OB/Peds Unit 1 exam questions

When assessing women, it is important for the nurse to keep in mind the possibility that they are victims of violence. The nurse should: A. Use an abuse assessment screen during the assessment of every woman.

A

A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system? ___________________

3-1-0-1-0

A key finding from the Human Genome Project is: A. approximately 20,000 to 25,000 genes make up the genome.

A

A maternity nurse should be aware of which fact about amniotic fluid? A. It serves as a source of oral fluid and as a repository for waste from the fetus. B. The volume remains about the same throughout the term of a healthy pregnancy. C. A volume of less than 300 mL is associated with gastrointestinal malformations. D. A volume of more than 2 L is associated with fetal renal abnormalities.

A

A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a: A. primipara. B. primigravida. C. multipara. D. nulligravida.

A

Based on genetic testing of a newborn, a dx of achondroplasia is made. The parents ask the nurse if this could happen to future children. Because this is an example of autosomal dominant inheritance, the nurse would tell the parents: A. For each pregnancy, there is a 50-50 chance the child will be affected by dwarfism B. This will not happen again because the dwarfism was caused by the harmful genetic effects of the infection you had during pregnancy. C. For each pregnancy, there is a 20% chance the child will be a carrier of the defective gene but unaffected by the disorder. D. Because you already have had an affected child, there is a decreased chance for this to happen in future pregnancies.

A

During a client's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as: A. Hegar sign. B. McDonald sign. C. Chadwick sign. D. Goodell sign.

A

Most of the genetic tests now offered in clinical practice are tests for: A. single-gene disorders.

A

Prior to the patient undergoing amniocentesis, the most appropriate nursing intervention is to: A. administer RhoD immunoglobulin. B. administer anticoagulant. C. send the patient for a computed tomography (CT) scan before the procedure. D. assure the mother that short-term radiation exposure is not harmful to the fetus.

A

The nurse is reviewing laboratory values to determine Rh incompatibility between mother and fetus. The nurse should assess which specific lab result? A. Indirect Coombs' test B.Hemoglobin level C. hCG (human chorionic gonadotrophin) level D. Maternal serum alpha-fetoprotein (MSAFP)

A

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

A

With regard to abnormalities of chromosomes, nurses should be aware that: A. they occur in approximately 10% of newborns.

A

With regard to medications, herbs, immunizations, and other substances normally encountered, the maternity nurse should be aware that: A. 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 seen in the final trimester. C. killed-virus vaccines (e.g., tetanus) should not be given 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

a 20 YO woman tells the nurse that she performs breast self-examination on a regular basis. the nurse evaluates the woman's understanding of BSE and ability to perform the technique correctly. Which of the following actions by the woman indicate that she needs further instructions regarding BSE? (SATA) A. performs BSE every month on the first day of her menstrual cycle D. Uses the tips of her four fingers to palpate her breast.

A, D

A nonstress test (NST) is ordered on a pregnant women at 37 weeks gestation. What are the most appropriate teaching points to include when explaining the procedure to the patient? (Select all that apply.) A. After 20 minutes, a nonreactive reading indicates the test is complete. B. Vibroacoustic stimulation may be used during the test. C. Drinking orange juice before the test is appropriate. D. A needle biopsy may be needed to stimulate contractions. E. Two sensors are placed on the abdomen to measure contractions and fetal heart tones.

A,B,D

During the preconception phase, the nurse should teach about which infectious diseases as risk factors for maternal complications? (Select all that apply.) A. Diabetes B. Rubella D. Anemia

A,B,D

The women's health nurse knows which statements regarding sexual response are accurate? (Select all that apply.) A. Women and men are more alike than different in their physiologic response to sexual arousal and orgasm. B. Vasocongestion is the congestion of blood vessels. C. The orgasmic phase is the final state of the sexual response cycle. Correct D. Facial grimaces and spasms of hands and feet are often part of arousal. E. Sexual difficulties should be disregarded in the after birth period.

A,C

The nurse should teach a pregnant woman that which substances are teratogens? (Select all that apply.) A.Cigarette smoke B. Isotretinoin (Retin A) C. Vitamin C D. Salicylic acid E. Rubella

A,D

What symptom described by a woman is characteristic of premenstrual syndrome (PMS)?

A. "I feel irritable and moody a week before my period is supposed to start."

Infections of the female mid reproductive tract, such as chlamydia, are dangerous primarily because these infections,

A. Are asymptomatic

A nurse counseling a client with endometriosis understands which statements regarding the management of endometriosis is accurate? (Select all that apply.)

A. Bone loss from hypoestrogenism is not reversible. B. Side effects from the steroid danazol include masculinizing traits. C. Surgical intervention often is needed for severe or acute symptoms.

A 55 YO woman tells the nurse that she has started to experience pain when she and her husband have intercourse. The nurse would record that this women is experiencing:

A. Dyspareunia

The nurse is assessing a woman's breast self-examination (BSE) technique. Which action indicates that a woman needs further instruction regarding BSE?

A. Performs every month on the first day of her menstrual period.

A 42-year-old woman asks the nurse about mammograms, now that she is "getting older." Which information provided by the nurse would not be correct given current American Cancer Society recommendations?

A. The American Cancer Society recommends mammograms every 1 to 2 years for women ages 40 to 49.

Which is correct concerning the performance of a Papanicolaou (Pap) smear?

A. The woman should not douche, use vaginal medications, or have intercourse for at least 24 hours before the test.

The nurse should include which information when teaching a 15-year old about genital tract infection prevention? (Select all that apply.)

A. Wear nylon undergarments B. Avoid tight-fitting jeans C. Use floral scented bath salts D. Decrease sugar intake E. Do not douche.

The Center for Disease Control (CDC) recommended medication for the treatment of chlamydia would be:

A. doxycycline.

With regard to dysfunctional uterine bleeding (DUB), the nurse should be aware that:

A. it is most commonly caused by anovulation.

To enhance the accuracy of the Papanicolaou (Pap) test, the nurse should instruct the pt to do which of the following? C. Avoid intercourse for 24-48 hours before the test.

C

A female carries the gene for hemophilia on one of her X chromosomes. Now that she is pregnant, she asks the nurse how this might affect her baby. The nurse should tell her: A. A female baby has a 50% chance of being a carrier. B. Hemophilia is always expressed if a male inherits the defective gene. C. Female babies are never affected by this disorder. D. A male baby can be a carrier or have hemophilia

B

A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates an understanding of the nurse's instructions if she states that a positive sign of pregnancy is: A. a positive pregnancy test. B. fetal movement palpated by the nurse-midwife. C. Braxton Hicks contractions. D. quickening.

B

A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate? B. "A baby in utero does respond to the mother's voice."

B

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be: 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

A woman's health nurse practitioner is going to perform a pelvic examination on a female pt. Which of the following nursing actions would be least effective in enhancing the pt's comfort and relaxation during the examination? B. Ask the pt questions as the examination is performed.

B

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. 3-1-1-13 B. 4-1-2-0-4 C. 3-0-3-0-3 D. 4-2-1-0-3

B

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? A. Less audible heart sounds (S1, S2) B. Increased pulse rate C. Increased blood pressure D. Decreased red blood cell (RBC) production

B

If exhibited by an expectant father, what would be a warning sign of ineffective adaptation to his partner's first pregnancy? A. Views pregnancy with pride as a confirmation of his virility. B. Consistently changes the subject when the topic of the fetus/newborn is raised. C. Expresses concern that he might faint at the birth of his baby. D. Experiences nausea and fatigue, along with his partner, during the first trimester.

