OB 12,13,26,14,15

Which presumptive sign or symptom of pregnancy would a client experience who is approximately 10 weeks of gestation? a. Amenorrhea b. Positive pregnancy test c. Chadwick sign d. Hegar sign

A- AMENORRHEA pgs.285

During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criterion? (Select all that apply.) a. Leukorrhea b. Development of the operculum c. Quickening d. Ballottement e. Lightening

C,D,E

Which condition is likely to be identified by the quadruple marker screen? a. Down syndrome b. Diaphragmatic hernia c. Congenital cardiac abnormality d. Anencephaly

a. down syndrome

Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? a. Multiple-marker screening b. L/S ratio c. BPP d. Blood type and crossmatch of maternal and fetal serum

a. multiple marker screening

Which finding in the urinalysis of a pregnant woman is considered a variation of normal? a. Proteinuria b. Glycosuria c. Bacteria in the urine d. Ketones in the urine

b. glycosuria

Cardiac output increases from 30% to 50% by the 32nd week of pregnancy. What is the rationale for this change? a. To compensate for the decreased renal plasma flow b. To provide adequate perfusion of the placenta c. To eliminate metabolic wastes of the mother d. To prevent maternal and fetal dehydration

b. to provide adequate perfusion of the placenta

While working with the pregnant client in her first trimester, what information does the nurse provide regarding when CVS can be performed (in weeks of gestation)?

c.10

A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine "several times" during the past year and occasionally drinks alcohol. Her blood pressure is 108/70 mm Hg. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics places this client in a high-risk category? a. Blood pressure, age, BMI b. Drug and alcohol use, age, family history c. Family history, blood pressure (BP), BMI d. Family history, BMI, drug and alcohol abuse

d

How does the nurse document a NST during which two or more FHR accelerations of 15 beats per minute or more occur with fetal movement in a 20-minute period? a. Nonreactive b. Positive c. Negative d. Reactive

d reactive

What represents a typical progression through the phases of a woman's establishing a relationship with the fetus? a. Accepts the fetus as distinct from herself—accepts the biologic fact of pregnancy—has feelings of caring and responsibility. b. Fantasizes about the child's gender and personality—views the child as part of herself—becomes introspective. c. Views the child as part of herself—has feelings of well-being—accepts the biologic fact of the pregnancy. d. "I am pregnant"—"I am going to have a baby"—"I am going to be a mother."

d. I AM PREGNANT

Which hormone is essential for maintaining pregnancy? a. Estrogen b. hCG c. Oxytocin d. Progesterone

d. progesterone

The pancreas forms in the foregut during the 5th to 8th week of gestation. A client with poorly controlled gestational diabetes asks the nurse what the effects of her condition will be on the fetus. What is the best response by the nurse? Poorly controlled maternal gestational diabetes will: a. produce fetal hypoglycemia. b. result in a macrocosmic fetus. c. result in a microcosmic fetus. d. enhance lung maturation.

results in macrosomic fetus

Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. However, the nurse or midwife may need to refer a client to a registered dietitian for in-depth nutritional counseling. Which conditions would require such a consultation? (Select all that apply.) a. Preexisting or gestational illness such as diabetes b. Ethnic or cultural food patterns c. Obesity d. Vegetarian diets e. Multifetal pregnancy

A,B,C,D

Congenital disorders refer to those conditions that are present at birth. These disorders may be inherited and caused by environmental factors or maternal malnutrition. Toxic exposures have the greatest effect on development between 15 and 60 days of gestation. For the nurse to be able to conduct a complete assessment of the newly pregnant client, he or she should be knowledgeable regarding known human teratogens. Which substances might be considered a teratogen? (Select all that apply.) a. Cytomegalovirus (CMV) b. Ionizing radiation c. Hypothermia d. Carbamazepine e. Lead

A,B,D,E

Relating to the fetal circulatory system, which special characteristics allow the fetus to obtain sufficient oxygen from the maternal blood? (Select all that apply.) a. Fetal hemoglobin (Hb) carries 20% to 30% more oxygen than maternal Hb. b. Fetal Hb carries 40% to 50% more oxygen than maternal Hb. c. Hb concentration is 50% higher than that of the mother. d. Fetal heart rate is 110 to 160 beats per minute. e. Fetal heart rate is 160 to 200 beats per minute.

