Chapter 13: Anatomy and Physiology of Pregnancy, Chapter 14 OB, OB chapter 15
9. 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
1. Which nutrients recommended dietary allowance (RDA) is higher during lactation than during pregnancy? a. Energy (kcal) b. Iron c. Vitamin A d. Folic acid
A
12. 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
33. 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
8. Which hormone is essential for maintaining pregnancy? a.Estrogen b.hCG c.Oxytocin d.Progesterone
D
20. A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. Which recommendation would the nurse make for this particular client after a tennis match? a. Drink several glasses of fluid. b. Eat extra protein sources such as peanut butter. c. Enjoy salty foods to replace lost sodium. d. Consume easily digested sources of carbohydrate.
A
Which sign or symptom is considered a first-trimester warning sign and should be immediately reported by the pregnant woman to her health care provider? a. Nausea with occasional vomiting b. Fatigue c. Urinary frequency d. Vaginal bleeding
d. Vaginal bleeding
10. Why might it be more difficult to diagnose appendicitis during pregnancy? a.The appendix is displaced upward and laterally, high and to the right. b.The appendix is displaced upward and laterally, high and to the left. c.The appendix is deep at the McBurneys point. d.The appendix is displaced downward and laterally, low and to the right.
A
12. Which nutritional recommendation regarding fluids is accurate? a. A womans 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 childs risk of tooth decay.
A
16. 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
17. Which guidance might the nurse provide for a client with severe morning sickness? a. Trying lemonade and potato chips b. Drinking plenty of fluids early in the day c. Immediately brushing her teeth after eating d. Never snacking before bedtime
A
19. A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding? a.Melasma b.Linea nigra c.Striae gravidarum d.Palmar erythema
A
2. 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
21. 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
22. 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
24. What is the correct term for a woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability? a.Primipara b.Primigravida c.Multipara d.Nulligravida
A
30. 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
6. 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
8. After the nurse completes nutritional counseling for a pregnant woman, she asks the client to repeat the instructions to assess the clients understanding. Which statement indicates that the client understands the role of protein in her pregnancy? a. Protein will help my baby grow. b. Eating protein will prevent me from becoming anemic. c. Eating protein will make my baby have strong teeth after he is born. d. Eating protein will prevent me from being diabetic.
A
1. 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
34. Pregnancy is a hypercoagulable state in which women are at a fivefold to sixfold increased risk for thromboembolic disease. The tendency for blood to clot is greater, attributable to an increase in various clotting factors. Which of these come into play during pregnancy? (Select all that apply.) a.Factor VII b.Factor VIII c.Factor IX d.Factor XIII e.Fibrinogen
A,B,C,E
31. A woman is in for a routine prenatal checkup. The nurse is assessing her urine for glycosuria and proteinuria. Which findings are considered normal? (Select all that apply.) a.Dipstick assessment of trace to +1 b.<300 mg/24 hours c.Dipstick assessment of +2 glucose d.>300 mg/24 hours e.Albumin < 30 mg/24 hours
A,B,E
30. 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
13. Which time-based description of a stage of development in pregnancy is correct? a.Viability22 to 37 weeks of gestation since the last menstrual period (assuming a fetal weight greater than 500 g) b.Termpregnancy from the beginning of 38 weeks of gestation to the end of 42 weeks of gestation c.Pretermpregnancy from 20 to 28 weeks of gestation d.Postdatepregnancy that extends beyond 38 weeks of gestation
B
10. 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 individuals 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 womans preconception weight becomes irrelevant.
B
11. 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
15. Of which physiologic alteration of the uterus during pregnancy is it important for the nurse to alert the patient? a.Lightening occurs near the end of the second trimester as the uterus rises into a different position. b.Womans increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softening. c.Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise. d.Uterine souffle is the movement of the fetus.
