NURS 326 Exam #1

What is the approximate time that the blastocyst spends traveling to the uterus for implantation? A. 2 days B. 7 days C. 12 days D. 14 weeks

B. 7 days

Nutritional planning for a newly pregnant woman of average height and weighing 145 pounds should include: A. A decrease of 200 calories a day. B. An increase of 300 calories a day. C. An increase of 500 calories a day. D. A maintenance of her present caloric intake per day.

B. An increase of 300 calories a day.

The developing cells are called a fetus from the: A. Time the fetal heart is heard B. Eighth week to the time of birth. C. Implantation of the fertilized ovum. D. End of the send week to the onset of labor.

B. Eighth week to the time of birth.

A nurse is performing an assessment of a primipara who is being evaluated in a clinic during her second trimester of pregnancy. Which of the following indicates an abnormal physical finding necessitating further testing? A. Consistent increase in fundal height B. Fetal heart rate of 180 BPM C. Braxton Hicks contractions D. Quickening

B. Fetal heart rate of 180 BPM

A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this patient? A. Knowledge deficit B. Fluid volume deficit C. Anticipatory grieving D. Pain

B. Fluid volume deficit

At a prenatal visit at 36 weeks' gestation, a client complains of discomfort with irregularly occurring contractions. The nurse instructs the client to: A. Lie down until they stop. B. Walk around until they subside. C. Time contraction for 30 minutes. D. Take 10 grains of aspirin for the discomfort.

B. Walk around until they subside.

A prenatal nurse is providing instructions to a group of pregnant clients regarding measures to prevent toxoplasmosis. Which statement if made by one of the clients indicates a need for further instructions? A. "I need to cook meat thoroughly." B. "I need to avoid touching mucous membranes of the mouth or eyes while handling raw meat." C. "I need to drink unpasteurized milk only." D. "I need to avoid contact with materials that are possibly contaminated with cat feces."

C. "I need to drink unpasteurized milk only."

A client who is 36 weeks pregnant comes to the clinic for a prenatal checkup. To assess the client's preparation for parenting, the nurse might ask which question? A. "Are you planning to have epidural anesthesia?" B. "Have you begun prenatal classes?" C. "What changes have you made at home to get ready for the baby?" D. "Can you tell me about the meals you typically eat each day?"

C. "What changes have you made at home to get ready for the baby?"

During a prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that the fetal heart rate is normal if which of the following is noted? A. 80 BPM B. 100 BPM C. 150 BPM D. 180 BPM

C. 150 BPM Rationale: Fetal heart rate should be in the 120-160 bpm range

Which of the following assessment findings would the nurse expect if the client develops DVT? A. Mid Calf pain, tenderness, and redness along the vein. B. Chills, fever, malaise, occurring 2 weeks after delivery. C. Muscle pain, the presence of Homans sign, and swelling in the affected limb. D. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery.

C. Muscle pain, the presence of Homans sign, and swelling in the affected limb.

Which of the following conditions is common in pregnant women in the 2nd trimester of pregnancy? A. Mastitis B. Metabolic alkalosis C. Physiologic anemia D. Respiratory acidosis

C. Physiologic anemia

The chief function of progesterone is the: A. Development of the female reproductive system. B. Stimulation of the follicles for ovulation to occur. C. Preparation of the uterus to receive a fertilized egg. D. Establishment of secondary male sex characteristics.

C. Preparation of the uterus to receive a fertilized egg.

When talking with a pregnant client who is experiencing aching swollen leg veins, the nurse would explain that this is most probably the result of which of the following? A. Thrombophlebitis B. Pregnancy-induced hypertension C. Pressure on blood vessels from the enlarging uterus D. The force of gravity pulling down on the uterus

C. Pressure on blood vessels from the enlarging uterus

A pregnant client states that she "waddles" when she walks. The nurse's explanation is based on which of the following is the cause? A. The large size of the newborn. B. Pressure on the pelvic muscles. C. Relaxation of the pelvic joints. D. Excessive weight gain.

C. Relaxation of the pelvic joints.

Which of the following would the nurse use as the basis for the teaching plan when caring for a pregnant teenager concerned about gaining too much weight during pregnancy? A. 10 pounds per trimester. B. 1 pound per week for 40 weeks. C. ½ pound per week for 40 weeks. D. A total gain of 25 to 30 pounds.

D. A total gain of 25 to 30 pounds.

In which of the following areas would the nurse expect to observe chloasma? A. Breast, areola, and nipples B. Chest, neck, arms, and legs C. Abdomen, breast, and thighs D. Cheeks, forehead, and nose

D. Cheeks, forehead, and nose

A nurse-midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? A. Auscultating for fetal heart sounds. B. Palpating the abdomen for fetal movement. C. Assessing the cervix for thinning. D. Initiating a gentle upward tap on the cervix.

D. Initiating a gentle upward tap on the cervix.

Which of the following danger signs should be reported promptly during the antepartum period? A. Constipation B. Breast tenderness C. Nasal stuffiness D. Leaking amniotic fluid

D. Leaking amniotic fluid

A pregnant woman at 32 weeks' gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to: A. Assess the woman's blood pressure and pulse. B. Have the woman breathe into a paper bag. C. Raise the woman's legs. D. Turn the woman on her left side.

D. Turn the woman on her left side.

A nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. The nurse tells the client to: A. Avoid wearing a bra. B. Wash the nipples and areola area daily with soap and massage the breasts with lotion. C. Wear tight-fitting blouses or dresses to provide support. D. Wash the breasts with warm water and keep them dry.

