Women's Health Chapter 12

1. A woman in the 34th week of pregnancy says to the nurse, "I still feel like having intercourse with my husband." The woman's pregnancy has been uneventful. The nurse responds based on the understanding that: A. it is safe to have intercourse at this time. B. intercourse at this time is likely to cause rupture of membranes. C. there are other ways that the couple can satisfy their needs. D. intercourse at this time is likely to result in premature labor.

A

15. A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal? A. 9 B. 7 C. 5 D. 3

A

26. A pregnant woman is scheduled to undergo an amniocentesis. When explaining this test to the client, the nurse would also include information about which test being done at the same time? A. ultrasound B. chorionic villus sampling C. biophysical profile D. Doppler flow study

A

27. A nurse is auscultating the chest of a client at 16 weeks' gestation. The nurse immediately notifies the health care provider about which finding? A. heart rate 25 bpm above baseline B. soft systolic murmur C. clear breath sounds D. symmetrical chest movement.

A

29. A pregnant woman is scheduled for chorionic villus sampling. The nurse is describing the procedure and the potential for complications. When providing care to the client after the testing, the nurse would be alert for which complication as the most common? Select all that apply. A. vaginal bleeding B. cramping C. spontaneous abortion D. rupture of membranes E. hematoma

A,B

16. A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomforts as common during the first trimester? Select all that apply. A. urinary frequency B. breast tenderness C. cravings D. backache E. leg cramps

A,B,C

23. A pregnant woman in her second trimester tells the nurse, "I've been passing a lot of gas and feel bloated." Which suggestion would be helpful for the woman? Select all that apply. A. "Watch how much beans and onions you eat." B. "Limit the amount of fluid you drink with meals." C. "Try exercising a little more." D. "Some say that eating mints can help." E. "Cut down on your intake of cheeses."

A,C,D,E

30. A 24-year-old client who is planning to become pregnant comes to the clinic for an evaluation. When assessing the client, which finding would alert the nurse to implement measures to reduce the client's risk for problems during pregnancy? Select all that apply. A. drinks wine 3 to 4 times/week B. quit smoking 4 years ago C. follows a vegetarian diet D. has a BMI of 22 E. uses ibuprofen daily

A,E

14. During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client? A. Ineffective tissue perfusion related to supine hypotensive syndrone B. Impaired gas exchange related to pulmonary congestion C. Activity intolerance related to increased metabolic requirements D. Anxiety related to fear of pregnancy outcome

B

17. A nurse is reviewing the medical record of a pregnant woman and notes that she is gravida II. The nurse interprets this to indicate the number of: A. births. B. pregnancies. C. spontaneous abortions. D. preterm births.

B

22. After teaching a group of prospective new parents about the different perinatal education methods, the nurse determines that the teaching was successful when the parents identify which method as the Bradley method? A. psychoprophylactic method B. partner-coached method C. natural birth method D. mind prevention method

B

24. When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes which goal as the primary one? A. Equip a couple with the knowledge to experience a pain-free birth. B. Provide knowledge and skills to actively participate in birth and parenting. C. Eliminate anxiety so that they can have an uncomplicated birth. D. Empower the couple to totally control the birth process.

B

25. During a routine prenatal visit, a client at 36 weeks' gestation states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. The nurse would develop a plan of care identifying interventions to promote which area as the priority? A. tissue perfusion B. gas exchange C. activity D. anxiety

B

3. A nurse is teaching a pregnant couple about birth education. The nurse determines that the teaching was successful when the couple makes which statement? A. "We'll have the knowledge to ensure a pain-free birth." B. "We'll know what to do to actively take part in our child's birth" C. "We won't be anxious, so the birth will be uncomplicated." D. "We will be in total control of the birth process."

B

32. The nurse is assessing the latest laboratory results of a pregnant client who is at 17 weeks gestation. The nurse should prepare to teach the client about which possible defects after noting the maternal serum alpha-fetoprotein level is elevated above normal? A. fetal hypoxia B. open spinal defects C. Down syndrome D. maternal hypertension

B

33. The nurse is preparing a client for a chorionic villi sampling procedure. Which factor should the nurse point out in the teaching session to the client? A. "The results should be available in about 2 weeks." B. "You'll have an ultrasound first and then the test." C. "Afterward, you can resume your exercise program." D. "This test is very helpful for identifying spinal defects."