B

What is an indicator for performing a contraction stress test? A. Increased fetal movement and small for gestational age B. Maternal diabetes mellitus and postmaturity C. Adolescent pregnancy and poor prenatal care D. History of preterm labor and intrauterine growth restriction

B

When assessing the fetal heart rate (FHR) of a woman at 30 weeks of gestation, the nurse counts a rate of 82 beats/min. Initially the nurse should: A. recognize that the rate is within normal limits and record it. B. assess the woman's radial pulse. C. notify the physician. D. allow the woman to hear the heartbeat.

B

Which of the following women is at greatest risk for developing hypogonadotropic amenorrhea? B. 13 YO figure skater

B

Which statements about multifetal pregnancy are most appropriate? (Select all that apply.) 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 are often more pronounced. E. Spontaneous rupture of membranes before term is uncommon.

B,C

Women experiencing PMS should be advised to avoid which of the following?

B. Coffee

What best describes the pattern of genetic transmission known as autosomal recessive inheritance?

B. Disorders in which both genes of a pair must be abnormal for the disorder to be expressed.

The nurse-midwife is teaching a group of women who are pregnant, including instruction on Kegel exercises. Which statement by a participant would indicate a correct understanding of the instruction?

B. I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises.

A woman is determined to be Group B streptococcus positive at the onset of her labor. The nurse should prepare this woman for which of the following?

B. IV administration of an antibiotics during labor

During a health history interview, a woman states that she thinks that she has "bumps" on her labia. She also states that she is not sure how to check herself. The correct response would be to:

B. explain the process of vulvar self-examination to the woman and reassure her that she will become familiar with normal and abnormal findings during the examination.

With regard to the diagnosis and management of amenorrhea, nurses should be aware that:

B. it may be caused by stress or excessive exercise or both.

When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should:

B. position the woman in a semi-Fowler position.

A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period (LMP) was September 10, 2013. Her expected date of birth (EDB) would be? ___________________

June 17, 2014

A nurse is reviewing information related to home pregnancy tests so as to prepare for a patient teaching session. Which statement by the patient indicates that additional instruction is needed following the teaching session? A. The patient states that she will follow directions as listed on the testing package. B. The patient indicates that a positive result will be seen if there is a color change on the applicator. C. The patient states there is no need for concern as home pregnancy test results are 100% correct. D. The patient can perform the test without any assistance in the home setting.

C

A nurse providing care for the antepartum woman should understand that the contraction stress test (CST): A. sometimes uses vibroacoustic stimulation. B. is an invasive test; however, contractions are stimulated. C. is considered negative if no late decelerations are observed with the contractions. D. is more effective than nonstress test (NST) if the membranes have already been ruptured.

C

A pregnant woman at 10 weeks of gestation jogs 3 or 4 times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her: A. "You do not 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

A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she: A. wiggles and points her toes during the cramp. B. applies cold compresses to the affected leg. C. extends her leg and dorsiflexes her foot during the cramp. D. avoids weight bearing on the affected leg during the cramp

C

A pregnant woman in her 1st trimester tells her nurse midwife that although she does drink alcohol during pregnancy, she does so only on the weekends and only a little bit. What should the nurse's initial response be to this woman's comment? C. Tell me what you mean by drinking a little on the weekend.

C

A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates: A.the fetus is at risk for Down syndrome. B. the woman is at high risk for developing preterm labor. C. lung maturity. D. meconium is present in the amniotic fluid.

C

A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? C. "They occur between the third and fifth weeks of development."

C

An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's BEST response would be: A. "This is normal behavior and should begin to subside by the second trimester." B. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know." C. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant." D. "You seem impatient with her. Perhaps this is precipitating her behavior."

C

During the first trimester the pregnant woman would be most motivated to learn about: A. fetal development. B. impact of a new baby on family members. C. measures to reduce nausea and fatigue so she can feel better. D. location of childbirth preparation and breastfeeding classes.

C

Pharmacologic preparations can be used to treat primary dysmenorrhea. Which preparation would be least effective in relieving the symptoms of primary dysmenorrhea? C. Acetaminophen

C

The nurse should include questions regarding sexuality when gathering data for a reproductive health history of a female patient. Which principle should guide the nurse when interviewing the patient?

C

Which hematocrit (Hct) and hemoglobin (Hgb) results represent(s) the lowest acceptable values for a woman in the third-trimester of pregnancy? A. 38% Hct; 14 g/dL Hgb B. 35% Hct; 13 g/dL Hgb C. 33% Hct; 11 g/dL Hgb D. 32% Hct; 10.5 g/dL Hgb

C

Which presumptive signs (felt by the woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause? A. Amenorrhea: Stress, endocrine problems B. Quickening: Gas, peristalsis C. Goodell sign: Cervical polyps Correct D. Chadwick sign: Pelvic congestion

C

A 28 YO woman has been dx with endometriosis. She has been placed on a course of tx with danazol. The woman exhibits understanding of this tx when she says which of the following? C. I should follow a low-fat diet because this medication can increase the level of cholesterol in my blood. D. I can experience a decrease in my breast size, oily skin, and hair growth on my face as a result for taking this medication. F. I may need to use a lubricant during intercourse to reduce discomfort.

C, D, F

A newly married 25 YO woman has been smoking since she was a teenager. She has come to the women's health clinic for a checkup before she begins trying to get pregnant. The woman demonstrates a need for further instruction about the effects of smoking on reproduction and health when she makes which of the following statements? SATA C. Smoking can make my pregnancy last longer than it should. E. Smoking will mean i will experience menopause at an older age than my friends who do not smoke.

C, E

The health care provider has ordered a magnetic resonance imaging (MRI) study to be done on a pregnant patient to evaluate fetal structure and growth. The nurse should include which instructions when preparing the patient for this test? (Select all that apply.) A. A lead apron must be worn during the test. B. A full bladder is required prior to the test. C. An intravenous line must be inserted before the test. D. Jewelry must be removed before the test. E. Remain still throughout the test.

C,D

When teaching a class of pregnant women about fetal development, the nurse would include which of the following statements? (SATA) A. The sex of your baby is determined by the 9th week of pregnancy B. The baby's heart begins to pump blood during the 10th week of pregnancy C. You should be able to feel you baby move by weeks 16-20 of pregnancy D. We will begin to hear your baby's heart beat using an ultrasound stethoscope by the 18th week of your pregnancy E. Your baby will be able to suck, swallow, and hiccup while in your uterus. F. By the 24th week of your pregnancy, you will notice your baby responding to sounds int he environment such as your voice and music

C,E,F

A couple has been counseled for genetic anomalies. They ask you, "What is karyotyping?" Your best response is:

C. "Karyotyping will provide information about the gender of the baby, and the number and structure of the chromosomes."

The student nurse is giving a presentation about milestones in embryonic development. Which information should be included?

C. At 20 weeks of age, the vernix caseosa and lanugo appear.

Which health risk is not associated with menopause?