D. Wash the breasts with warm water and keep them dry.

An expectant couple asks the nurse about intercourse during pregnancy and whether it is safe for the baby. How should the nurse respond? a. Intercourse is safe until the third trimester. b. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present. c. Safer-sex practices should be used once the membranes rupture. d. Intercourse should be avoided if any spotting from the vagina occurs afterward.

b. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.

In counseling a pregnant patient on nutrition the nurse knows the following is true regarding nutrition and pregnancy. a. Normal weight gain for a pregnant patient is between 15 to 30 pounds. b. Most nutrients should derive from complex carbohydrates. c. Teens are most likely to gain too much weight during pregnancy. d. The pregnant patient should be advised they are eating for 2 and should double their calories.

b. Most nutrients should derive from complex carbohydrates.

Increased levels of estrogen lead to increased vascularity and congestion in the nasal tissues. As a result pregnant patient often complain of what symptom? a. Runny nose b. Nasal stuffiness and epistaxis c. Decreased smell d. Itchy, red nose

b. Nasal stuffiness and epistaxis

Which of the following statement about ovulation is true? a. The timing of ovulation varies among women and may occur days before the start of menstrual flow. b. Once released the ovum is only viable for 24 hours. c. Ovulation marks the start of the follicular phase

b. Once released the ovum is only viable for 24 hours.

With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that during pregnancy: a. The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester. b. Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus. c. Killed-virus vaccines (e.g., tetanus) should not be given, but live-virus vaccines (e.g., measles) are permissible. d. No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.

b. Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.

A nurse is reviewing physical activity pattern for a pregnant woman who reports that she is still playing tennis at 32 weeks of gestation. Which recommendation would be most important relative to nutritonal requirements for an active pregnant woman who exercises? a. Extra protein sources, such as peanut butter b. Several glasses of fluid c. Easily digested sources of carbohydrate d. Salty foods to replace lost sodium

b. Several glasses of fluid

A maternity nurse is working with a father of a pregnant client to assist with acceptance of the pregnancy and preparation for childbirth. What should the nurse understand related to the father's role in pregnancy? a. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home. b. The father goes through three phases of acceptance of his own. c. Typically men remain ambivalent about fatherhood right up to the birth of their child. d. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth.

b. The father goes through three phases of acceptance of his own.

Braxton Hicks contractions are a ______ signs of pregnancy. a. presumptive b. probable c. positive

b. probable

Oxytocin increases as the fetus matures and may stimulate contractions during pregnancy. What hormone assists in preventing uterine contractions by simulating smooth muscle? a. relaxin b. progesterone c. estrogen d. LH

b. progesterone

A nurse is teaching a client who is 6 weeks gestation about common discomforts of pregnancy. Which of the following should the nurse include? a. Breast tenderness b. Urinary frequency c. Epistaxis d. Dysuria e. Epigastric pain

a, b, and c

A patient is currently pregnant. She had one elective abortion at 10 weeks gestation and one spontaneous abortion at 12 weeks gestation. How would you indicate this using the 5-digit system? a. 3-0-0-2-0 b. 1-0-0-2-0 c. 3-0-2-2-0 d. 3-0-0-2-1

a. 3-0-0-2-0

The nurse is recording a pregnant patient's obstetrical history using the 5 digit system. The patient has 3 children: history of a stillbirth at 36 weeks, twins delivered at 30 weeks gestation, a spontaneous abortion at 12 weeks, and a son delivered at 40 weeks. The nurse records the patient's OB history as which of the following? a. 5-1-2-1-3 b. 4-1-3-1-4 c. 3-1-3-1-4 d. 4-1-1-2-3

a. 5-1-2-1-3

Which statement is most accurate regarding persons who should participate in preconception counseling? a. All persons and their partners as they make decisions about their reproductive future, including becoming parents. b. Individuals older than 40 years of age who wish to become pregnant. c. Sexually active individuals who do not use birth control. d. Individuals with chronic illnesses such as diabetes who are planning to get pregnant.

a. All persons and their partners as they make decisions about their reproductive future, including becoming parents.

A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. Which intervention should the nurse implement? a. Discuss options with the couple, including amniocentesis to determine whether the fetus is affected. b. Refer the couple to a psychologist for emotional support. c. Tell the couple they need to have an abortion within 2 to 3 weeks. d. Explain that the fetus has a 50% chance of having the disorder.

a. Discuss options with the couple, including amniocentesis to determine whether the fetus is affected.

A nurse is reviewing nutritonal supplementation for pregnant women. Which minerals and vitamins should the nurse identify as being recommended? a. Iron and folate b. Fat-soluble vitamins A and D c. Calcium and zinc d. Water-soluble vitamins C and B6

a. Iron and folate

How would the nurse docuement a woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability? a. Primipara b. Multipara c. Nulligravida d. Primigravida

a. Primipara

Which ovarian hormone is responsible for the changes in the endometrium that occur after ovulation to facilitate implantation should fertilization occur? It is also responsible for the rise in temperature that occurs after ovulation. a. Progesterone b. Estrogen c. Luteinizing hormone d. Prostagladin

a. Progesterone

The first cell of the new individual is called a? a. Zygote b. Blastocyst c. Embryo d. Fetus

a. Zygote

Amenorrhea is a ______ sign of pregnancy. a. presumptive b. probable c. positive

a. presumptive

A nurse is reviewing the history of a woman who wants to become pregnant. Which medication profile would indicate to the nurse a potential concern relative to toxic exposure? (Select all that apply.) a. Tylenol OTC occasionally for a headache; twice last week b. Coumadin for atrial fibrillation c. Anticonvulsant for seizure disorder d. Multivitamins once a day e. Lithium for bipolar disorder

b, c, and e

A client who is at 8 weeks of gestation tells the RN that she isn't sure she is happy about being pregnant. Which of the following responses should the nurse make? a. "I will inform the provider that you are having these feelings" b. "It is normal to have these feelings during the first few months of pregnancy" c. "You should be happy that you are going to bring a new life into the world" d. "I am going to make you an appointment with a counselor so you can discuss these thoughts"

b. "It is normal to have these feelings during the first few months of pregnancy"

