Antepartum Practice Questions
During a visit to the clinic, a client in the first trimester tells the nurse, "My nose is so stuffy, lately. Could I have a cold?" Which response by the nurse is appropriate? "Probably. Let's see if you have any other symptoms." "A stuffy nose is common in pregnancy because of high estrogen levels." "It is more likely that you are having some allergies to something." "I will check to see if you we can give you an antihistamine to help."
"A stuffy nose is common in pregnancy because of high estrogen levels."
A woman states that she frequently awakes with 'painful leg cramps' during the night. Which of the following assessments should the nurse make? 1. Dietician evaluation 2. Goodell's sign 3. Hegar's sign 4. Posture evaluation
1. A dietary evaluation is indicated since painful leg cramps can be caused by consuming too little calcium or too must phosphorous.
It is discovered that a pregnant woman practices pica. Which of the following complications is most often associated with this behavior? 1. Hypothyroidism 2. Iron-deficiency anemia 3. Hypercalcemia 4. Overexposure to zinc
2. Iron - deficiency anemia is often seen in clients who engage in pica.
The nurse asks a 31-week gestation client to lie on an examination table during a prenatal examination. In which of the following positions should the client be placed? 1. Orthopenic 2. Lateral-recumbent 3. Sims' 4. Semi-Fowler's
4. It makes it more difficult for a woman to breathe in the third trimester, therefore Semi-Fowler's position is appropriate.
A lacto-ovo-vegetarian client is pregnant and is seeking nutritional guidance at her initial prenatal visit. What foods would the nurse recommend to her in keeping with her current dietary practices? Increased intake of fruits and nuts A combination of egg and milk or other dairy products Fortified soy milk with increased nuts and seeds Broiled pork and whole grain rice
A combination of egg and milk or other dairy products
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? Activate the air bag in the car. Use a lap belt that crosses over the uterus. Apply a padded shoulder strap properly. Always wear a three-point seat belt.
Always wear a three-point seat belt.
The nurse in a primary care clinic and a client have come to see the primary care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the woman's plan to have a family. The woman responds, "Why do I have to plan for a family?" What would be the nurse's best response? Families are always best when pregnancies are not planned. The couple can control the time between births when they plan their family. An unwanted pregnancy can always be aborted. The couple can decide on a method of birth control.
The couple can control the time between births when they plan their family.
The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse? There is not enough fiber in your diet. The intestines are displaced by the growing fetus. This shouldn't be happening. hCG is delaying peristalsis.
The intestines are displaced by the growing fetus.
The nurse informs the client that a diaphragm is an example of which type of contraception? chemical barrier mechanical barrier transdermal intrauterine
mechanical barrier
A young woman says she needs a temporary contraceptive but has a latex allergy. She mentions that she has had a papillomavirus infection. Also, she says she is terrible about remembering to take pills. Which method should the nurse recommend? transdermal contraception sterilization cervical cap diaphragm
transdermal contraception
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. infant nutritional needs. family dynamics. cultural differences.
genetic conditions and disorders. This is most important! Maslow
A nurse is assessing a pregnant client who is in the first trimester. The client tells the nurse, "I feel pretty good but there are some things that I have noticed with my body." Which information is commonly reported during this time? Select all that apply. itchy palms tender breasts increased energy levels urinary hesitancy abdominal pressure
itchy palms tender breasts abdominal pressure
The nurse educates the vegetarian client about which nutritional need during pregnancy? taking a B12 supplement limiting the intake of fiber supplementing the diet with vitamins A and C avoiding high intake of dark green vegetables.
taking a B12 supplement
A fertilized ovum is known as which structure? fetus zygote embryo chorion
zygote
The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of pregnancy. Which of the following comments by the client indicates that teaching was successful? (select all) 1. "During the third trimester I may experience frequent urination." 2. "During the third trimester I may experience heartburn." 3. "During the third trimester I may experience nagging backaches." 4. "During the third trimester I may experiences persistent headache." 5. "During the third trimester, I may experience blurred vision."
