OB Chapter 7

Which statement correctly describes the contraction stress test (CST)? a) Monitors the baby's response to contractions to determine well- being b) A CST is indicated if the NST is reactive c) The fetal heart rate is assessed during maternal exercise d) An artificial larynx is used to stimulate the fetus

Monitors the baby's response to contractions to determine well- being

Gestational diabetes occurs around the 24th week of gestation. When should every woman be screened for gestational diabetes? a) Between 16 and 20 weeks' gestation b) Between 24 and 28 weeks' gestation c) Between 20 and 24 weeks' gestation d) Between 28 and 32 weeks' gestation

Between 24 and 28 weeks' gestation

A woman who is 3 months pregnant enjoys a slow, long walk daily. Which of the following would be most appropriate for her concerning this for the remainder of her pregnancy? a) Continue this as long as she enjoys it. b) Reduce walking to half a block daily. c) Engage in aerobics for greater benefits. d) Stop and rest every block.

Continue this as long as she enjoys it.

What might the nurse first suspect when measuring uterine fundal height at the umbilicus in a client at 14 weeks' gestation? a) Deficient amniotic fluid b) Multiple fetal pregnancy c) Urinary retention d) Intrauterine growth retardation

Multiple fetal pregnancy

You advise your pregnant patient to keep a small high-carbohydrate snack on the bedside table. This advice is given to ameliorate which condition? a) Heartburn b) Faintness c) Slowed GI transit time d) Nausea and vomiting

Nausea and vomiting

By the time a woman is 36 weeks' gestation, where would the nurse expect to find the uterus? a) Halfway between the umbilicus and bottom edge of the ribcage b) Near the bottom of the sternum c) Under the edge of the ribcage d) At the umbilicus

Near the bottom of the sternum

Your patient has been recommended to have a contraction test done after the results of her non-stress test. The results of the test are as follows: No late decelerations in a 10 minute period of time after having three contractions of 50 seconds duration. You would interpret this test as: a) Reactive contraction stress test b) Non-reactive contraction stress test c) Negative contraction stress test d) Positive contraction stress test

Negative contraction stress test

A client at 41 weeks gestation has undergone a non-stress test. The results of this non-stress test were two fetal accelerations of 5 bpm that lasted for 5 seconds over a 20-minute period. The nurse knows these results would be considered to be which of the following? a) Negative b) Nonreactive c) Postive d) Reactive

Nonreactive

A patient in the OB clinic is complaining of being awakened by leg cramps while sleeping. Select the appropriate nursing intervention. a) Encourage her to drink more fluids, 10 glasses a day b) Dorsiflex the foot while extending her leg during the cramp c) Use plantar flexion exercises 3 times every day d) Avoid any supplementation of vitamins or minerals

Dorsiflex the foot while extending her leg during the cramp

Some women contract with other women to provide support during pregnancy and delivery, to provide emotional support during labor and delivery, and to aid in establishing breastfeeding. What is the name of the woman who is contracted? a) Partera b) Doula c) Midwife d) Pregnancy aide

Doula

If a pregnant woman's estimated date of delivery (EDD) is April 23, what was the first day of her last menstrual period (LMP), according to Nagele's rule? a) July 19 b) July 23 c) July 16 d) July 13

July 16

A non-stress test is performed on a pregnant woman. The nurse informs the client the test was reactive. Which of the following statements by the patient indicates understanding of the test results? a) The results indicate a contraction stress test is needed for evaluation b) The test is non-reactive, which is reassuring c) The fetal heart rate increases with activity and indicates fetal well-being d) There is no evidence of congenital anomalies or deformities

The fetal heart rate increases with activity and indicates fetal well-being

The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client? a) Multipara b) Primigravida c) Nulligravida d) Primipara

Primigravida

At each prenatal visit, a patient provides a urine sample to the health care provider. What is this urine sample tested for at each visit? a) Protein and albumin b) Glucose and white blood cells c) Protein and glucose d) White blood cells and albumin

Protein and glucose

A woman accustomed to daily exercise complains late in her second trimester of pregnancy that she is experiencing "terrible" heartburn at night. What would you advise her to do? a) Stop or severely curtail her exercise. b) Seek emergency medical care. c) Take sodium bicarbonate. d) Put 6-inch blocks under the head of her bed.

Put 6-inch blocks under the head of her bed.