A group of student nurses are reviewing human chorionic gonadotropin (hCG) levels as it relates to pregnancy. Which finding if observed by the student nurses would indicate a potential problem? a. Expected peak between 60 and 70 days into the pregnancy b. Increased plasma levels in correlation to expected gestational age c. Increase in levels 7 to 8 days after implantation d. Decrease in plasma levels at the end of pregnancy

b. Increased plasma levels in correlation to expected gestational age

The nurse is caring for a primigravida at about 2 months and 1-week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says: A. "Nausea and vomiting can be decreased if I eat a few crackers before rising." B. "If I start to leak colostrum, I should cleanse my nipples with soap and water." C. "If I have a vaginal discharge, I should wear nylon underwear." D. "Leg cramps can be alleviated if I put an ice pack on the area."

A. "Nausea and vomiting can be decreased if I eat a few crackers before rising."

A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The physician has documented the presence of a Goodell's sign. The nurse determines this sign indicates: A. A softening of the cervix. B. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus. C. The presence of hCG in the urine. D. The presence of fetal movement.

A. A softening of the cervix.

In the 12th week of gestation, a client completely expels the products of conception. Because the client is Rh-negative, the nurse must: A. Administer RhoGAM within 72 hours. B. Make certain she receives RhoGAM on her first clinic visit. C. Not give RhoGAM, since it is not used with the birth of a stillborn. D. Make certain the client does not receive RhoGAM since the gestation only lasted 12 weeks.

A. Administer RhoGAM within 72 hours.

A 35 year patient is 30 weeks pregnant. They have 2 boys one born at 31 weeks and one born at 38 weeks. The patient also has 1 daughter born at 38 weeks and reports that they miscarried at 16 weeks. What is the patient's GTPAL?

5-2-1-1-3

Which of the following best describes preterm labor? A. Labor that begins after 20 weeks gestation and before 37 weeks gestation. B. Labor that begins after 15 weeks gestation and before 37 weeks gestation C. Labor that begins after 24 weeks gestation and before 28 weeks gestation. D. Labor that begins after 28 weeks gestation and before 40 weeks gestation.

A. Labor that begins after 20 weeks gestation and before 37 weeks gestation.

After the first four months of pregnancy, the chief source of estrogen and progesterone is the: A. Placenta B. Adrenal cortex C. Corpus luteum D. Anterior hypophysis

A. Placenta

The pituitary hormone that stimulates the secretion of milk from the mammary glands is: A. Prolactin B. Oxytocin C. Estrogen D. Progesterone

A. Prolactin

The nurse is counseling a couple who has sought information about conceiving. The couple asks the nurse to explain when ovulation usually occurs. Which statement by the nurse is correct? A. Two weeks before menstruation. B. Immediately after menstruation. C. Immediately before menstruation. D. Three weeks before menstruation.

A. Two weeks before menstruation.

Which of the following fundal heights indicates less than 12 weeks' gestation when the date of the LMP is unknown? A. Uterus in the pelvis B. Uterus at the xiphoid C. Uterus in the abdomen D. Uterus at the umbilicus

A. Uterus in the pelvis

A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Which of the following signs indicates a probable sign of pregnancy? Select all that apply. A. Uterine enlargement B. Fetal heart rate detected by nonelectric device C. Outline of the fetus via radiography or ultrasound D. Chadwick's sign E. Braxton Hicks contractions F. Ballottement

A, D, E, and F

A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education? A. "I will maintain strict bedrest throughout the remainder of the pregnancy." B. "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding." C. "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." D. "I will watch for the evidence of the passage of tissue."

A. "I will maintain strict bedrest throughout the remainder of the pregnancy."

A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for: A. Any bleeding, such as in the gums, petechiae, and purpura. B. Enlargement of the breasts. C. Periods of fetal movement followed by quiet periods. D. Complaints of feeling hot when the room is cool.

A. Any bleeding, such as in the gums, petechiae, and purpura.

Rho (D) immune globulin (RhoGAM) is prescribed for a woman following delivery of a newborn infant and the nurse provides information to the woman about the purpose of the medication. The nurse determines that the woman understands the purpose of the medication if the woman states that it will protect her next baby from which of the following? A. Being affected by Rh incompatibility. B. Having Rh-positive blood. C. Developing a rubella infection. D. Developing physiological jaundice.

A. Being affected by Rh incompatibility.

A patient is in her last trimester of pregnancy. Nurse Vickie should instruct her to notify her primary health care provider immediately if she notices: A. Blurred vision B. Hemorrhoids C. Increased vaginal mucus D. Shortness of breath on exertion

A. Blurred vision

A pregnant client calls the clinic and tells a nurse that she is experiencing leg cramps and is awakened by the cramps at night. To provide relief from the leg cramps, the nurse tells the client to: A. Dorsiflex the foot while extending the knee when the cramps occur. B. Dorsiflex the foot while flexing the knee when the cramps occur. C. Plantar flex the foot while flexing the knee when the cramps occur. D. Plantar flex the foot while extending the knee when the cramps occur.

