Maternity Exam 2 (NURS-333)

An ultrasound indicates that the arms and legs of the baby are flexed into the chest and thighs, and the head is bent down towards the chest. This describes fetal: 1. lie 2. attitude 3. station 4. presentation

2. attitude

where is the genetic material of the sperm stored? 1. tail 2. midpiece 3. head 4. axoneme

3. head

which of the following choices can the nurse teach a prenatal client is equivalent to one 2-oz meat serving? 1. 4 tbsp peanut butter 2. 2 eggs 3. 1 cup cooked lima beans 4. 2 ounces mixed nuts

2. 2 eggs; all other options are equivalent to 2 servings of meat

During a follow-up prenatal visit, a pregnant woman asks the nurse, "How long do you think I will be in labor?" Which response by the nurse would be most appropriate?

"It's difficult to predict how your labor will progress, but we'll be there for you the entire time."

The mesoderm germ layer gives rise to the following structures:

(middle layer): skeleton/skeletal CT, Muscles, Urinary/Renal, Circulatory, Reproductive organs, Lymphatic

The nurse has determined through digital exam that the client's cervix is 8 cm dilated. The client has a slight urge to push. The nurse should encourage the mother to not bear down until after the cervix is completely dilated to prevent: Select all that apply. 1. maternal exhaustion 2. enhanced perineal thinning 3. tearing and bruising of the cervix 4. lack of pain control 5. cervical edema

1, 3, 5

Which of the following findings in an 8-week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? 1. Body mass index of 17 2. Blood pressure 100/60 3. Hematocrit of 36% 4. hemoglobin of 13.2

1. Body mass index of 17; patient is entering the pregnancy underweight (dont need to know for exam...); all other measurements are WNL

A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevation will indicate a high probability that the client is pregnant? 1. Chorionic gonadotropin 2. oxytocin 3. prolactin 4. luteinizing hormone

1. Chorionic gonadotropin; oxytocin the the labor hormone so not a sign of pregnancy, prolactin stimulates lactogenesis after delivery, luteinizing hormone stimulates ovulation Chorionic gonadotropin is produced by the fertilized egg and keeps the corpus luteum intact. the CL secretes enough progesterone and estrogen to keep the pregnancy going until the placenta takes over

A woman states that she frequently awakens with "painful leg cramps" during the night. Which of the following assessments should the nurse make? 1. Dietary evaluation 2. Goodell's sign 3. Hegar's sign 4. Posture evaluation

1. Dietary evaluation; leg cramps can be caused by too little calcium or phosphorus; make sure getting dairy and soda/processed meats? lol

A young couple who underwent preconception genetic counseling and testing have learned that they are at high risk for having a child with Down syndrome. They have decided not to have children. What would be the most appropriate response for the nurse to give? 1. I understand, here is the phone number for the genetic counselor if you wish to speak further on this topic 2. you made the right choice, I don't have kids and I'm fine 3. I really urge you to reconsider your decision, having a child with downs can be rewarding

1. I understand, here is the phone number for the genetic counselor if you wish to speak further on this topic

A woman has been having contractions since 4 a.m. At 8 a.m., her cervix is dilated to 5 cm. Contractions are frequent, and mild to moderate in intensity. Cephalopelvic disproportion (CPD) has been ruled out. After giving the mother some sedation so she can rest, what would the nurse anticipate preparing for? 1. Oxytocin induction of labor 2. Amnioinfusion 3. Increased intravenous infusion 4. Cesarean section

1. Oxytocin induction of labor

A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? (SATA) 1. Pap smear. 2. Mammogram. 3. Glucose challenge test. 4. Biophysical profile. 5. Complete blood count.

1. Pap smear mammogram will not be performed (xray dangerous for baby), glucose challenge test would be done in the SECOND trimester to determine gDM, biophysical profile will be done in THIRD trimester

A gravida's fundal height is noted to be at the xiphoid process. The nurse is aware that which of the following fetal changes is likely to be occurring at the same time in the pregnancy? 1. Surfactant is formed in the fetal lungs. 2. Eyes begin to open and close. 3. Respiratory movements begin. 4. Spinal column is completely formed.

1. Surfactant is formed in the fetal lungs (36 weeks) eyes open and close at 28 weeks fetal respiratory movements at 24 weeks spinal colum completely formed well before end of FIRST trimester

A woman is planning to become pregnant. Which of the following actions should she be counseled to take before stopping birth control? Select all that apply. 1. Take a daily multivitamin. 2. See a medical doctor. 3. Drink beer instead of vodka. 4. Stop all over-the-counter medications. 5. Stop smoking cigarettes.

1. Take a daily multivitamin. 2. See a medical doctor. 5. Stop smoking cigarettes. She should have a routine physical exam to address any medical illness before beginning the pregnancy process

When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of? 1. ambivalence 2. depression 3. anxiety 4. ecstasy

1. ambivalence; depression and anxiety at this point is concerned as at any point and ecstasy is unlikely as of now; most women will be startled about pregnancy and begin to accept it ~20 weeks

The nurse has taken a health history on four primigravid clients at their first prenatal visits. It is high priority that which of the clients receive nutritional counselling? 1. The woman diagnosed with phenylketonuria 2. the woman who had grave's disease 3. the woman with cushing's syndrome 4. the woman diagnosed with myasthenia gravis

1. The woman diagnosed with phenylketonuria; they need to be on a strict diet bc if she consumes phenylalanine, her baby could develop severe intellectual disability

A pregnant client is lactose intolerant. Which of the following alternative calcium rich foods could this woman consume? 1. Turnip greens 2. Green benas 3. Cantaloupe 4. nectarines

1. Turnip greens

A pregnant client calls the clinic nurse to say she is worried about symptoms she is experiencing. The nurse advises the client to come immediately to the clinic because of which reported symptoms? Select all that apply. 1. Vaginal bleeding 2. Abdominal pain 3. Constipation 4. Epigastric pain 5. Blurring of vision

1. Vaginal bleeding 2. Abdominal pain 4. Epigastric pain 5. Blurring of vision These are all indicative that something is wrong in the pregnancy

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? 1. Avoid eating greasy foods. 2. Drink orange juice before rising. 3. Drink two glasses of water with each meal 4. Eat 3 large meals plus a bedtime snack.

