregnancy test

quickening (fetal movement)

On a routine prenatal visit, what is the sign or symptom that a healthy primigravida at 20 weeks' gestation will most likely report for the first time? Quickening Palpitations Pedal edema Vaginal spotting

Shortness of breath on exertion Shortness of breath on exertion is an expected cardiopulmonary adaptation during pregnancy caused by an increased ventricular rate and elevated diaphragm. Tachycardia, dyspnea at rest, and progressive dependent edema are pathologic signs of impending cardiac decompensation.

The nurse is assessing a pregnant client during the third trimester. Which clinical finding is expected in the later stages of pregnancy? Tachycardia Dyspnea at rest Progressive dependent edema Shortness of breath on exertion

audible fetal heartbeat The presence of the fetal heartbeat is a positive sign of pregnancy. The feeling of movement is a presumptive sign of pregnancy. An enlarged abdomen is a probable sign of pregnancy. The bluish color of the cervix (Chadwick sign) is caused by pelvic congestion and edema; it is a probable sign of pregnancy.

The nurse is obtaining the health history of a woman who is visiting the prenatal clinic for the first time. She states that she is 5 months pregnant. Which positive sign of pregnancy should the nurse evaluate in this client?

G4, T1, P1, A1, L3 Four pregnancies = G (gravida) 4. One pregnancy that ended at 38 weeks = T (term) 1. One pregnancy that ended at 32 weeks = P (preterm) 1. One pregnancy that ended at 18 weeks = A (abortion) 1. One set of twins and a singleton = L (living) 3.

Using the five-digit system, determine the obstetric history in this situation: The client is 38 weeks into her fourth pregnancy. Her third pregnancy, a twin gestation, ended at 32 weeks with a live birth, her second pregnancy ended at 38 weeks with a live birth, and her first pregnancy ended at 18 weeks. G4, T2, P1, A1, L2 G4, T1, P2, A1, L1 G4, T1, P1, A1, L3 G4, T2, P1, A1, L1

No greater chance than any other

A client visiting the prenatal clinic for the first time asks the nurse about the probability of having twins because her husband is one of a pair of fraternal twins. What is the appropriate response by the nurse?

Drink water until bladder is full A full bladder raises the uterus above the pelvis, providing better visualization of its contents. It is not necessary to arrive for the test with an empty stomach. The bladder should not be emptied until after the test. It is not necessary to evacuate the bowels before the test.

A 40-year-old primigravida is scheduled to have her first abdominal ultrasound. What should the nurse's instructions include? Postponing breakfast until after the test Drink water until bladder is full Emptying the bladder immediately before the test Inserting a suppository after arising on the day of the test

Emesis, Nausea, Backache, Dyspepsia Maternal discomforts during pregnancy that are associated with fetal growth and hormonal changes include emesis (vomiting), nausea, backache, and dyspepsia (heartburn). Constipation, not diarrhea, is an expected maternal discomfort caused by fetal growth and hormonal changes.

Which topics should the nurse include in the teaching session for a pregnant client regarding maternal discomforts caused by fetal growth and hormonal changes? Emesis Nausea Diarrhea Backache Dyspepsia

On the 21st day of the cycle Ovulation usually occurs 14 days before menses; in a 35-day cycle, ovulation may occur as late as the 21st day. Day 12 of the cycle is the proliferative phase; ovulation has not yet occurred. If the woman had a 28-day cycle, ovulation is expected on the 14th day of the cycle. By the 25th day of the cycle, the ovum in this woman has passed out of the fallopian tube and can no longer be fertilized.

A 30-year-old client with a 35-day menstrual cycle is trying to become pregnant. The nurse counsels the client and her partner about the optimal timing of intercourse during the cycle. The nurse determines that the counseling has been effective when the couple state that they should have intercourse when? On the 12th day of the cycle On the 14th day of the cycle On the 21st day of the cycle On the 25th day of the cycle

"Avoid drugs and don't smoke or drink alcohol."

What is the best advice a nurse can provide to a pregnant woman in her first trimester? "Cut down on drugs, alcohol, and cigarettes." "Avoid drugs and don't smoke or drink alcohol." "Avoid smoking, limit alcohol consumption, and don't take aspirin." "Take only prescription drugs, especially in the second and third trimesters."

G5 T1 P1 A2 L2. G (gravida) stands for the total number of pregnancies a client has had. Gravida 5 indicates that this is the client's fifth pregnancy. T (term) stands for the number of neonates born at the expected date of birth. The neonate born at 38 weeks' gestation was born at term.

A pregnant client arrives at the prenatal clinic, and the nurse obtains her obstetrical history. The client has two children at home, one born at 38 weeks' gestation and the second born at 34 weeks' gestation. She has also had one miscarriage, at 18 weeks, and an elective abortion. Using the GTPAL system, what is the client's obstetrical record?