A. Dorsiflex the foot while extending the knee when the cramps occur.

A nursing instructor is conducting a lecture and is reviewing the functions of the female reproductive system. She asks the student nurse to describe the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). The student nurse accurately responds by stating that: A. FSH and LH are released from the anterior pituitary gland. B. FSH and LH are secreted by the corpus luteum of the ovary C. FSH and LH are secreted by the adrenal glands D. FSH and LH stimulate the formation of milk during pregnancy.

A. FSH and LH are released from the anterior pituitary gland.

A pregnant woman's last menstrual period began on April 8, 2020, and ended on April 13. Using Naegele's rule her estimated date of birth would be: A. January 15, 2021 B. January 20, 2021 C. July 1, 2021 D. November 5, 2020

A. January 15, 2021

The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The nurse should tell the patient that she can expect to feel the fetus move at which time? A. Between 10 and 12 weeks' gestation B. Between 16 and 20 weeks' gestation. C. Between 21 and 23 weeks' gestation. D. Between 24 and 26 weeks' gestation.

B. Between 16 and 20 weeks' gestation.

In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the: A. Oxytocin is too high. B. Blood level of LH is too high. C. Progesterone level is high. D. Endometrial wall is sloughed off.

B. Blood level of LH is too high.

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child that was delivered at 37 weeks and tells the nurse that she doesn't have any history of abortion or fetal demise. The nurse would document the GTPAL for this client as: A. G = 3, T = 2, P = 0, A = 0, L =1 B. G = 2, T = 0, P = 1, A = 0, L =1 C. G = 1, T = 1. P = 1, A = 0, L = 1 D. G = 2, T = 0, P = 0, A = 0, L = 1

B. G = 2, T = 0, P = 1, A = 0, L =1

Gravida refers to which of the following descriptions? A. A serious pregnancy. B. Number of times a female has been pregnant. C. Number of children a female has delivered. D. Number of term pregnancies a female has had.

B. Number of times a female has been pregnant.

A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately tells the client that fetal circulation consists of: A. Two umbilical veins and one umbilical artery. B. Two umbilical arteries and one umbilical vein. C. Arteries carrying oxygenated blood to the fetus. D. Veins carrying deoxygenated blood to the fetus.

B. Two umbilical arteries and one umbilical vein.

A nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant client to describe the process of quickening. Which of the following statements if made by the student indicates an understanding of this term? A. "It is the irregular, painless contractions that occur throughout pregnancy." B. "It is the soft blowing sound that can be heard when the uterus is auscultated." C. "It is the fetal movement that is felt by the mother." D. "It is the thinning of the lower uterine segment."

C. "It is the fetal movement that is felt by the mother."

The nurse recognizes that an expected change in the hematologic system that occurs during the 2nd trimester of pregnancy is: A. A decrease in WBC's B. Increase in hematocrit. C. An increase in blood volume. D. A decrease in sedimentation rate.

C. An increase in blood volume.

Heartburn and flatulence, common in the second trimester, are most likely the result of which of the following? A. Increased plasma HCG levels B. Decreased intestinal motility C. Decreased gastric acidity D. Elevated estrogen levels

C. Decreased gastric acidity

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. Using the GTPAL format, the nurse should identify that the client is: A. G4 T3 P2 A1 L4 B. G5 T2 P2 A1 L4 C. G5 T2 P1 A1 L4 D. G4 T3 P1 A1 L4

C. G5 T2 P1 A1 L4

A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the first day of her last menstrual period was September 19th, 2013. Using Naegele's rule, the nurse determines the estimated date of confinement as: A. July 26, 2013 B. June 12, 2014 C. June 26, 2014 D. July 12, 2014

C. June 26, 2014

Which of the following common emotional reactions to pregnancy would the nurse expect to occur during the first trimester? A. Introversion, egocentrism, narcissism. B. Awkwardness, clumsiness, and unattractiveness. C. Anxiety, passivity, extroversion. D. Ambivalence, fear, fantasies.

D. Ambivalence, fear, fantasies.

The nurse is aware that an adaptation of pregnancy is an increased blood supply to the pelvic region that results in a purplish discoloration of the vaginal mucosa, which is known as: A. Ladin's sign B. Hegar's sign C. Goodell's sign D. Chadwick's sign

D. Chadwick's sign

Which of the following answers best describes the stage of pregnancy in which maternal and fetal blood are exchanged? A. Conception B. 9 weeks' gestation, when the fetal heart is well developed. C. 32-34 weeks gestation D. Maternal and fetal blood are never exchanged.

D. Maternal and fetal blood are never exchanged.

A nurse is assessing a pregnant client who has had bariatric surgery. Which assessment factors would pose the highest nutritional concerns for this client based on her surgical history? (Select all that apply.) a. Monitoring of iron levels b. Amount of weight loss that has occurred post procedure. c. Amount of weight gain during pregnancy d. Monitoring of calcium levels e. Monitoring of B vitamins

a, c, d, and e

A nurse teaching a pregnant patient about the importance of iron in their diet would tell the patient to consume which foods as good sources of iron? (Circle all that apply.) a. Whole-grain breads and cereals b. Oranges c. Salmon d. Raisins e. Spinach f. Tomatoes

a, d, and e

The nurse is working in a prenatal clinic. The nurse understands that probable signs of pregnancy include which of the following?( Select all that apply) a. Human chorionic gonadotropin in the urine b. Breast tenderness c. Morning sickness d. Fetal heart sounds e. Ballottement f. Hegar's sign

a, e, and f Rationale: Breast tenderness and morning sickness are presumptive signs. Fetal heart sounds are positive signs.