During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as: a) Variable decelerations b) Reactive pattern c) A nonreactive pattern d) Fetal tachycardia

Reactive pattern

The Bradley method of childbirth preparation FOCUSES on: a) Substitution of responses to pain and fear based on conditioned reflex theory b) The physiology of childbirth c) The need for quietness, solitude, darkness, and physical relaxation d) Closing the gate by cutaneous stimuli

The need for quietness, solitude, darkness, and physical relaxation

The Dick-Read method EMPHASIZES which of the following? a) Self hypnosis b) Environmental variable such as darkness and quiet c) Substitution of responses to pain and fear with more positive behavior on the basis of Pavlov's conditioned reflex theory d) Reduction of pain through reduction of fear and tension during labor

Reduction of pain through reduction of fear and tension during labor

A 24-year-old pregnant woman complains of excessive vaginal discharge. The discharge is not associated with a strong odor, itching, or irritation but she finds it messy and unpleasant. What do you advise her to do? a) Douche and wash frequently with mild soap and warm, not hot, water b) Decrease her fluid intake c) See her primary care provider to be tested for STIs d) Use sanitary pads

Use sanitary pads

A nurse is assessing a pregnant client. Which of the following would the nurse document as an abnormal finding in a pregnancy? a) Pedal edema b) Visual changes c) Lordosis d) Linea nigra

Visual changes

A patient, 31 years old, at 28 weeks gestation with her second pregnancy is in the clinic for a prenatal check-up. She informs you of frequent low back pain and ankle edema by the end of the day. What interventions should you suggest to relieve these discomforts? a) Sit semi-fowlers with feet below for breaks at work. b) Lie on right side with feet elevated and a heating pad on her back. c) Rest when possible with feet elevated at or above the heart. d) Soak feet every night and perform pelvic rocks.

Rest when possible with feet elevated at or above the heart.

A pregnant woman is planning on taking a vacation that involves extensive travel by automobile. Which of the following guidelines should you give her? a) Sit in the back seat with feet elevated b) Stop and walk every few hours c) Travel no more than 120 miles daily d) Limit trips away from home, great than 200 miles

Stop and walk every few hours

What variables are assessed in a biophysical profile? a) Fetal breathing, heart rate reactivity, muscle tone, body movements, and amniotic fluid volume b) Fetal weight, length, breathing, heart rate, muscle tone, and body movements c) Fetal weight, breathing, heart rate, muscle tone, body movements, and amniotic fluid d) Fetal length, breathing, heart rate, muscle tone, body movements, and amniotic fluid volume

Fetal breathing, heart rate reactivity, muscle tone, body movements, and amniotic fluid volume

As part of her first prenatal visit, you are taking a pregnant woman's obstetric history. She has an 18-month-old daughter who was delivered 2 days after her estimated date of delivery and a 3-year-old son who was born at 35 weeks' gestation. Before her son was born, she lost two pregnancies: one at 12 weeks and the other at 21 weeks. Using the GTPAL method, how would you record this history? a) G4 T1 P2 A2 L2 b) G5 T2 P2 A1 L1 c) G4 T1 P1 A2 L2 d) G5 T1 P2 A1 L2

G5 T1 P2 A1 L2

A woman presents to the clinic in the first trimester of pregnancy. She has three children living at home. One of them was born prematurely at 34 weeks. The other two were full-term at birth. She has a history of one miscarriage. How do you record her obstetric history on the chart using the GTPAL format? a) G3 T2 P1 A1 L3 b) G4 T2 P1 A1 L3 c) G4 T3 P0 A1 L3 d) G5 T2 P1 A1 L3

G5 T2 P1 A1 L3

The triple marker screen measures 2 hormones in conjunction with MSAFP. What 2 additional hormone levels are measured? a) Estriol and progesterone b) HCG and estriol c) FSH and LH d) HCG and hPL

HCG and estriol

Which of the following would the nurse include when teaching a pregnant woman about chorionic villi sampling? a) "This test is very helpful for identifying spinal defects." b) "The results should be available in about a week." c) "You'll have an ultrasound first and then the test." d) "Afterwards, you can resume your exercise program."

"You'll have an ultrasound first and then the test."

A patient at 6 weeks of pregnancy asks if she can listen to the fetal heart sounds. The nurse informs the patient that fetal heart sounds cannot be heard with a Doppler until when? a) 24 weeks b) 8 weeks c) 10 to 12 weeks d) 18 to 20 weeks

10 to 12 weeks

The nurse assesses the uterine fundus and finds it to be halfway between the symphysis pubis and the umbilicus. The nurse would determine that this corresponds to how many gestational weeks? a) 6 b) 20 c) 16 d) 12

16

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She delivered one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation. a) 3, 2, 1, 1, 1 b) 4, 2, 2, 1, 1 c) 4, 1, 1, 1, 1 d) 3, 2, 1, 2, 1

4, 1, 1, 1, 1

A client is 6 weeks pregnant, and has been scheduled for chorionic villus sampling. For this procedure the LPN is aware that the patient would be scheduled to return in: a) ten weeks b) twelve weeks c) 6 weeks d) thirty weeks

6 weeks

The nurse should administer Rhogam (Rh immune globulin) to the pregnant woman who is Rho(D)-, after which of the following tests? a) NST (Non Stress Test) b) CST (Contraction Stress Test) c) Biophysical Profile d) Amniocentesis

Amniocentesis

A client at 16 weeks' gestation is scheduled for prenatal testing. Which of the following would the nurse anticipate as the most likely screening test for congenital anomalies based on the current age of this pregnancy? a) Nuchal translucency testing. b) Chorionic villi sampling. c) Amniocentesis. d) Cardocentesis.