Doppler ultrasound at 10 to 12 weeks A fetal heartbeat can be obtained at 10 to 12 weeks with electronic Doppler ultrasound. The heartbeat cannot be obtained with a stethoscope, and 4 weeks is too early to hear a fetal heart. A fetoscope cannot pick up the heartbeat until the 17th week. The heart rate can be detected 8 to 10 weeks earlier than 20 weeks.

A primigravida asks when she will be able to hear the fetal heartbeat for the first time. The nurse should explain that the heartbeat can be heard with what? A stethoscope at 4 weeks A fetoscope at 10 to 12 weeks Doppler ultrasound after 20 weeks Doppler ultrasound at 10 to 12 weeks

"Development occurs in a head-to-toe and central-to-peripheral pattern." "Pregnancy includes the preembryonic, embryonic, and fetal stages of development." "Pregnancy includes the preembryonic, embryonic, and fetal stages of development." Information the nurse should include in a teaching session regarding fetal growth and development during pregnancy includes that development occurs in a head-to-toe (cephalocaudal) and central-to-peripheral (proximal-distal) pattern; the three stages of pregnancy include the preembryonic, embryonic, and fetal stages of development; and the embryo grows from a single cell to a complex physiologic being. While all major organs do develop during pregnancy not all function prior to birth. The embryonic, not the fetal, stage of development is most vulnerable to teratogenic influences.

Which statements should the nurse include in a teaching session for pregnant couples regarding fetal growth and development? "All major organs are developed and function prior to birth." "Development occurs in a head-to-toe and central-to-peripheral pattern." "The fetal stage of development is most vulnerable to teratogenic influences." "Pregnancy includes the preembryonic, embryonic, and fetal stages of development." "Pregnancy includes the preembryonic, embryonic, and fetal stages of development."

Longer gastrointestinal emptying time Gastrointestinal motility is reduced during pregnancy because of the high level of placental progesterone and displacement of the stomach superiorly and the intestines laterally and posteriorly; absorption of some drugs, vitamins, and minerals may be increased because of their slow passage through the gastrointestinal tract. The glomerular filtration rate increases during pregnancy. The amount of gastric secretion is somewhat lower in the first and second trimesters; it increases in the third trimester. The development of fetal-placental circulation is unrelated to the absorption of drugs.

A client starting her second trimester asks a nurse in the prenatal clinic whether she can safely take an over-the-counter medicine. The nurse explains why she should consult with her primary healthcare provider before taking any oral medications. What physiologic alteration associated with pregnancy may change the client's response to medication? Decreased glomerular filtration rate Longer gastrointestinal emptying time Increased secretion of hydrochloric acid Development of fetal-placental circulation

Cardiac output increases. Blood pressure decreases. The heart is displaced upward. Cardiac output increases during the second trimester due to an increasing plasma volume. The blood pressure decreases because of the enlarged intravascular compartment and hormonal effects on peripheral resistance. As the fetus grows and the enlarging uterus outgrows the pelvic cavity, it displaces the heart upward and to the left. The blood volume starts to increase earlier, but does not peak until the third trimester. The reduction in hematocrit occurs in the first trimester; the erythrocyte increase may not be in direct proportion to the blood volume, lowering hematocrit and hemoglobin levels, which remain lower throughout pregnancy.

A nurse is teaching a prenatal class regarding the physiologic alterations that occur during the second trimester of pregnancy. What cardiovascular changes should the nurse include? Cardiac output increases. Blood pressure decreases. The heart is displaced upward. The blood plasma volume peaks. The hematocrit level is lowered.

G5 T2 P1 A1 L4

A pregnant client is making her first antepartum visit. She has a 2-year-old son born at 40 weeks, a 5-year-old daughter born at 38 weeks, and 7-year-old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. How does the nurse, using the GTPAL format, document the client's obstetric history? G4 T3 P2 A1 L4 G5 T2 P2 A1 L4 G5 T2 P1 A1 L4 G4 T3 P1 A1 L4

Even with the umbilicus Around the 22nd week of gestation the top of the fundus is at the level of the umbilicus. Just above the symphysis pubis is too low for a pregnancy between the fifth and sixth months of gestation. Two fingerbreadths above the umbilicus is too high for 20 to 22 weeks' gestation. Halfway between the symphysis pubis and umbilicus is too low for a pregnancy between the fifth and sixth months of gestation.

