OB prepu questions

A pregnant woman undergoing amniocentesis asks her nurse why the baby needs this fluid. What would be an accurate response from the nurse?

"Amniotic fluid cushions your baby to prevent injury."

A couple has just learned that their son will be born with Down's syndrome. The nurse shows a lack of understanding when making which of the following statements?

"I will alert your entire family about this so you don't have to."

A pregnant woman enjoys exercising at a local health spa once a week. Which of the following comments would lead you to believe she needs additional health teaching?

"Nothing feels nicer than a hot sauna after exercise."

A client reports occasional headaches. She wants to know what she can take to alleviate the discomfort. What would be the best response by the nurse?

"The safest medication to take for your headaches during your pregnancy would be acetaminophen (Tylenol)."

When she discovers that she is unexpectedly pregnant, a patient calls the nurse in a panic. She reports that although she does not drink heavily, the night she must have gotten pregnant she was at a wedding and had drunk quite a lot. The day after the wedding she had taken several acetaminophens. Since that day 3 weeks earlier, she has also had a nightly glass of wine with dinner. She asks if she has caused irreversible damage to the fetus. What is an appropriate response for the nurse to make?

"You didn't know you were pregnant, so you haven't done anything wrong. The fetus isn't exposed to the mother's blood until after it implants, so the wedding's not an issue. But, don't have any more alcohol while you're pregnant."

A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week?

1 lb Explanation: The recommended weight gain pattern for a woman whose prepregnant weight is within the normal range would be 1 lb per week during the second and third trimesters. Underweight women should gain slightly more than 1 lb per week. Overweight women should gain about 2/3 lb per week

A pregnant client is scheduled to undergo chorionic villi sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed?

10-12 weeks of gestation

Mrs. Kelly comes to the clinic for her usual prenatal check-up. The nurse measures the fundal height at 24 cm. What is the estimated length of her gestation?

24 weeks

A pregnant woman comes to the clinic for a visit. This is her third pregnancy. She had a miscarriage at 12 weeks and gave birth to a son, now 3 years old, at 32 weeks. Using the GTPAL system, the nurse would document this woman's obstetric history as:

30111 Explanation: The woman's obstetric history would be documented as 30111, G (gravida) = 3 (current pregnancy), T (term pregnancies) = 0, P (number of preterm pregnancies) = 1, A (number of pregnancies ending before 20 weeks viability) = 1, and L (number of living children) = 1.

A nurse is assessing a client's nutritional intake during pregnancy. What is the best method for accomplishing this?

A 24-hour nutrition recall

You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a probable sign of pregnancy?

A positive pregnancy test

You prepare a couple to have a karyotype performed. Which of the following describes a karyotype?

A visual presentation of the chromosome pattern of an individual

A pregnant client has heard about Down syndrome and wants to know about the risk factors associated with it. Which of the following would the nurse include as a risk factor?

Advanced maternal age

What advice should the nurse provide to a pregnant patient who admits to continuing to drink alcohol 1 to 2 times a week?

Alcohol should not be consumed during pregnancy.

Amniotic fluid does not grow stagnant because

Amniotic fluid is constantly formed by the amnion Explanation: Amniotic fluid is formed by the amnion; a main portion of it is swallowed by the fetus and then excreted by the fetus back into the fluid area. The fluid is constantly being produced and filtered.

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?

An antacid

The blood tests for a primigravida client indicate that the client is Rh-negative and her partner is Rh-positive. What is an appropriate nursing intervention for this client?

Arrange for Rho immune globulin at 28 weeks' gestation

You meet a family at the prenatal clinic. What is the most effective way to assess the woman's usual food intake during her pregnancy?

Ask her to describe her intake for the last 24 hours.

Amniocentesis

Aspirated from amniotic sac; safety concern include infection, pregnancy lost, and fetal needle injuries. Indications for testing include; chromosome analysis, alpha-fetoprotein, DNA markers, viral studies, karyotyping, cystic fibrosis, and sickle cell trait. Usually performed between 15-20 weeks.