C. Breast cancer

A 65-year-old woman, G6 P6006, is complaining of increasing stress incontinence and pelvic pressure and fullness. Pelvic examination reveals a bulging in the anterior vaginal wall. This woman is most likely experiencing:

C. cystocele.

An effective relief measure for primary dysmenorrhea would be to:

C. decrease intake of salt and refined sugar about 1 week before menstruation is about to occur.

A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should:

C. discuss options with the couple, including amniocentesis to determine whether the fetus is affected.

Self-care instructions for a woman following a modified radical mastectomy would include that she:

C. expect a decrease in sensation or tingling in her affected arm as her body heals.

A 40-year-old woman with a body mass index (BMI) indicating clinical obesity is 10 weeks pregnant. Which diagnostic tool is appropriate to suggest to her at this time to assess the status of the pregnancy? A. Biophysical profile B. Amniocentesis C. Maternal serum alpha-fetoprotein (MSAFP) D. Transvaginal ultrasound

D

A maternal serum alpha-fetoprotein (MSAFP) test is performed at 16 to 18 weeks of gestation. An elevated level has been associated with: A. Down syndrome. B. sickle cell anemia. C. cardiac defects. D. open neural tube defects such as spina bifida.

D

A pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to: A. assess the woman's blood pressure and pulse. B. have the woman breathe into a paper bag. C.raise the woman's legs. D.turn the woman on her side.

D

A pregnant woman carries a single gene for CF. The father of her baby does not. Which of the following is true concerning the genetic pattern of CF as it applies to this family? A. The pregnant woman has CF herself B. There isa 50% chance her baby will have the disorder C. There is a 25% chance her baby will be a carrier D. There is no chance her baby will be affected by the disorder.

D

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. The nurse tells her: A. Because you are in your second trimester, there is no problem with having one drink with dinner. B. One drink every night is too much. One drink 3 times a week should be fine. C. Because you are 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

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman would indicate a correct understanding of the test? A. "I will need to have a full bladder for the test to be done accurately." B. "I should have my husband drive me home after the test because I may be nauseous." C. "This test will help to determine if the baby has Down syndrome or a neural tube defect." D. "This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."

D

An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. The nurse should tell the couple that: A. intercourse should be avoided if any spotting from the vagina occurs afterward. B. intercourse is safe until the third trimester. C. safer-sex practices should be used once the membranes rupture. D. intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present.

D

An obese pregnant woman with gestational diabetes is learning self-injection of insulin. While evaluating the woman's technique for self-injection of a mixture of NPH and Rapid-Acting insulin, the nurse would recognize that the woman understood the instructions when she: A. washed her hands and put on a pair of clean gloves B. shook the NPH insulin vial vigorously to fully mix the insulin C. drew the NPH insulin into her syringe first D. Spread her skin taut and punctured the skin at a 90* angle

D

If exhibited by a pregnant woman, what represents a positive sign of pregnancy? A. Morning sickness B. Quickening C. Positive pregnancy test D. Fetal heartbeat auscultated with Doppler/fetoscope

D

In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that: A. a blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high. B. shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. C. the systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant. D. compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the latter stage of term pregnancy.

D

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that: A. chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. B. screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects. C. percutaneous umbilical blood sampling (PUBS) is one of the quad-screen tests for Down syndrome. D. MSAFP is a screening tool only; it identifies candidates for more definitive procedures

D

The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that: A. she will have to give birth at home. B. she must see an obstetrician as well as the midwife during pregnancy. C. she will not be able to have epidural analgesia for labor pain. D. she must be having a low risk pregnancy.

D

What laboratory results would be a cause for concern if exhibited by a woman at her first prenatal visit during the second month of her pregnancy? A. Hematocrit 38%, hemoglobin 13 g/dL B. White blood cell count 6000/mm3 C. Platelets 300,000/mm3 D. Rubella titer 1:6

D

With regard to the estimation and interpretation of the recurrence of risks for genetic disorders, nurses should be aware that: D. the risk factor remains the same no matter how many affected children are already in the family.

D

When obtaining a reproductive health history from a female patient, the nurse should:

D. explain the purpose for the questions asked and how the information will be used.

The nurse should refer the patient for further testing if she noted this on inspection of the breasts of a 55-year-old woman: A. left breast slightly smaller than right breast. B. eversion (elevation) of both nipples. C. bilateral D. small dimple located in the upper outer quadrant of the right breast.symmetry of venous network, which is faintly visible. D. small dimple located in the upper outer quadrant of the right breast.

D. small dimple located in the upper outer quadrant of the right breast.

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

a

A client asks her nurse, My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean? The best response by the nurse is: a. Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby. b. Your placenta isnt working properly, and your baby is in danger. c. This means that we will need to perform an amniocentesis to detect if you have any placental damage. d. Dont worry about it. Everything is fine.

a

A first-time mother at 18 weeks of gestation comes 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 this is the Braxton Hicks sign and teaches the client that this type of contraction: A. Is Painless B. Increases with walking C. Causes cervical dilation D. Impedes O2 flow to the fetus

a

A maternity nurse should be aware of which fact about the amniotic fluid? a. It serves as a source of oral fluid and a repository for waste from the fetus. b. The volume remains about the same throughout the term of a healthy pregnancy. c. A volume of less than 300 mL is associated with gastrointestinal malformations. d. A volume of more than 2 L is associated with fetal renal abnormalities.

a

A new mother asks the nurse about the white substance covering her infant. The nurse explains that the purpose of vernix caseosa is to: a. Protect the fetal skin from amniotic fluid. b. Promote normal peripheral nervous system development. c. Allow transport of oxygen and nutrients across the amnion. d. Regulate fetal temperature.

a

A pregnant woman is scheduled for a transvaginal ultrasound test to establish gestational age. In preparation this woman for the test, the nurse would: A. place the woman in a supine position with her hips elevated on a folded pillow B. instruct her to come for the test with a full bladder C. administer an analgesic 30 minutes before the test. D. lubricate the vaginal probe with transmission gel

a

A pregnant womans biophysical profile score is 8. She asks the nurse to explain the results. The nurses best response is: a. The test results are within normal limits. b. Immediate delivery by cesarean birth is being considered. c. Further testing will be performed to determine the meaning of this score. d. An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery.

a

A woman asks the nurse, What protects my babys umbilical cord from being squashed while the babys inside of me? The nurses best response is: a. Your babys umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby. b. Your babys umbilical floats around in blood anyway. c. You dont need to worry about things like that. d. The umbilical cord is a group of blood vessels that are very well protected by the placenta.

a

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have: A. Amenorrhea B. Positive Pregnancy Test C. Chadwicks sign D. Hegars sign

a

A woman at 30 wks of gestation with a class II cardiac disorder calls her PCP's office and speaks to the NP. She tells the nurse that she has been experiencing a frequent, moist cough for the past few days. In addition, she has been feeling more tired and is having difficulty completing her routine activities as a result of some difficulty with breathing. The nurse's best response would be: A. Have someone bring you to the office so we can assess your cardiac status B. Try to get more rest during the day because this is a difficult time for your heart. C. Take an extra diuretic tonight before you go to bed, since you may be developing some fluid in your lungs. D. Ask your family to come over and do your housework for the next few days so you can rest.

a

A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that: a. This is a normal respiratory change in pregnancy caused by elevated levels of estrogen. b. This is an abnormal cardiovascular change, 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 using cocaine intranasally.

a

A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min without any decelerations. The interpretation of this test is said to be: A. Negative B. Positive C. Satisfactory D. Unsatisfactory

a

A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a: A. Primipara B. Primigravida C. Multipara D. Nulligravida

a

A woman's last menstrual period (LMP) began on September 10, 2016, and it ends on September 15, 2016. Using Nagele's rule, the estimated date of birth would be: A. June 17, 2017 B. June 22, 2017 C. August 17, 2017 D. December 3, 2017

a

Appendicitis may be difficult to diagnose in pregnancy because the appendix is: a. Displaced upward and laterally, high and to the right. b. Displaced upward and laterally, high and to the left. c. Deep at McBurney point. d. Displaced downward and laterally, low and to the right.