B
16. Assessment of a womans nutritional status includes a diet history, medication regimen, physical examination, and relevant laboratory tests. Which finding might require consultation to a higher level of care? a. Oral contraceptive use may interfere with the absorption of iron b. Illnesses that have created nutritional deficits, such as PKU, may require nutritional care before conception. c. The womans socioeconomic status and educational level are not relevant to her examination; they are the province of the social worker. d. Testing for diabetes is the only nutrition-related laboratory test most pregnant women need.
B
18. 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
18. Which renal system adaptation is an anticipated anatomic change of pregnancy? a.Increased urinary output makes pregnant women less susceptible to urinary infections. b.Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty. c.Renal (kidney) function is more efficient when the woman assumes a supine position. d.Using diuretic agents during pregnancy can help keep kidney function regular.
B
23. A client states that she plans to breastfeed her newborn infant. What guidance would be useful for this new mother? a. The mothers 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
26. 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
27. 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
28. 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
29. A patient in her first trimester complains of nausea and vomiting. She asks, Why does this happen? What is the nurses 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
3. 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.Nonpapable 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
3. Which statement made by a lactating woman leads the nurse to believe that the client might have lactose intolerance? a. I always have heartburn after I drink milk. b. If I drink more than a cup of milk, I usually have abdominal cramps and bloating. c. Drinking milk usually makes me break out in hives. d. Sometimes I notice that I have bad breath after I drink a cup of milk.
B
31. 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
4. The musculoskeletal system adapts to the changes that occur throughout the pregnancy. Which musculoskeletal alteration should the client expect? a.Her center of gravity will shift backward. b.She will have increased lordosis. c.She will have increased abdominal muscle tone. d.She will notice decreased mobility of her pelvic joints.
B
5. 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 womans 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
7. 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
1. A womans 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 4-1-2-0-4
7. 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
2. Foodborne illnesses can cause adverse effects for both mother and fetus. The nurse is in an ideal position to evaluate the clients knowledge regarding steps to prevent a foodborne illness. The nurse asks the client to teach back the fours simple steps of food preparation. What are they? (Select all that apply.) a. Purchase b. Clean c. Separate d. Cook e. Chill
B, C, D, E
11. With regard to weight gain during pregnancy, the nurse should be aware of which important information? a. In pregnancy, the womans height is not a factor in determining her target weight. b. Obese women may have their health concerns, but their risk of giving birth to a child with major congenital defects is the same as with women of normal weight. c. Women with inadequate weight gain have an increased risk of delivering a preterm infant with intrauterine growth restriction (IUGR). d. Greater than expected weight gain during pregnancy is almost always attributable to old-fashioned overeating.
C
13. Which minerals and vitamins are usually recommended as a supplement in a pregnant clients diet? a. Fat-soluble vitamins A and D b. Water-soluble vitamins C and B6 c. Iron and folate d. Calcium and zinc
C
15. While obtaining a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. Which nutritional problem does this behavior indicate? a. Preeclampsia b. Pyrosis c. Pica d. Purging
C
17. 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
2. A pregnant womans 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
24. The labor and delivery nurse is preparing a client who is severely obese (bariatric) for an elective cesarean birth. Which piece of specialized equipment will not likely be needed when providing care for this pregnant woman? a. Extra-long surgical instruments b. Wide surgical table c. Temporal thermometer d. Increased diameter blood pressure cuff
C
28. If a clients 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
5. A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is this clients total recommended weight gain during pregnancy? a. 20 kg (44 lb) b. 16 kg (35 lb) c. 12.5 kg (27.5 lb) d. 10 kg (22 lb)
C
9. Pregnant adolescents are at greater risk for decreased BMI and fad dieting with which condition? a. Obesity b. Gestational diabetes c. Low-birth-weight babies d. High-birth-weight babies
C
14. Which vitamins or minerals may lead to congenital malformations of the fetus if taken in excess by the mother? a. Zinc b. Vitamin D c. Folic acid d. Vitamin A
D
14. 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
19. Nutrition is an alterable and important preventive measure for a variety of potential problems such as low birth weight and prematurity. While completing the physical assessment of the pregnant client, the nurse is able to evaluate the clients nutritional status by observing a number of physical signs. Which physical sign indicates to the nurse that the client has unmet nutritional needs? a. Normal heart rate, rhythm, and blood pressure b. Bright, clear, and shiny eyes c. Alert and responsive with good endurance d. Edema, tender calves, and tingling
D
20. Which gastrointestinal alteration of pregnancy is a normal finding? a.Insufficient salivation (ptyalism) is caused by increases in estrogen. b.Acid indigestion (pyrosis) begins early but declines throughout pregnancy. c.Hyperthyroidism often develops (temporarily) because hormone production increases. d.Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.