Which of the following nursing interventions is appropriate when preparing a woman for an amniocentesis?

Be certain she knows that there is are risks of complication, such as premature labor, from amniocentesis

What anatomic area should be examined when assessing Montgomery tubercles?

Breasts

During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which of the following would the nurse identify as an abnormal finding?

Bruising

Some women are lactose intolerant. Lactose intolerance occurs more frequently in individuals of African, Hispanic, Native American, Ashkenazic Jewish, and Asian descent. What is the major concern for a lactose intolerant woman who is pregnant?

Calcium deficiency

A nurse is caring for a pregnant client who has been diagnosed with lordosis. The nurse offers preventive measures for which of the following consequences of lordosis when caring for this client?

Chronic backache

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?

Continue this as long as she enjoys it.

A couple is talking with a nurse about the pregnant woman's current experience with morning sickness in the first trimester. While they are talking, the nurse notes that the woman's husband appears clammy and pale. After a moment, he excuses himself to go to the restroom. When he returns, he jokes that he has "caught" his wife's morning sickness. He also remarks that he has gained weight recently. The nurse should explain to the couple that the husband is experiencing which of the following?

Couvade syndrome

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called?

Couvade syndrome

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?

Doula

Spermatogenesis is the process by which primary spermatocytes become mature sperm. When does spermatogenesis begin?

During puberty

A client in the first trimester complains to the nurse of nausea and vomiting, especially in the morning. Which instruction would be most appropriate to help prevent or reduce the client's compliant?

Eat dry crackers or toast before rising

A woman who is 4 months pregnant has pyrosis. Which of the following suggestions would you give her?

Eat small meals and do not lie down after meals

A woman in her third trimester is suffering from heartburn. Which of the following should the nurse advise her to do?

Eat small meals frequently rather than large meals

The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which of the following danger sign might occur at this point in her pregnancy?

Excessive vomiting Explanation: Excessive vomiting is a warning sign in the first trimester. Dyspnea, lower abdominal pressures, and swelling of face or extremities may occur late in pregnancy

Which of the following is a positive sign of pregnancy?

Fetal movement felt by examiner

Which of the following is a positive sign of pregnancy?

Fetal movement felt by examiner Explanation: The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test may come back as a false positive. Hegar's sign is a softening of the uterine isthmus. Uterine contractions may occur at any time.

Fetal circulation differs from the circulatory path of the newborn infant. In utero the fetus has a hole connecting the right and left atria of the heart. This allows oxygenated blood to quickly pass to the major organs of the body. What is this hole called?

Foramen ovale Explanation: The foramen ovale is a hole that connects the right and left atria so the majority of oxygenated blood can quickly pass into the left side of the fetal heart and go to the brain and the rest of the fetal body

You are seeing a patient who is going to be married in a month. There is a history of Huntington disease in her family. The genetic testing has come back and the patient has just been told she carries the gene for Huntington disease and will develop the disease when she gets older. The patient asks you if this information is confidential and if it will remain that way. You explain to the patient that her family should be told and so should her fiancé. The patient forcefully tells you "no." She is not going to tell either her family or her fiancé. What is the nurse's best response?

I will respect your wishes and keep your information confidential. I do wish you would reconsider though

A pregnant woman is experiencing morning sickness. Which of the following responses indicates a need for further teaching?

I'll take antacids between meals

If constipation is a problem for a woman during pregnancy, which of the following measures would be best to recommend?

Increasing fluid intake

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?

Intimate partner abuse

A couple wants to start a family. They are concerned that their child will be at risk for cystic fibrosis because they each have a cousin with cystic fibrosis. They are seeing a nurse practitioner for preconceptual counseling. What would the nurse practitioner tell them about cystic fibrosis?

It is an autosomal recessive disorder

A woman complains of constant redness and itching of her palms early in her pregnancy. She fears that she is suffering an allergic reaction and asks the nurse whether this is normal. Which of the following should the nurse mention?

It is caused by increased estrogen levels and should disappear in time

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?

