Maternity Unit 1
A nurse is caring for a patient with Hyperemesis Gravidarum. Nutritional recommendations for this patient include: -Blood transfusion -Fluid and electrolyte replacement -Intake of folic acid -Intake of iron supplements
Fluid and electrolyte replacement
A client asks the nurse why taking folic acid is so important before and during pregnancy. The nurse should instruct the client that: -"Folic acid is important in preventing neural tube defects in newborns and preventing anemia in mothers." -"Folic acid consumption helps with the absorption of iron during pregnancy." -"Folic acid is needed to promote blood clotting and collagen formation in the newborn." -"Folic acid in foods helps regulate blood glucose levels."
"Folic acid is important in preventing neural tube defects in newborns and preventing anemia in mothers."
A patient in the first trimester is suffering with nausea and vomiting. Which response by the patient would indicate the need for further teaching? -"I have my saltines at my bedside to munch on before I get up." -"I know this morning sickness will pass and I should feel better in the 2nd trimester." -"I can carry ginger candy to help when I'm nauseous throughout the day." -"I have been addicted to Mexican food and fried pickles lately."
"I have been addicted to Mexican food and fried pickles lately."
Which statement supports understanding of how to avoid TORCH infections in pregnancy? -"I will obtain a rubella vaccine early in pregnancy." -"I should avoid large crowds during pregnancy." -"I will eat only cooked deli meat on sandwiches." -"I will clean the cat's litter box every other day."
"I should avoid large crowds during pregnancy." or "I will eat only cooked deli meat on sandwiches."
When discussing exercise regimes throughout pregnancy, which response by the patient indicates a need for additional teaching? -"I will be sure to drink water before and after exercising." -"I will try to lift weights and bench press to get stronger for birth." -"I will remember to stretch prior to exercising." -"I should try to exercise for 30 minutes every day."
"I will try to lift weights and bench press to get stronger for birth."
A nurse is teaching a prenatal class measures that can be done to relieve backaches during pregnancy. Which of the following measures should the nurse include? Select all that apply. -Use proper body mechanics -Perform Kegel exercises twice a day -Perform pelvic rock exercises every day -Avoid any lifting -Avoid constrictive clothing
-Perform pelvic rock excercises every day -Avoid any lifting
A nurse is caring for a patient who is prescribed Rh immune globulin (RhoGAM) standard dose IM. How should the nurse describe the action of this medication to the patient? -"RhoGAM prevents the formation of Rh antibodies in mothers who are Rh negative." -"RhoGAM destroys the Rh antibodies in mothers who are Rh negative." -"RhoGAM destroys the Rh antibodies in newborns who are Rh positive." -"RhoGAM prevents the formation of Rh antibodies in newborns who are Rh positive."
"RhoGAM prevents the formation of Rh antibodies in mothers who are Rh negative."
A patient at 30 weeks' gestation will be traveling to visit relatives who live several hours away. Which of the following recommendations is most appropriate? -"Try to avoid traveling anywhere in the car during your third trimester." -"Avoid wearing your seat belt to prevent injury to the baby." -"Taking the trip is okay if you stop every 1 to 2 hours and walk." -"Limit the time you spend in the car to a maximum of 4 to 5 hours."
"Taking the trip is okay if you stop every 1-2 hours and walk"
At her prenatal visit, a pregnant woman mentions to her nurse that one minute she's happy that she is pregnant, and the next minute she feels sad and cries. Which response by the nurse is most appropriate? -"Have you talked to your husband about how you feel?" -"You'll feel better in a month or so." -"Tell me about what is making you feel sad." -"You feel this way because hormonal changes cause mood swings."
"Tell me about what is making you sad"
A patient asks her nurse why she feels hot and light-headed when she lies down in bed. She explains that she's always been a "back sleeper" and she can't understand why she is so uncomfortable sleeping this way since being pregnant. Which response by the nurse describes why she would exhibit these symptoms? -"This is due to increased cardiac output." -"This is due to pressure from the uterus on the diaphragm." -"This is due to weight of the uterus on the vena cava." -"This is due to an increase in blood volume."