a

As relates to the fathers acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that: a. The father goes through three phases of acceptance of his own. b. The fathers attachment to the fetus cannot be as strong as that of the mother because it does not start until after 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

Compared with contraction stress test (CST), nonstress test (NST) for antepartum fetal assessment: a. Has no known contraindications. b. Has fewer false-positive results. c. Is more sensitive in detecting fetal compromise. d. Is slightly more expensive.

a

During a clients physical examination the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as: A. Hegars sign B. McDonalds sign C. Chadwicks Sign D> Goodells sign

a

Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that: a. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing. b. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins. c. Identical twins are more common in white families. d. Fraternal twins are same gender, usually male.

a

Nurses should be aware that the biophysical profile (BPP): a. Is an accurate indicator of impending fetal death. b. Is a compilation of health risk factors of the mother during the later stages of pregnancy. c. Consists of a Doppler blood flow analysis and an amniotic fluid index. d. Involves an invasive form of ultrasound examination.

a

Prenatal testing for human immunodeficiency virus (HIV) is recommended for: A. All women, regardless of risk factors. B. A women who has had more than one sexual partner C. A woman who has had a sexually transmitted infection. D. A woman who is monogamous with her parther

a

The mucous plug that forms in the endocervical canal is called the: A. Operculum B. Leukorrhea C. Funic Souffle D. Ballottement

a

The multiple marker test is used to assess the fetus for which condition? A. Down Syndrome B. Diaphragmatic hernia C. Congenital cardiac abnormality D. Anencephaly

a

The nurse caring for a pregnant client knows that her health teaching regarding fetal circulation has been effective when the client reports that she has been sleeping: a. In a side-lying position. b. On her back with a pillow under her knees. c. With the head of the bed elevated. d. On her abdomen.

a

The nurse caring for the laboring woman should know that meconium is produced by: A. Fetal Intestines B. Fetal Kidneys C. Amniotic Fluid D. The placenta

a

The nurse is assessing the knowledge of new parents with a child born with maple syrup urine disease (MSUD). This is an autosomal recessive inherited disorder, which means that: a. Both genes of a pair must be abnormal for the disorder to be expressed. b. Only one copy of the abnormal gene is required for the disorder to be expressed. c. The disorder occurs in males and heterozygous females. d. The disorder is carried on the X chromosome.

a

The nurse must be cognizant that an individuals genetic makeup is known as his or her: A. Genotype B. Phenotype C. Karyotype D. Chromotype

a

The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what other tool would be useful in confirming the diagnosis? A. Doppler blood flow analysis B. Contraction stress test C. Amniocentesis D. Daily fetal movement counts

a

The placenta allows exchange of oxygen, nutrients, and waste products between the mother and fetus by: a. Contact between maternal blood and fetal capillaries within the chorionic villi. b. Interaction of maternal and fetal pH levels within the endometrial vessels. c. A mixture of maternal and fetal blood within the intervillous spaces. d. Passive diffusion of maternal carbon dioxide and oxygen into the fetal capillaries.

a

Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? a. Multiple-marker screening b. Lecithin/sphingomyelin (L/S) ratio c. Biophysical profile d. Type and crossmatch of maternal and fetal serum

a

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 2 C. She drives her car slowly D. She wears only low-heeled shoes

a

Which of the following group descriptions is most accurate regarding those persons who should participate in preconception counseling? A. All women and their partners as they make decisions about their reproductive future, including becoming parents.

a

Which statement about pregnancy is accurate? a. A normal pregnancy lasts about 10 lunar months. b. A trimester is one third of a year. c. The prenatal period extends from fertilization to conception. d. The estimated date of confinement (EDC) is how long the mother will have to be bedridden after birth.

a

While teaching the expectant mother about personal hygiene during pregnancy, maternity nurses should be aware that: 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

With regard to medications, herbs, shots, and other substances normally encountered by pregnant women, the maternity nurse should be aware that: 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 seen in the final trimester. c. Killed-virus vaccines (e.g., tetanus) should not be given 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

With regard to prenatal genetic testing, nurses should be aware that: Genetic disorders affect people of all socioeconomic backgrounds, races, and ethnic groups equally. Genetic health care is more concerned with populations than individuals. The most important of all nursing functions is providing emotional support to the family during counseling. Taking genetic histories is the province of large universities and medical centers. a. Maternal serum screening can determine whether a pregnant woman is at risk of carrying a fetus with Down syndrome. b. Carrier screening tests look for gene mutations of people already showing symptoms of a disease. c. Predisposition testing predicts with near certainty that symptoms will appear. d. Presymptomatic testing is used to predict the likelihood of breast cancer.

a

Congenital disorders refer to conditions that are present at birth. These disorders may be inherited and caused by environmental factors or maternal malnutrition. Toxic exposures have the greatest effect on development between 15 and 60 days of gestation. For the nurse to be able to conduct a complete assessment of the newly pregnant client, she should understand the significance of exposure to known human teratogens. These include(Select all that apply): a. Infections. b. Radiation. c. Maternal conditions. d. Drugs. e. Chemicals.

a,b,c,d,e

Intrauterine growth restriction (IUGR) is associated with numerous pregnancy-related risk factors (Select all that apply). a. Poor nutrition b. Maternal collagen disease c. Gestational hypertension d. Premature rupture of membranes e. Smoking

a,b,c,e

A woman is in for a routine prenatal checkup. You are assessing her urine for 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 D. >300 mg/24 hours

a,b

A nurse is working with a pre gestational diabetic woman to plan the diet she will follow during pregnancy. Which of the following nutritional guidelines should be used to ensure a euglycemic state and appropriate weight gain? (SATA) A. substantial bedtime snack composed of complex carbs with some protein and fat B. Average calories prepay of 2200 during the first trimester and 2500 during the second and third trimesters. C. caloric distribution among 3 meals and one or 2 snacks D. Minimum of 45% carbs daily E. Protein intake of at least 30% of the total kilocalories in a day. F. Fat intake of 30-40% of the daily caloric intake

a,b,c

Signs and symptoms that a woman should report immediately to her health care provider include (Select all that apply): a. V aginal bleeding. b. Rupture of membranes. c. Heartburn accompanied by severe headache. d. Decreased libido. e. Urinary frequency.

a,b,c

Transvaginal ultrasonography is often performed during the first trimester. While preparing your 6-week gestation patient for this procedure, she expresses concerns over the necessity for this test. The nurse should explain that this diagnostic test may be indicated for a number of situations (Select all that apply). a. Multifetal gestation b. Obesity c. Fetal abnormalities d. Amniotic fluid volume e. Ectopic pregnancy

a,b,c,e

When communicating with an abused woman, which of the following statements should be avoided? A. Why do you think your husband hits you even though you are pregnant? B. I cannot believe how terrible your husband is being to you. D. Tell me why you did not go to the seller I recommended to you; they are very helpful and you would have avoided this beating if you had gone. E. Next time you come in for care, I want you to be sure to bring your husband so I can talk to him myself.

a,b,d,e

Which congenital malformations result from multifactorial inheritance (Select all that apply)? a. Cleft lip b. Congenital heart disease c. Cri du chat syndrome d. Anencephaly e. Pyloric stenosis

a,b,d,e

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, you discover that she 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,b,e