1. avoid eating greasy foods she should eat SALTINES before rising, OJ may actually increase gastric content acidity, it's good to separate food and fluids, mothers should eat small frequent meals throughout the day

A client comes to the emergency department reporting strong contractions that have occurred for the past two hours. Which of the following assessments will indicate to the nurse that the client is in true labor? 1. cervical dilation and effacement 2. irregular contractions

1. cervical dilation and effacement; this is the number 1 sign of true labor

A nurse is advising a pregnant woman about the danger sigs of pregnancy. The nurse should teach the mother that she should notify the physician immediately if she experiences which of the following signs/symptoms? 1. convulsions 2. double vision 3. epigastric pain 4. persistent vomiting 4. polyuria

1. convulsions 2. double vision 3. epigastric pain 4. persistent vomiting all are red flags; first three are indicative of HTN disorders in pregnant women

The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above prepregnancy levels? 1. Glucose 2. Fibrinogen 3. Hematocrit 4. Bilirubin

2. Fibrinogen (at 40 weeks, closer to due date, the coagulation factors will increase to prevent excessive blood loss during delivery Glucose should be WNL, hematocit levels are usually lower, and BR levels should be WNL

An 18-week gestation client telephones the obstetrician's office stating, "I'm really scared. I think I have breast cancer. My breasts are filled with tumors." The nurse should base the response on which of the following? 1. Breast cancer is often triggered by pregnancy. 2. Nodular breast tissue is normal during pregnancy. 3. The woman is exhibiting signs of a psychotic break. 4. Anxiety attacks are especially common in the second trimester.

2. Nodular breast tissue is normal during pregnancy; high estrogen levels cause cause hypertrophy and hyperplasia of breast tissue to prepare for BF

A woman who is seen in the prenatal clinic is found to be 8 weeks pregnant. She confides to the nurse that she is afraid her baby might be "permanently damaged because I had 5 beers the night I had sex." Which of the following responses by the nurse would be appropriate? 1. I would let the doctor know if I were you 2. It is unlikely that the baby was affected 3. abortion during the first trimester are very safe 4. An ultrasound will tell you if the baby was affected

2. It is unlikely that the baby was affected; first 2 WEEKS after fertilzation matter the most, not really the night of conception

The nurse receives a phone call from a client who claims she is pregnant. The client reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10. What would the client's estimated date of delivery (EDD) be if she is pregnant? 1. Nov. 13 2. Jan. 17 3. Jan. 10 4. Dec. 3

2. Jan. 17

A 36-week gestation gravid client is complaining of dyspnea when lying flat. Which of the following is the likely clinical reason for this complaint? 1. maternal hypertension 2. fundal height 3. hydraamnios 4. congestive heart failure

2. fundal height; at 36 weeks at the xyphoid process so can impede proper breathing

The client presents for cervical ripening in anticipation of labor induction tomorrow. What should the nurse include in her plan of care for this client? 1. Apply an internal fetal monitor. 2. Monitor the client using electronic fetal monitoring. 3. Withhold oral intake and start intravenous fluids. 4. Place the client in a upright, sitting position.

2. Monitor the client using electronic fetal monitoring. The client should be monitored using electronic fetal monitoring for at least 30 minutes and up to 2 hours after placement to assess the contraction pattern and the fetal status.

The nurse is caring for a laboring client. To identify the duration of a contraction, the nurse should: 1. measure the time from the beginning of the contraction to the start of the next contraction 2. measure the time from the beginning of the contraction to the end of the same contraction 3. measure the time from the beginning of the contraction to the peak of the same contraction 4. palpate the mother's fundus and feel for the tight/tenseness

2. measure the time from the beginning of the contraction to the end of the same contraction

Which of the following exercises should be taught to women who complain of backaches? 1. Kegeling 2. Pelvic lifting 3. Leg lifting 4. crunching

2. Pelvic lifting; cat and cow basically

A patient who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice? 1. Lightening of the nipples and areolas 2. Reddish streaks called striae on her abdomen 3. A decrease in hair thickness 4. Small purplish dots on her face and arms

2. Reddish streaks called striae on her abdomen; stretch marks are expected in pregnancy

The nurse midwife tells a client that the baby is growing and that the ballottement was evident during the vaginal examination. How should the nurse explain what the nurse midwife means by ballottement? 1. The nurse midwife saw that the mucus plug was intact 2. The nurse midwife felt the baby rebound after being pushed 3. The nurse midwife palpated the fetal parts through the uterine wall 4. The nurse midwife assessed that the baby is head down

2. The nurse midwife felt the baby rebound after being pushed;

A woman has been admitted for an external version. She has completed an ultrasound exam and is attached to the fetal monitor. Prior to the procedure, why will terbutaline be administered? 1. To provide analgesia 2. To relax the uterus 3. To induce labor 4. To prevent hemorrhage

2. To relax the uterus; terbutaline (tocolytics) are given to relax the uterus

A client states that she is a strong believer in vitamin supplements to maintain her health. The nurse advises the woman that it is recommended to refrain from consuming excess quantities of which of the following vitamins during pregnancy? 1. Vitamin C 2. Vitamin D 3. Vitamin B2 4. Vitamin B12

