OB week 4

A woman is concerned that orgasm will be harmful during pregnancy. Which statement is factual?

Some women experience orgasm intensely during pregnancy.

A woman who is 3 months pregnant enjoys a slow, long walk daily. Which action would be most appropriate for her for the remainder of her pregnancy?

Continue this as long as she enjoys it.

Why is a Papanicolaou smear done at the first prenatal visit?

It identifies abnormal cervical cells.

A pregnant woman is planning on taking a vacation that involves extensive travel by automobile. Which guideline should the nurse give her?

Stop and walk every few hours.

A pregnant client in her second trimester informs the nurse that she needs to travel by air the following week. Which precaution should the nurse instruct the client to take during the flight?

Wear support hose.

A young woman comes in for her annual exam. She reports missing her last two periods but she is confident that she cannot be pregnant because she took a home pregnancy test and the result was negative. Which sign would positively confirm a pregnancy?

a fetal heartbeat

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called?

couvade syndrome

A woman is to undergo chorionic villus sampling as part of a risk assessment for genetic disorders. What statement would the nurse include when describing this test to the woman?

"A small piece of tissue from the fetal placenta will be removed and analyzed."

At 40 weeks' gestation, a woman in for her prenatal visits states to the nurse "I am tired of being pregnant." What is the appropriate response by the nurse?

"That is a very normal feeling, especially at this point in pregnancy."

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse?

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

A client in her second trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also reports increased pigmentation on her breasts and genitalia. Which statement by the nurse is most appropriate?

"This is called facial melasma and should fade after the birth."

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer?

"You will experience quickening, and you will actually feel the baby."

A nurse is teaching a prenatal class and is asked the purpose of amniotic fluid. Which statements are correct? Select all that apply.

-Amniotic fluid promotes fetal movement enhancing musculoskeletal development. -Sufficient amounts of amniotic fluid cushion the fetus from trauma. -Amniotic fluid allows the fetal umbilical cord to be relatively free from compression. -Sufficient amounts of amniotic fluid help the fetus maintain a constant body temperature.

A client in her second trimester of pregnancy arrives at a health care facility reporting heartburn. What instructions should the nurse offer to help the client deal with heartburn? Select all that apply.

-Avoid overeating. -Limit consumption of food before bedtime. -Sleep in a semi-Fowler's position.

When discussing the many changes the woman's body undergoes during pregnancy, the nurse may include that the woman's total blood volume will increase by approximately how much by the 30th week gestation?

1,500 mL

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

24

A 23-year-old female has come to the clinic for her first prenatal visit. After the examination reveals no concerns and potential low-risk pregnancy, the nurse discusses nutritional needs for her and her growing baby. As per the Institute of Medicine, the nurse suggests the client take which amount of ferrous iron daily?

27mg

A woman in her first trimester of pregnancy is concerned about the effect that pregnancy will have on her appearance. She is fit but underweight, and she plans to restrict her weight gain as much as possible during pregnancy. How much weight should the nurse advise her to gain?

28 to 40 pounds (13 to 18 kilograms)

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.

4, 1, 1, 1, 1

The blood volume in pregnant women increases by what percent?

40-50%

A nurse is counseling a couple who have a 5-year-old daughter with Down syndrome. The nurse recognizes that their daughter's genome is represented by which chromosone combination?

47XX21+

The nurse is caring for a client at the prenatal clinic. The client reports that she has felt some fluttering sensations in her lower abdomen and she noticed that her waistline is now totally gone. Additionally, she shows the nurse her nipples and the areola are much darker. Based upon this assessment, in which month of pregnancy is this client?

4th month

What advice should the nurse provide to a pregnant client who admits to continuing to drink alcohol 1 to 2 times a week?

Alcohol should not be consumed during pregnancy.

A client in the third trimester of pregnancy has to travel a long distance by car. The client is anxious about the effect the travel may have on her pregnancy. Which instruction should the nurse provide to promote easy and safe travel for the client?

Always wear a three-point seat belt.