Amniocentesis.

A woman in her first trimester is having trouble maintaining adequate nutrition because of nausea and vomiting. She also complains that her heartburn gets worse after eating so she avoids food even when she feels hungry. To help with her nutritional deficit, she is taking a multivitamin supplement. Which substance do you caution her to avoid within 1 hour of ingesting her multivitamin supplement? a) An antacid b) Fatty or fried foods c) Coffee or other caffeinated beverages d) Acetaminophen

An antacid

Mrs. Smith asks you to compute her expected date of birth. Based on the fact that her last menstrual flow began on July 20, her date would be a) May 20. b) April 13. c) March 13. d) April 27.

April 27.

The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation? a) At the level of the symphysis pubis b) At the level near the bottom of the sternum c) Three finger-breadths above the umbilicus d) At the level of the umbilicus

At the level of the umbilicus

During the physical exam at the first prenatal visit a speculum exam is performed. What sign of pregnancy does the practitioner look for during the speculum exam? a) Nagel's sign b) Hagar's sign c) Goodell's sign d) Chadwick's sign

Chadwick's sign

A woman has come to her doctor's office to determine whether she is pregnant. As part of her assessment, the nurse asks the woman the date of her last menstrual period. In which component of the client's health history should the nurse record the client's answer to this question? a) History of past illnesses b) Day history/social profile c) Demographic data d) Chief concern

Chief concern

Ramona Silver, age 38, has one child with Tay-Sachs disease. She and her partner both carry the Tay-Sachs gene and did not intend to have more children, but she has just discovered that she is pregnant. She plans to have an abortion if tests show that the fetus has the Tay-Sachs gene. Which test will the primary care provider likely order? a) Amniocentesis b) A multiple marker screening test c) Percutaneous umbilical blood sampling d) Chorionic villus sampling

Chorionic villus sampling

A pregnant woman comes in for a routine third-trimester exam, which included a pelvic exam. She calls several hours later, very worried, to report a small amount of bleeding. What should you tell her? a) To return right away b) Not to worry but to report any heavy increase in bleeding c) That her cervical mucous plug may have been expelled d) That the bleeding, called Chadwick's sign, is a normal part of pregnancy

Not to worry but to report any heavy increase in bleeding

When discussing rest and sleep with a pregnant woman, which of the following positions would you suggest that she use for napping? a) On her stomach with a pillow under her breasts b) On her back with a pillow under her knees and hips c) On her back with a pillow under her head d) On her side with the weight of the uterus on the bed

On her side with the weight of the uterus on the bed

The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which of the following is the recommended schedule for prenatal care? a) Once every 4 weeks for the first 36 weeks, then weekly until the birth. b) Once every 3 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth. c) Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth. d) Once every 4 weeks for the first 28 weeks, then every 3 weeks until 36 weeks, and then every 2 weeks until the birth.

Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth.

A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which of the following? a) Fetal hypoxia b) Down syndrome c) Open spinal defects d) Maternal hypertension

Open spinal defects

During the initial prenatal visit, a client indicates that she frequently experiences stress incontinence. Which of the following should the nurse recommend to the client to help relieve this condition? a) Perform Kegel exercises b) Increase intake of water c) Perform monthly perineal self-examination d) Reduce intake of fluids

Perform Kegel exercises

Based on the incidence of disease in woman, which assessment of lower extremities would be most important to make in a pregnant woman? a) Diameter of the calf muscle b) Blanching and refilling of toenails c) Lateral movement of the kneecap d) Presence of varicosities

Presence of varicosities

One function of the nurse when dealing with a pregnant client is to teach self-care during pregnancy. One of the topics that the nurse provides teaching about is breast care. What does the nurse teach the client about keeping the breasts clean? a) Use a mild soap and cool water to keep the nipples clean b) Use hot water and a mild soap to keep the nipples clean c) Wash the nipples with a deodorant soap to keep them clean and help toughen them d) Wash the nipples with clean water only

Wash the nipples with clean water only

You advise a pregnant woman to reduce her fluid intake with meals. Which condition is the woman trying to relieve or prevent? a) Heartburn b) Blood clots c) Constipation d) Nosebleeds

Heartburn

Several laboratory tests are performed during the first prenatal visit. Which of the following is one of those lab tests? a) Rubeola titer b) Basic metabolic panel c) Hepatitis screen d) Potassium level

Hepatitis screen

An adolescent who is 8 weeks' pregnant is at her first pernatal visit. During the health history interview, the nurse asks the patient, "Are you afraid of anyone?" What is the nurse assessing with this question? a) Mental status b) Social history c) Mood d) Intimate partner abuse

Intimate partner abuse

Safety of the mother and infant is the primary concern in a prenatal exercise program. The following should be considered EXCEPT: a) Maternal heart rate should not exceed 140 beats/minute b) Jerky, bouncing movements should be avoided c) Maintaining a supine position while exercising is preferable d) Deep flexion of the joints should be avoided

Maintaining a supine position while exercising is preferable