Exam #3 PrepU Questions

A gravid woman who is in her first trimester reports experiencing constipation. Which statement by the client indicates the need for further instruction? A. "Taking gentle enemas no more frequently than once a week is acceptable." B. "Increasing my water intake will aid in reducing my constipation." C. "Exercise such as walking daily helps increase my bowel movements." D. "Adding more vegetables to my diet will be helpful."

A. "Taking gentle enemas no more frequently than once a week is acceptable."

A patient is at 22 weeks' gestation is preparing to have her fundal height measured. Given the patient's stage of gestation and following McDonald's rule, what result does the nurse expect? A. 44 cm B. 22 cm C. 11 cm D. 2.2 cm

B. 22 cm

A mother comes in with her 17-year-old daughter to find out why she has not had a menstrual cycle for a few months. Examination confirms the daughter is pregnant with a fundal height of approximately 24 cm. The nurse interprets this finding as indicating that the daughter is approximately how many weeks pregnant? A. 22 B. 24 C. 20 D. 18

B. 24

A client in the third trimester of pregnancy has to travel a long distance by car. The client is anxious about the effect the travel may have on her pregnancy. Which instruction should the nurse provide to promote easy and safe travel for the client? A. Activate the air bag in the car. B. Always wear a three-point seat belt. C. Apply a padded shoulder strap properly. D. Use a lap belt that crosses over the uterus.

B. Always wear a three-point seat belt.

Which disease process would the nurse screen for under potential genetic disorders? A. Rheumatic fever B. Cystic fibrosis C. Tuberculosis D. Asthma

B. Cystic fibrosis

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. A. fetal heartbeat B. hydatidiform mole C. ultrasound pictures D. breast changes E. morning sickness F. amenorrhea

D. breast changes E. morning sickness F. amenorrhea

When preparing a class for a group of pregnant women about nicotine use during pregnancy, the nurse describes the major risks associated with nicotine use, including? A. increased risk of stillbirth. B. increased risk of spontaneous abortion (miscarriage). C. increased risk of placental abruption (abruptio placentae). D. decreased birth weight in neonates.

D. decreased birth weight in neonates.

Part of the initial prenatal assessment should include the client's immunization history. The nurse informs the client to avoid which type of vaccines while she is pregnant? A. toxoid vaccine B. bacterial vaccine C. inactivated virus vaccine D. live virus vaccine

D. live virus vaccine

A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation (dilatation) and enlargement of the birth canal. What is this hormone? A. progesterone B. estrogen C. human placental lactogen D. relaxin

D. relaxin

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? A. positive hCG blood result B. continued amenorrhea C. uterine growth D. ultrasound picture of her fetus

D. ultrasound picture of her fetus

A pregnant client reports occasional headaches. She wants to know what she can take to alleviate the discomfort. What would be the best response by the nurse? A. "The safest medication to take for your headaches during your pregnancy would be acetaminophen." B. "Wait until you reach your third trimester. You can take something to relieve headaches then." C. "You don't want to harm the baby by taking medications now, do you?" D. "The safest medication to take for your headaches during your pregnancy would be ibuprofen."

A. "The safest medication to take for your headaches during your pregnancy would be acetaminophen."

What is the most effective way for a nurse to assess a woman's usual food intake during her pregnancy? A. Ask her to describe her intake for the last 24 hours. B. Assess her skin for hydration and color. C. Ask her to describe her total intake for a week. D. Assess a list she makes describing a good diet.

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

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem? A. Hemorrhoids B. Gastrointestinal reflux C. Varicose veins D. Umbilical hernia

A. Hemorrhoids

A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next? A. Inform the client this is a normal response to pregnancy that many women experience. B. Determine if the client's significant other is experiencing similar feelings about the pregnancy. C. Schedule the client a consult with a psychiatric health care provider. D. Provide the client with information about pregnancy support groups.

A. Inform the client this is a normal response to pregnancy that many women experience.

The nurse is assessing a pregnant client at 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are? A. Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples B. Normal bumps of pregnancy; they do nothing C. Striae, stretching of the breast tissue D. Might be sign of cancer; need to speak with health care provider

A. Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples

The nurse is assessing a client at her first prenatal visit and reports her LMP started December 1. Which date will the nurse predict for the EDD? A. September 8 B. July 7 C. October 7 D. August 8

A. September 8

A pregnant client in her 12th week of gestation has come to a health care center for a physical examination of her abdomen. Where should the nurse palpate for the fundus in this client? A. at the symphysis pubis B. midway between the symphysis and umbilicus C. at the umbilicus D. below the ensiform cartilage