"This is due to weight of the uterus on the vena cava."
Which of the following responses by the nurse would be most appropriate when answering questions about the brown discolorations on her nose and cheeks? -"This usually disappears after delivery." -"It will fade if you use a prescribed cream." -"The discoloration is due to dilated capillaries." -"It is a sign of skin melanoma."
"This usually disappears after delivery"
A nurse is performing a nutritional assessment on a patient that is experiencing Pica. Which food choices support this finding? Select all that apply. -Eating starch -Eating chocolate -Eating spicy foods -Eating soil -Eating ice
-Eating starch -Eating soil -Eating ice
A patient presents to the prenatal clinic with presumptive signs of pregnancy. Which of the following should the nurse expect? (select all that apply) -Goodell's sign -Nausea and vomiting -Chadwick's sign -Amenorrhea -Quickening
-N/V -Amenorrhea -Quickening
As a patient is leaving a prenatal visit at 26 weeks, the nurse educates her on signs and symptoms she would need to report if experienced before her next visit. Select all of the instructions that apply from the list below. -Painful abdominal cramps -Urinary frequency -Moderate vaginal bleeding -Temperature > 99.0 -Changes in fetal activity
-Painful abdominal cramps -Moderate vaginal bleeding -Changes in fetal activity
A new patient comes to the prenatal clinic asking about common pregnancy symptoms. Which of the following should the nurse include in her teaching plan? Select all that apply. -Moderate bleeding is common in the first trimester of pregnancy. -Urinary frequency is a result of increased susceptibility to urinary tract infections. -Sensations of fetal movement are often felt around 18 weeks gestation. -Easy fatigability is characteristic of the first trimester of pregnancy. -Morning sickness usually subsides after about 12-16 weeks of pregnancy.
-Sensations of fetal movement are often felt around 18 weeks gestation -Easy fatiguability is characteristic of the first trimester of pregnancy -Morning sickness usually subsides after about 12-16 weeks of pregnancy
What teaching can be provided to pregnant women to reduce their risk of experiencing UTIs during pregnancy? Select all that apply. -Take frequent bubble baths to stay clean -Wipe the perineal area back to front -Wear cotton underwear -Hold urine to promote large void volume -Drink at least 8 glasses of water per day
-Wear cotton underwear -Drink at least 8 glasses of water per day
A client has her first prenatal visit at 19 weeks' gestation. Which finding requires further investigation? -Blood pressure of 124/72 mm Hg -Weight of 144 lb (65.kg) -Fundal height of 22 cm -Urine negative for protein
Fundal height of 22 cm
A woman at 31 weeks pregnant asks when she needs to return for her next visit. According to the ACOG guidelines, how soon should the nurse recommend the patient to schedule her next visit? -3 weeks -4 weeks -1 week -2 weeks
2 weeks
The nurse is documenting the obstetric history of a patient pregnant with triplets who has a child at home born at 36 weeks' gestation. Which of the following is an accurate accounting of this patient's history? -G4 P1 -G1 P1 -G2 P2 -G2 P1
G2 P1
While at a prenatal visit, a patient asks her midwife when she will have to drink "the sugary drink" and have her blood drawn to screen for insulin resistance and gestational diabetes. Which time frame correctly identifies when this screening is normally done in pregnancy? -12-16 weeks -24-28 weeks -35-37 weeks -4-8 weeks
24-28 weeks
A woman is 14 weeks pregnant. She has had a previous spontaneous abortion at 16 weeks gestation and a pregnancy that ended at 41 weeks with the birth of a girl that died after a traumatic delivery. What is her gravidity and parity using the GTPAL system? -3-0-1-1-0 -2-1-0-1-0 -2-0-0-1-1 -3-1-0-1-0
3-1-0-1-0