July 16 Explanation: According to Nagele's rule, the last menstrual period was July 16th. Take the LMP and add 7 days and subtract 3 months; if finding the LMP from the EDD, subtract 7 days and add 3 months.

When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem?

Low-set ears

A client in her second trimester of pregnancy visits a healthcare facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which of the following precautions should the nurse instruct the pregnant client to take when practicing aerobic exercises?

Maintain tolerable intensity of exercise

During her 12 week prenatal check-up, the patient informs you on interview she has developed bumps on the dark part of her nipples. She wants to know what these bumps are. What is the appropriate answer?

Montgomery's tubercles, secrete lubricant for the nipples

A woman in her 15th week of pregnancy is about to undergo amniocentesis. Which of the following nursing interventions should be made first?

Obtain a signed consent form

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?

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

Amniotic fluid is produced throughout the pregnancy by the fetal membranes. Amniotic fluid has four major functions. What is one of these functions?

Physical protection

A woman calls the clinic to schedule an appointment because "I think I might be pregnant." Upon further assessment gathering of information from the woman, which of the following would be a probable sign of pregnancy?

Positive home pregnancy test

Early in pregnancy, frequent urination results mainly from which of the following?

Pressure on the bladder from the uterus

Amanda's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is Amanda experiencing?

Presumptive Explanation: The most common presumptive sign of pregnancy is a missed menstrual period, or amenorrhea. Other presumptive signs include nausea, fatigue, swollen, tender breasts, and frequent urination

The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client?

Primigravida

A nurse is caring for a client who is 8 months pregnant. Which instruction is the nurse most likely to give her?

Rest on the left side for at least 1 hour in the morning and afternoon.

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?

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

Which of the following statements would the nurse include in the teaching plan for a pregnant woman related to changes in the uterus?

The uterus changes from a pear-shaped organ to an oval one. Explanation: The uterus starts as a pear-shaped organ and becomes oval as length increases over width. Uterine growth is primarily related to an increase in size of the myometrial cells. The uterus remains in the pelvic cavity for the first 3 months, after which it progressively ascends into the abdomen. The uterus reaches its highest level at the xiphoid process at approximately 36 weeks. Between 38 to 40 weeks, fundal height drops as the fetus begins to descend and engage into the pelvis

What should the nurse explain to the pregnant patient about the importance of the fetal stage of development?

There is additional growth and development of the organs and body systems. Explanation: The fetal stage is from the beginning of the ninth week after fertilization and continues until birth. At this time, the developing human is called a fetus. During the fetal stage, there is additional growth and maturation of the organs and body systems.

A nurse is preparing a patient for rhythm strip testing. She places the woman into a semi-Fowler's position. What is the appropriate rationale for this measure?

To prevent supine hypotension syndrome Explanation: The term "rhythm strip testing" means assessment of the fetal heart rate for whether a good baseline rate and long- and short-term variability are present. For this, help a woman into a semi-Fowler's position (either in a comfortable lounge chair or on an examining table or bed with an elevated backrest) to prevent her uterus from compressing the vena cava and causing supine hypotension syndrome during the test. Placing her in this position does not decrease the heart rate of the fetus. It is not done to aid the woman as she pushes in labor, as she is not in labor yet. It is not done to prevent her from falling out of bed.

A number of inherited diseases can be detected in utero by amniocentesis. Which of the following diseases can be detected by this method?

Trisomy 21

Green tea should be avoided during pregnancy. (True/False)

True

Pregnant women seem to be more susceptible to carpal tunnel syndrome than others.

True

Some women report cravings for nonfood substances such as clay, dirt, cornstarch, or ice cubes during pregnancy. (True/False)

True

Morning sickness is associated with rising levels of human chorionic gonadotropin (hCG) and progesterone.

True Explanation: Known as morning sickness, nausea and vomiting begins to be noticed at the same time levels of hCG and progesterone begin to rise so these may contribute to its cause. Another reason may be a systemic reaction to increased estrogen levels or decreased glucose levels, because glucose is being used in such great quantities by the growing fetus.

During an examination, a client who's 32 weeks pregnant becomes dizzy, lightheaded, and pale while supine. What should the nurse do first?