A. at the symphysis pubis

A pregnant woman who is a vegetarian asks the nurse, "What would you suggest to make sure that I get enough protein in my diet while I am pregnant?" Which food(s) would be appropriate for the nurse to suggest? Select all that apply. A. beans B. nuts C. green leafy vegetables D. lentils E. orange juice

A. beans B. nuts D. lentils

What is the major concern for a lactose intolerant woman who is pregnant? A. calcium deficiency B. nausea and vomiting C. vitamin D deficiency D. dangerous symptom of abdominal cramping

A. calcium deficiency

A woman is 10 weeks' pregnant and tells the nurse that this pregnancy was unplanned and she has no real family support. The nurse's most therapeutic response would be to? A. encourage her to identify someone that she can talk to and share the pregnancy experience. B. offer to meet with the client on a regular basis to provide her someone to talk to about her concerns. C. tell her to move home so her family will be nearby to help her. D. remind her that she is still early in the pregnancy and she will feel better about it as the pregnancy progresses.

A. encourage her to identify someone that she can talk to and share the pregnancy experience.

What is a positive sign of pregnancy? A. fetal movement felt by examiner B. positive pregnancy test C. Hegar sign D. uterine contractions

A. fetal movement felt by examiner

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response? A. physical symptoms similar to the mother B. no changes, only the mother has changes during pregnancy C. feeling distanced from the mother D. desire to be the woman and give birth

A. physical symptoms similar to the mother

A young woman with scoliosis has just learned that she is pregnant. Several years ago, she had stainless-steel rods surgically implanted on both sides of her vertebrae to strengthen and straighten her spine. However, her pelvis is unaffected by the condition. What does the nurse anticipate in this woman's pregnancy? A. potential for greater than usual back pain B. increased risk of miscarriage C. cesarean birth D. increased risk of fetal trauma

A. potential for greater than usual back pain

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are? A. prolactin and oxytocin. B. estrogen and progesterone C. follicle-stimulating hormone and thyroid hormone. D. luteinizing hormone and hCG

A. prolactin and oxytocin.

During the initial obstetrical clinic visit, the nurse shares with a client that several blood studies will be drawn. What screening is performed for black women because of the ethnically inherited nature of the disease? A. sickle-cell trait or disease B. Tay-Sachs disease C. cystic fibrosis D. beta-thalassemia

A. sickle-cell trait or disease

The nurse is assessing a client at her first prenatal visit and notes the fundal height is palpable at the level of the umbilicus. The nurse predicts the client is at which gestational age? A. 24 weeks B. 20 weeks C. 22 weeks D. 18 weeks

B. 20 weeks

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? A. "Apply over-the-counter bleach cream to the area once a day." B. "Avoid sun because it will make the discoloring darker." C. "This discoloring could be permanent, and you could use makeup to cover it up." D. "This discoloring could be the start of skin cancer. We can refer you to the primary care provider."

B. "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? A. "I only want my family to see the baby after it is born." B. "I am unsure who the father of the baby is. I will be raising it alone." C. "I needed Rho(D) immune globulin after my last pregnancy. Will I need it again?" D. "I am not sure if I want to keep the baby. It is a hard decision."

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

The nurse is caring for a client at 8 weeks' gestation who states, "I did not plan for this right now and I am not happy or excited about this pregnancy. I am not sure what to do." Which response by the nurse is best? A. "We can refer you to a clinic for potential termination if you desire." B. "Many women feel this way during the first trimester." C. "You will become excited and happy when you feel the baby move." D. "Do not worry. Once you hold this baby, everything will be fine."

B. "Many women feel this way during the first trimester."

The nurse cares for a pregnant client at the first prenatal visit and reviews expected changes that will occur during pregnancy. Which information will the nurse include in the education? A. Hemoglobin levels rise significantly during pregnancy. B. During pregnancy blood volume can increase by 40% to 50%. C. Blood pressure decreases in the third trimester. D. Pregnancy typically causes a decrease in respiratory rate.

B. During pregnancy blood volume can increase by 40% to 50%.

The nurse is educating a woman about the importance of folic acid before conception and during pregnancy, to prevent neural tube defects in the fetus. The client plans to take prenatal vitamins and minerals. What food source would the nurse recommend to add to the woman's diet? A. Oily fish such as salmon B. Green leafy vegetables C. Green and iced tea D. Yogurt and low-fat milk

B. Green leafy vegetables

A 22-year-old client comes to the walk-in clinic complaining of fatigue, breast heaviness and extreme tenderness, and a clear vaginal discharge. What question would the nurse ask this client? A. Do you have a family history of breast cancer? B. Have you been sexually active in the past 2 months? C. Do you have vaginal itching? D. Are you taking oral contraceptives?