During a routine prenatal visit, a woman reports a white, thick vaginal discharge. She denies any itching or irritation, but she wants to know if she should be concerned. Which response by the nurse would be an appropriate answer? -Notify the healthcare provider of a possible infection. -Explain that the discharge is entirely normal. -Explain that the discharge is related to rupture of membranes. -Advise that the discharge would need to be cultured
Explain that the discharge is entirely normal
A woman's obstetric history indicates that she is pregnant for the fifth time and three of her children from prior pregnancies are living. One child was born at 35 weeks gestation; one child was born at 39 weeks of gestation, and her last child was born at 33 weeks of gestation. She also had a miscarriage at 19 weeks. What is her gravidity and parity using the GTPAL system? -5-1-2-1-3 -5-4-1-0-2 -5-2-1-0-2 -5-2-1-1-3
5-1-2-1-3
A nurse is educating a pregnant woman on what to eat during pregnancy. Which of the following precautions should a pregnant client take regarding nutritional requirements? -Limit folic acid intake -Limit fluid intake -Limit alcohol intake -Limit caffeine intake
Limit caffeine intake
Throughout pregnancy, a woman's posture may change as the uterus expands. Which postural change may result? -Scoliosis -Lordosis -Turtle neck -Kyphosis
Lordosis
A nurse is caring for a client who has a positive pregnancy test. The nurse is teaching the client about common discomforts in the second trimester of pregnancy as well as warning signs of potential danger. The nurse should instruct the client to call the clinic if she experiences which of the following? -Nausea and vomiting -Urinary frequency -Leukorrhea -Facial Edema
Facial edema
What should the nurse include in the nutritional plan for a newly pregnant woman who has a normal BMI? -A decrease of 200 calories per day -An increase of 600 calories per day -A decrease of 100 calories per day -An increase of 300 calories per day
An increase of 300 calories per day
When measuring the fundal height of a primigravid patient at 20 weeks' gestation, the nurse should locate the fundal height at which of the following points? -At the level of the umbilicus -Near the symphysis pubis -Between the umbilicus and xiphoid process -Near the xiphoid process
At the level of the umbilicus
A woman and her partner present for an initial visit. The woman states that her last menstrual period began on November 9, 2020. What is her EDD? -November 2, 2021 -August 2, 2021 -August 16, 2021 -September 16, 2021
August 16, 2021
A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was May 12, 2020. What is her expected due date (EDD)? -March 12, 2021 -February 19, 2021 -April 5, 2021 -May 19, 2021
February 19, 2021
A patient and the father of the baby (FOB) present to the prenatal clinic. The FOB complains of nausea, vomiting, and fatigue similar to that of the patient. The nurse interprets this information as suggesting the FOB is experiencing which of the following? -Pica -Mittelschmerz -Couvade -Ptyalism
Couvade
Which of the following should the nurse include when discussing changes that can occur during the first trimester of pregnancy? -Preparing for the responsibilities of parenthood. -Enjoying the role of nurturer. -Differentiating the self from the fetus. -Experiencing ambivalence about pregnancy.
Experiencing ambivalence about pregnancy
Which of the following food choices should the nurse recommend as a good source of calcium? -Dark green leafy vegetables -Tea or coffee -Meat, poultry and fish -White breads and rice
Dark, green, leafy vegetable
A nurse is assessing a pregnant patient during the third trimester. What clinical finding is an expected response to the pregnancy during the third trimester? -Dependent edema -Nausea -Round ligament pain -Headaches
Dependent edema
A patient at 34 weeks' gestation reports problems of constipation at her routine visit. What suggestion by the nurse would be most beneficial for the patient? -Add more protein to her diet. -Take a mild laxative daily -Drink 8-10 glasses of water and walk daily. -Drink hot tea or coffee each morning.