1, 2, & 3. Frequency is seen once lightening, or the descent of the fetus into the pelvis, has occurred. Heartburn and backaches are common complaints of pregnant women.
A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? Trace of glucose 2+ Protein in urine Specific gravity of 1.010 Straw-like color
2+ Protein in urine
A third-trimester client is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the visit? (select all) 1. Blood glucose 2. Blood pressure 3. Fetal heart rate 4. Urine protein 5. Pelvic ultrasound
2, 3, & 4. The blood pressure is assessed at each prenatal visit. The fetal heart rate is assessed at each prenatal visit. Depending on the equipment available, it will be assessed mechanically via Doppler or manually via fetoscope. The fetal heart is audible via Doppler many weeks before it is audible via fetoscope. Urine protein is performed at each prenatal visit.
When assessing the fruit intake of a pregnant client, the nurse notes that the client usually eats 1 piece of fruit per day and drinks a 12 oz glass of fruit juice per day. Which of the following is the most important communication for the nurse to make? 1. "You are effectively meeting your daily fruit requirements." 2. "Fruit juices are excellent sources of folic acid." 3. "It would be even better if you were to consume more whole fruits and less fruit juice." 4. "Your fruit intake far exceeds the recommended daily fruit intake."
3. It is recommended that pregnant clients eat whole fruits rather than consume large quantities of fruit juice.
A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2012. Using Naegle's rule, the nurse calculates the client's estimated date of delivery as: 1. May 20, 2013 2. June 20, 2013 3. June 27, 2013 4. July 3, 2013
3. June 27, 2013. Calculate estimated date of delivery from the last normal menstrual period. Subtract 3 months from the date, add 7 days to the date and adjust the year.
A client makes an appointment with an obstetrician and assessment reveals positive Hegar and Chadwick signs. What should the nurse teach the client about these results? The client more likely has a gynecologic disorder rather than pregnancy The client is definitively pregnant Pregnancy cannot be confirmed She is probably pregnant, but this must be confirmed by other means
She is probably pregnant, but this must be confirmed by other means
After teaching a pregnant woman how to perform fetal movement (kick) counts (PRESUMPTIVE SIGN), the nurse determines that the teaching was successful when the client makes which statement? "I'll do the count once a week on a morning that I'm not rushed for work." "I'll sit comfortably in a recliner or lie on my side when I do the counts." "I won't expect more than three movements to happen in an hour." "I'll do the counts while I'm sitting and watching my son's basketball game."
"I'll sit comfortably in a recliner or lie on my side when I do the counts." YOU NEED 10 (TEN) MOVEMENTS IN 1 HOUR
A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? 1. Backache 2. Urinary Frequency 3. Dyspnea on exertion 4. Fatigue 5. Diarrhea
2 & 4. Backaches usually do not develop until the second trimester of pregnancy and dyspnea is associated with the third trimester of pregnancy. Diarrhea is not normally heard in prenatal clients.
The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the physician? 1. 17 weeks gestation, denies feeling fetal movement 2. 24 weeks gestation, fundal height of the umbilicus 3. 27 weeks gestation, salivates excessively 4. 34 weeks gestation, experiences uterine cramping 5. 37 weeks gestation, complains of hemorrhoidal pain
2 & 4. The fundal height at 24 weeks should be 4 cm above the umbilicus. The fundal height at the level of the umbilicus is expected at 20 weeks gestation. The woman with uterine cramping may be going into uterine labor.
