Quiz 1: Maternity Ch. 3, 4, 5

A nurse is educating a prenatal client at her second visit. The client is worried about "blotchy brown spots" on her forehead. The nurse reassures the client about this change by giving which appropriate response?

"Avoid sun because it will make the discoloring darker."

The nurse is assessing a client's risk for sexually transmitted infections. Which statement by the client would be cause for concern?

"I am unsure who the father of the baby is. I will be raising it alone."

The nurse is concerned that a pregnant patient is not adjusting emotionally to being pregnant. Which statement indicates that the patient may need additional counseling?

"I need to get right back to work after delivery."

The nurse instructs a pregnant patient on the need to increase foods containing folic acid. Which patient statement indicates that teaching has been effective?

"I will add spinach to my salad every evening."

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective?

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic."

The nurse determines that a pregnant patient is working through developmental tasks. Which statement did the patient make to the nurse?

"My mother and I are closer than ever before."

The nurse teaches a pregnant patient the manifestations associated with complications while pregnant. Which statement indicates that additional patient teaching is needed?

"Pain with urination is expected during pregnancy."

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse?

"The hormones of pregnancy may cause anxiety or depression postpartum."

On a prenatal visit, a woman in her second trimester has an ultrasound that confirms that the baby is a girl. Which statement by the mother would be troubling to the nurse concerning this finding?

"We don't want to name her because we don't want to get too attached."

Amanda is about 16 weeks pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to Amanda's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

During the interview portion of her first prenatal visit, a woman reports she thinks she may have a vaginal infection. When questioned, she reports the discharge is thick, greenish-yellow, and she is very uncomfortable. She reports she thinks it is "yeast." How should the nurse reply?

"Yeast is usually a thick, cheesy, white discharge so we will need to evaluate it during the pelvic exam."

Major goals of prenatal care:

-ensure a safe birth for mother and child -promote good health habits and reduce risk factors -teach healthy habits that may be continued after pregnancy -educate self care -provide physical care -prepare parents for responsibilities of parenthood

A patient at 6 weeks' gestation 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?

10 to 12 weeks

A patient makes an appointment at the prenatal clinic because she thinks she might be pregnant. Which assessment is a probable sign of pregnancy?

A positive pregnancy test

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

After a routine examination, a patient tells the nurse that she plans to use a home pregnancy test to determine if she is pregnant. What should the nurse's response be to this patient's plan?

Arrange for prenatal care if the test is positive

The process of oogenesis begins before birth but is not complete until the childbearing years. At what point does the second meiotic division occur in this process?

At the time of fertilization by the sperm

Which information provided by a client would be considered a presumptive sign of pregnancy?

Breast tenderness

Progesterone affects on urinary system during pregnancy

Causes the renal pelvis and ureters to lose tone, resulting in decreased peristalsis to the bladder

A woman has come to the clinic for her first prenatal visit. Which method would be the most effective way for the nurse to initiate data gathering for a health history?

Conduct an interview in a private room to obtain her health history.

Medical therapy during pregnancy for the patient with gestational diabetes:

Diet modification monitoring of blood glucose levels insulin exercise select fetal assessments

During an assessment, a patient who is 5 months pregnant tells the nurse that she has to change her diet because she is just becoming too fat. Which nursing diagnosis should the nurse use to guide interventions for the patient at this time?

Disturbed body image

Care of the bleeding woman with excessive bleeding:

Document blood loss monitor v/s, I&O Observe for: pain, uterine rigidity or tenderness Verify blood type monitor IV infusion prepare for surgery monitor fetal heart rate and contractions monitor lab results, including coagulation studies administer oxygen by mask prepare for newborn auscultation

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history?

G3, T0, P1, A1, L1

The nurse is appraising the laboratory results of a pregnant client who is in her second trimester and notes the following: TSH slightly elevated, glucose in the urine, complete blood count low normal, and normal electrolytes. The nurse prioritizes further testing to rule out which condition?

Gestational diabetes

How to calculate EDD

Go back 3 months from last known period, then add 7 days

A woman comes to the prenatal clinic and undergoes a pelvic exam. The doctor notes a softening of the uterine isthmus. The nurse recognized that this finding is known as what sign?

Hegar sign

The nurse is caring for a neonate whose mother received no medical care for either of her pregnancies. When assessing the neonate's status, which would indicate a potential A, B, and O incompatibility?

Hemolytic anemia

Which physical change would the nurse expect to find in a pregnant client? Select all that apply.

Increased blood volume Supine hypotension

A nurse is reviewing a journal article about fetal development and the formation of various body systems. When reading about the development of the digestive system, the nurse finds information related to the developmental abnormality of omphalocele. The nurse demonstrates understanding of this information by identifying which situation as the reason for an omphalocele?

Intestines failed to return to the abdominal cavity during intrauterine life.

A pregnant patient asks why an α-fetoprotein serum level has been ordered. What should the nurse explain to the patient about this test?

It may reveal chromosomal abnormalities.

Manifestations of placenta previa:

Painless vaginal bleeding; usually bright red

When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes which goal as the primary one?

Provide knowledge and skills to actively participate in birth and parenting.

A teenager arrives in the emergency department in active labor having no prenatal care. Upon examination in L & D, the nurse notices a cluster of pinpoint vesicles with a red base on her vulva which the teenager asks the nurse to not touch "her rash" because it hurts when touched. At this point, which intervention should the nurse perform next?