What instruction should a nurse offer to a pregnant client or a client who wishes to become pregnant to help her avoid exposure to teratogenic substances?

Avoid medications.

Why is the first prenatal visit usually the longest prenatal visit?

Baseline data is collected.

A pregnant client in her first trimester of pregnancy reports spontaneous, irregular, painless contractions. What does this indicate?

Braxton Hicks contractions

A client presents to the clinic because she thinks she may be pregnant. On examination, the nurse notes that the client's cervix and vaginal mucosa appear a bluish-purple color. The nurse interprets this finding as which sign?

Chadwick's sign

Nondisjunction of a chromosome results in which diagnosis?

Down syndrome

A client in the first trimester reports having nausea and vomiting, especially in the morning. Which instruction would be most appropriate to help prevent or reduce the client's compliant?

Eat dry crackers or toast before rising.

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely?

Fundal height has dropped since the last recording.

A pregnant client arrives for her second prenatal appointment. Her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks gestation. How will the nurse document her "G" and "L" for her records?

G3 L2

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

G3 P0020

During her 12 week prenatal check up, the client informs the nurse on interview that she has developed bumps on the dark part of her nipples. She wants to know what these bumps are. What is the nurse's appropriate answer?

Montgomery's tubercles, secrete lubricant for the nipples

In preparing for a prenatal class to discuss the hormonal changes during pregnancy, which information would the nurse most likely include?

Over-the-counter antacids can be used to treat acid reflux with the health care provider's knowledge.

A pregnant client and her husband have had a session with a genetic specialist. What is the role of the nurse after the client has seen a specialist?

Review what has been discussed with the specialist.

When describing the characteristics of the amniotic fluid to a pregnant woman, which would the nurse include?

The amount gradually fluctuates during pregnancy.

The nurse midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell's sign. Which description illustrates this alteration?

The cervix softens.

Which event will result in zygote formation?

The nucleus of the ovum and sperm make contact and combine chromosomes.

A nurse is caring for a 32-year-old Jewish client who is pregnant with a female baby. The parents are not directly related by blood. The mother reports that her husband's cousin had an infant born with Tay-Sachs disease that died two years ago and she is concerned about her baby. Which information does the nurse need to give the client to help alleviate her concerns regarding her baby having the same disease?

There is a risk to the baby based upon the Jewish background, so genetic testing would be recommended.

The nurse prepares a couple to have a karyotype performed. What describes a karyotype?

a visual presentation of the chromosome pattern of an individual

Many factors influence how a woman adapts psychologically to pregnancy. What is the psychological adaptation the woman must come to terms with during the second trimester?

accept the baby

The nurse should administer Rho(D) immune globulin to the pregnant woman who is Rho(D)-, after which test?

amniocentesis

The fluid-filled, inner membrane sac surrounding the fetus is which structure?

amnion

Amniotic fluid does not grow stagnant because:

amniotic fluid is constantly formed by the amnion.

During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which would the nurse identify as an abnormal finding?

bruising

Many changes occur in the body of a pregnant woman. Some of these are changes in the integumentary system. What is one change in the integumentary system called?

chloasma

What are the two fetal membranes?

chorion and amnion

A nurse working in the newborn nursery hears an innocent murmur on auscultation of a 24-hour-old infant's chest. The nurse recognizes this as most likely the result of which condition?

delayed fetal shunt closure

Some women contract with other women to provide support during pregnancy and birth, to provide emotional support during labor and birth, and to aid in establishing breastfeeding. What is the name of the woman who is contracted?

doula

Which finding from a woman's initial prenatal assessment would be considered a possible complication of pregnancy that requires reporting to a primary care provider for management?

episodes of double vision

A pregnant client states she was unable to breastfeed her last child because her breasts did not produce milk. She desires to breastfeed this child. Which hormones would the nurse monitor to during this pregnancy?

estrogen and human placental lactogen (hPL)

The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy?

excessive vomiting

When providing preconception care to a client, the nurse would identify which medication as being safe to continue during pregnancy?

famotidine

A nurse is providing prenatal care to a pregnant woman. Understanding a major component of this care, the nurse would conduct a risk assessment for:

genetic conditions and disorders.