A woman asks the nurses about the function of amniotic fluid. Which of the following statements by the woman indicates that the teaching was successful? (select all) 1. The fluid provides fetal nutrition 2. The fluid cushions the fetus from injury 3. The fluid enables the fetus to grow 4. The fluid provides the fetus with a stable thermal environment 5. The fluid enables the fetus to practice swallowing
2, 3, 4, & 5. The umbilical cord, not the amniotic fluid, delivers nutrition to the developing fetus
A nurse is discussing the serving sizes in the grain food group with a new prenatal client. Which of the following foods equals 1 oz serving size from the grain group? (select all) 1. 1 bagel 2. 1 slice of bread 3. 1 cup of cooked pasta 4. 1 tortilla 5. 1 cup dry cereal
2, 4, & 5. 1 slice of bread, 1 tortilla, and 1 cup of dry cereal = 1 oz serving
Which of the following choices can the nurse teach a prenatal client is equivalent to one 2 oz protein serving? 1. 4 tbsp peanut butter 2. 2 eggs 3. 1 cup cooked lima beans 4. 2 ounces of mixed nuts
2. 2 eggs = one 2 oz protein serving
A woman confides in the nurse that she practices pica. Which of the following alternatives could the nurse suggest to the woman? 1. Replace laundry starch with salt 2. Replace ice with frozen fruit juice 3. Replace soap with cream cheese 4. Replace soil with uncooked pie crust
2. Fruit juice, although high in sugar, contains vitamins unlike the other options.
A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to ask at this time? 1. "Your period is probably just irregular." 2. "We could do a blood test to check." 3. "Home pregnancy test results are very accurate." 4. "My recommendation would be to repeat the test in one week."
2. Serum pregnancy tests are more sensitive than urine tests. 1 IS WRONG BECAUSE UR SUPPOSED TO ASSESS BEFORE DIAGNOSING!
A woman tells the nurse that she would like suggestions for alternate vitamin C sources because she isn't very fond of citrus fruits. Which of the following suggestions is appropriate? 1. Barley and brown rice 2. Strawberries and potatoes 3. Buckwheat and lentils 4. Wheat flour and figs
2. Strawberries and potatoes are excellent sources of vitamin C, as are zucchini, blueberries, kiwi, green beans, and green peas.
The nurse assesses a 20-week gestational client at a routine prenatal visit. What will the nurse predict the fundal height to be on this client experiencing an uneventful pregnancy? 24 cm 12 cm 16 cm 20 cm
20 cm
A woman comes to the clinic for her first prenatal checkup. The woman has a body mass index (BMI) of 22. The nurse would anticipate that this client should gain approximately how much weight during her pregnancy? 25 to 35 lbs (11 to 16 kg) 28 to 40 lbs (13 to 18 kg) 15 to 25 lbs (7 to 11 kg) 11 to 20 lbs (5 to 9 kg)
25 to 35 lbs (11 to 16 kg)
A client asks the nurse what was mean why the physician told her she had a positive Chadwick's sign. Which of the following information about the finding would be appropriate for the nurse to convey at this time? 1. "It is a purplish stretch mark on your abdomen." 2. "It means that you are having heart problems." 3. "It is a bluish coloration of your cervix and vagina." 4. "It means the doctor heard abnormal sounds when you breathed in."
3. A positive Chadwick's sign means that the client's cervix and vagina are a bluish color. This is a probably sign of pregnancy.
The following for changes occur in the preganancy. Which of them usually increases the father's interest and involvement in the pregnancy? 1. Learning the results of the pregnancy test 2. Attending childbirth education classes 3. Hearing the fetal heartbeat 4. Meeting the obstetrician or midwife
3. Hearing the fetal heartbeat often increases father's interests in their partner's pregnancies.
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks' gestation; delivered a daughter, now 5 years old, at 30 weeks' gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 yaers ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman's gravidity and parity? 1. G4 P2121 2. G4 P1212 3. G5 P1122 4. G5 P2211
3. The client has been pregnant five times (G5); she birthed 1 son, 1 daughter, and had a miscarriage, and had 1 first trimester abortion. Her parity accurately reflects her obstetrical history, 1 full term delivery, 1 preterm delivery, 2 abortions, and 2 living children.
A client makes the following statement after finding out that her pregnancy test is positive. "This is not a good time. I am in college and the baby will be due during final exams." Which of the following responses by the nurse would be most appropriate at this time? 1. "I'm absolutely positive that everything will turn out all right." 2. "I suggest that you e-mail your professors to set up an alternate plan." 3. "It sounds like you are feeling a little overwhelmed right now." 4. "You and the baby's father will find a way to get through the pregnancy."