A,C,D

The diagnosis of pregnancy is based on which positive signs of pregnancy? (Select all that apply.) a. Identification of fetal heartbeat b. Palpation of fetal outline c. Visualization of the fetus d. Verification of fetal movement e. Positive hCG test

A,C,D

A woman's obstetric history indicates that she is pregnant for the fourth time, and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system? a. 3-1-1-1-3 b. 4-1-2-0-4 c. 3-0-3-0-3 d. 4-2-1-0-3

B-Using the GTPAL system, 4-1-2-0-4 is the correct calculation of this woman's gravidity and parity. The numbers reflect the woman's gravidity and parity information. Her information is calculated as: G reflects the total number of times the woman has been pregnant; she is pregnant for the fourth time. T indicates the number of pregnancies carried to term, not the number of deliveries at term; only one of her pregnancies resulted in a fetus at term. P is the number of pregnancies that resulted in a preterm birth; the woman has had two pregnancies in which she delivered preterm. A signifies whether the woman has had any abortions or miscarriages before the period of viability; she has not. L signifies the number of children born who are currently living; the woman has four children. 3-1-1-1-3 is an incorrect calculation of this woman's gravidity and parity; 3-0-3-0-3 is an incorrect calculation of this woman's gravidity and parity; and 4-2-1-0-3 is an incorrect calculation of this woman's gravidity and parity.

A newly married couple plans to use the natural family planning method of contraception. Understanding how long an ovum can live after ovulation is important to them. The nurse knows that his or her teaching was effective when the couple responds that an ovum is considered fertile for which period of time? a. 6 to 8 hours b. 24 hours c. 2 to 3 days d. 1 week

B. 24 HOURS

During the initial visit with a client who is beginning prenatal care, which action should be the highest priority for the nurse? a. The first interview is a relaxed, get-acquainted affair during which the nurse gathers some general impressions of his or her new client. b. If the nurse observed handicapping conditions, he or she should be sensitive and not inquire about them because the client will do that in her own time. c. The nurse should be alert to the appearance of potential parenting problems, such as depression or lack of family support. d. Because of legal complications, the nurse should not ask about illegal drug use; that is left to the physician.

C.The nurse should be alert to the appearance of potential parenting problems, such as depression or lack of family support

Which information is the highest priority for the nurse to comprehend regarding the BPP? a. BPP is an accurate indicator of impending fetal well-being. b. BPP is a compilation of health risk factors of the mother during the later stages of pregnancy. c. BPP consists of a Doppler blood flow analysis and an amniotic fluid index (AFI). d. BPP involves an invasive form of an ultrasonic examination.

a. BPP is an accurate indicator of impending fetal well being

A client has arrived for her first prenatal appointment. She asked the nurse to explain exactly how long the pregnancy will be. What is the nurse's best response? a. Normal pregnancy is 10 lunar months. b. Pregnancy is made up of four trimesters. c. Pregnancy is considered term at 36 weeks. d. Estimated date of delivery (EDD) is 40 completed weeks.

a. a normal pregnancy is 10 lunar months

Which nutritional recommendation regarding fluids is accurate? a. A woman's daily intake should be six to eight glasses of water, milk, and/or juice. b. Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worry. c. Of the artificial sweeteners, only aspartame has not been associated with any maternity health concerns. d. Water with fluoride is especially encouraged because it reduces the child's risk of tooth decay.

a. a womans daily intake should be six to eight glasses of milk juice or water a day

Which information regarding amniotic fluid is important for the nurse to understand? a. Amniotic fluid serves as a source of oral fluid and a repository for waste from the fetus. b. Volume of the amniotic fluid remains approximately the same throughout the term of a healthy pregnancy. c. The study of fetal cells in amniotic fluid yields little information. d. A volume of more than 2 L of amniotic fluid is associated with fetal renal abnormalities.

a. amniotic fluid serves as a source of or fluid and repository waste from the fetus

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

a. both prescription and over the counter drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus

A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that these are Braxton Hicks contractions. What other information is important for the nurse to share? a. Braxton Hicks contractions should be painless. b. They may increase in frequency with walking. c. These contractions might cause cervical dilation. d. Braxton Hicks contractions will impede oxygen flow to the fetus.