2. Vitamin D; fat soluble vitamins can build up in the body and megadoses of Vitamin A & D are known to cause teratogenic effects

A woman in her third trimester advises the nurse that she wishes to breastfeed the baby, "but I don't think my nipples are right." Upon examination the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time? 1. Advise the client that it is unlikely she will be able to breastfeed 2. refer the client to a lactation consultant for advice 3. call the labor room and notify them that a client with inverted nipples will be admitted 4. teach the woman exercises in order to evert her nipples

2. refer the client to a lactation consultant for advice; shouldnt be doing exercises and many women with inverted nipples can still BF, no need to call labor room but good to document this finding. Also exercises can cause contractions bc of oxytocin release so DONT EXERCISE NIPPLES. lactation consultant will likely recommend a breast shield.

A woman confides in the nurse that she practices pica. Which of the following alternatives could the nurse suggest to the woman? 1. replace laundry starch with salt 2. replace ice with frozen fruit juice 3. replace soap with cream cheese 4. replace soil with uncooked pie crust

2. replace ice with frozen fruit juice ; get vitamins but careful about sugar

Below are four important landmarks of fetal development. Please place them in chronological order: 1. Four-chambered heart is formed. 2. Vernix caseosa is present. 3. Blastocyst development is complete. 4. Testes have descended into the scrotal sac.

3, 1, 2, 4 (testes descend at mid-third trimester)

A 20-year-old client states that the at-home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time? 1. "Congratulations, you and your family must be so happy" 2. "Have you told the baby's father yet?" 3. "How do you feel about the results?" 4. "Please tell me when your last menstrual period was"

3. "How do you feel about the results?" 4 is important but you have to take the emotional route

A 34-week gestation woman calls the obstetric office stating, "since last night, i have had three nosebleeds." Which of the following responses by the nurse is appropriate? 1. "You should see the doctor rot make sure you are not becoming severely anemic" 2. "Do you have a temperature?" 3. "One of the hormones of pregnancy makes the nasal passages prone to bleeds" 4. "Do you use any inhaled drugs?"

3. "One of the hormones of pregnancy makes the nasal passages prone to bleeds"; this is due to estrogen increased levels which causes vasocongestion of the mucous membranes of the body

A client asks the nurse what was meant when the physician told her she had a positive Chadwick's sign. Which of the following information about the finding would be appropriate for the nurse to convey at this time? 1. "It is a purplish stretch mark on your abdomen" 2."it means you are having heart palpitations" 3. "it is a bluish coloration of the cervix and vagina" 4. "it means the doctor heard abnormal sounds when you breathed in"

3. "it is a bluish coloration of the cervix and vagina" the purplish stretch marks are called striae Chadwicks is a probable sign of pregnancy, it is caused by the increased circulatory estrogen levels causing increased vascularization in the cervix and vagina

A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect to exhibit? 1. Backache 2. Dyspnea 3. Fatigue 4. Diarrhea

3. Fatigue; first trimester most common complaint

What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing? 1. Pap smear 2. Hepatitis B screening (HBsAg) 3. Fundal height measurement 4. Complete blood count

3. Fundal height measurement

he nurse is creating a poster for pregnant mothers. Which description of fetal development should the nurse include? 1. Four primary germ layers form from the blastocyst. 2. After fertilization, the cells only become larger for several weeks. 3. Most organs are formed by 8 weeks after fertilization. 4. The embryonic stage is from fertilization until 5 months.

3. Most organs are formed by 8 weeks after fertilization.

The nurse discusses sexual intimacy with a pregnant couple. Which of the following should be included in the teaching plan? 1. vaginal intercourse should cease by the beginning of the third trimester 2. breast fondling should be discouraged because of the potential for preterm labor 3. the couple may find it necessary to experiment with alternate positions 4. vaginal lubricant should be used sparingly throughout the pregnancy

3. the couple may find it necessary to experiment with alternate positions; not enough oxytocin receptors to worry abt preterm labor (unless high risk for it) until they are at full term so can continue sex easily

After nutrition counselling, a woman, G3 P1101 proclaims she certainly can't eat any strawberries during her pregnancy. Which of the following is likely the cause for this statement? 1. the woman is allergic to strawberries 2. strawberries have been shown to cause birth defects 3. the woman believes in old wives' tales 4. the premature baby died because the woman ate strawberries

3. the woman believes in old wives' tales

A client is admitted to the labor unit with contractions 1-2minutes apart lasting 60-90 seconds. The client is apprehensive and irritable. This client is most likely in what phase of​ labor? 1. latent phase 2. active phase 3. transition phase 4. functional phase

3. transition phase

A woman is 36 weeks gestation, which of the following tests will be done during her prenatal visit? 1. glucose challenge test 2. amniotic fluid volume assessment 3. vaginal and rectal cultures 4. karyotype analysis

3. vaginal and rectal cultures; GCT is done at 24 wks (beginning of 2nd trimester), amniotic fluid volume assessment is done as part of biophysical profile and done only when Dr concerned abt fetal health; karyotype analysis is done early in pregnancy

When analyzing the need for health teaching of a prenatal multigravida, the nurse should ask which of the following questions? 1. "what are the ages of your children?" 2. "What is your marital status?" 3. "do you ever drink any alcohol?" 4."do you have any allergies?"