A nurse is reviewing barriers to prenatal care. What type of cultural concern should the nurse identify as being the most likely deterrent? a. Modesty b. Ignorance c. Belief that physicians are evil d. Religion

a. Modesty

The fertilized zygote travels through the fallopian tube to the uterus within 2 to 3 days. Implantation of the zygote occurs within_ days? a. 7-10 days b. 36 hours c. Two weeks d. 5 days

a. 7-10 days

A group of maternity nurses are providing education to pregnant clients about changes in blood pressure. What information should the nurses include? a. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy. b. The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant. c. Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. d. A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.

a. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.

Which condition would a nurse identify as not contributing to an increase in maternity-related health care costs? a. Early postpartum discharges b. The use of high-tech equipment c. The cost of care for low-birth-weight (LBW) infants d. Maternal medical risk factors, such as diabetes

a. Early postpartum discharges

A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is: a. Fetal movement palpated by the nurse-midwife. b. Braxton Hicks contractions. c. Quickening. d. A positive pregnancy test result.

a. Fetal movement palpated by the nurse-midwife.

The nurse caring for a pregnant woman knows that her health teaching regarding fetal circulation has been effective when the woman reports that she has been sleeping: a. In a side-lying position. b. On her abdomen. c. With the head of the bed elevated. d. On her back with a pillow under her knees.

a. In a side-lying position.

A nurse is reviewing the impact of inadequate weight gain during pregnancy. Which finding should the nurse anticpate as being at highest risk based on inadquate weight gain? a. Intrauterine growth restriction. b. Down syndrome. c. Diabetes mellitus. d. Spina bifida.

a. Intrauterine growth restriction.

A maternity nurse's role is to help guide a woman's acceptance of pregnancy. What information should the maternity nurse understand related to potential effects of maternal feeling as they relate to acceptance of pregnancy? a. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes. b. Ambivalent feelings during pregnancy are usually seen only in emotionally immature or very young mothers. c. Nonacceptance of the pregnancy very often equates to rejection of the child. d. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth.

a. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes.

A nurse is planing to teach a pregnancy class to expectant parents and discuss multiple births. What information should the nurse include? a. Rates of twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing. b. Identical twins are more common in Caucasian families. c. Fraternal twins are same gender, usually male. d. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins.

a. Rates of twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing.

A nurse is working with a pregnant client. Which behavior if observed by the nurse indicates that a woman is "seeking safe passage" for herself and her infant? a. She keeps all prenatal appointments. b. She "eats for two." c. She wears only low-heeled shoes. d. She drives her car slowly.

a. She keeps all prenatal appointments.

A patient has come into the ob/gyn's office today for preconception conceptual counseling. The patient asks how they will know ovulation is occurring. The nurse tells them which of the following? a. Signs of ovulation include pain in the lower abdomen (mittlelschmerz), thin, clear, stretchy cervical mucous. b. Signs of ovulation include mittleschmerz and thin cloudy mucous. c. Signs of ovulation include generalized discomfort, increased urination, and abundant clear thin stretchy mucous.

a. Signs of ovulation include pain in the lower abdomen (mittlelschmerz), thin, clear, stretchy cervical mucous.

A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. Which finding does the nurse identify? a. The lungs are mature. b. The fetus is at risk for Down syndrome. c. The woman is at high risk for developing preterm labor. d. Meconium is present in the amniotic fluid.

a. The lungs are mature.

A 22-year-old woman pregnant with a single fetus had a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this finding? a. The woman's weight gain is appropriate for this stage of pregnancy. b. This weight gain indicates possible gestational hypertension. c. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR). d. This weight gain cannot be evaluated until the woman has been observed for several more weeks.

a. The woman's weight gain is appropriate for this stage of pregnancy.

Which statement should the nurse identify as not being accurate regarding multifetal pregnancy? a. Twin pregnancies come to term with the same frequency as single pregnancies. b. Backache and varicose veins are often more pronounced. c. The mother should be counseled to increase her nutritional intake and gain more weight. d. The expectant mother often experiences anemia because the fetuses have a greater demand for iron.

a. Twin pregnancies come to term with the same frequency as single pregnancies.

A nurse is caring for a client who is pregnant and is reviewing manifestations of complications the client should report promptly to the provider. Which of the following should the nurse include? a. Vaginal bleeding b. Swelling of the ankles c. Heartburn after eating d. Lightheadedness when lying on the back

a. Vaginal bleeding

The stretchable quality of the cervical mucus at the time of ovulation is known as? a. Menarche b. Spinnbarkeit c. Mittelschmerz d. leukorrhea

b. Spinnbarkeit

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know whether it is safe for her to have a drink with dinner now. How should the nurse respond? a. "One drink every night is too much. One drink three times a week should be fine." b. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy." c. "Because you're in your second trimester, there's no problem with having one drink with dinner." d. "Because you're in your second trimester, you can drink as much as you like."

b. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

An expectant father confides in the nurse that his pregnant wife, at 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" What is the nurse's best reponse? a. "This is normal behavior and should begin to subside by the second trimester." b. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant." c. "You seem imclient with her. Perhaps this is precipitating her behavior." d. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor I know."

b. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant."