a. braxton hicks contractions should be painless

The various systems and organs of the fetus develop at different stages. Which statement is most accurate? a. Cardiovascular system is the first organ system to function in the developing human. b. Hematopoiesis originating in the yolk sac begins in the liver at 10 weeks of gestation. c. Body changes from straight to C-shape occurs at 8 weeks of gestation. d. Gastrointestinal system is mature at 32 weeks of gestation.

a. cardiovascular system is the first organ system to function in the developing human

The nurse sees a woman for the first time when she is 30 weeks pregnant. The client has smoked throughout the pregnancy, and fundal height measurements now are suggestive of intrauterine growth restriction (IUGR) in the fetus. In addition to ultrasound to measure fetal size, what is another tool useful in confirming the diagnosis? a. Doppler blood flow analysis b. Contraction stress test (CST) c. Amniocentesis d. Daily fetal movement counts

a. doppler blood flow analysis

The nurse has formulated a diagnosis of Imbalanced nutrition: Less than body requirements for the client. Which goal is most appropriate for this client to obtain? a. Gain a total of 30 pounds. b. Consistently take daily supplements. c. Decrease her intake of snack foods. d. Increase her intake of complex carbohydrates.

a. gain a total of 30 pounds

Which development related to the integumentary system is correct? a. Very fine hairs called lanugo appear at 12 weeks of gestation. b. Eyelashes, eyebrows, and scalp hair appear at 28 weeks of gestation. c. Fingernails and toenails develop at 28 weeks of gestation. d. By 32 weeks, scalp hair becomes apparent.

a. lanugo at 12 weeks

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

a. many protein rich foods are also good sources of calcium, iron, and b vitamins

Of these psychosocial factors, which has the least negative effect on the health of the mother and/or fetus? a. Moderate coffee consumption b. Moderate alcohol consumption c. Cigarette smoke d. Emotional distress

a. moderate coffee consumption

A woman is undergoing a nipple-stimulated CST. She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline heart rate of approximately 120 beats per minute without any decelerations. What is the correct interpretation of this test? a. Negative b. Positive c. Satisfactory d. Unsatisfactory

a. negative

What is the correct term used to describe the mucous plug that forms in the endocervical canal? a. Operculum b. Leukorrhea c. Funic souffle d. Ballottement

a. operculum

A new mother asks the nurse about the "white substance" covering her infant. How should the nurse explain the purpose of vernix caseosa? a. Vernix caseosa protects the fetal skin from the amniotic fluid. b. Vernix caseosa promotes the normal development of the peripheral nervous system. c. Vernix caseosa allows the transport of oxygen and nutrients across the amnion. d. Vernix caseosa regulates fetal temperature.

a. protects from amniotic fluid

Which behavior 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 slowly drives her car. d. She wears only low-heeled shoes.

a. she keeps all of her prenatal appointments

What is important for the nurse to recognize regarding the new father and his acceptance of the pregnancy and preparation for childbirth? a. The father goes through three phases of acceptance of his own. b. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after the birth. c. 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. d. Typically, men remain ambivalent about fatherhood right up to the birth of their child.

a. the father goes through three phases of acceptance of his own

A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. Which statement best describes why this may be happening to this client? a. This respiratory change is normal in pregnancy and caused by an elevated level of estrogen. b. This cardiovascular change is abnormal, and the nosebleeds are an ominous sign. c. The woman is a victim of domestic violence and is being hit in the face by her partner. d. The woman has been intranasally using cocaine.

a. this respiratory change is normal in pregnancy and caused by an elevated level of estrogen

An expectant couple attending childbirth classes have questions regarding multiple births since twins "run in the family." What information regarding multiple births is important for the nurse to share? a. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing. b. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins. c. Identical twins are more common in Caucasian families. d. Fraternal twins are the same gender, usually male.