B. Have you been sexually active in the past 2 months?

A nurse is giving a prenatal class on teratogens that have an affinity for specific body tissues. Which teratogen is accurately paired with the specific body tissue affected? A. Thalidomide attacks the lungs. B. Mercury attacks the nervous tissue. C. Lead attacks the joints. D. Tetracycline attacks the muscles.

B. Mercury attacks the nervous tissue.

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy? A. Fatigue B. Positive home pregnancy test C. Nausea and vomiting D. Amenorrhea

B. Positive home pregnancy test

A woman has heard that hypotension can be a problem during pregnancy, but she is not sure what it is or what causes it. The nurse explains that it is simply a temporary bout of low blood pressure due to impaired blood return to the heart. It is commonly caused by sleeping in a position that causes compression of the vena cava blood vessel. To avoid this condition, which suggestion should the nurse make? A. Sleep with your feet elevated. B. Sleep on your side. C. Sleep face down. D. Sleep flat on your back.

B. Sleep on your side.

During a routine antepartal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse do next? A. Notify the healthcare provider of a possible infection. B. Tell the woman that this is entirely normal. C. Check the discharge for evidence of ruptured membranes. D. Advise the woman about the need to culture the discharge.

B. Tell the woman that this is entirely normal.

A nurse is assigned to educate a pregnant client regarding the changes in the structures of the respiratory system taking place during pregnancy. Which conditions are associated with such changes? Select all that apply. A. persistent cough B. nasal and sinus stuffiness C. nosebleed D. Kussmaul respirations E. thoracic rather than abdominal breathing

B. nasal and sinus stuffiness C. nosebleed E. thoracic rather than abdominal breathing

Which occupation may expose a fetus to environmental hazards? Select all that apply. A. carpenter B. nurse anesthetist working in a busy oral surgeon's office C. accountant D. short-order cook for a busy deli E. nurse working for a pulmonologist who administers inhalation F. ribavirin routinely to the client population

B. nurse anesthetist working in a busy oral surgeon's office D. short-order cook for a busy deli E. nurse working for a pulmonologist who administers inhalation ribavirin routinely to the client population

The nurse is teaching a pregnant woman about breast feeding. The nurse determines that the teaching was successful when the woman identifies which hormone as being released when the newborn sucks at the breast? A. antidiuretic hormone B. oxytocin C. cortisol D. follicle stimulating hormone

B. oxytocin

After teaching a woman about the importance of folic acid in pregnancy, the nurse determines that the teaching was successful when the woman identifies which food(s) as being high in folic acid? Select all that apply. A. almonds B. spinach C. broccoli D. apples E. oranges

B. spinach C. broccoli E. oranges

A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a bloody mucus discharge noted in the toilet after an OB office visit several hours earlier. What is the best response from the triage nurse? A. "Bloody mucus is a sign you are in labor. Please come to the hospital." B. "If the provider did an exam, it might be just normal vaginal secretions, so don't worry about it." C. "A one time discharge of bloody mucus in the toilet might have been your mucus plug." D. "It might be nothing. If it happens again call your provider who is on-call."

C. "A one time discharge of bloody mucus in the toilet might have been your mucus plug."

A nurse is teaching a client who is 30 weeks' pregnant about ways to deal with heartburn. The nurse determines a need for additional teaching based on which client statement? A. "I should chew my food slowly." B. "I need to raise the head of my bed about 15 to 30 degrees." C. "I should lie down for 1/2 hour after eating." D. "I need to cut out caffeine."

C. "I should lie down for 1/2 hour after eating."

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? A. "Milk production requires higher levels of calcium; therefore, if I am going to breastfeed, I must take a calcium supplement during pregnancy." B. "I can eat any seafood that I like because it contains phosphorus, which is a nutrient that pregnant women need." C. "I will need to take iron supplementation throughout my pregnancy even if I am not anemic." D. "Because I am pregnant, I can eat anything I want and not worry about weight gain."

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

A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week? A. 2 lb (0.90 kg) B. 1.5 lb (0.68 kg) C. 1 lb (0.45 kg) D. 2/3 lb (0.30 kg)

C. 1 lb (0.45 kg)

A client in her third month of pregnancy arrives at the health care facility for a regular follow-up visit. The client reports discomfort due to increased urinary frequency. Which instruction should the nurse offer the client to reduce the client's discomfort? A. Drink fluids with meals rather than between meals. B. Munch on dry crackers and toast in the early morning. C. Avoid consumption of caffeinated drinks. D. Avoid an empty stomach at all times.