3. This is the most appropriate response.
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. 3, 2, 1, 2, 1 4, 2, 2, 1, 1 3, 2, 1, 1, 1 4, 1, 1, 1, 1
4, 1, 1, 1, 1 Dont let the preterm fool u!
A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse's best response? 1. "Because the organ systems in the baby are developing right now, it is risky to take medicine." 2. "You can take any of the over-the-counter medications because they are all safe in pregnancy." 3. "The physician will prescribe a category x-medication for you." 4. "You can take acetaminophen because it is a category 'B' medicine."
4. Category 'B' medications have been shown to be safe to take throughout pregnancy.
A 12-week gestation client tells the nurse that she and her husband eat sushi at least once per week. She states, "I know that fish is good for me, so I want to make sure that we eat it regularly." Which of the following responses is appropriate? 1. "You are correct. Fish is very healthy for you." 2. "You can eat fish, but sushi is too salty to eat during pregnancy." 3. "Sushi is raw. Raw fish is especially high in mercury." 4. "It is recommended that fish be cooked to destroy harmful bacteria."
4. This is the appropriate response. It is recommended that during pregnancy the client only eats cooked fish.
A client informs the nurse that she is "very constipated." Which of the following foods would be best for the nurse to recommend to the client? 1. Pasta 2. Rice 3. Yogurt 4. Celery
4. Celery is a high in fiber food.
A 37-week gravid client states that she noticed a "white liquid" leaking from her breasts during a recent shower. Which of the following nursing responses is appropriate at this time? 1. Advise the woman that she may have a galactocele 2. Encourage the woman to pump her breasts to stimulate an adequate milk supply 3. Assess the liquid because breast discharge is diagnostic of a mammary infection. 4. Reassure the mother that this is normal in the third trimester
4. It is normal for colostrum to be expressed late in pregnancy.
A client is having an US done at her prenatal appt at 8 weeks gestation. She asks about the sex of her baby. Which response is appropriate? 1. "The technician did not tell me the sex, but I will let the doctor tell you what is it." 2. "The organs are completely formed and present but the baby is too small for them to be seen." 3. "The technician says the baby has a penis. It looks like you are having a boy." 4. "I am sorry, it will not be possible to see the sex of the baby for another month or so."
4. The sex is not visible at 8-weeks.
A client is 35 weeks gestation. Which of the following findings would the nurse expect to see? 1. Nausea and vomiting 2. Maternal ambivalence 3. Fundal height 10 cm above the umbilicus 4. Use of three pillows for sleep comfort
4. The use of three pillows for sleeping comfortable us often seen. Nausea and vomiting and ambivalence should not be happening. The fundus should be 15cm at 35 weeks.
A vegan is being counseled regarding vitamin intake. It is essential that this woman supplement which of the following B vitamins? 1. B1 (thiamine) 2. B2 (niacin) 3. B6 (pyridoxine) 4. B12 (cobalamin)
4. Vitamin B12 is found in animal products. Those who take in too little of the vitamin are susceptible to anemia and nervous system disorders. It is also essential for DNA synthesis.
A client in her third month of pregnancy arrives at the health care facility for a regular follow-up visit. The client reports discomfort due to increased urinary frequency. Which instruction should the nurse offer the client to reduce the client's discomfort? Avoid consumption of caffeinated drinks. Drink fluids with meals rather than between meals. Avoid an empty stomach at all times. Munch on dry crackers and toast in the early morning.
Avoid consumption of caffeinated drinks.
The nurse teaches a sedentary pregnant client with a BMI of 35 about the importance of healthy lifestyle during pregnancy. Which goal would be appropriate for this client? Walk for 30 minutes 5 days a week. Adhere to a weight reduction diet. Participate in a daily aerobic dance program. Begin lifting weights for 30 minutes per day.
Walk for 30 minutes 5 days a week.