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

A 39-year-old primigravida woman believes that she is approximately 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day; however, she tells the nurse that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique would be useful at this time? a. Ultrasound examination b. Maternal serum alpha-fetoprotein (MSAFP) screening c. Amniocentesis d. Nonstress test (NST)

a. ultrasound examination

A woman asks the nurse, "What protects my baby's umbilical cord from being squashed while the baby's inside of me?" What is the nurse's best response? a. "Your baby's umbilical cord is surrounded by connective tissue called Wharton's jelly, which prevents compression of the blood vessels." b. "Your baby's umbilical cord floats around in blood and amniotic fluid." c. "You don't need to be worrying about things like that." d. "The umbilical cord is a group of blood vessels that are very well protected by the placenta."

a. your babys umbilical cord is surrounded by connective tissue called whartons jelly which prevents compression of the blood vessels

A client asks her nurse, "My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean?" What is the nurse's best response? a. "Your placenta changes as your pregnancy progresses, and it is given a score that indicates how well it is functioning." b. "Your placenta isn't working properly, and your baby is in danger." c. "We need to perform an amniocentesis to detect if you have any placental damage." d. "Don't worry about it. Everything is fine."

a. your placenta changes as your pregnancy progresses and its given a score that indicates how well its functioning

Which statement concerning neurologic and sensory development in the fetus is correct? a. Brain waves have been recorded on an electroencephalogram as early as the end of the first trimester (12 weeks of gestation). b. Fetuses respond to sound by 24 weeks of gestation and can be soothed by the sound of the mother's voice. c. Eyes are first receptive to light at 34 to 36 weeks of gestation. d. At term, the fetal brain is at least one third the size of an adult brain.

b respond to sound by 24 weeks of age and are soothed by the mother voice

Many clients are concerned about the increased levels of mercury in fish and may be reluctant to include this source of nutrients in their diet. What is the best advice for the nurse to provide? a. Canned white tuna is a preferred choice. b. Shark, swordfish, and mackerel should be avoided. c. Fish caught in local waterways is the safest. d. Salmon and shrimp contain high levels of mercury.

b shark swordfish and mackerel should be avoided

Ideally, when should prenatal care begin? a. Before the first missed menstrual period b. After the first missed menstrual period c. After the second missed menstrual period d. After the third missed menstrual period

b. after the first missed period

An MSAFP screening indicates an elevated level of alpha-fetoprotein. The test is repeated, and again the level is reported as higher than normal. What is the next step in the assessment sequence to determine the well-being of the fetus? a. PUBS b. Ultrasound for fetal anomalies c. BPP for fetal well-being d. Amniocentesis for genetic anomalies

b. an ultrasound for fetal anomalies

The maternity nurse is cognizant of what important structure and function of the placenta? a. As the placenta widens, it gradually thins to allow easier passage of air and nutrients. b. As one of its early functions, the placenta acts as an endocrine gland. c. The placenta is able to keep out most potentially toxic substances, such as cigarette smoke, to which the mother is exposed. d. Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.

b. as one of its early functions, the placenta acts as an endocrine gland

To prevent gastrointestinal (GI) upset, when should a pregnant client be instructed to take the recommended iron supplements? a. On a full stomach b. At bedtime c. After eating a meal d. With milk

b. at bed time

A 41-week pregnant multigravida arrives at the labor and delivery unit after a NST indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool yields more detailed information about the condition of the fetus? a. Ultrasound for fetal anomalies b. Biophysical profile (BPP) c. MSAFP screening d. Percutaneous umbilical blood sampling (PUBS)

b. biophysical profile

A client states that she plans to breastfeed her newborn infant. What guidance would be useful for this new mother? a. The mother's intake of vitamin C, zinc, and protein can now be lower than during pregnancy. b. Caffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful. c. Critical iron and folic acid levels must be maintained. d. Lactating women can go back to their prepregnant caloric intake.

b. caffeine consumed by the mother accumulates in the infant who may be unusually active and wakeful

The nurse is providing health education to a pregnant client regarding the cardiovascular system. Which information is correct and important to share? a. A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia, requires close medical and obstetric observation no matter how healthy she may appear otherwise. b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term. c. Palpitations are twice as likely to occur in twin gestations. d. All of the above changes will likely occur.

b. changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestations to term

During the first trimester, which of the following changes regarding her sexual drive should a client be taught to expect? a. Increased sexual drive, because of enlarging breasts b. Decreased sexual drive, because of nausea and fatigue c. No change in her sexual drive d. Increased sexual drive, because of increased levels of female hormones

b. decreased because of nausea and fatigue

Which action is the highest priority for the nurse when educating a pregnant adolescent? a. Emphasize the need to eliminate common teenage snack foods because they are high in fat and sodium. b. Determine the weight gain needed to meet adolescent growth, and add 35 pounds. c. Suggest that she not eat at fast-food restaurants to avoid foods of poor nutritional value. d. Realize that most adolescents are unwilling to make dietary changes during pregnancy.

b. determine the weight gain needed to meet adolescent growth, and add 35 lbs

Which statement best describes the rationale for the physiologic anemia that occurs during pregnancy? a. Physiologic anemia involves an inadequate intake of iron. b. Dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia. c. Fetus establishes the iron stores. d. Decreased production of erythrocytes occur.

b. dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia

A 3-year-old girl's mother is 6 months pregnant. What concern is this child most likely to verbalize? a. How the baby will get out? b. How will the baby eat? c. Will you die having the baby? d. What color eyes will the baby have?

b. how will the baby eat

What type of cultural concern is the most likely deterrent to many women seeking prenatal care? a. Religion b. Modesty c. Ignorance d. Belief that physicians are evil

b. modesty

The nurse working with pregnant clients must seek to gain understanding of the process whereby women accept their pregnancy. Which statement regarding this process is most accurate? a. Nonacceptance of the pregnancy very often equates to a rejection of the child. b. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes. c. Ambivalent feelings during pregnancy are usually only expressed in emotionally immature or very young mothers. d. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will naturally resolve themselves after birth.

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

A patient in her first trimester complains of nausea and vomiting. She asks, "Why does this happen?" What is the nurse's best response? a. "Nausea and vomiting are due to an increase in gastric motility." b. "Nausea and vomiting may be due to changes in hormones." c. "Nausea and vomiting are related to an increase in glucose levels." d. "Nausea and vomiting are caused by a decrease in gastric secretions."

b. nausea and vomiting ar due to changes in hormones

Which statement regarding the probable signs of pregnancy is most accurate? a. Determined by ultrasound b. Observed by the health care provider c. Reported by the client d. Confirmed by diagnostic tests

b. observed by the health care provider

The nurse is planning the care for a laboring client with diabetes mellitus. This client is at greater risk for which clinical finding? a. Oligohydramnios b. Polyhydramnios c. Postterm pregnancy d. Chromosomal abnormalities

b. polyhydramnios

Which clinical finding is a major use of ultrasonography in the first trimester? a. Amniotic fluid volume b. Presence of maternal abnormalities c. Placental location and maturity d. Cervical length

b. presence of maternal abnormalities

Which statement regarding the structure and function of the placenta is correct? a. Produces nutrients for fetal nutrition b. Secretes both estrogen and progesterone c. Forms a protective, impenetrable barrier to microorganisms such as bacteria and viruses d. Excretes prolactin and insulin

b. secrets both estrogen and progesterone

A client is seen at the clinic at 14 weeks of gestation for a follow-up appointment. At which level does the nurse expect to palpate the fundus? a. Nonpalpable above the symphysis at 14 weeks of gestation b. Slightly above the symphysis pubis c. At the level of the umbilicus d. Slightly above the umbilicus

b. slightly above the symphysis pubis. It may be palpated above the symphysis pubis sometime between the 12th and 14th weeks of pregnancy. As the uterus grows, it may be palpated above the symphysis pubis sometime between the 12th and 14th weeks of pregnancy. At 14 weeks, the uterus is not yet at the level of the umbilicus. The fundus is not palpable above the umbilicus until 22 to 24 weeks of

A 31-year-old woman believes that she may be pregnant. She took an over-the-counter (OTC) pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview, the nurse inquires about the woman's last menstrual period and asks whether she is taking any medications. The client states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which confirms that she is not pregnant. What is the most likely cause of the false-positive pregnancy test result? a. The pregnancy test was taken too early. b. Anticonvulsant medications may cause the false-positive test result. c. The woman has a fibroid tumor. d. She has been under considerable stress and has a hormone imbalance.