The nurse is explaining the process of conception and implantation to a group of women attending a preconception planning education program. When describing the hormones involved in these events, the nurse would identify which hormone as being responsible for ensuring implantation of the embryo at the beginning of conception?

human chorionic gonadotropin (hCG)

A nurse is interviewing the family members of a pregnant client to obtain a genetic history. While asking questions, which information would be most important?

if couples are related to each other or have blood ties

Part of the initial prenatal assessment should include the client's immunization history. The nurse informs the client to avoid which type of vaccines while she is pregnant?

live virus vaccine

When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem?

low-set ears

The nurse advises a pregnant client to keep a small high-carbohydrate snack on the bedside table. This advice is given to ameliorate which condition?

nausea and vomiting

When discussing rest and sleep with a pregnant woman, the nurse would suggest which position for napping?

on her side with the weight of the uterus on the bed

The nurse is teaching a pregnant woman about breast feeding. The nurse determines that the teaching was successful when the woman identifies which hormone as being released when the newborn sucks at the breast?

oxytocin

A nursing student correctly identifies that a person's outward appearance or expression of genes is referred to as the:

phenotype.

A woman calls the clinic to schedule an appointment because "I think I might be pregnant." Upon further assessment gathering of information from the woman, which finding would be a probable sign of pregnancy?

positive home pregnancy test

A client in her third trimester of pregnancy visits the health care center and asks why she is constipated. The nurse would include which most likely cause when responding to the client?

pressure on intestine by the growing fetus

Early in pregnancy, frequent urination results mainly from which cause?

pressure on the bladder from the uterus

The hormone responsible for the initiation of lactation is what?

prolactin

A nursing student correctly identifies which action to be the best way to prevent complications of pregnancy?

receiving prenatal care

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

relaxin

A pregnant client is asking about medications, supplements, and vaccines. Which would the nurse indicate as potentially teratogenic?

rubella vaccine

Which change in the breasts should a nurse recognize as a normal change associated with pregnancy?

tingling sensations and tenderness

A client who has just given a blood sample for pregnancy testing in the health care provider's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy?

visualization of the fetus by ultrasound

Positive signs of pregnancy are diagnostic, meaning nothing else can elicit that sign except pregnancy. What is the earliest positive sign of pregnancy?

visualization of the gestational sac or fetus

A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome?

Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg.

A woman, who is 18 weeks' gestation, is at a follow-up appointment regarding the positive test results of alpha-fetoprotein testing. Which would the nurse suspect with the positive test result?

Down syndrome

A pregnant woman undergoing amniocentesis asks her nurse why the baby needs this fluid. What would be an accurate response from the nurse?

"Amniotic fluid cushions your baby to prevent injury."

A woman at 15 weeks' gestation works at a daycare center thinks she may have just been exposed to rubella at work. The client asks how this may affect her fetus. What is the best response the nurse can give?

"By the end of the eighth week all of the organ systems and major structures are present, so exposure to any teratogen can lead to birth defects. More assessments are needed."

The nurse is caring for a client and her partner who are considering a future pregnancy. The client reports her last two pregnancies ended in stillbirth related to an underlying genetic disorder. What response by the nurse is most appropriate?

"Consultation with a genetic counselor before you become pregnant would likely be beneficial."

A nurse is teaching a client who is 30 weeks pregnant about ways to deal with heartburn. The nurse determines a need for additional teaching based on which client statement?

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

A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during her pregnancy. Which client statement alerts the nurse to the need for further teaching?

"I should substitute intercourse with nonsexual touch to avoid harming the fetus."

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective?

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

A pregnant woman is experiencing morning sickness. Which response indicates a need for further teaching?

"I'll take antacid between meals."

A nurse is conducting a presentation for a group of nurses at the prenatal clinic on basic genetic information. After teaching the group about genetics, the nurse determines that the teaching was effective based on which statement by the group?