3. do you ever drink any alcohol you must think specifically about HEALTH TEACHING; if you're giving the prenatal health teaching to a patient, whether or not they consume alcohol will show how effective past teaching was/their current knowledge

The following four changes occur during pregnancy. Which of them usually increases the father's interest and involvement in the pregnancy? 1. learning the results of the pregnancy test 2. attending childbirth education classes 3. hearing the fetal heartbeat 4. meeting the obstetrician or midwife

3. hearing the fetal heartbeat; this occurs before the classes begin even though that also increases father's interest

The glucose challenge screening test is performed at or after 24-weeks' gestation to assess for the maternal physiological response to which of the following pregnancy hormones? 1. Estrogen 2. progesterone 3. human placental lactogen 4. human chorionic gonadotropin

3. human placental lactogen; hPL is an insulin antagonist. The test must be done at 24 weeks, any earlier and the hPL levels haven't peaked, often giving a false negative result

Which of the following developmental features would the nurse expect to be absent in a 41-week gestation fetus? 1. fingernails 2. eyelashes 3. lanugo 4. milia

3. lanugo;

A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which of the following? 1. cystic fibrosis 2. down's syndrome 3. open neural tube 4. cleft lip

3. open neural tube

A nurse is describing how the fetus moves through the birth canal. Which of the following would the nurse correctly identify as being most important in allowing the fetal head to adapt and move through the bony pelvis? 1. fontanelle 2. biparietal diameter 3. sutures 4. frontal bone

3. sutures; sutures allow for molding and thus easier descent down the pelvis

A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse's best response? 1. "Because the organ systems in the baby are developing right now, it is risky to take medicine." 2. "You can take any of the over-the-counter medications because they are all safe in pregnancy." 3. "The physician will prescribe a category 'X' medication for you." 4. "You can take acetaminophen because it is a category 'B' medicine."

4. "You can take acetaminophen because it is a category 'B' medicine.". Client is now in the second trimester so the organ systems have stopped developing. Not all OTC meds may be safe, they may be category X which is proven teratogens. category B is relatively safe

When performing a vaginal examination during labor, the nurse feels the presenting part at 1 centimeter below the woman's ischial spines. The nurse should chart the station as: 1. -1 2. -3 3. 0 4. +1

4. +1

a client is having an ultrasounds assessment done at her prenatal appointment at 8 weeks' gestation. She asks the nurse, "Can you tell what the sex of my baby is yet?" Which of the following responses would be appropriate for the nurse to make at this time? 1. The technician did tell me the sex, but I will have to let the doctor tell you what it is" 2. the organs are completely formed and present, but the baby is too small for any to be seen 3. the technician says that the baby has a penis. It looks like you are having a boy" 4. I am sorry. It will not be possible to see which sex the baby has for another month or so

4. I am sorry. It will not be possible to see which sex the baby has for another month or so; see around same time as quickening

A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? 1. Nausea. 2. Dyspnea. 3. Urinary frequency. 4. Leg cramping.

4. Leg cramping; most common complaint in the second trimester. urinary freq is seen in the first trimester and late third trimester

The nurse asks a 31-week gestation client to lie on the examining table during a prenatal examination. In which of the following positions should the client be placed? 1. Orthopneic. 2. Lateral-recumbent. 3. Sims'. 4. Semi-Fowler's.

4. Semi-Fowler's; this prevents IVC syndrome while also allowing assessment of the fetus; lat-recum would not allow for assessment

A 37-gravid client states that she noticed a "white-liquid_ leaking from her breasts during a recent shower. Which of the following nurse responses is appropriate at this time? 1. Advise the woman that she may have a galactocele 2. encourage the woman to pump her breasts to stimulate adequate milk supply 3. assess the liquid because breast discharge is diagnostic of a mammary infection 4. reassure the mother that this is normal in the third trimester

4. reassure the mother that this is normal in the third trimester; DO NOT RECOMMEND PUMPING = CAUSES OXYTOCIN RELEASE AND BEGINS CONTRACTIONS

A nurse has identified the following nursing diagnosis for a prenatal client: Altered nutrition: less than body requirements related to poor folic acid intake. Which of the following foods should the nurse suggest the client to consume? 1. potatoes and grapes 2. cranberries and squash 3. apples and corn 4. oranges and spinach

4. oranges and spinach

A client asks the nurse, "Could you explain how the baby's blood and my blood separate at delivery?" Which of the following responses is appropriate for the nurse to make? 1. When the placenta i born, the circulatory systems separate 2. when the doctor clamps the cord, the blood stops mixing 3. the separation happens after the baby takes the first breath. The baby's oxygen no longer has to come from you 4. the blood actually never mixes. your blood supply and the baby's blood supply are completely separate

4. the blood actually never mixes. your blood supply and the baby's blood supply are completely separate

A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the pre-procedure teaching? 1. fast for 12 hours before the test 2. bring a urine specimen to the laboratory on the day of the test 3. be prepared to have 4 blood specimens taken on the day of the test 4. the test should take one hour to complete

4. the test should take one hour to complete; This is an nonfasting test, without any urine specimen needed and also only requires 1 tube of blood. 1 hour after client consumes 50g of a concentrated glucose solution, a serum glucose level is done. if it is above or equal to 130mg/dL then the client is referred to a 3 hour GT test to determine whether or not she has gDM

The nurse is teaching a prenatal class about false labor. The nurse should teach patients that false labor most likely will include which of the following? (Select all that apply.) A. Contractions that do not intensify while walking B. An increase in the intensity and frequency of contractions C. Progressive cervical effacement and dilatation D. Pain in the abdomen that does not radiate E. Increased thin vaginal secretions

A. Contractions that do not intensify while walking D. Pain in the abdomen that does not radiate True labor contractions intensify while walking. True labor results in pain beginning low in the abdomen and radiating upward or into the back. True labor results in increased intensity and frequency of contractions. True labor results in progressive dilation. True labor results in an increase in vaginal secretions.