A patient is 6 weeks pregnant. Their previous pregnancies resulted in the live birth of a daughter at 40 weeks gestation, the live birth of a son at 38 weeks gestation, and a spontaneous abortion at 10 weeks gestation. How would you indicate this using the 5-digit system? a. 3-2-1-1-2 b. 4-2-0-1-2 c. 4-2-1-1-3 d. 3-2-0-1-2

b. 4-2-0-1-2

A nurse in a prenatal clinic is caring for four clients. Which of the following client's weights should be reported to the provider? a. 4 lb weight gain in the first trimester b. 8 lb weight gain in the first trimester c. 15 lb weight gain in the second trimester d. 25 lb weight gain in the third trimester

b. 8 lb weight gain in the first trimester

A patient comes into the prenatal clinic stating they have a positive pregnant test. Their LMP is 11/24/21. What is their EDD? a. 8/2/22 b. 8/31/22 c. 10/31/22 d. 10/2/22

b. 8/31/22

The nurse is reviewing danger signs of pregnancy with a client who is 32 weeks pregnant. What information should the nurse tell the client to observe for? a. Edema in the ankles and feet at the end of the day b. Alteration in the pattern of fetal movement c. Constipation d. Heart palpitations

b. Alteration in the pattern of fetal movement

A client who is at 7 weeks of gestation is experiencing N/V in the morning. Which of the following should the nurse include? a. Awaken during the night to eat a snack b. Eat crackers or plain toast before getting out of bed c. Skip breakfast and eat lunch after nausea has subsided d. Eat a large evening meal

b. Eat crackers or plain toast before getting out of bed

The most vulnerable period of fetal development occurs during this period. a. Second trimester b. Embryonic stage c. Third trimester

b. Embryonic stage

A 25 - year old pregnant patient is at 10 weeks of gestation. Their BMI is calculated to be 24. Regarding weight gain during pregnancy, the nurse should recommend: a. A total weight gain of 39 lbs b. First - trimester weight gain of 2 to 4 lbs c. Weight gain of 1 lb. each week for 40 weeks d. Weight gain of 6 lbs. during the second and third trimester

b. First trimester weight gain of 2 to 4 lbs.

A nurse is reviewing cardiovascular system changes that occur during pregnancy. Which finding would the nurse consider to be normal for a woman in her second trimester? a. Less audible heart sounds (S1, S2) b. Increased pulse rate c. Increased blood pressure d. Decreased red blood cell (RBC) production

b. Increased pulse rate

A nurse is counseling a pregnant client about protein intake. Which information should the nurse provide? a. Many women need to increase their protein intake during pregnancy. b. Many protein-rich foods are also good sources of calcium, iron, and B vitamins. c. High-protein supplements can be used without risk by women on macrobiotic diets. d. As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet.

b. Many protein-rich foods are also good sources of calcium, iron, and B vitamins.

Which of the following statement about ovulation is true? a. The timing of ovulation varies among individuals and may occur days before the start of menstrual flow. b. Once released the ovum is only viable for 24 hours. c. Ovulation marks the start of the follicular phase

b. Once released the ovum is only viable for 24 hours.

Which action taken by the nurse would indicate that he or she is practicing appropriate family-centered care techniques? a. The father is discouraged from accompanying his wife during a cesarean birth. b. The nurse encourages the mother and father to make choices whenever possible. c. The nurse updates the family about what is going to happen but instructs the client's sister that she cannot be present in the room during the birth. d. The nurse believes that he or she is acting in the best interest of the client and commands her what to do throughout labor.

b. The nurse encourages the mother and father to make choices whenever possible.

Supine Hypotension Syndrome occurs in pregnancy due to, a. Weight of the gravid uterus causes obstruction on vena cava which increases blood volume back to the heart. b. Weight of the gravid uterus causes obstruction on the vena cava which decreases blood volume back to the heart. c. Weight of the gravid uterus causes obstruction on the renal arteries which decreases blood volume back to the heart.

b. Weight of the gravid uterus causes obstruction on the vena cava which decreases blood volume back to the heart.

A nurse is teaching a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following should the nurse include? Select all that apply. a. avoid any lifting b. perform legal exercises twice daily c. perform the pelvic rock exercise daily d. use proper body mechanics e. avoid constrictive clothing

c and d

Which of the following statements regarding the Ovarian Cycle is correct? Select all that apply. a. The timing of ovulation may vary among individuals b. The follicular phase never varies. c. The luteal phases typically lasts 14 days and ends with menses. d. The follicular phase may vary in length.

c and d

A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? a. "We don't really know when such defects occur." b. "It depends on what caused the defect." c. "They occur between the third and fifth weeks of development." d. "They usually occur in the first 2 weeks of development."

c. "They occur between the third and fifth weeks of development."

A nurse is assessing a pregnant woman at 10 weeks of gestation who jogs three or four times per week. The client expresses concern about the effect of exercise on the fetus. How should the nurse respond? a. "You don't need to modify your exercising any time during your pregnancy." b. "Jogging is too hard on your joints; switch to walking now." c. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." d. "Stop exercising, because it will harm the fetus."

c. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. How would the nurse document her gravidity and parity according to the GTPAL system? a. -1-0-1-0 b. 2-0-0-1-1 c. 3-1-0-1-0 d. 3-0-1-1-0

c. 3-1-0-1-0

A patient is 28 weeks pregnant. Her first pregnancy ended in a spontaneous abortion at 12 weeks gestation. The second pregnancy resulted in the live birth of twin boys at 32 weeks gestation. The third pregnancy resulted in the live birth of a daughter at 39 weeks gestation. How would you indicate this using the 5-digit system? a. 4-1-1-1-2 b. 4-1-2-1-2 c. 4-1-1-1-3 d. 3-1-2-1-3

c. 4-1-1-1-3

Pregnant patients with Pica are at risk for which of the following ? a. Low weight gain b. Hypertension c. Anemia d. Asthma

c. Anemia

A nurse is reviewing maternal nutritional needs during lactation. Which statement should the nurse identify as being accurate? a. Critical iron and folic acid levels must be maintained. b. The mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy. c. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful. d. Lactating women can go back to their prepregnant calorie intake.

c. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.