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 a padded bra. Wear low-heeled shoes. Wear support hose. Wear cotton clothes.
Wear support hose.
A client presents at the clinic and is interested in obtaining emergency contraception (EC). The nurse explains that EC must be used within 72 hours of unprotected sex to be effective. This is because: ECs simply prevent embryo creation and uterine implantation from occurring in the first place. ECs can induce an abortion (elective termination of pregnancy) of a recently implanted embryo. ECs can help prevent STIs. ECs are more effective than regular birth control.
ECs simply prevent embryo creation and uterine implantation from occurring in the first place.
The nurse is explaining the latest laboratory results to a pregnant client who is in her third trimester. After letting the client know she is anemic, which heme iron-rich foods should the nurse encourage her to add to her diet? Legumes Dairy Grains Meats
Meats MEAT IS RICH IN IRON!
The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns? Her body is changing and she may be angry about it. Pregnant women often experience mood swings and self-centeredness but this is normal. Moodiness and irritability are not usual responses to pregnancy. What you are describing may be normal but we need to talk to her more in depth
Pregnant women often experience mood swings and self-centeredness but this is normal.
A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her? She is 30 years old. She has irregular menstrual cycles. She has a history of allergy to foreign protein. She has a family history of thromboembolism.
She has a family history of thromboembolism.
A pregnant woman of Jewish descent comes to the clinic for counseling and tells the nurse that she is worried her baby may be born with a genetic disorder. Which disease does the nurse identify to be a risk for this client's baby based on the family's ancestry? sickle cell anemia beta-thalassemia Tay-Sachs disease Down syndrome
Tay-Sachs disease (Autosomal recessive!)
A woman uses a diaphragm for contraception. The nurse would instruct her to return to the clinic to have her diaphragm fit checked after which occurrence? cervical infection a weight gain of 10 lb (4.5 kg) a vaginal infection six months of nonuse
a weight gain of 10 lb (4.5 kg)
pregnant woman who is a vegetarian asks the nurse, "What would you suggest to make sure that I get enough protein in my diet while I am pregnant?" Which food(s) would be appropriate for the nurse to suggest? Select all that apply. beans lentils nuts green leafy vegetables orange juice
beans lentils nuts
The nurse is teaching about an iron supplement that the client is going to take every day. The nurse teaches the client to take the iron supplement with which type of fluid? citrus juice ice water low-fat milk hot tea
citrus juice
The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? provides rich blood supply to decidua maintains nutrient-rich decidua continues progesterone production by corpus luteum sustains life of placenta
continues progesterone production by corpus luteum
A young couple is exploring their contraceptive options and are curious about using an intrauterine contraceptive device. The nurse explains that there are two types, one that uses hormones and one that uses: copper. magnesium. silicone. potassium.
copper.
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? linea rubria Chadwick sign ballottement melasma (chloasma)
melasma (chloasma)
A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend? oral contraceptive pills (OCPs) postcoital douching diaphragm vasectomy
oral contraceptive pills (OCPs)
A nursing student correctly identifies that a person's outward appearance or expression of genes is referred to as the: allele. phenotype. genotype. genome.
phenotype.
A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation (dilatation) and enlargement of the birth canal. What is this hormone? relaxin progesterone estrogen human placental lactogen
relaxin
Assessment of a pregnant client reveals leukorrhea. Which instruction will the nurse include when teaching the client about how to care for this condition? douching daily using tampons showering daily wearing polyester underwear
showering daily
Which question would be most important for a nurse to ask a G2P1 client who has a child with sickle cell anemia? "When was your last exacerbation?" "Have you done well to control your stress?" "Do you know the sex of your baby?" "Did you and your partner get genetic testing?
"Did you and your partner get genetic testing? This is a priority!! He literally has a genetic disorder
The nurse is conducting an initial history and assessment on a client at 10 weeks' gestation who is pregnant with her first child. Which question is a priority for the nurse to ask the client at this time? "Does anyone in your or the father's family have any genetic disorders?" "Do you plan to breastfeed or bottle feed your new baby?" "Are you planning to develop a birth plan for use during the birthing process?" "Was your mother or grandmother diagnosed with gestational diabetes?"