Drink 8-10 glasses of water and walk daily
A client who recently learned of being pregnant tells the nurse that she stopped eating meat years ago and started eating fish daily because it is healthier. Which teaching point is appropriate for this client based on her current diet? -Eat up to 12 ounces a week of a variety of fish and shellfish. -Avoid shrimp, salmon, and catfish because they have high mercury levels. -Eat plenty of fish such as swordfish and shark while pregnant. -Follow a complete vegetarian diet as a healthier alternative to eating fish
Eat up to 12 ounces a week of a variety of fish and shellfish
The midwife orders a pregnancy blood test. Which finding would confirm the findings of a home pregnancy test? -Elevated follicle stimulating hormone level -Elevated human chorionic gonadotropin level -Elevated estrogen level -Elevated progesterone level
Elevated human chorionic gonadotropin level
A patient comes for a routine prenatal visit at 22 weeks' gestation. What is the rationale for assessing the fundal height? -Identify the need for increased weight gain -Estimate fetal growth -Assess the location of the placenta -Determine the level of uterine activity
Estimate fetal growth
A nurse is reviewing a new prescription for iron supplements with a patient who is 10 weeks pregnant and has iron deficiency anemia. Which of the following beverages should the nurse instruct the patient to take the iron supplements with? -Tea or Coffee -Ice water -Orange Juice -Whole milk
Ice water
A nurse is doing an assessment of a pregnant client who states that she smokes one pack of cigarettes each day. The nurse should: -Insist that the client stop smoking immediately for the health of her baby. -Inform the client of the risks to the fetus and ask if she'd like a referral to a smoking cessation support group. -Do nothing; smoking is a personal decision. -Ask the client to cut down to half a pack a day.
Inform the client of the risks to the fetus and ask if she'd like a referral to a smoking cessation support group.
A nurse is counseling a prenatal patient about getting enough iron in her diet. When discussing considerations for taking iron supplements, which of the following should the nurse explain? -Iron supplements can lead to diarrhea. -Iron is best absorbed when being taken with meals. -Iron absorption is inhibited by taking the supplement with milk. -Milk, coffee, and tea will aid iron absorption if consumed with the iron.
Iron absorption is inhibited by taking the supplement with milk.
A patient who is 12 weeks' gestation is experiencing nausea, vomiting, breast tenderness, and fatigue. She tells the nurse she is concerned because she has lost weight but she cant focus on herself because her husband has expressed frustration with her constant complaints. Which is the priority nursing diagnosis based on this data? -Fatigue -Dysfunctional family processes -Ineffective breastfeeding -Nausea and vomiting
Nausea and vomiting
A 25-year-old is pregnant at 36 weeks gestation. She is diagnosed with a urinary tract infection. Based on her gestation age and on drug classification in pregnancy, which of the following drugs is safe for this patient? -Trimethoprim/sulfamethoxazole (category C in the third trimester). -Nitrofurantoin (category C in the first trimester). -Trimethoprim/sulfamethoxazole (category B in the first trimester). -Nitrofurantoin (category B in the third trimester)
Nitrofurantoin (category B in the third trimester)
The nurse is instructing a patient who is at 12 weeks' gestation on smoking cessation and avoiding substance abuse. Which is the rationale for why these should be avoided during pregnancy? -Stops the synthesis of protein in the developing fetus. -Interferes with hormone excretion of the fetus. -Facilitates the transfer of viruses into the developing fetus. -Passes into the developing fetus through the placenta very easily.
Passes into the developing fetus through the placenta very easily.
Which of the following gastrointestinal changes in pregnancy could potentially harm the fetus? -Pica -Pytosis -Ptyalism -Decreased peristalsis
Pica
A patient presents to the prenatal clinic and reports she has not had a period for about 5 months, so she thinks she might be pregnant. Which of the following is a positive sign of pregnancy? -Elevated human chorionic gonadotropin. -Breast enlargement and tenderness. -Uterine Enlargement -Presence of fetal heart tones.