A woman came to her first prenatal visit, she stated that she delivered three children at 40 weeks' gestation, delivered twins at 36.5 weeks' gestation and one at 39 weeks. She also had 1 miscarriage between her 2nd and 3rd child. Express her obstetrical history using the GTPAL system.

G7 T4 P1 A1 L5

A 20-week gestation client is being seen in the prenatal clinic. Place an "X" on the abdomen where the nurse would expect the fundal height to be felt.

Place the X at the umbilicus.

When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage? A)Regular contractions B)Cervical dilation C)Fetal movement through the birth canal D)Placental separation

B) Cervical dilation

After teaching a group of students about the maternal bony pelvis, which statement by the group indicates that the teaching was successful? A) The bony pelvis plays a lesser role during labor than soft tissue. B) The pelvic outlet is associated with the true pelvis. C) The false pelvis lies below the imaginary linea terminalis. D) The false pelvis is the passageway through which the fetus travels.

B) The pelvic outlet is associated with the true pelvis; The maternal bony pelvis consists of the true and false portions. The true pelvis is made up of three planes—the inlet, the mid pelvis, and the outlet. The bony pelvis is the more important part of the passageway because it is relatively unyielding. The false pelvis lies above the imaginary linea terminalis. The true pelvis is the bony passageway through which the fetus must travel.

A 25-year-old primigravida is 20 weeks pregnant. At the clinic, her nurse begins a prenatal assessment and obtains the following vital signs. Which finding would require the nurse to contact the physician? A. Pulse 88/min B. Respirations 30/min C. Temperature 37.4°C (99.3°F) D. Blood pressure 134/82

B. Respirations 30/min; Tachypnea is not a normal finding and requires medical care A slight increase in pulse and temperature are expected findings during pregnancy due to the increased oxygen consumption to support fetal metabolism. The blood pressure is within normal limits.

A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating: A)Latent phase of the first stage of labor B)Active phase of the first stage of labor C)Transition phase of the first stage of labor D)Pelvic phase of the second stage of labor

C)Transition phase of the first stage of labor

During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to: a. Order an EKG. b. Report this abnormal finding immediately to her care provider. c. Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension. d. Order a nonstress test to assess fetal well-being.

C. Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension. Teaching the woman to avoid lying on her back because of occlusion of the vena cava with the gravid uterus causes supine hypotension syndrome.

Assessment of a woman in labor reveals: cervical dilation of 3 cm cervical effacement of 30% contractions occurring every 7 to 8 minutes (lasting about 40 seconds) The nurse determines that this client is in what stage of labor?

latent phase of labor

The pregnant client who is at 14 weeks' gestation asks the nurse why the doctor used to call her baby an embryo, and now calls it a fetus. What is the best answer to this question? 1. "A fetus is the term used from the ninth week of gestation and onward." 2. "We call a baby a fetus when it is larger than an embryo." 3. "An embryo is a baby from conception until the eighth week." 4. "The official term for a baby in utero is really zygote."

1. "A fetus is the term used from the ninth week of gestation and onward."

At her first prenatal visit, a woman is discussing fetal development with the nurse. The client asks, "When will my baby actually have a heartbeat?" The nurse should say the heartbeat of an embryo is distinguishable by what time? 1. "The fourth week" 2. "The sixth week" 3. "The eighth week" 4. "The twelfth week"

1. "The fourth week"

The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected findings? 1. 12 weeks' gestation, with fetal heart tones heard by Doppler fetoscope 2. 22 weeks' gestation, client reports no fetal movement felt yet 3. 16 weeks' gestation, fundus three finger breadths above umbilicus 4. Marked edema

1. 12 weeks' gestation, with fetal heart tones heard by Doppler fetoscope

The midwife has just palpated the fundal height at the location noted on the picture below. It is likely that the client is how many weeks pregnant? 1. 12 2. 20 3. 28 4. 36

1. 12; this is showing the symphysis pubis which is where the fundus will be felt at 12 weeks

Which finding would the nurse view as normal when evaluating the laboratory results of a 34-week gestation client? 1. anemia 2. thrombocytopenia 3. polycythemia 4. hyperbilirubinemia

1. ANEMIA; ideopathic thrombocytopenia is an ABNORMAL finding

Which of the following vital sign changes should the nurse highlight for a pregnant woman's obstetrician? 1. Prepregnancy blood pressure (BP) was 100/60 and third trimester BP 140/90 2. Prepregnancy respiratory rate (RR) 16rpm and third trimester 22rpm 3. Prepregnancy heart rate (HR) 76bpm and third trimester HR 88bpm 4. Prepregnancy temperature (T) 98.6F and thirs trimester 99.2F

1. Prepregnancy blood pressure (BP) was 100/60 and third trimester BP 140/90; all other findings are expected. Progesterone causes decrease in contractility of smooth muscle therefore decreases HR, and is also thermogenic causing increase temp. The woman's BMR is higher therefore she will breathe more breaths (20-24bpm)

The client at 42 weeks' pregnancy is admitted for induction of her labor. Which statement indicates that she understands the indications for the induction? 1. Prolonging this labor further could harm me 2. My baby just needed some extra time and will now be big and strong 3. My placenta will continue to provide for my baby even if I keep him in longer 4. If I wait longer I would need a C-section but my baby would be fine

1. Prolonging this labor further could harm me

During a prenatal visit, a gravid client is complaining of ptyalism. which of the following nursing interventions is appropriate? 1. encourage the woman to brush her teeth carefully 2. advise the woman to have her blood pressure checked regularly 3. encourage the woman to wear supportive hosiery 4. advise the woman to avoid eating rare meat