Which of the following are finger- like projections that develop from the trophoblast and extend into the blood filled spaces of the endometrium? a. Chorion b. Amnion c. Chorionic villi d. Wharton's Jelly

c. Chorionic villi

A maternity nurse is counseling a pregnant client about getting enough iron in her diet. What information should the nurse provide? a. Iron supplements are permissible for children in small doses. b. Iron absorption is inhibited by a diet rich in vitamin C. c. Constipation is common with iron supplements. d. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.

c. Constipation is common with iron supplements.

The hormone relaxin causes the relaxation of the pelvic joints. Considerable separation of the symphysis pubis and sacroiliac joints may cause the following symptoms in the pregnant patients. a. Pain in the knees b. Cramping of the lower abdomen c. Difficulty ambulating and pain

c. Difficulty ambulating and pain

A nurse observes a pregnant woman experiencing nausea and vomiting. What intervention should the nurse suggest to the client? a. Limit fluid intake throughout the day. b. Increase her intake of high-fat foods to keep the stomach full and coated. c. Eat small, frequent meals (every 2 to 3 hours). d. Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.

c. Eat small, frequent meals (every 2 to 3 hours).

Which hormone is secreted by the hypothalamus when ovarian hormones are reduced to a low level? It stimulates the pituitary gland to secrete two critical hormones. a. Follicle -stimulating hormone (FSH) b. Estrogen c. Gonadotropin-releasing hormone (GnRH) d. Prostaglandin

c. Gonadotropin-releasing hormone (GnRH)

A nurse is reviewing presumptive and probable signs of pregnancy. Which finding should the nurse identify as not being correlated to a possible etiology? a. Amenorrhea stress, endocrine problems b. Quickening gas, peristalsis c. Goodell sign cervical polyps d. Chadwick sign pelvic congestion

c. Goodell sign cervical polyps

During a client's physical examination, the nurse notes that the lower uterine segment is soft on palpation. How should the nurse document this finding? a. Chadwick sign. b. McDonald sign. c. Hegar sign. d. Goodell sign.

c. Hegar sign.

The earliest biochemical marker for pregnancy is which of the following? a. Luteinizing hormone b. Progesterone c. Human chorionic gonadotropin

c. Human chorionic gonadotropin

A nurse is reviewing maternal medical risk factors. Which of the following would the nurse identify as being the two most frequently reported maternal medical risk factors? a. Behaviors and lifestyles. b. Drug use and alcohol abuse. c. Hypertension associated with pregnancy and diabetes. d. Homelessness and lack of insurance.

c. Hypertension associated with pregnancy and diabetes.

The hormone responsible for the release of the mature ovum is? a. Estrogen b. Progesterone c. Luteinizing Hormone d. Prolactin

c. Luteinizing Hormone

The hormone responsible for the release of the mature ovum is? a. Estrogen b. Progesterone c. Luteinizing hormone d. Prolactin

c. Luteinizing hormone

A nurse is reviewing the concept of fetal growth. Which finding should the nurse identify as being within normal range of development? a. Lungs take shape by 8 weeks. b. Heart starts beating at 12 weeks. c. Main blood vessels form by 8 weeks. d. Brain configuration is complete by 8 weeks.

c. Main blood vessels form by 8 weeks.

Which statement best reflects the nurse's role in genetic counseling? a. Encourage patient to make decisions regarding the continuation of the pregnancy. b. Advise the patient on their best options. c. Maintain a professional demeanor while providing nonjudgmental support. d. Provide information on referrals for further testing.

c. Maintain a professional demeanor while providing nonjudgmental support.

Which information should the nurse provide to the woman who wants to have a nurse-midwife provide obstetric care? a. She will have to give birth at home. b. She must see an obstetrician as well as the midwife during pregnancy. c. She must be having a low-risk pregnancy. d. She will not be able to have epidural analgesia for labor pain.

c. She must be having a low-risk pregnancy.

A pregnant patient at 8 weeks of gestation tells the provider that they have been experiencing nausea with occasional vomiting every day. Which recommendation by the nurse would be most appropriate? a. Eating starchy and fried foods. b. Avoid eating before going to bed. c. Start eating small meals 6 to 8 times a day. d. Skip meals when nausea is present.

c. Start eating small meals 6 to 8 times a day.

Twins may be dizygotic, monozygotic, or conjoined. Which statement about Dizygotic twins is correct? a. These twins have 2 eggs, 1 amnion, 1 chorion, and 2 placentas. b. These twins have 2 eggs, 2 amnions, 2 chorions, and 1 placenta. c. These twins have 2 eggs, 2 amnions, 2 chorions, and 2 placentas.

c. These twins have 2 eggs, 2 amnions, 2 chorions, and 2 placentas.

Which statement regarding the placental circulation is correct? a. Oxygenated blood from the mother mixes with fetal blood. b. Oxygenated blood from the mother is transported to the fetus via the umbilical artery. c. other is transported to the fetus viaOxygenated blood from the mother washes over the chorionic villi which contains fetal capillaries.

c. other is transported to the fetus viaOxygenated blood from the mother washes over the chorionic villi which contains fetal capillaries.