A pregnant woman is concerned about what she should do if she notices signs of preterm labor such as uterine contractions. After reviewing the signs of preterm labor with the woman, the nurse reviews measures the pt should implement should the signs occur. The nurse should discuss which of the following measures with the woman? (SATA) A. Empty bladder B. Drink 3-4 glasses of water to ensure adequate hydration C. Assume a supine position D. Assess contractions for 2 or more hours E. Report contractions that occur every 10 minutes or more often for 1 hour.

a,b,e,f

A nurse is assessing a pregnant woman during a prenatal visit. Several presumptive indicators of pregnancy are documented. Which of the following are presumptive indicators? (SATA) A. N/V B. Quickening C. Ballottement D. Palpation of fetal movement by the nurse E. Hegar's sign F. Amenorrhea

a,b,f

A nurse is teaching a class of young women in a drug rehab program about the risks associated with using illicit drugs during pregnancy. Which of the following statements indicates they understood the nurse's instructions? A. My baby won't get enough oxygen if i smoke weed. C. Cocaine can make the placenta separate from my baby too early. D. If I use heroin during pregnancy my baby will go through withdrawals after birth.

a,c,d

Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy. These include (select all that apply) a. Human chorionic gonadotropin (hCG) b. Insulin c. Estrogen d. Progesterone e. Testosterone

a,c,d

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

a,c,d

A pregnant woman at 10 weeks gestation exhibits the following signs of pregnancy during a routine prenatal checkup. Which ones would be categorized as probable signs of pregnancy? (SATA) A. hCG in the urine B. Breast tenderness C. Ballottement D. Fetal Heart Sounds E. Hegar Sign F. Amenorrhea

a,c,e

During an early bird prenatal class a nurse teaches a group of newly dx pregnant women about their emotional reactions during pregnancy. Which of the following should the nurse discuss with the women? (SATA) A. Sexual desire is usually increased during the second trimester of pregnancy B. A referral for counseling should be sought if a woman experiences ambivalence in the first trimester C. Rapid, unpredictable mood swings reflect gestational bipolar disorder D. The need to seek safe passage and prepare for birth begins early in the third trimester E. A woman's own mother will be her greatest source of emotional support during pregnancy F. Attachment to the infant begins late in the third trimester when she begins to prepare for birth by attending childbirth preparation classes.

a,d

The nurse evaluates a pregnant woman's knowledge about prevention of UTI at the prenatal visit following a class on infection prevention that the woman attended. The nurse would recognize that the woman needs further instruction when she tells the nurse about which one of the following measures that she now uses to prevent UTI? (SATA) A. I drank about 1 qt of fluid a day B. I have stopped using bubble baths and bath oils. C. I have started wearing panty hose and underpants with a cotton crotch D. I have yogurt for lunch or as an evening snack E. I should stop having intercourse with my partner since it increases my risk for UTI F. If I drink cranberry juice during breakfast and dinner I will not get a bladder infection

a,e,f

a 26 YO woman who has just been dx with fibrocystic change in her breasts. Which of the following nursing DX would be a priority for this woman?

a. acute pain r/t cyclical enlargement of breast cysts or lumps.

A 3-year-old girls mother is 6 months pregnant. What concern is this child likely to verbalize? A. How the baby will get out B. What the baby will eat C. Whether her mother will die D. What color eyes the baby has

b

A 31-year-old woman believes that she may be pregnant. She took an 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 woman states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. She also has a history of irregular periods. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which reveals that she is not pregnant. What is the most likely cause of the false- positive pregnancy test result? a. She took the pregnancy test too early. b. She takes anticonvulsants. c. She has a fibroid tumor. d. She has been under considerable stress and has a hormone imbalance.

b

A 40 YO woman is 18 weeks of gestation is having a triple marker test performed. She is obese, and her health history reveals that she is Rh negative. The primary purpose for this test is to screen for: A. spinal bifida B. down syndrome C. gestational diabetes D. Rh antibodies

b

A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus? a. Ultrasound for fetal anomalies b. Biophysical profile (BPP) c. Maternal serum alpha-fetoprotein (MSAFP) screening d. Percutaneous umbilical blood sampling (PUBS)

b

A mans wife is pregnant for the third time. One child was born with cystic fibrosis, and the other child is healthy. The man wonders what the chance is that this child will have cystic fibrosis. This type of testing is known as: a. Occurrence risk. b. Recurrence risk. c. Predictive testing. d. Predisposition testing.

b

A patient in her first trimester complains of nausea and vomiting. She asks, Why does this happen? The nurses best response is: a. It is due to an increase in gastric motility. b. It may be due to changes in hormones. c. It is related to an increase in glucose levels. d. It is caused by a decrease in gastric secretions.

b

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. The nurse would recommend that she: A. Do Kegel Exercises B. Do pelvic rock exercises C. Use a softer mattress D. Stay in bed for 24 hours

b

A woman has been diagnosed with a high risk pregnancy. She and her husband come into the office in a very anxious state. She seems to be coping by withdrawing from the discussion, showing declining interest. The nurse can best help the couple by: a. Telling her that the physician will isolate the problem with more tests. b. Encouraging her and urging her to continue with childbirth classes. c. Becoming assertive and laying out the decisions the couple needs to make. d. Downplaying her risks by citing success rate studies.

b

A woman is 15 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is: a. You should have felt the baby move by now. b. Within the next month, you should start to feel fluttering sensations. c. The baby is moving; however, you cant feel it yet. d. Some babies are quiet, and you dont feel them move.

b

A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level? A. Not palpable above the symphysis at this time B. Slightly above the symphysis pubis. C. At the level of the umbilicus D. Slightly above the ubilicus

b

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

b

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be: 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

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

b

At a previous antepartal visit, the nurse taught a pregnant woman dx with a class II cardiac disorder about measures to use to lower her risk for cardiac decompensation. This woman would demonstrate need for further instruction if she tells the nurse she will use which of the following measures? A. increase roughage in her diet B. remain on bed rest, getting out of bed only to go to the bathroom. C. sleep 10 hrs every night and take a short nap after meals. D. will call the nurse immediately if she experiences any pain or swelling in her legs

b

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? a. Less audible heart sounds (S1, S2) b. Increased pulse rate c. Increased blood pressure d. Decreased red blood cell (RBC) production

b

During an examination of a pregnant woman the nurse notes that her cervix is soft on this tip. The nurse would document this finding as A. Friability B. Goodell sign C. Chadwick sign D. Hegar sign

b

During the first trimester, a woman can expect which of the following changes in her sexual desire? a. An increase, because of enlarging breasts b. A decrease, because of nausea and fatigue c. No change d. An increase, because of increased levels of female hormones

b

In presenting to obstetric nurses interested in genetics, the genetic nurse identifies the primary risk(s) associated with genetic testing as: a. Anxiety and altered family relationships. b. Denial of insurance benefits. c. High false-positive results associated with genetic testing. d. Ethnic and socioeconomic disparity associated with genetic testing.

b

In the first trimester, ultrasonography can be used to gain information on: a. Amniotic fluid volume. b. Location of Gestational sacs c. Placental location and maturity. d. Cervical length.

b

In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that: a. Nonacceptance of the pregnancy very often equates to rejection of the child. b. Mood swings most likely are the result of worries about finances and a changed lifestyle as well as profound hormonal changes. c. Ambivalent feelings during pregnancy usually are seen only in emotionally immature or very young mothers. d. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth.