b. the anti convulsant medications may cause the false positive test

A woman who is 16 weeks pregnant asks the nurse, "Is it possible to tell by ultrasound if the baby is a boy or girl yet?" What is the best answer? a. "A baby's sex is determined as soon as conception occurs." b. "The baby has developed enough to enable us to determine the sex by examining the genitals through an ultrasound scan." c. "Boys and girls look alike until approximately 20 weeks after conception, and then they begin to look different." d. "It might be possible to determine your baby's sex, but the external organs look very similar right now."

b. the baby has developed enough to determine the sex by examining the genitals through an ultrasound

During the physical examination of a client beginning prenatal care, which initial action is most important for the nurse to perform? a. Only women who show physical signs or meet the sociologic profile should be assessed for physical abuse. b. The client should empty her bladder before the pelvic examination. c. The distribution, amount, and quality of body hair are of no particular importance. d. The size of the uterus is discounted in the initial examination because it will be increasing in size during the second trimester.

b. the client should empty her bladder before the pelvic examination

Which statement regarding multifetal pregnancy is incorrect? a. The expectant mother often develops anemia because the fetuses have a greater demand for iron. b. Twin pregnancies come to term with the same frequency as single pregnancies. c. The mother should be counseled to increase her nutritional intake and gain more weight. d. Backache and varicose veins often are more pronounced with a multifetal pregnancy.

b. twin pregnancies come to term with the same frequency as single pregnancies

A woman is 15 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. What is the nurse's best answer? a. "You should have felt the baby move by now." b. "Within the next month, you should start to feel fluttering sensations." c. "The baby is moving; however, you can't feel it yet." d. "Some babies are quiet, and you don't feel them move."

b. within the next month, you should start to feel fluttering sensations

Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy. Why is this the case? a. Maternal nutritional status is extremely difficult to adjust because of an individual's ingrained eating habits. b. Adequate nutrition is an important preventive measure for a variety of problems. c. Women love obsessing about their weight and diets. d. A woman's preconception weight becomes irrelevant.

be. adequate nutrition is an important preventative measure for a variety of problems

If a client's normal prepregnancy diet contains 45 g of protein daily, how many more grams of protein should she consume per day during pregnancy? a. 5 b. 10 c. 25 d. 30

c 25

Which consideration is essential for the nurse to understand regarding follow-up prenatal care visits? a. The interview portions become more intensive as the visits become more frequent over the course of the pregnancy. b. Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester. c. During the abdominal examination, the nurse should be alert for supine hypotension. d. For pregnant women, a systolic BP of 130 mm Hg and a diastolic BP of 80 mm Hg is sufficient to be considered hypertensive.

c during the abdominal exam, the nurse should be alert for supine hypotension

The indirect Coombs' test is a screening tool for Rh incompatibility. If the titer is greater than ______, amniocentesis may be a necessary next step. a. 1:2 b. 1:4 c. 1:8 d. 1:12

c. 1:8

Which statement accurately describes the centering model of care? a. Group sessions begin with the first prenatal visit. b. Blood pressure (BP), weight, and urine dipsticks are obtained by the nurse at each visit. c. Approximately 8 to 12 women are placed in each gestational-age cohort group. d. Outcomes are similar to traditional prenatal care.

c. 8-12 women are placed in each gestational age group

A 30-year-old gravida 3, para 2-0-0-2 is at 18 weeks of gestation. Which screening test should the nurse recommend be ordered for this client? a. BPP b. Chorionic villi sampling c. MSAFP screening d. Screening for diabetes mellitus

c. MSAFP screening

A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about? a. Calcium b. Protein c. Vitamin B12 d. Folic acid

c. b12

A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? a. "That must have been a coincidence; babies can't respond like that." b. "The fetus is demonstrating the aural reflex." c. "Babies respond to sound starting at approximately 24 weeks of gestation." d. "Let me know if it happens again; we need to report that to your midwife."

c. babies respond to sound starting at approximately 24 weeks

Which information should nurses provide to expectant mothers when teaching them how to evaluate daily fetal movement counts (DFMCs)? a. Alcohol or cigarette smoke can irritate the fetus into greater activity. b. Kick counts should be taken every hour and averaged every 6 hours, with every other 6-hour stretch off. c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours. d. A count of less than four fetal movements in 1 hour warrants future evaluation.