Report this finding to the health care provider immediately so he or she can plan the birth route.

A pregnant woman has come to the clinic for her first prenatal visit. The nurse informs the woman that the physician will do a pelvic examination at this time and that she should go empty her bladder. What is the primary reason the nurse instructs the patient to empty her bladder?

Urinating now will allow easier identification of organs.

TORCH

T- toxoplasmosis O- other infections R- rubella C- cytomegalovirus H- herpes simplex virus

The client is 32 weeks pregnant and has been referred for biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective?

The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.

Why is there a demand for iron during pregnancy?

The fetus must store an adequate supply to meet the needs in the first 3-6 months after birth

Recommended schedule for prenatal visits:

Visits should begin prior to pregnancy from conception- 28 weeks go every 4 weeks 29-36 weeks go every 2 weeks 37 weeks to birth go every week

A patient is to have an amniocentesis with ultrasound. What does the nurse explain to the patient that amniocentesis can determine? Select all that apply.

Whether the fetal lungs are mature enough to support respiration outside of the womb. For genetic testing.

The nurse is caring for a woman in a prenatal clinic who thinks she might be pregnant. Which assessment is a probable sign of pregnancy?

a positive pregnancy test

Uterine souffle

a soft blowing sound heard over the uterus during auscultation. the sound is synchronized with the mother's pulse and is caused by blood entering the dilated arteries of the uterus

Danger signs during pregnancy:

a sudden gush of fluid from vagina vaginal bleeding abdominal pain persistent vomiting epigastric pain edema of face and hands severe, persistent headaches blurred vision or dizziness chills with fever greater than 100.4 painful urination or reduced output

Place the following events in the sequence the pregnant woman would experience them, from first to last. All options must be used.

amennorhea uterine enlargement quickening Braxton Hicks contractions labor

Presumptive signs of pregnancy:

amenorrhea nausea breast tenderness deepening pigmentation urinary frequency quickening (fetal movement)

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

amenorrhea breast changes morning sickness

A nurse at the health care facility assesses a client in the 20th week of gestation. The client is healthy and progressing well, without any sign of complications. Where should the nurse expect to measure the fundal height in this client?

at the level of the umbilicus

The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?

at the level of the umbilicus

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to:

detect fetal heart sounds with a Doppler.

Following her first prenatal visit, a woman will be scheduled for a sonogram to confirm pregnancy length and document healthy fetal growth at 3 to 5 weeks of pregnancy.

false

What is a positive sign of pregnancy?

fetal movement felt by examiner

A nurse is taking a history during a client's first prenatal visit. Which assessment finding would alert the nurse to the need for further assessment?

history of diabetes for 4 years

Abuse during pregnancy:

if a woman confides that she eis being abused during pregnancy, this information must be kept absolutely confidential. Her life may be in danger if her abuser learns that she has told anyone. She should be referred to local shelters, but the decision to leave her abuser is her alone.

isoimmunization

if fetal Rh-positive blood leaks into the Rh-negative mother's circulation, her body may respond by making antibodies to destroy the Rh-positive erythrocytes.

Which change in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy?

increased lordosis

An adolescent who is 8 weeks' pregnant is at her first perinatal visit. During the health history interview, the nurse asks the client, "Are you afraid of anyone?" What is the nurse assessing with this question?

intimate partner abuse

funic souffle

is a soft swishing sound heard as the blood passes through the umbilical cord vessels.

Common discomforts with pregnancy:

nausea vomiting breast tenderness urinary frequency vaginal discharge heart burn constipation flatulence

The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended 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

Signs of congestive heart failure during pregnancy:

orthopnea persistent cough moist lung sounds difficulty breathing palpitations fatigue or fainting severe pitting edema of lower extremities or generalized edema changes in fetal heart rate indicating hypoxia or growth restriction if placental blood flow is reduced

The nurse teaches a pregnant woman about breast-feeding, stating that stimulation of the breast through sucking or touching stimulates the secretion of which hormone?

oxytocin

In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down flat on my back." The nurse explains that this is due to:

pressure of the gravid uterus on the vena cava.

Early in pregnancy, frequent urination results mainly from which cause?

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

Hegars sign

softening of the lower uterine segment

The nurse is reviewing all of the documentation on determining estimated date of delivery. Which objective data is included? Select all that apply.

sonogram fundal height calculating Naegele rule

Chadwicks sign

the purplish or bluish discoloration of the cervix, vagina and vulva caused by increased vascular congestion

Goodells sign

the softening of the cervix the vagina caused by increased vascular congestion

Implantation generally occurs at which place on the uterus?

the upper posterior surface

While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a:

trisomy numeric abnormality.

The nurse is assessing a primigravida woman at a routine prenatal visit. Which assessment finding is reinforcing to the client that she is definitely pregnant?

ultrasound picture of her fetus

A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which possible effect would the nurse include?

urinary frequency

The nurse is evaluating the fetal heart rate rhythm strip and determines that the amplitude varies with a rate 15 to 20 beats/min. What does this assessment finding indicate to the nurse about variability?

variability is normal

A client who has just given a blood sample for pregnancy testing in the health care provider'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. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy?

visualization of the fetus by ultrasound