1. encourage the woman to brush her teeth carefully; the increased estrogen levels cause gingivitis along with ptyalism. The ptyalism may also cause/be seen in women with increased N/V so it's best for them to keep their teeth healthy due to the acidity of vomit

A woman has just completed her first trimester. Which of the following fetal structures can the nurse tell the woman are well formed at this time? 1. genitals 2. heart 3. fingers 4. alveoli 5. kidneys

1. genitals 2. heart 3. fingers 5. kidneys all are fully formed by end of 12 weeks

What is the reversal protocol for extreme hypotension caused by epidural? 1. give (500-1000) fluids beforehand to preload and give vasopressin 2. give (500-1000) fluids after and give vaspression 1. give (500-1000) fluids beforehand to preload and give ephedrine 2. give (500-1000) fluids after and give ephedrine

1. give (500-1000) fluids beforehand to preload and give ephedrine

A father experiencing couvade syndrome is likely to exhibit which of the following symptoms/behaviors? 1. heartburn 2. promiscuity 3. hypertension 4. indifference

1. heartburn; HTN in prospective father should be investigated

a nurse is working in the prenatal clinic. which of the following findings seen in third-trimester pregnant women would the nurse consider to be within normal limits? (SATA) 1. leg cramps 2. varicose veins 3. hemorrhoids 4. fainting spells 5. lordosis

1. leg cramps 2. varicose veins 3. hemorrhoids 5. lordosis fainting spells are never normal in pregnant women; all others are normal but further teaching may be necessary

A 38-week gestation client, Bishop score 1, is advised by her nurse midwife to take evening primrose daily. The office nurse advises the client to report which of the following side effects that had been attributed to the oil? 1. skin rash 2. pedal edema 3. blurred vision 4. tinnitus

1. skin rash; h/a and nausea are also common

The nurse is teaching a couple about fetal development. Which statement by the nurse is correct about the morulla stage of development? 1. the fetilized egg has yet to implant into the uterus 2. the lung fields are finally fully formed 3. the sex of the fetus can clearly be identified 4. the eyelids are unfused and begin to open and close

1. the fetilized egg has yet to implant into the uterus

The nurse is caring for a pregnant client who is a vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods? 1. tofu, legumes, broccoli 2. corn, yams, green beans 3. potatoes, parsnips, turnips 4. cheese, yogurt, fish

1. tofu, legumes, broccoli; best sources of iron and protein (which vegans often lack)

A 32-year-old multigravida presents to the clinic with the following musculoskeletal concerns. Upon assessment, the nurse contacts the physician for which of the following? 1. unilateral leg swelling 2. seperation of rectus abdominus 3. lordosis or swayback 4. waddling gait

1. unilateral leg swelling ; the number one cause of this is DVT which pregnant women are at high risk for due to their hypercoaguable state

The client has been pushing for two hours, and is exhausted. The fetal head is visible between contractions. The physician informs the client that a vacuum extractor could be used to facilitate the delivery. Which statement indicates that the client needs additional information about vacuum extraction assistance? 1. "A small cup will be put onto the baby's head, and a gentle suction will be applied." 2. "I can stop pushing and just rest if the vacuum extractor is used." 3. "The baby's head might have a bruise from the vacuum cup." 4. "The vacuum will be applied for a total of ten minutes or less."

2. "I can stop pushing and just rest if the vacuum extractor is used." The vacuum is only effective if the woman is pushing in conjunction

A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to make at this time? 1. "Your period is probably just irregular." 2. "We could do a blood test to check." 3. "Home pregnancy test results are very accurate." 4. "My recommendation would be to repeat the test in one week."

2. "We could do a blood test to check." serum pregnancy tests are more sensitive than urine ones and will give a definitive answer; 4 is technically correct, but if she did not do it correctly the first time shes not likely to do it correctly again

A 16-year-old, G1 P0000, is being seen at her 10-week gestation visit. She tells the nurse that she felt the baby move that morning. Which of the following responses by the nurse is appropriate? 1. "That is very exciting. The baby must be very healthy." 2. "Would you please describe what you felt for me?" 3. "That is impossible. The baby is not big enough yet." 4. "Would you please let me see if I can feel the baby?"

2. "Would you please describe what you felt for me?"

the nurse is evaluating the 24-hour dairy intake of four gravid clients. Which of the following clients consumed the highest number of dairy servings during 1 day? 1. 4 oz whole milk, 2 oz hard cheese, 1 cup of pudding with milk and 2 oz of cream cheese 2. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 1 1/2 oz hard cheese 3. 1/2 cup cottage cheese, 8oz whole milk, 1 cup of buttermilk, 1 1/2 oz hard cheese 4. 1/2 cup frozen yogurt, 8 oz skim milk, 4 oz cream cheese, 1 1/2 cup of cottage cheese

2. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 1 1/2 oz hard cheese; 1 cup of any milk is one dairy serving and 1 1/2 oz of hard cheese is one serving

A nurse is discussing the serving sizes in the grain food group with a new prenatal client. Which of the following foods equals 1 serving size from the grain group? 1. 1 bagel 2. 1 slice of bread 3. 1 cup cooked pasta 4. 1 tortilla 5. 1 cup dry cereal

2. 1 slice of bread 4. 1 tortilla 5. 1 cup dry cereal 1 sandwich is two servings bc 1 bread slice is 1 serving

The client presents to labor and delivery stating that her water broke two hours ago. Barring any abnormalities, what information should the nurse give the client about how often the nurse expects to take the client's temperature? 1. every shift 2. every 4 hours 3. once every 12 hours 4. once a day