c. he fetal alarm signal should go off when fetal movements stop entirely for 12 hours

Which minerals and vitamins are usually recommended as a supplement in a pregnant client's diet? a. Fat-soluble vitamins A and D b. Water-soluble vitamins C and B6 c. Iron and folate d. Calcium and zinc

c. iron and folate

The nurse is providing education to a client regarding the normal changes of the breasts during pregnancy. Which statement regarding these changes is correct? a. The visibility of blood vessels that form an intertwining blue network indicates full function of the Montgomery tubercles and possibly an infection of the tubercles. b. The mammary glands do not develop until 2 weeks before labor. c. Lactation is inhibited until the estrogen level declines after birth. d. Colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.

c. lactation is inhibited until the estrogen level declines after birth

Which statement regarding the development of the respiratory system is a high priority for the nurse to understand? a. The respiratory system does not begin developing until after the embryonic stage. b. The infant's lungs are considered mature when the L/S ratio is 1:1, at approximately 32 weeks of gestation. c. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. d. Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks of gestation.

c. maternal hypertension can reduce maternal placental blood flow, accelerating lung maturity

A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2015. What is the client's expected date of birth (EDB)? a. September 17, 2015 b. November 7, 2015 c. November 21, 2015 d. December 17, 2015

c. november 21, 2015

Which clinical finding in a primiparous client at 32 weeks of gestation might be an indication of anemia? a. Ptyalism b. Pyrosis c. Pica d. Decreased peristalsis

c. pica

Dental care during pregnancy is an important component of good prenatal care. Which instruction regarding dental health should the nurse provide? a. Regular brushing and flossing may not be necessary during early pregnancy because it may stimulate the woman who is already nauseated to vomit. A cleaning is all that is necessary. b. Dental surgery, in particular, is contraindicated during pregnancy and should be delayed until after delivery. c. If dental treatment is necessary, then the woman will be most comfortable with it in the second trimester. d. If a woman has dental anxiety, then dental care may interfere with the expectant mother's need to practice conscious relaxation and to prepare for labor.

c. should be done in the second trimester

A client arrives for her initial prenatal examination. This is her first child. She asks the nurse, "How does my baby get air inside my uterus?" What is the correct response by the nurse? a. "The baby's lungs work in utero to exchange oxygen and carbon dioxide." b. "The baby absorbs oxygen from your blood system." c. "The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream." d. "The placenta delivers oxygen-rich blood through the umbilical artery to the baby's abdomen."

c. the placenta provides O2 to the baby and excretes carbon dioxide into your bloodstream

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. "Defects occur between the third and fifth weeks of development." d. "They usually occur in the first 2 weeks of development."

c. they usually occur between the third and fifth weeks of development

Some pregnant clients may complain of changes in their voice and impaired hearing. What should the nurse explain to the client concerning these findings? a. Voice changes are caused by decreased estrogen levels. b. Displacement of the diaphragm results in thoracic breathing. c. Voice changes and impaired hearing are due to the results of congestion and swelling of the upper respiratory tract. d. Increased blood volume causes changes in the voice.

c. voice changes and impaired hearing are due to the results of congestion and swelling of the upper respiratory tract

What should the nurse be cognizant of concerning the client's reordering of personal relationships during pregnancy? a. Because of the special motherhood bond, a woman's relationship with her mother is even more important than with the father of the child. b. Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other. c. Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father. d. The woman's sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier.

c. women usually express two major relationship needs during pregnancy

A client in the third trimester has just undergone an amniocentesis to determine fetal lung maturity. Which statement regarding this testing is important for the nurse in formulating a care plan? a. Because of new imaging techniques, an amniocentesis should have been performed in the first trimester. b. Despite the use of ultrasonography, complications still occur in the mother or infant in 5% to 10% of cases. c. Administration of Rho(D) immunoglobulin may be necessary. d. The presence of meconium in the amniotic fluid is always a cause for concern.