D
21. A woman in the 34th week of pregnancy reports that she is very uncomfortable because of heartburn. Which recommendation would be appropriate for this client? a. Substitute other calcium sources for milk in her diet. b. Lie down after each meal. c. Reduce the amount of fiber she consumes. d. Eat five small meals daily.
D
22. 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
23. Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth? a.Epulis b.Chloasma c.Telangiectasia d.Striae gravidarum
D
25. 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 clients 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
25. 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
26. The major source of nutrients in the diet of a pregnant woman should be composed of what? a. Simple sugars b. Fats c. Fiber d. Complex carbohydrates
D
27. A pregnant womans diet may not meet her increased need for folates. Which food is a rich source of this nutrient? a. Chicken b. Cheese c. Potatoes d. Green leafy vegetables
D
29. Which action is the first priority for the nurse who is assessing the influence of culture on a clients diet? a. Evaluate the clients 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 clients culture.
D
4. 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
6. A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant. Which guidance should she expect to receive? a. Discontinue all contraception now. b. Lose weight so that you can gain more during pregnancy. c. You may take any medications you have been regularly taking. d. Make sure you include adequate folic acid in your diet.
D
What is the primary role of the doula during labor? a. Helps the woman perform breathing techniques and provides support to the woman and her partner b. Checks the fetal monitor tracing for effects of the labor process on the fetal heart rate c. Takes the place of the father as a coach and support provider d. Administers pain medications as needed by the woman
Helps the woman perform breathing techniques and provides support to the woman and her partner
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 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.
If dental treatment is necessary, then the woman will be most comfortable with it in the second trimester
Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)? a. All women, regardless of risk factors b. Women who have had more than one sexual partner c. Women who have had a sexually transmitted infection (STI) d. Woman who are monogamous with one partner
a. All women, regardless of risk factors
A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of the exercise on the fetus. Which guidance should the nurse provide? a. "You don't need to modify your exercising any time during your pregnancy." b. "Stop exercising because it will harm the fetus." c. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." d. "Jogging is too hard on your joints; switch to walking now."
c. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."
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 (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.
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 prenatal appointments.
A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview, the nurse learns that the client has not had any immunizations. Which immunizations should she receive at this point in her pregnancy? (Select all that apply.) a. Tetanus b. Diphtheria c. Chickenpox d. Rubella e. Hepatitis B
a. Tetanus b. Diphtheria e. Hepatitis B
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 client at 34 weeks of gestation seeks guidance from the nurse regarding personal hygiene. Which information should the nurse provide? a. Tub bathing is permitted even in late pregnancy unless membranes have ruptured. b. The perineum should be wiped from back to front. c. Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath. d. Expectant mothers should use specially treated soap to cleanse the nipples.
a. Tub bathing is permitted even in late pregnancy unless membranes have ruptured.
Which signs and symptoms should a woman immediately report to her health care provider? (Select all that apply.) a. Vaginal bleeding b. Rupture of membranes c. Heartburn accompanied by severe headache d. Decreased libido e. Urinary frequency
a. Vaginal bleeding b. Rupture of membranes c. Heartburn accompanied by severe headache
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 menstrual period.