"My genome is my genetic blueprint."

Which statement made by parents at a genetic counseling session indicate understanding of the risks to their child for the disorder of dwarfism?

"There is a 25% chance our newborn may be affected by the disorder if we are carriers."

After teaching a group of women about the signs of pregnancy, the nurse understands that teaching was successful if the group makes which statement?

"They will be able to hear the fetal heart rate on auscultation."

A pregnant client reports an increase in a thick, whitish vaginal discharge. Which response by the nurse would be most appropriate?

"This discharge is normal during pregnancy."

A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week?

1 lb (.45 kg)

Amanda is about 16 weeks pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to Amanda's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

Which processes, if they occur during the formation of the placenta, would lead to a successful pregnancy? Select all that apply.

-Implantation of the trophoblast occurs in the upper uterus. -Three days after conception, the trophoblast makes human chorionic gonadotropin (hCG). -The trophoblast develops into the placenta.

During the development of the fetus, its chorionic villi eventually meet with an area of uterine tissue to form the placenta. Which statements accurately describe a function of the placenta? Select all that apply.

-It produces hormones that help maintain the pregnancy. -It slows the maternal immune response. -It carries waste away for excretion by the mother.

Which characteristics about amniotic fluid would alert the prenatal nurse to further investigate? Select all that apply.

-Oligohydramnios is noted on assessment. -Polyhydramnios is noted on assessment. -The client has approximately 2 L of amniotic fluid at term.

The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which signs and symptoms would the nurse include? Select all that apply.

-headache with visual changes in the third trimester -sudden leakage of fluid during the second trimester -lower abdominal pain with shoulder pain in the first trimester

A pregnant client is scheduled to undergo chorionic villi sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed?

10 to 12 weeks of gestation

At the first prenatal visit of all clients who come to the clinic appropriate blood screenings are obtained. The nurse realizes that a hemoglobin A1c above which level is concerning for diabetes and warrants further testing?

6.5%

During a routine antepartal visit, a pregnant woman reports a white, thick vaginal discharge. What would the nurse do next?

Ask the woman if she is having any itching or irritation.

Which change related to the vital signs is expected in pregnant women?

Blood pressure decreases.

A woman who is 4 months pregnant has pyrosis. Which suggestion would the nurse give her?

Eat small meals and do not lie down after meals.

A client in her second trimester of pregnancy has developed varicose veins and experiences leg cramps. Which suggestion would be most appropriate?

Elevate legs while sitting.

A client has been confirmed to be pregnant. She gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history?

G3, P2

A client presents to the office for her obstetric history. She tells the nurse she has 4 children living at home. One child was born at 34 weeks, another child at 37 weeks, two were born consecutively at 38 and 39 weeks, and one was aborted. Record the client's obstetric record using the GTPAL format.

G5, T2, P2, A1, L4

The nurse is performing an assessment of a woman who has come to a health care facility for a diagnosis of pregnancy. The women is positive for breast changes, nausea, and amenorrhea. On physical exam, it is noted that the client has softening of the cervix. How should the nurse document this in her notes?

Goodell's sign

A couple wants to start a family. They are concerned that their child will be at risk for cystic fibrosis because they each have a cousin with cystic fibrosis. They are seeing a nurse practitioner for preconceptual counseling. What would the nurse practitioner tell them about cystic fibrosis?

It is an autosomal recessive disorder.

A client in her second trimester of pregnancy visits a health care facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which precaution should the nurse instruct the pregnant client to take when practicing aerobic exercises?

Maintain tolerable intensity of exercise.

A baby is born with what the primary care provider believes is a diagnosis of trisomy 21. This means that the infant has three number 21 chromosomes. What factor describes this genetic change?

The client has a nondisjunction occurring during meiosis.

When describing the role of a doula to a group of pregnant women, the nurse would include which information?

The doula primarily focuses on providing continuous labor support.