b

Maternal serum alpha-fetoprotein (MSAFP) screening indicates an elevated level. MSAFP screening is repeated and again is reported as higher than normal. What would be the next step in the assessment sequence to determine the well-being of the fetus? A. Percutaneous Umbilical Blood Sampling (PUBS) B. Ultrasound for fetal anomalies C. Biophysical profile for fetal wellbeing D. Amniocentesis for genetic anomalies

b

Physiologic anemia often occurs during pregnancy as a result of: a. Inadequate intake of iron. b. Dilution of hemoglobin concentration. c. The fetus establishing iron stores. d. Decreased production of erythrocytes.

b

Risk factors tend to be interrelated and cumulative in their effect. While planning the care for a laboring client with diabetes mellitus, the nurse is aware that she is at a greater risk for: A. Oligohydramnios B. Polyhydramnios C. Postterm Pregnancy D. Chromosomal Abnormalities

b

The maternity nurse understands that vascular volume increases 40% to 60% during pregnancy to: a. Compensate for decreased renal plasma flow. b. Provide adequate perfusion of the placenta. c. Eliminate metabolic wastes of the mother. d. Prevent maternal and fetal dehydration.

b

The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change? 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

The nurse caring for a newly pregnant woman would advise her that ideally prenatal care should 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

The nurse should have knowledge of the purpose of the pinch test. It is used to: a. Check the sensitivity of the nipples. b. Determine whether the nipple is everted or inverted. c. Calculate the adipose buildup in the abdomen. d. See whether the fetus has become inactive.

b

The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurses instructions if she states that a positive sign of pregnancy is: a. A positive pregnancy test. b. Fetal movement palpated by the nurse-midwife. c. Braxton Hicks contractions. d. Quickening.

b

To reassure and educate pregnant clients about changes in the uterus, nurses should be aware that: a. Lightening occurs near the end of the second trimester as the uterus rises into a different position. b. The 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. The uterine souffle is the movement of the fetus.

b

To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that: a. A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear. b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term. c. Palpitations are twice as likely to occur in twin gestations. d. All of the above changes likely will occur.

b

To reassure and educate pregnant clients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that: a. Increased urinary output makes pregnant women less susceptible to urinary infection. b. Increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty. c. Renal (kidney) function is more efficient when the woman assumes a supine position. d. Using diuretics during pregnancy can help keep kidney function regular.

b

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

Which finding in the urine analysis 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

Which nursing intervention is necessary before a second-trimester transabdominal ultrasound? a. Place the woman NPO for 12 hours. b. Instruct the woman to drink 1 to 2 quarts of water. c. Administer an enema. d. Perform an abdominal preparation.

b

Which statement about multifetal pregnancy is inaccurate? 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.

b

Which time-based description of a stage of development in pregnancy is accurate? a. Viability22 to 37 weeks since the last menstrual period (LMP) (assuming a fetal weight >500 g) b. Termpregnancy from the beginning of week 38 of gestation to the end of week 42 c. Pretermpregnancy from 20 to 28 weeks d. Postdatepregnancy that extends beyond 38 weeks

b

With regard to chromosome abnormalities, nurses should be aware that: a. They occur in approximately 10% of newborns. b. Abnormalities of number are the leading cause of pregnancy loss. c. Down syndrome is a result of an abnormal chromosome structure. d. Unbalanced translocation results in a mild abnormality that the child will outgrow.

b

With regard to the initial physical examination of a woman beginning prenatal care, maternity nurses should be cognizant of: a. Only women who show physical signs or meet the sociologic profile should be assessed for physical abuse. b. The woman should empty her bladder before the pelvic examination is performed. 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.

b

You are a maternal-newborn nurse caring for a mother who just delivered a baby born with Down syndrome. What nursing diagnosis would be the most essential in caring for the mother of this infant? a. Disturbed body image b. Interrupted family processes c. Anxiety d. Risk for injury

b

The nurse counseling a 30 YO woman regarding effective measures to use to relieve the discomfort associated with dysmenorrhea can suggest which of the following? (SATA) B. Use back massages and heat application to abdomen to enhance relaxation and circulation. D. Add veg such as asparagus to the diet. E. Perform guided imagery for relaxation and distraction. F. Limit intake of salty and fatty foods.

b,d,e,f

a 52 YO woman asks the NP about how often she should be assessed for the common health problems women of her age could experience. The nurse would recommend which of the following screening measures? (SATA) B. A fecal occult blood test every year. D. Clinical breast examination every year. F. Vision examination every 2-4 years

b,d,f

A woman's health NP is preparing an educational presentation on the topic of intimate partner violence to a group of women who come to the clinic where she practices. As part of the presentation, she plans to dispel commonly held myths regarding IPV. Which of the following statements represents the facts related to IPV? (SATA) B. Of women who experience battering, 25% are battered by an intimate partner. E. Counseling may be successful in helping the batterer stop his behavior. F. Women do not like to be beaten and will often do anything to avoid a confrontation.

b,e,f

When assessing a pregnant woman at 28 weeks of gestation who is dx with mitral valve stenosis, the nurse must be alert for signs indicating cardiac decompensation. Signs of cardiac decompensation would include which of the following? (SATA) A. dry, hacking cough B. Increasing fatigue C. Wheezing with inspiration and expiration D. Bradycardia E. Progressive generalized edema F. orthopnea with increasing dyspnea

b,e,f

A recommended medication effective in the tx of vulvovaginal candidates would be which of the following?

b. Miconazole

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her: a. You dont 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

herbal preparations can be used as part of the tx for a variety of menstrual disorders. Which of the following herbs would be beneficial for a woman experiencing menorrhagia?

b. shepherd's purse d. black haw

A finding associated with HPV infection would include which of the following?

b. soft papillary swelling occurring singly or in clusters.

When providing dc instructions to a woman who had a modified right radical mastectomy, the nurse should emphasize the importance of which of the following?

b. telling health care providers not to take a BP or draw blood on her right arm.

A father and mother are carriers of phenylketonuria (PKU). Their 2-year-old daughter has PKU. The couple tells the nurse that they are planning to have a second baby. Because their daughter has PKU, they are sure that their next baby wont be affected. What response by the nurse is most accurate? a. Good planning; you need to take advantage of the odds in your favor. b. I think youd better check with your doctor first. c. You are both carriers, so each baby has a 25% chance of being affected. d. The ultrasound indicates a boy, and boys are not affected by PKU.

c

A nurse instructs a female pt regarding vulvar self-examination (VSE). Which of the statements made by the pt will require further instruction? C. i will use the examination to determine when i should get medications at the pharmacy for infections.

c

A patient at 24 weeks of gestation contacts the nurse at her obstetric providers office to complain that she has cravings for dirt and gravel. The nurse is aware that this condition is known as ________ and may indicate anemia. A. Ptyalism B. Pyrosis C. Pica D. Decreased peristalsis

c

A pregnant woman at 25 weeks gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate? a. That must have been a coincidence; babies cant respond like that. b. The fetus is demonstrating the aural reflex. c. Babies respond to sound starting at about 24 weeks of gestation. d. Let me know if it happens again; we need to report that to your midwife.

c

A pregnant woman with a cardiac disorder will begin anticoagulant therapy to prevent clot formation. In preparing this woman for this tx measure, the nurse would expect to teach the woman about self-administration of which of the following medications? a. furosemide B. propranolol C. Heparin D. Warfarin

c

A womans cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? a. We dont really know when such defects occur. b. It depends on what caused the defect. c. They occur between the third and fifth weeks of development. d. They usually occur in the first 2 weeks of development.