c.administration of Rho immunoglobulin may be necessary

At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytic medications are administered and she is placed on bed rest, she continues to experience regular uterine contractions and her cervix is beginning to dilate and efface. What is an important test for fetal well-being at this time? a. PUBS b. Ultrasound for fetal size c. Amniocentesis for fetal lung maturity d. NST

c.amniocentesis for fetal lung maturity

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy. Which statement regarding monitoring techniques is the most accurate? a. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. b. MSAFP screening is recommended only for women at risk for NTDs. c. PUBS is one of the triple-marker tests for Down syndrome. d. MSAFP is a screening tool only; it identifies candidates for more definitive diagnostic procedures.

d. MSAFP is a screening tool only. it identifies candidates for more definitive diagnostic things

A client states that she does not drink milk. Which foods should the nurse encourage this woman to consume in greater amounts to increase her calcium intake? a. Fresh apricots b. Canned clams c. Spaghetti with meat sauce d. Canned sardines

d. canned sardines

To reassure and educate their pregnant clients regarding changes in their blood pressure, nurses should be cognizant of what? a. 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. b. 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. c. Systolic blood pressure slightly increases as the pregnancy advances; diastolic pressure remains constant. d. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of a term pregnancy.

d. compression of the illiac vains and inferior vena cava by the uterus contributes to the hemorids

Which action is the first priority for the nurse who is assessing the influence of culture on a client's diet? a. Evaluate the client's weight gain during pregnancy. b. Assess the socioeconomic status of the client. c. Discuss the four food groups with the client. d. Identify the food preferences and methods of food preparation common to the client's culture.

d. identify food preferences and methods of food preparation common to the client culture

What is the most basic information that a nurse should be able to share with a client who asks about the process of conception? a. Ova are considered fertile 48 to 72 hours after ovulation. b. Sperm remain viable in the woman's reproductive system for an average of 12 to 24 hours. c. Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum. d. Implantation in the endometrium occurs 6 to 10 days after conception.

d. implantatation in the endometrium occur 6 to 10 days after conception

pregnancy hormones prepare the vagina for stretching during labor and birth. Which change related to the pelvic viscera should the nurse share with the client? a. Because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are easier to evaluate. b. Quickening is a technique of palpating the fetus to engage it in passive movement. c. The deepening color of the vaginal mucosa and cervix (Chadwick sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor. d. Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.

d. increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester

A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parent's class. Which aspect of their birth plan should be considered potentially unrealistic and require further discussion with the nurse? a. "My husband and I have agreed that my sister will be my coach because he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is okay." b. "We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labor." c. "We want the labor and birth to take place in a birthing room. My husband will come in the minute the baby is born." d. "Regardless of the circumstances, we do not want the fetal monitor used during labor because it will interfere with movement and doing effleurage."

d. regardless of the circumstances, we do not want the fetal monitor

Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth? a. Epulis b. Chloasma c. Telangiectasia d. Striae gravidarum

d. striae gravidum

Some of the embryo's intestines remain within the umbilical cord during the embryonic period. What is the rationale for this development of the gastrointestinal system? a. Umbilical cord is much larger at this time than it will be at the end of pregnancy. b. Intestines begin their development within the umbilical cord. c. Nutrient content of the blood is higher in this location. d. Abdomen is too small to contain all the organs while they are developing.

d. the abdomen is too small to contain all the organs while they are developing

Which pregnant woman should strictly follow weight gain recommendations during pregnancy? a. Pregnant with twins b. In early adolescence c. Shorter than 62 inches or 157 cm d. Was 20 pounds overweight before pregnancy

d. was 20 lbs overweight before the pregnancy

A woman who is 8 months pregnant asks the nurse, "Does my baby have any antibodies to fight infection?" What is the most appropriate response by the nurse? a. "Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA)." b. "Your baby won't receive any antibodies until he is born and you breastfeed him." c. "Your baby does not have any antibodies to fight infection." d. "Your baby has IgG and IgM."

d. your baby has IgG and IgM

hCG is an important biochemical marker for pregnancy and therefore the basis for many tests. Which statement regarding hCG is true? a. hCG can be detected as early as weeks after conception. b. hCG levels gradually and uniformly increase throughout pregnancy. c. Significantly lower-than-normal increases in the levels of hCG may indicate a postdate pregnancy. d. Higher-than-normal levels of hCG may indicate an ectopic pregnancy or Down syndrome.

d.higher than normal levels of hCP may indicate and ectopic pregnancy or downs