Turn client on left side

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?

Use sanitary pads

A patient who has just given a blood sample for pregnancy testing in the doctor's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. Which of the following should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy?

Visualization of the fetus by ultrasound Explanation: There are only three documented or positive signs of pregnancy: 1) demonstration of a fetal heart separate from the mother's, 2) fetal movements felt by an examiner, and 3) visualization of the fetus by ultrasound. The absence of a period is an example of a presumptive symptom, which is a symptom that, when taken as a single entity, could easily indicate other conditions. Laboratory tests of either urine or blood serum for human chorionic gonadotropin (hCG) are examples of probable signs of pregnancy, which are objective and so can be verified by an examiner

Alpha- Fetoprotein analysis

glycoprotein produced by yolk sac and fetal gut, and later by fetal liver in the fetus the AFP level increases until 14-15 weeks then it falls. In normal pregnancies the AFP from fetal serum enters amniotic fluid through fetal urination. This biomarker screening is recommended for all pregnant women. Abnormal findings or an increase-- inappropriate increases cause neural tube defects such as, spina bifida or anencephaly, impending fetal death, congenital nephrosis, or contamination of fetal blood.

Fetal Nuchal Translucency

intravaginal ultrasound that measures fluid collection in the subcutaneous space between the skin and the cervical spine of the fetus. Indicated to identify fetal anomalies;abnormal fluid collection can be associated with genetic disorders(trisomies 13,18,21) Turner Syndrome, cardiac deformities, and sol;or physical anomalies. When the measurement of FNT is more than 2.5 this is ABNORMAL/ performed between 10 & 14 weeks

A pregnant woman works as a secretary at a large corporation. She states that she wants to take a leave of absence from work for pregnancy but is afraid she will lose seniority standing because of this. You would advise her that

legally, her employer cannot penalize her this way.

The purpose of a circulatory shunt, such as the ductus arteriosus, is to

permit oxygenated blood to supply the most important fetal organs. Explanation: The ductus arteriosus helps propel oxygenated blood quickly to the coronary arteries, brain, and kidneys.

Chorionic villus sampling

procedure for obtaining chorionic villi for prenatal evaluation of chromosomal disorders, enzyme deficiencies, gender determination, and to identify sex linked disorders such as, hemophilia, sickle cell anemia, and Tay Sachs Duchenne muscular dystrophy, phenylkentoneuria, and detect fetal karyotype. Can be used to detect numerous disorders except neural tube defects. Typically performed between 10-12 weeks gestation.

Girls with Turner Syndrome will usually exhibit

short stature Explanation: Girls with Turner syndrome usually have a single X chromosome, causing them to have short stature and infertility. Persons with sickle cell anemia have painful joints. Color blindness occurs in persons diagnosed with Huntington disease and they may exhibit chorealike movements. Progressive dementia occurs in early-onset familial Alzheimer's disease

When providing education on pre-conceptual considerations to a female patient and her spouse, the nurse knows that teratogens during the embryonic stage pose the greatest risk to the fetus. What weeks of gestation are considered the embryonic stage?

week 2 week 8 Explanation: The embryonic stage produces the greatest risk of damaging effects to the fetus because the cells are rapidly dividing and differentiating into specific body structures. Week 9 to birth is the fetal stage; the fertilization to the week 2 is the pre-embryonic stage. Weeks 2 to 8 are the time period known as the embryonic stage.

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which of the following data collected by the nurse are presumptive signs of her pregnancy? Select all that apply.

• Breast changes • Morning sickness • Amenorrhea Explanation: Presumptive signs are possible signs of pregnancy that appear in the first trimester, often only noted subjectively by the mother (e.g., breast changes, amenorrhea, morning sickness). Probable signs are signs that appear in the first and early second trimesters, seen via objective criteria, but can also be indicators of other conditions (e.g., hydatidiform mole). Positive signs affirm that proof exists that there is a developing fetus in any trimester and are objective criteria seen by a trained observer or diagnostic study, (e.g., ultrasound.)