A nonstress test is performed on a pregnant woman. The nurse informs the client the test was reactive. Which statement by the client indicates understanding of the test results?

The fetal heart rate increases with activity and indicates fetal well-being.

A teenager in the clinic is refusing to eat during her pregnancy because she does not want to "get fat." What information should the nurse provide on the outcomes of the infant related to poor maternal weight gain?

The infant will be small and could have problems.

A pregnant woman states that she would like to take a tub bath but has heard from her aunt that this could be dangerous to the baby. Which instruction should the nurse give to the client?

Tub baths are fine unless you are unstable on your feet or are experiencing vaginal bleeding.

A mother has come to the clinic with her 13-year-old daughter to find out why she has not started her menses. After a thorough examination and history, genetic testing is prescribed to rule out which abnormality?

Turner syndrome

The nurse is caring for a woman in a prenatal clinic who thinks she might be pregnant. Which assessment is a probable sign of pregnancy?

a positive pregnancy test

A pregnant client has heard about Down syndrome and wants to know about the risk factors associated with it. What would the nurse include as a risk factor?

advanced maternal age

During pregnancy, one of progesterone's actions is to allow sodium to be "wasted" or lost in the urine. The nurse would expect to see which hormone increased to help counteract this loss?

aldosterone

During pregnancy the cardinal rule regarding taking medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy?

asthma

A potential complication for the mother and fetus is Rh incompatibility; therefore, assessment should include blood typing. If the mother is Rh negative, her antibody titer should be evaluated. If treatment with Rho(D) immune globulin is indicated, the nurse would expect to administer it at which time?

at 28 weeks

As a pregnant woman lies on the examining table, she grows very short of breath and dizzy. This phenomenon probably happens because:

blood is trapped in the vena cava in a supine position.

After teaching a class on the various structures formed by the embryonic membranes, the nurse determines that the teaching was successful when the class identifies which structure as being formed by the mesoderm?

bones

A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone?

maintains the endometrial lining of the uterus during pregnancy

An 18-year-old pregnant woman asks the nurse why she has to have a routine alpha-fetoprotein serum level drawn. The nurse explains that this:

may reveal chromosomal abnormalities.

The nurse explains to a pregnant client, who is anemic, that she will need to take vitamins with iron during her pregnancy. What foods would the nurse include on the client's diet plan?

meats

While providing an education to a prenatal class for first-time mothers and fathers during the first trimester, the nurse includes information that the father may experience which occurrence as normal during the pregnancy?

physical symptoms similar to the mother

Amanda's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is Amanda experiencing?

presumptive

The placenta is the site where antibodies in the mother's blood pass into the fetal circulation. These antibodies give passive immunity to the fetus for several common childhood diseases. There are some infections for which the mother does not provide antibodies to the fetus. What infection is the fetus not protected from?

rubella

Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S?

sickle cell anemia

During pregnancy, there are many psychological changes. What is the most critical component for a positive psychological experience with pregnancy by the woman?

social support

A nurse is conducting a presentation at a community health center about congenital malformations. The nurse describes that some common congenital malformations can occur and are recognized to be caused by multiple genetic and environmental factors. Which example would the nurse most likely cite?

spina bifida

he nurse correctly identifies "gravida 3, para 2" as which definition?

two previous pregnancies, two children born at term, and currently pregnant

A 33-year-old pregnant client asks the nurse about testing for birth defects that are safe for both her and her fetus. Which test would the nurse state as being safe and noninvasive?

ultrasound

Which assessment finding in a woman is a positive sign of pregnancy?

visualization of the fetus by ultrasound at 6+ weeks

When providing education on pre-conceptual considerations to a female client and her spouse, the nurse knows that teratogens during the embryonic stage pose the greatest risk to the fetus. The nurse describes this stage as occurring during which time frame?

weeks 2 to 8

In attempting to determine what caused a child to be born with deafness, the nurse can explore with the mother if she had exposure to a teratogenic agent during which weeks' gestation?

weeks 3 to 8

A fertilized ovum is known as which structure?

zygote