Presence of fetal heart tones (positive=undeniable)
The nurse confirms a patient is experiencing abdominal enlargement and has changes in the pigmentation of the face and abdomen. Which sign of pregnancy is the woman experiencing? -Presumptive -Probable -Positive -Diagnostic
Presumptive
Which of the following hormones is responsible for maintaining an implanted pregnancy? -Luteinizing hormone -Human chorionic gonadotropin -Estrogen -Progesterone
Progesterone
The nurse is completing the admission assessment on a client who is 12 weeks pregnant and is visiting a women's health clinic. The client tells the nurse, "I am a vegan." Based on the client's statement, which is most appropriate for the nurse? -Tell the client it is not safe to adhere to the vegan diet due to missing important nutrients during her pregnancy. -Discuss the importance of eating adequate amounts of meat and dairy products during pregnancy. -Recommend that the client eat a wide variety of foods such as grains, legumes, nuts and vegetables daily during the pregnancy. -Inform the client that iron supplements should be taken with prenatal vitamins to ensure adequate iron intake.
Recommend that the client eat a wide variety of foods such as grains, legumes, nuts and vegetables daily during the pregnancy.
A multigravida client is 19 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? -Round ligament pain -Nausea -Insomnia -Perineal pain
Round ligament pain
A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work, the nurse notices the patient does not have immunity to rubella. Which of the following times should the nurse understand is recommended for rubella immunization? -During the next pregnancy -In the third trimester -Immediately -Shortly after giving birth
Shortly after giving birth
Which time-based description of a stage of development in pregnancy is accurate? -Preterm— pregnancy from 20 to 28 weeks. -Viability—22 to 37 weeks since the last menstrual period (LMP) (assuming a fetal weight greater than 500 g). -Term—pregnancy from the beginning of week 37 of gestation to the end of week 42. -Postdate—pregnancy that extends beyond 38 weeks.
Term—pregnancy from the beginning of week 37 of gestation to the end of week 42.
In the later part of the 3rd trimester, a pregnant woman may experience shortness of breath. How may this complaint be explained? -She is experiencing a complication of pregnancy. -This is a normal occurrence because the fetus is using more oxygen. -The fundus is pushing the diaphragm upward. -The woman is having an allergic reaction to pregnancy.
The fundus is pushing the diaphragm upward.
A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. What does the nurse suspect? -This is an abnormal cardiovascular change and the nosebleeds are an ominous sign. -The patient may have a nasal polyp from inflammation. -The patient may need to be evaluated by an ear, nose, and throat specialist complications. -There is vasocongestion of the mucus membranes resulting from hormones.
There is vasocongestion of the mucus membranes resulting from hormones.
A nurse working in Labor and Delivery responds to a patient's call light. The patient is lying supine in bed and complains of feeling short of air and lightheaded. Based on your knowledge of pregnancy physiology, which of the following interventions should the nurse attempt first to help relieve the patient's symptoms? -Turn the patient to a left lateral position -Apply oxygen via nasal cannula -Get the patient out of bed to ambulate -Call the healthcare provider
Turn the patient to a left lateral position
The nurse is reviewing the immunization record for a patient who just learned she is pregnant. Which vaccine is not safe to give during pregnancy? -Pertussis -Tetanus -Influenza -Varicella
Varicella
The nurse is discussing natural family planning during a pre-conception counseling visit. The patient asks when the most likely time for conception to occur is. Which of the following is the best response by the nurse? -When follicle stimulating hormone is high. -When progesterone levels are lowest. -When luteinizing hormone is high. -When estrogen levels are low.
When luteinizing hormone is high
A nurse is teaching a couple about the process of fertilization. The nurse teaches that fertilization takes place in which part of the fallopian tube? -The fimbria (outer third). -The isthmus (inner third) -The ampulla (outer third). -The ampulla (inner third).
the ampulla (outer third)