C. Avoid consumption of caffeinated drinks.

Why is a Papanicolaou test done at the first prenatal visit? A. It predicts whether cervical cancer will occur. B. It helps to date the pregnancy. C. It identifies abnormal cervical cells. D. It detects if uterine cancer is present.

C. It identifies abnormal cervical cells.

During late pregnancy, the nurse teaches a pregnant woman to lay on her left side to avoid what condition? A. Frequent urination B. Preeclampsia C. Supine hypotension syndrome D. Heartburn

C. Supine hypotension syndrome

The nurse receives a call from a concerned client, who is 39 weeks' gestation, indicating the woman has "blood-tinged mucus seeping from the vagina." What does the nurse understand about this? A. The woman has likely been overly active, and should be evaluated for complications. B. The woman should rest on her left side and drink water. C. This is known as "bloody show" and is a normal finding at this time. D. This is known as Braxton Hicks contractions and is not a concern at this time.

C. This is known as "bloody show" and is a normal finding at this time.

Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing? A. initial blood tests B. ultrasound for fetal measurements C. clean-catch urine D. measurement of fundal height

C. clean-catch urine

Which finding from a woman's initial prenatal assessment would be considered a possible complication of pregnancy that requires reporting to a primary care provider for management? A. nasal congestion and swollen nasal membranes B. palpitations when lying on her back C. episodes of double vision D. increased lumbar curvature

C. episodes of double vision

During a routine antepartal visit, a pregnant woman says, "I've noticed my gums bleeding a bit since I've become pregnant. Is this normal?" The nurse bases the response on the understanding of which effect of pregnancy? A. elevated progesterone levels B. effects of regurgitation from relaxation of the cardiac sphincter C. influence of estrogen and blood vessel proliferation D. increased venous pressure

C. influence of estrogen and blood vessel proliferation

A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth? A. progesterone B. prolactin C. oxytocin D. estrogen

C. oxytocin

When caring for a newborn, the nurse observes that the neonate has developed white patches on the mucus membranes of the mouth. Which condition is the newborn most likely experiencing? A. rubella B. cytomegalovirus infection C. thrush D. toxoplasmosis

C. thrush

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse? A. "Expect your other children to react positively to their new brother/sister." B. "Caring for your new infant is instinctual and will come naturally to you." C. "Your old coping methods will adequately get you through this period of adjustment." D. "The hormones of pregnancy may cause anxiety or depression postpartum."

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

A primigravida at her 12-week prenatal visit expresses concern that she hasn't felt her baby move yet. What is the best response from the nurse? A. "You won't be able to feel movements until you lie down and concentrate on them." B. "Fetal movements can be felt at 13 weeks." C. "You should start to feel fetal movements within the next few weeks." D. "You usually cannot feel them until approximately 16 to 20 weeks."

D. "You usually cannot feel them until approximately 16 to 20 weeks."

A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? A. Straw-like color B. Specific gravity of 1.010 C. Trace of glucose D. 2+ Protein in urine

D. 2+ Protein in urine

Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks' pregnant. The nurse would expect this woman's heart rate to be approximately? A. 90 beats per minute. B. 100 beats per minute. C. 95 beats per minute. D. 85 beats per minute.

D. 85 beats per minute.

At 32 weeks' gestation a client with a BMI of 23 has gained 24 lb (11 kg). What is the nurse's recommendation for weight gain for the remainder of this pregnancy? A. Watch the diet so no additional weight is gained during this pregnancy. B. Limit weight gain to less than 5 lb (2 kg) for the remainder of this pregnancy. C. Increase weight gain to 1.5 lb (0.68 kg) per week during this pregnancy. D. Continue to gain approximately 1 lb (.45 kg) per week during this pregnancy.

D. Continue to gain approximately 1 lb (.45 kg) per week during this pregnancy.

A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found? A. Below the symphysis pubis B. At the level of the umbilicus C. At the xiphoid process D. Halfway between the symphysis pubis and the umbilicus

D. Halfway between the symphysis pubis and the umbilicus

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother? A. Age at the time of pregnancy B. Early prenatal care C. Having a planned pregnancy D. Social support

D. Social support

The nursing instructor is explaining the nursing care that is given to a client during her pregnancy. The instructor determines the session is successful when the students correctly choose which method will be used to evaluate the effectiveness of the nursing care they will provide? A. Identify the nursing diagnoses for the specific client. B. Ask the client to respond to a preprinted survey about nursing care. C. Interview the client on her first postpartum visit about the nursing care she have received. D. Verify that desired outcomes for identified goals have been met.

D. Verify that desired outcomes for identified goals have been met.