A pregnant client's last menstrual period was on February 11. A physical assessment on July 18 should reveal the top of the fundus to be where? <p>A pregnant client's last menstrual period was on February 11. A physical assessment on July 18 should reveal the top of the fundus to be where? Even with the umbilicus Just above the symphysis pubis Two fingerbreadths above the umbilicus Halfway between the symphysis and umbilicus

Rubella titer less than 1:8 (nonimmune) The rubella titer is very low, indicating that the client does not have adequate antibodies against rubella and is susceptible. The client will need a rubella vaccine after the pregnancy ends. This early in pregnancy, a fetoscope may not pick up fetal heart tones, although a Doppler or ultrasonic fetoscope may. A hemoglobin reading of 11 g/dL and a hematocrit of 31% indicate probable pseudoanemia, a common finding in early pregnancy. Because both parents are Rh negative, the mother will not need Rh immune globulin at 28 weeks or at the end of pregnancy.

A woman arrives for an appointment at an obstetrics clinic. During the visit the nurse records the following information. Which finding indicates a need for future intervention? History: Age 23 years Gravida 1, Para 0 Last menstrual period 7 weeks ago Physical Findings: Uterine enlargement consistent with first trimester pregnancy Chadwick's sign positive Goodell's sign positive No fetal heartbeat with fetoscope Vitals: Temp: 98.4F Pulse: 92 beats/min Resp: 26 breaths/min blood pressure: 112/74 Lab: Pregnancy test positive hemoglobin 11 hematocrit 31 blood type A-, father O- Rubella titer <1:8(non-immune); Rubella titer less than 1:8 (nonimmune) No fetal heartbeat heard with fetoscope Hemoglobin 11 g/dL, hematocrit 31% Maternal blood type A-negative, father O-negative

Three vessels: one vein and two arteries The umbilical cord contains three vessels; one vein carries oxygenated blood to the fetus, and two arteries return deoxygenated blood to the placenta. A cord with two vessels may be associated with congenital abnormalities. If an infant has four vessels: two veins and two arteries, the infant has a cord anomaly.

During a newborn assessment the nurse counts the infant's cord vessels. What does the nurse expect to observe in a healthy newborn? two vessels: one vein and one artery Three vessels: two veins and one artery Four vessels: two veins and two arteries Three vessels: one vein and two arteries

Although obese, the client must gain some weight to meet the fetus's nutritional needs, and a 2-lb (0.91 kg) weight gain is appropriate. Weight loss is contraindicated during pregnancy because it may interfere with fetal growth and development. Maintaining the same weight from last month to this month may indicate that the nutritional needs of the fetus are not being met. The client's statement that she lost weight last week does not constitute objective data.

During her first visit to the prenatal clinic a client is found to be obese. During the ensuing 5 months, the client has been unsuccessful in adhering to her nutritional plan. Which finding indicates to the nurse that the client has been successful during the sixth month? Weight loss of 1 lb (0.45 kg) Weight gain of 2 lb (0.91 kg) No change in weight from last month The client's statement that she lost weight last week

Preterm labor Multiple gestation Chromosomal anomalies Bleeding in the first trimester Increased risk for preterm labor is linked to age; it occurs more commonly in older primigravidas and adolescents. Mature women have an increased incidence of multiple gestations as a result of fertility drug use and in vitro fertilization. After 35 years of age, mature women have an increased risk of having children with chromosomal abnormalities. Bleeding in the first trimester as a result of spontaneous abortion is more common in mature gravidas. Seizures are not more common in mature gravidas.

Women who become pregnant for the first time at a later reproductive age (35 years or older) are at risk for which complications? Seizures Preterm labor Multiple gestation Chromosomal anomalies Bleeding in the first trimester

1 Smoker 2 Twin gestation Smokers generally have a nutrient-poor diet and are at risk for continuing the same diet through pregnancy. Multifetal pregnancies require nutrition above the normal requirements for pregnancy. A hemoglobin reading of 12 g/dL and fasting blood sugar of 80 mg/dL are normal values. Caffeine intake of 180 mg/day is less than the daily recommended intake.

What are the indicators of nutritional risk in pregnancy in a client who is of normal weight? Smoker Twin gestation Hemoglobin of 12 g/dL (120 mmol/L) Term delivery 2 years ago Caffeine intake of 180 mg/day Fasting blood sugar of 80 mg/dL (4.4 mmol/L)

Anemia Poor maternal weight gain pregnancy-induced hypertension Medical concerns in adolescent pregnancies include maternal anemia, poor weight gain, and pregnancy-induced hypertension. Adolescents often receive delayed or inadequate prenatal care, increasing the risk of a low-birthweight infant, not an obese one. Pregnancy-induced diabetes is a risk factor associated with pregnancies involving maternal obesity and maternal age greater than 25 years.

What are the medical concerns in adolescent pregnancies? Anemia Fetal obesity Poor maternal weight gain Pregnancy-induced diabetes Pregnancy-induced hypertension