c

An essential component of prenatal health assessment of pregnant women is the determination of VS. Which of the following would be an expected change in VS findings as a result of pregnancy? A. Increase in systolic BP by 30 or more after assuming the supine position B. Increase in diastolic BP by 5-10 beginning in the first trimester C. Chest breathing replaces abdominal breathing with upward displacement of the diaphragm D. Gradual decrease in baseline pulse of approximately 20 bPM

c

As part of preparing a 24 YO woman at 42 weeks of gestation for a non stress test, the nurse would: A. tell the woman to fast for 8 hours before the test B. explain that the test will evaluate how well her baby is moving inside her uterus C. show her how to indicate when her baby moves D. attach a spiral electrode to the presenting part to determine FHR patterns

c

At 35 weeks of pregnancy a woman experiences preterm labor. Tocolytics are administered and she is placed on bed rest, but she continues to experience regular uterine contractions, and her cervix is beginning to dilate and efface. What would be an important test for fetal well-being at this time? a. Percutaneous umbilical blood sampling (PUBS) b. Ultrasound for fetal size c. Amniocentesis for fetal lung maturity d. Nonstress test (NST)

c

At approximately _____ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and weighs approximately 1110 g. A. 20 B. 24 C. 28 D. 30

c

During a contraction stress test, four contractions lasting 45-55 seconds were recorded in 10 minute period. A late deceleration was noted during the third contraction. The nurse conducting the test would document the results as A. negative B. Positive C. suspicious D. unsatisfactory

c

During her pregnancy, a woman with pre gestational diabetes has been monitoring her blood glucose level several times a day. Which of the following levels would require further assessment? A. 85 mg/dL before breakfast B. 90 mg/dL before lunch C. 135 mg/dL 2 hours before supper D. 126 mg/dL 1 hour after breakfast

c

In particular terms regarding genetic health care, nurses should be aware that: A. Genetic disorders affect people of all socioeconomic backgrounds, races, and ethnic groups equally. B. Genetic health care is more concerned with populations than individuals C. The most important of all nursing functions is providing emotional support to the family during counseling. D. Taking genetic histories is the province of large universities and medical centers

c

In response to requests by the U.S. Public Health Service for new models of prenatal care, an innovative new approach to prenatal care known as centering pregnancy was developed. Which statement would accurately apply to the centering model of care? a. Group sessions begin with the first prenatal visit. b. At each visit, blood pressure, weight, and urine dipsticks are obtained by the nurse. c. Eight to 12 women are placed in gestational-age cohort groups. d. Outcomes are similar to those of traditional prenatal care.

c

In the past, factors to determine whether a woman was likely to develop a high risk pregnancy were evaluated primarily from a medical point of view. A broader, more comprehensive approach to high-risk pregnancy has been adopted today. There are now four categories based on threats to the health of the woman and the outcome of pregnancy. Which of the following is not one of these categories? A. Biophysical B. Psychosocial C. Geographic D. Environmental

c

Sally comes in for her first prenatal examination. This is her first child. She asks you (the nurse), How does my baby get air inside my uterus? The correct response is: a. The babys lungs work in utero to exchange oxygen and carbon dioxide. b. The baby absorbs oxygen from your blood system. c. The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream. d. The placenta delivers oxygen-rich blood through the umbilical artery to the babys abdomen.

c

Some pregnant clients may complain of changes in their voice and impaired hearing. The nurse can tell these clients that these are common reactions to: a. A decreased estrogen level. b. Displacement of the diaphragm, resulting in thoracic breathing. c. Congestion and swelling, which occur because the upper respiratory tract has become more vascular. d. Increased blood volume.

c

The measurement of lecithin in relation to sphingomyelin (L/S ratio) is used to determine fetal lung maturity. Which ratio reflects maturity of the lungs? A. 1.4:1 B. 1.8:1 C. 2:1 D. 1:1

c

The nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should: a. Tell the couple they need to have an abortion within 2 to 3 weeks. b. Explain that the fetus has a 50% chance of having the disorder. c. Discuss options with the couple, including amniocentesis to determine whether the fetus is affected. d. Refer the couple to a psychologist for emotional support.

c

The nurse providing care for the antepartum woman should understand that contraction stress test (CST): a. Sometimes uses vibroacoustic stimulation. b. Is an invasive test; however, contractions are stimulated. c. Is considered negative if no late decelerations are observed with the contractions. d. Is more effective than nonstress test (NST) if the membranes have already been ruptured.

c

The nurse should be aware that the partners main role in pregnancy is to: a. Provide financial support. b. Protect the pregnant woman from old wives tales. c. Support and nurture the pregnant woman. d. Make sure the pregnant woman keeps prenatal appointments.

c

To provide the patient with accurate information about dental care during pregnancy, maternity nurses should be aware that: a. Dental care can be dropped from the priority list because the woman has enough to worry about and is getting a lot of calcium anyway. b. Dental surgery, in particular, is contraindicated because of the psychologic stress it engenders. c. If dental treatment is necessary, the woman will be most comfortable with it in the second trimester. d. Dental care interferes with the expectant mothers need to practice conscious relaxation.

c

To reassure and educate pregnant clients about changes in their breasts, nurses should be aware that: a. The visibility of blood vessels that form an intertwining blue network indicates full function of Montgomerys tubercles and possibly 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

When nurses help their expectant mothers assess the daily fetal movement counts, they should be aware that: a. Alcohol or cigarette smoke can irritate the fetus into greater activity. b. Kick counts should be taken every half hour and averaged every 6 hours, with every other 6-hour stretch off. c. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours. d. Obese mothers familiar with their bodies can assess fetal movement as well as average-size women.

c

While working with the pregnant woman in her first trimester, the nurse is aware that chorionic villus sampling (CVS) can be performed during pregnancy at: A. 4 wks B. 8 wks C. 10 wks D. 14 wks

c

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

c

With regard to amniocentesis, nurses should be aware that: a. Because of new imaging techniques, amniocentesis is now possible in the first trimester. b. Despite the use of ultrasound, complications still occur in the mother or infant in 5% to 10% of cases. c. The shake test, or bubble stability test, is a quick means of determining fetal maturity. d. The presence of meconium in the amniotic fluid is always cause for concern.

c

With regard to follow-up visits for women receiving prenatal care, nurses should be aware that: 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 blood pressure (BP) of 130 and a diastolic BP of 80 is sufficient to be considered hypertensive.

c

With regard to the development of the respiratory system, maternity nurses should be understand that: a. The respiratory system does not begin developing until after the embryonic stage. b. The infants lungs are considered mature when the lecithin/sphingomyelin (L/S) ratio is 1:1, at about 32 weeks. c. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. d. Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks.

c

With regard to the initial visit with a client who is beginning prenatal care, nurses should be aware that: a. The first interview is a relaxed, get-acquainted affair in which nurses gather some general impressions. b. If nurses observe handicapping conditions, they should be sensitive and not inquire about them because the client will do that in her own time. c. Nurses should be alert to the appearance of potential parenting problems, such as depression or lack of family support. d. Because of legal complications, nurses should not ask about illegal drug use; that is left to physicians.

c

During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criteria? a. Leukorrhea b. Development of the operculum c. Quickening d. Ballottement e. Lightening

c,d,e

When teaching women about breast cancer, the nurse should emphasize which of the following facts? (SATA) c. the mortality rate of breast caner decreases with early detection e. maintaining a normal weight and reducing alcohol intake could have an effect on reducing a women's changes of developing breast cancer. f. the majority of breast lumps found by women are not malignant.

c,e,f

A 40 YO woman at risk for breast cancer (BC) has elected chemoprevention as an approach to reduce her risk. She will be receiving tamoxifen. The nurse will recognize that this woman understands instructions given to her regarding this medication if she make which of the following statements?