B

5. During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client? A. Ineffective tissue perfusion related to supine hypotensive syndrome B. Impaired gas exchange related to pulmonary congestion C. Activity intolerance related to increased metabolic requirements D. Anxiety related to fear of pregnancy outcome

B

8. A client's last menstrual period was April 11. Using the Naegele rule, her estimated date of delivery (EDD) would be: A. January 4. B. January 18. C. January 25. D. February 24.

B

11. A pregnant woman in the 36th week of gestation reports that her feet are quite swollen at the end of the day. After careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. Which intervention is appropriate for the nurse to suggest? A. "Limit your intake of fluids." B. "Eliminate salt from your diet." C. "Try elevating your legs when you sit." D. "Wear spandex-type full-length pants."

C

13. A pregnant woman is flying across the country to visit her family. After teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful? A. "I'll sit in a window seat so I can focus on the sky to help relax me." B. "I won't drink too much fluid so I don't have to urinate so often." C. "I'll get up and walk around the airplane about every 2 hours." D. "I'll do some upper arm stretches while sitting in my seat."

C

18. A nurse measures a pregnant woman's fundal height and finds it to be 28 cm. The nurse interprets this to indicate that the client is at how many weeks' gestation? A. 14 weeks' gestation B. 20 weeks' gestation C. 28 weeks' gestation D. 36 weeks' gestation

C

19. A pregnant woman has a rubella titer drawn on her first prenatal visit. The nurse explains that this test measures: A. platelet level. B. Rh status. C. immunity to German measles. D. red blood cell count.

C

2. On the first prenatal visit, examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as: A. Hagar sign. B. Goodall sign. C. Chadwick sign. D. Homans sign.

C

20. A nurse is working with a pregnant client to schedule follow-up visits for the pregnancy. Which statement by the client indicates that she understands the scheduling? A. "I need to make visits every 2 months until I am 36 weeks' pregnant." B. "Once I get to 28 weeks' pregnant, I have to come twice a month." C. "From now until I am 28 weeks' pregnant, I will be coming once a month." D. "I will make sure to get a day off every 2 weeks to make my visits."

C

6. When preparing a woman for an amniocentesis, the nurse would instruct her to perform which action? A. Shower with an antiseptic scrub. B. Swallow the preprocedure sedative. C. Empty the bladder. D. Lie on the left side.

C

7. A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks' gestation, a 2-year-old son born at 39 weeks' gestation, and a spontaneous abortion (miscarriage) 1 year ago at 6 weeks' gestation. Using the GTPAL method, the nurse would document her obstetric history as: A. 3 2 1 0 3. B. 3 1 2 2 3. C. 4 1 1 1 3. D. 4 2 1 3 1.

C

10. A nurse is assessing a pregnant woman in her last trimester. Which question would be most appropriate to use to gather information about weight gain and fluid retention? A. "What's your usual dietary intake for a typical week?" B. "What size maternity clothes are you wearing now?" C. "How puffy does your face look by the end of a day?" D. "How swollen do your ankles appear before you go to bed?

D

12. A pregnant woman needs an update in her immunizations. Which vaccination would the nurse ensure that the woman receives? A. measles B. mumps C. rubella D. hepatitis B

D

21. A nurse is describing the various birth methods to pregnant couples. Which information would the nurse include as part of the Lamaze method? A. focus on the pleasurable sensations of birth B. concentration on sensations while turning on to own bodies C. interruption of the fear-tension-pain cycle D. use of specific breathing and relaxation techniques

D

28. A nurse is reviewing the results of four clients who have undergone amniocentesis. Which client would the nurse recommend that the health care provider see first? A. client at 16 weeks' gestation with placenta previa and high alpha-fetoprotein level B. client at 34 weeks' gestation with gestational diabetes and L/S ratio of 2:1 C. client at 36 weeks' gestation with preeclampsia and amniotic fluid negative for bilirubin D. client at 38 weeks' gestation with fetal heart rate of 110 and green amniotic fluid sample

D

31. A client comes to the prenatal clinic for her first visit. When determining the client's estimated due date, the nurse understands what which method is the most accurate? A. Nagele's rule B. gestational wheel C. birth calculator D. ultrasound

D

4. When assessing a woman at follow-up prenatal visits, the nurse would anticipate which procedure to be performed? A. hemoglobin and hematocrit B. urine for culture C. fetal ultrasound D. fundal height measurement

D

9. During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. This occurs about 4 or 5 times during the testing period. The nurse interprets this as: A. variable decelerations. B. fetal tachycardia. C. a nonreactive pattern. D. reactive pattern.

D