2. every 4 hours

A 10-week gravid client is being seen in the prenatal clinic. For the nurse caring for this patient, providing anticipatory guidance for which of the following should be a priority? 1. pain management during labor 2. methods to relieve backaches 3. breastfeeding positions 4. characteristics of the newborn

2. methods to relieve backaches. all other information is too early to provide; she will be experiencing backaches very soon since she is entering the second trimester

A client makes the following statement after finding out that her pregnancy test is positive. "This is not a good time. I am in college and the baby will be due during final exams!" Which of the following responses by the nurse would be most appropriate at this time? 1. "I'm absolutely positive that everything will turn out right." 2. "I suggest that you email your professors to set up an alternative plan" 3. "It sounds like you're feeling a little overwhelmed right now" 4. "You and your baby's father will find a way to get through the pregnancy"

3. "It sounds like you're feeling a little overwhelmed right now" 2 is correct, but you should acknowledge her feelings first

the nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that she might experience in the coming weeks. Which of the following comments by the client indicates that further teaching is needed? 1. "During the third trimester I may experience frequent urination" 2. "During the third trimester I may experience heartburn" 3. "During the third trimester I may experience back pain" 4. "During the third trimester I may experience persistent headache"

4. "During the third trimester I may experience persistent headache" this should NOT BE SEEN IN PREGNANT WOMEN; indicates pre-eclampsia

An ultrasound of a fetus' heart shows that normal fetal circulation is occurring." Which of the following statements is consistent with the finding? a. the foramen ovale is a hole between the ventricles b. the umbilical vein contains oxygen-poor blood c. the right atrium contains both oxygen-rich and oxygen-poor blood d. the ductus venosus lies between the aorta and the pulmonary artery

c. the right atrium contains both oxygen-rich and oxygen-poor blood; FO is b/t atria, UA has oxygen-poor blood, ductus venosus is b/t umbilical vein and IVC

Place an "X" on the drawing of the cross section of a placenta at the site of gas exchange

the Xs would be at all the materal vasculature

A woman delivers a fetal demise that has lanugo covering the entire body, nails that are present on the fingers and toes, but eyes that are still fused. Based on this information, the nurse knows that the baby is about how many weeks gestation? 1. 15 2. 22 3. 29 4. 36

2. 22; eyes remained fused till 29 weeks

The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings would the nurse highlight for the physician? 1. 17 weeks' gestation; denies feeling fetal movement 2. 24 weeks' gestation; fundal height at umbilicus 3. 27 weeks' gestation; complains of excess salivation 4. 34 weeks' gestation; complains of hemorrhoidal pain

2. 24 weeks' gestation; fundal height at umbilicus; at 24weeks, the fundal height should be (+/-2) 4cm above umbilicus; 1. the mother should feel movement around 20 weeks 3&4 are normal findings in pregnancy

A woman, 6 weeks pregnant, is having a vaginal examination. Which of the following would the practitioner expect to find? 1. Thin cervical muscle. 2. An enlarged ovary. 3. Thick cervical mucus. 4. Pale pink vaginal wall.

2. An enlarged ovary; this is because the corpus luteum is still functioning (???)

A 25-year-old primigravida is at 20 weeks' gestation. The nurse takes her vital signs and notifies the healthcare provider immediately because of which finding? 1. Pulse 88/minute 2. Rhonchi in both bases 3. Temperature 37.4° C (99.3° F) 4. Blood pressure 122/78

2. Rhonchi in both bases all other VS are normal and slightly elevated temperature is expected

a third-trimester client is being seen for routine prenatal care. which of the following assessments will the nurse perform during the visit? (SATA) 1. blood glucose 2. blood pressure 3. fetal heart rate 4. urine protein 5. pelvic ultrasound

2. blood pressure 3. fetal heart rate 4. urine protein; pelvic ultrasound is not done at most well visits unless indicated

A nurse midwife has advised a 39-week gestation gravid to take evening primrose oil 2500mg daily as complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions? 1. relieve back strain 2. improve development of colostrum 2. ripen the cervix 3. reduce the incidence of hemorrhoids

2. ripen the cervix; in the body EPO converts to prostaglandins which cause cervical ripening

A patient at 16 weeks' gestation has a hematocrit of 32% and a hemoglobin level of 9.9 g/dL. Her baseline (prepregnant) hematocrit was 40% and hemoglobin 13.4 g/dL. Which statement by the nurse best explains this change? 1. the red blood cells production is down due to the energy of the mother being shunted to the fetus 2. the physiological hemodilution of erythrocytes due to the increased plasma volume 3. Iron deficiency of pregnant women due to shunting to the fetus 4. Pica causing too much consumption of non food items

2. the physiological hemodilution of erythrocytes due to the increased plasma volume

A woman is carrying dizygotic twins. She asks the nurse about the babies. Which of the following explanations is accurate? 1. during a period of rapid growth, the fertilized egg is divided completely 2. when the woman ovulated, she expelled two mature ova 3. the babies share one placenta and a common chorion 4. the babies will definitely be the same sex and have the same blood type

2. when the woman ovulated, she expelled two mature ova; these twins are fraternal meaning two different sperm fertilized two different eggs

a 12-week gestation client tell the nurse that she and her husband eat sushi at least once per week. She states, "I know that fish is good for me, so I make sure we can eat it regularly." Which of the following responses by the nurse is appropriate? 1. "You are correct. Fish is very healthy for you." 2. You can eat fish, but sushi is too salty during pregnancy" 3. "Sushi is raw. raw fish is especially high in mercury" 4. "It is recommended that fish be cooked to destroy harmful bacteria"

4. "It is recommended that fish be cooked to destroy harmful bacteria"

The nurse has presented a session on pain relief options to a prenatal class. Which statement indicates that additional teaching is needed? 1. "An epidural can be continuous or can be given in one dose." 2. "A spinal is usually used for a cesarean birth." 3. "Pudendal blocks are effective when a vacuum is needed." 4. "Local anesthetics provide good labor pain relief."