c. I can take this medication on an empty stomach

The nurse recognizes that a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period is: A. nonreactive B. Positive C. Negative D. Reactive

d

The phenomenon of someone other than the mother-to-be experiencing pregnancy-like symptoms such as nausea and weight gain applies to the: A. Mother of the pregnant woman B. Couples teenage daughter C. Sister of the pregnant woman D. Expectant father

d

To reassure and educate pregnant clients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that: a. Because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are much 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 (Chadwicks 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

A 34 YO woman at 36 weeks gestation has been scheduled for a biophysical profile. She asks the nurse why the test needs to be performed. The nurse would tell her that the test: A. determines how well her baby will breathe after it is born B. evaluates the response of her baby's heart to uterine contractions. C. measures her baby's head size and length D. observes her baby's activities in utero to predict fetal well-being

d

A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to suggest to her at this time? a. Biophysical profile (BPP) b. Amniocentesis c. Maternal serum alpha-fetoprotein (MSAFP) screening d. Transvaginal ultrasound

d

A pre gestational diabetic woman at 20 weeks of gestation exhibits the following: thirst, nausea, vomiting, abdominal pain, drowsiness, and increased urination. Her skin is dry and flush and her breathing is rapid with a fruit odor. A priority nursing action when caring for this woman would be to: A. provide the woman with a simple carbohydrate immediately. B. request an order for an antiemetic C. assist the woman into a lateral position to rest. D. administer insulin according to the woman's blood glucose level.

d

A pregnant woman with four children reports the following OB history: a stillbirth at 32 weeks of gestation, triplets born via C-section at 30 weeks of gestation, a spontaneous abortion at 8 weeks gestation and a daughter born vaginally at 39 weeks of gestation. Which of the following accurately expresses this woman's current OB history using the 5-digit system A.. 5-1-4-1-4 B. 4-1-3-1-4 C. 5-2-2-0-3 D. 5-1-2-1-4

d

To reassure and educate their pregnant clients about changes in their blood pressure, maternity nurses should be aware that: 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. The systolic blood pressure increases slightly as pregnancy advances; the 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 term pregnancy.

d

A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine several times during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the woman in a high risk category? a. Blood pressure, age, BMI b. Drug/alcohol use, age, family history c. Family history, blood pressure, BMI d. Family history, BMI, drug/alcohol abuse

d

A woman at 30 wks gestation assumes a supine position for a fundal measurement and Leopold's maneuvers. She begins to complain about feeling dizzy and nauseated. Her skin feels damp and cool. The nurse's first action would be: A. Assess the woman's rest rate and effort B. Provide the woman with an emesis basin C. Elevate the woman's legs 20* from her hips D. Turn the woman on her side

d

A woman is 3 months pregnant. At her prenatal visit, she tells the nurse that she doesnt know what is happening; one minute shes happy that she is pregnant, and the next minute she cries for no reason. Which response by the nurse is most appropriate? a. Dont worry about it; youll feel better in a month or so. b. Have you talked to your husband about how you feel? c. Perhaps you really dont want to be pregnant. d. Hormonal changes during pregnancy commonly result in mood swings.

d

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. The nurse would tell her: a. Since youre in your second trimester, theres 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 youre 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

A woman who is 8 months pregnant asks the nurse, Does my baby have any antibodies to fight infection? The most appropriate response by the nurse is: a. Your baby has all the immune globulins necessary: IgG, IgM, and IgA. b. Your baby wont receive any antibodies until he is born and you breastfeed him. c. Your baby does not have any antibodies to fight infection. d. Your baby has IgG and IgM.

d

Doulas are becoming important members of a laboring woman's health care team. Which of the following activities should be expected as part of the doula's role responsibilities? A. Monitoringydration of the laboring woman, including adjusting the IV flow rates B. Interpreting electronic fetal monitoring tracings to determine the well-being of the maternal-fetal unit C. Eliminating the need for the husband/partner to be present during labor and birth D. Providing continuous support throughout labor and birth, including explanations of labor progress

d

For what reason would breastfeeding be contraindicated? A. Hep B B. Enverted Nipples C. Hx of BC 3 years ago D. HIV positive

d

Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and the basis for many tests. A maternity nurse should be aware that: a. hCG can be detected 2.5 weeks after conception. b. The hCG level increases gradually and uniformly throughout pregnancy. c. Much lower than normal increases in the level of hCG may indicate a postdate pregnancy. d. A higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome.

d

In comparing the abdominal and transvaginal methods of ultrasound examination, nurses should explain to their clients that: a. Both require the woman to have a full bladder. b. The abdominal examination is more useful in the first trimester. c. Initially the transvaginal examination can be painful. d. The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.

d

In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose? a. To promote family unity b. To ward off the evil eye c. To appease the gods of fertility d. To protect the mother and fetus during pregnancy

d

Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth? A. Epulis B. Chloasma C. Telangiectasia D. Striae Gravidarum

d

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that: a. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis. b. Maternal serum alpha-fetoprotein (MSAFP) screening is recommended only for women at risk for neural tube defects. c. Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome. d. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

d

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

d

The _____ is/are responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream. A. Decidua Basalis B. Blastocyst C. Germ Layer D. Chorionic Villi

d

The most basic information a maternity nurse should have concerning conception is that: a. Ova are considered fertile 48 to 72 hours after ovulation. b. Sperm remain viable in the womans reproductive system for an average of 12 to 24 hours. c. Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum. d. Implantation in the endometrium occurs 6 to 10 days after conception.

d

The nurse caring for the pregnant client must understand that the hormone essential for maintaining pregnancy is: a. Estrogen. b. Human chorionic gonadotropin (hCG). c. Oxytocin. d. Progesterone.

d

What represents a typical progression through the phases of a womans establishing a relationship with the fetus? a. Accepts the fetus as distinct from herselfaccepts the biologic fact of pregnancyhas a feeling of caring and responsibility b. Fantasizes about the childs gender and personalityviews the child as part of herselfbecomes introspective c. Views the child as part of herselfhas feelings of well-beingaccepts the biologic fact of pregnancy d. I am pregnant.I am going to have a baby.I am going to be a mother.

d

When discussing work and travel during pregnancy with a pregnant patient, nurses should instruct them that: 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 a number of times. d. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.

d

Which statement about a condition of pregnancy is accurate? 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

Which symptom is considered a first-trimester warning sign and should be reported immediately by the pregnant woman to her health care provider? A. N/ occasional vomiting B. Fatigue C. Urinary frequency D. Vaginal bleeding

d

While you are assessing the vital signs of a pregnant woman in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate? a. Have the patient stand up and retake her blood pressure. b. Have the patient sit down and hold her arm in a dependent position. c. Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms. d. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.

d

With regard to the estimation and interpretation of the recurrence of risks for genetic disorders, nurses should be aware that: a. With a dominant disorder, the likelihood of the second child also having the condition is 100%. b. An autosomal recessive disease carries a one in eight risk of the second child also having the disorder. c. Disorders involving maternal ingestion of drugs carry a one in four chance of being repeated in the second child. d. The risk factor remains the same no matter how many affected children are already in the family.

d

When providing a woman recovering from primary herpes with info regarding the recurrence of herpes infection of the genital tract, the nurse would tell her which of the following?

d. itching and tingling often occur before th appearance of vesicles

When assessing a woman with a dx of fibroadenoma, the nurse would expect to find which of the following characteristics?

d. well-delineated, firm movable lump in one breast