Which sign of a potential complication is the most important for the nurse to share with the client? a. Constipation b. Alteration in the pattern of fetal movement c. Heart palpitations d. Edema in the ankles and feet at the end of the day
b. Alteration in the pattern of fetal movement.
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 sexual drive, because of nausea and fatigue
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
A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild-to-moderate intensity. Which intervention should the nurse recommend? a. Kegel exercises b. Pelvic rock exercises c. Softer mattress d. Bed rest for 24 hours
b. Pelvic rock exercises
The number of routine laboratory tests during follow-up visits is limited; however, those that are performed are essential. Which statements regarding group B Streptococcus (GBS) testing are correct? (Select all that apply.) a. Performed between 32 and 34 weeks of gestation. b. Performed between 35 and 37 weeks of gestation. c. All women should be tested. d. Only women planning a vaginal birth should be tested. e. Women with a history of GBS should be retested.
b. Performed between 35 and 37 weeks of gestation. c. All women should be tested. e. Women with a history of GBS should be retested.
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.
The client is instructed to place her thumb and forefinger on the areola and gently press inward. What is the purpose of this exercise? a. To check the sensitivity of the nipples b. To determine whether the nipple is everted or inverted c. To calculate the adipose buildup in the abdomen d. To see whether the fetus has become inactive
b. To determine whether the nipple is everted or inverted.
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.
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 examination, the nurse should be alert for supine hypotension.
A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2019. What is the client's expected date of birth (EDB)? a. September 17, 2019 b. November 7, 2019 c. November 21, 2019 d. December 17, 2019
c. November 21, 2019
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.
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 her partner. 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 partner. 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: feeling loved and valued and having the child accepted by the partner.
A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. Which guidance should the nurse provide? a. "Since you're in your second trimester, there's no problem with having one drink with dinner." b. "One drink every night is too much. One drink three times a week should be fine." c. "Since you're in your second trimester, you can drink as much as you like." d. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."
d. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."
A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she does not know what is happening; one minute she is happy that she is pregnant and the next minute she cries for no reason. Which response by the nurse is most appropriate? a. "Don't worry about it; you'll feel better in a month or so." b. "Have you talked to your husband about how you feel?" c. "Perhaps you really don't want to be pregnant." d. "Hormone changes during pregnancy commonly result in mood swings."
d. "Hormone changes during pregnancy commonly result in mood swings."
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"—"I am going to have a baby"—"I am going to be a mother."
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 partner 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 partner 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 used during labor because it will interfere with movement and doing effleurage."
While assessing the vital signs of a pregnant woman in her third trimester, the client reports feeling faint, dizzy, and agitated. Which nursing intervention is appropriate? a. Have the patient stand up, and then retake her BP. b. Have the patient sit down, and then hold her arm in a dependent position. c. Have the patient lie supine for 5 minutes, and then recheck her BP on both arms. d. Have the patient turn to her left side, and then recheck her BP in 5 minutes.
d. Have the patient turn to her left side, and then recheck her BP in 5 minutes.
A woman who is 16 weeks pregnant has come in for a follow-up visit with her partner. To reassure the client regarding fetal well-being, which is the highest priority action for the nurse to perform? a. Assess the fetal heart tones with a Doppler stethoscope. b. Measure and document the girth of the woman's abdomen. c. Complete an ultrasound examination (sonogram) in a timely manner. d. Offer the woman and her partner the opportunity to listen to the fetal heart tones.
d. Offer the woman and her partner the opportunity to listen to the fetal heart tones.
Many pregnant women have questions regarding work and travel during pregnancy. Which education is a priority for the nurse to provide? a. Women should sit for as long as possible and cross their legs at the knees from time to time for exercise. b. Women should avoid seat belts and shoulder restraints in the car because they press on the fetus. c. Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them several times. d. While working or traveling in a car or on an airplane, women should arrange to walk around at least every hour or so.
d. While working or traveling in a car or on an airplane, women should arrange to walk around at least every hour or so.