Visualization of fetus on U/S is considered a ______ sign of pregnancy. a. presumptive b. probable c. positive

c. positive

A group of student nurses are reiviewing length for a normal pregnancy. Which time span should the student nurse identify as being appropriate? a. 9 lunar months, 8.5 calendar months, 39 weeks, 272 days b. 9 calendar months, 10 lunar months, 42 weeks, 294 days c. 9 calendar months, 38 weeks, 266 days d. 10 lunar months, 9 calendar months, 40 weeks, 280 days

d. 10 lunar months, 9 calendar months, 40 weeks, 280 days

A nurse is monitoring lab results for a client in the third trimester of pregancy. Which hematocrit (HCT) and hemoglobin (HGB) results should the nurse identify as being the lowest acceptable value? a. 32% HCT; 10.5 g/dL HGB b. 35% HCT; 13 g/dL HGB c. 38% HCT; 14 g/dL HGB d. 33% HCT; 11 g/dL HGB

d. 33% HCT; 11 g/dL HGB

A pregnant client is experiencing some integumentary changes and is concerned that they may represent abnormal findings. Which of the following findings should the nurse provide to the client that would be considered "normal abnormal" findings during pregnancy so that she should not be alarmed? (Select all that apply.) Select all that apply. a. Superficial thrombophlebitis b. Facial edema c. Allodynia d. Vascular spiders e. Melasma f. Linea nigra

d, e, and f

A nurse is reviewing postpartum nutrition needs with a group of clients who have begun breastfeeding. Which of the following statements by a member of the group indicates an understanding of the teaching? a. "I am glad I can have my morning coffee" b. "I should take folic acid to increase my milk supply" c. "I will continue adding 300 calories a day" d. "I will continue my calcium supplements because I don't like milk"

d. "I will continue my calcium supplements because I don't like milk"

The menstrual cycle includes 4 phases. During the ischemic phase which of the following is occurring? a. Levels of estrogen decrease and progesterone increases. b. Blood supply to the endometrium increases as uterus gets ready to shed its lining. c. Estrogen and progesterone levels increase. d. Blood supply to the endometrium is decreased.

d. Blood supply to the endometrium is decreased.

The nurse has given information about relief of leg cramps to a pregnant client. Which client action if observed by the nurse indicates that the client has understood the instructions? a. Applies cold compresses to the affected leg. b. Avoids weight bearing on the affected leg during the cramp. c. Wiggles and points her toes during the cramp. d. Extends her leg and dorsiflexes her foot during the cramp.

d. Extends her leg and dorsiflexes her foot during the cramp.

A pregnant woman has been diagnosed with oligohydramnios. Which presentation would the nurse suspect to find on physical examination? a. FHR baseline is within normal range b. Fetus is in a breech position c. Increased fundal height d. Fetus with possible renal problems

d. Fetus with possible renal problems

From the nurse's perspective, what measure should be the focus of the health care system in order to reduce the rate of infant mortality further? a. Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days b. Mandating that all pregnant women receive care from an obstetrician c. Expanding the number of neonatal intensive care units (NICUs) d. Implementing programs to ensure women's early participation in ongoing prenatal care

d. Implementing programs to ensure women's early participation in ongoing prenatal care

A nurse is working with a pregnant client and providing information about weight gain. Which suggestion should the nurse identify as not being appropriate? a. Obese women should gain at least 7 kg. b. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale. c. Underweight women should gain 12.5 to 18 kg. d. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.

d. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.

A nurse is reviewing physiological concepts related to amniotic fluid. Which statement should the nurse identify as being accurate? a. A volume of more than 2 L is associated with fetal renal abnormalities. b. The volume remains about the same throughout the term of a healthy pregnancy. c. A volume of less than 300 ml is associated with gastrointestinal malformations. d. It serves as a source of oral fluid and as a repository for waste from the fetus.

d. It serves as a source of oral fluid and as a repository for waste from the fetus.

A nurse is reviewing a new prescription for iron supplements with a client who is 8 weeks pregnant and has iron-deficiency anemia. Which of the following beverages should the nurse instruct the patient to take the supplements with? a. Ice water b. Low-fat or whole milk c. Tea or coffee d. Orange juice

d. Orange juice

During the____phase of the endometrial cycle blood supply to the uterine lining becomes luxuriant with blood and glandular secretions suitable to protect and nurture a fertilized ovum. a. Ischemic b. Proliferation c. Luteal d. Secretory

d. Secretory

Mary is 30 weeks pregnant and at her prenatal visit. Mary lies in a supine position so the nurse can assess fundal height. Mary soon complains of dizziness and nausea. The nurse observes that Mary's skin is damp and cool. The nurse's priority action is to: a. Assess the woman's pulse and blood pressure. b. Elevate the woman's legs on a pillow. c. Prepare to administer medication for nausea. d. Turn the woman on her left side.

d. Turn the woman on her left side.

The nurse is teaching a class on healthy behaviors during pregnancy at the prenatal clinic. Which of following statements about healthy behaviors in pregnancy is correct? a. Travel is prohibited during the second trimester of pregnancy. b. Relaxing in a hot tub is good for round ligament pain. c. The flu vaccine is contraindicated in pregnancy. d. When exercising in pregnancy the heart rate should not increase greater than 140 bpm.

d. When exercising in pregnancy the heart rate should not increase greater than 140 bpm.