4. "Local anesthetics provide good labor pain relief." Local Anesthetics are only used before an episiotomy or for lac repair

The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor? 1. "My first child has cerebral palsy." 2. "My first child has hypertension." 3. "My first child has asthma." 4. "My first child has cystic fibrosis."

4. "My first child has cystic fibrosis."; CF is an autosomal recessive genetic disorder. CP is not a genetic disease. HTN and asthma may be genetic but don't warrant genetic counselling

A woman whose prenatal weight was 105lb weighs 109lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time? 1. "we expect you to gain 1 lb per week, so your weight is a little low at this time" 2. "most women gain no weight during the first trimester, so I would suggest you eat fewer deserts for the next few weeks" 3. "you entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need" 4. "your weight gain is exactly what we would expect it to be at this time"

4. "your weight gain is exactly what we would expect it to be at this time" her wt gain is WNL for the first trimester

A client who was seen in the prenatal clinical at 20 weeks' gestation weighed 128 lb at that time. Approximately how many points would the nurse expect the client to weigh at her next visit at 24 weeks' gestation? 1. 129 lb 2. 130 lb 3. 131 lb 4. 132 lb

4. 132 lb; second trimester you want them to be gaining a pound a week

A women is unable to cope with her uterine contractions. Her cervix is dilated to 5 cm. When the nurse suggests the use of systemic analgesic to make her more comfortable, she ask, "Will my baby get the medicine too?" The nurse's best reply would be: A) "This medicine does not cross the placenta, so your baby will not be medicated." B) "Some of the medicine does go through the placenta, but your baby will metabolize it rapidly through her liver and kidneys" C) "Some of the medicine does go to the baby. However, we are giving it now, so it should be out of the baby's system at the time of birth." D) "We will give you an intramuscular injection. That will cross the placenta more slowly than intravenous medication."

C) "Some of the medicine does go to the baby. However, we are giving it now, so it should be out of the baby's system at the time of birth." Systemic Analgesics cross the placenta and the baby will likely not be able to metabolize it quickly due to it's immature kidneys and liver. Systemic analgesics are not given IM thus that option can be ruled out. The key to systemic analgesia is to give them in a TIMELY manner; the closer they are given to birth, the more likely the baby is to endure it's negative side effects

An ultrasound of a fetus' heart shows that "normal fetal circulation is occurring." Which of the following statements is consistent with the finding? a. A right to left shunt is seen between the atria. b. Blood is returning to the placenta via the umbilical vein. c. Blood is returning to the right atrium from the pulmonary system. d. A right to left shunt is seen between the umbilical arteries.

a. A right to left shunt is seen between the atria.

The nurse notes each of the following findings in a woman in a 12-week gestation client. Which of the findings would enable the nurse to tell the client that she is positively pregnant? a. Fetal heart rate via Doppler b. Positive pregnancy test c. Positive Chadwick's sign d. Montgomery gland enlargements

a. Fetal heart rate via Doppler; all other signs are presumptive/probable

An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? Select all that apply. 1. Amenorrhea. 2. Breast tenderness. 3. Quickening. 4. Frequent urination. 5. Uterine growth.

1. Amenorrhea. 2. Breast tenderness. 3. Quickening. 4. Frequent urination. Uterine Growth is a probable sign of pregnancy

A mother has just experienced quickening. Which of the following developmental changes would the nurse expect to occur at the same time in the woman's pregnancy? 1. Fetal heart begins to beat. 2. Lanugo covers the fetal body. 3. Kidneys secrete urine. 4. Fingernails begin to form.

2. Lanugo covers the fetal body (at around 20wks, same time as quickening) FHR begins to beat first trimester kidney's secrete urine at 12 weeks (amniotic fluid is composed mostly of urine) fingernails form at week 10 but dod not completely cover the tips of the fingers till mid third trimester

The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings? A. Document the findings on the prenatal chart B. Have the physician see the patient today C. Instruct the patient to avoid direct sunlight D. Analyze previous thyroid hormone lab results

B. Have the physician see the patient today; Mottling of the skin is indicative of poor oxygenation and a circulation problem. Skin and nail bed pallor can indicate either hypoxia or anemia. These abnormalities must be reported to the physician immediately. Spider nevi are common in pregnancy due to the increased vascular volume and high estrogen levels. Nasal passages can be inflamed during pregnancy from edema, caused by increased estrogen levels. The thyroid gland increases in size during pregnancy due to hyperplasia.

The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as: a. Positive signs of pregnancy b. Presumptive signs of pregnancy c. Probable signs of pregnancy d. Possible signs of pregnancy

b. Presumptive signs of pregnancy; Presumptive signs of pregnancy are not probable nor positive they are simply presumptive and usually subjective

A nurse is teaching a prenatal client about cardiovascular changes during pregnancy. The client asks the nurse why she becomes dizzy when getting out of a chair or out of bed. What rationale should the nurse provide as to the cause of this dizziness during pregnancy? a. Decreased absorption of hemoglobin in the blood b. Increased production of fibrinogen and plasma c. Decreased production of estrogen and progesterone d. Increased blood volume in the lower extremities

d. Increased blood volume in the lower extremities

The patient has read that the placenta produces hormones that are vital to the function of the fetus. It is evident that that the patient understands the function of the placenta when she states, "The hormone primarily responsible for the maintenance of pregnancy past the 11th week is: 1. hPL 2. prolactin 3. progesterone 4. hcG

progesterone