"Does anyone in your or the father's family have any genetic disorders?"
A 45-year-old man has just been diagnosed with Huntington disease. He and his spouse are concerned about their four children. Based on the knowledge of patterns of inheritance, how will the nurse respond? "This disorder is carried on the X chromosome so only your female children would be affected." "Each of your children will have a 50% chance of inheriting the disease." "Both genes of a pair must be abnormal for the disorder to occur in your children." "Your male children are more likely to be affected than your female children."
"Each of your children will have a 50% chance of inheriting the disease." Autosomal dominant disorders: uHuntington's Disease Achondroplasia; polycystic kidney disease, blood types (A & B), Rh factor
A woman is planning to become pregnant. Which of the following actions should she be counseled to take before stopping birth control (select all) 1. Take a daily multivitamin 2. See a medical doctor 3. Drink beer instead of vodka 4. Stop all over-the counter medications 5. Stop smoking cigarettes
1, 2, & 5. Multivitamins are very important, a checkup needs to happen, and smoking needs to stop. Drinking alcohol is contraindicated and not all over the counter meds need to be stopped.
A antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? (select all) 1. Amenorrhea 2. Breast tenderness 3. Quickening 4. Frequent urination 5. Abdominal Enlargement
1, 2, 3, & 4.
A nurse is advising a pregnant woman about the danger signs of pregnancy. The nurse should teach the mother that she should notify the physician immediately if she experiences which of the following signs/symptoms? (select all) 1. Convulsions 2. Double vision 3. Epigastric pain 4. Persistent vomiting 5. Polyuria
1, 2, 3, & 4. All are correct except polyuria, which may be a sign of diabetes or another illness.
A nurse is working in the prenatal clinic. Which of the following findings seen in third-trimester pregnant women would the nurse consider to be within normal limits? (select all) 1. Legs cramps 2. Varicose veins 3. Hemorrhoids 4. Fainting spells 5. Lordosis
1, 2, 3, & 5. Leg cramps are normal, although the client's diet should be assessed. Varicose veins, hemorrhoids, and lordosis are normal.
A father experiencing couvade syndrome is likely to exhibit which of the following symptoms/behaviors? (select all) 1. Heartburn 2. Promiscuity 3. Hypertension 4. Bloating 5. Abdominal pain
1, 4, & 5. Heartburn, bloating, and abdominal pain are common. Couvade symptoms are exhibiting a strong affiliation between themselves and their partners.
When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of? 1. Ambivalence 2. Depression 3. Anxiety 4. Ecstasy
1. Ambivalence should be expected.
Which finding would the nurse view as normal when evaluation the laboratory reports of a 24-week gestation client? 1. Anemia 2. Thrombocytopenia 3. Polycythemia 4. Hyperbilirubinemia
1. Anemia is an expected finding. By the end of the second trimester, the blood supply of the woman increases by approximately 50%. This increase is necessary for the client to be able to perfuse the placenta. there is a concurrent increase in red blood cell production, but the vast majority of women are unable to produce the RBCs in sufficient numbers to keep pace with the increase in blood volume. As a result, clients develop what is commonly known as "physiological anemia of pregnancy." A hemotcrit of 32% of considered normal for pregnant woman.
A nurse is discussing diet with a pregnant woman. Which of the following foods should the nurse advise the client to avoid consuming during her pregnancy? 1. Bologna 2. Cantaloupe 3. Asparagus 4. Popcorn
1. Bologna should not be consumed during pregnancy unless it is thoroughly cooked.
A mother is experiencing nausea and vomiting every afternoon. The ingestion of which of the following spices has been show to be a safe complementary therapy for this complaint? 1. Ginger 2. Sage 3. Cloves 4. Nutmeg
1. Ginger has been shown to be a safe antiemetic agent for pregnant women.
The nurse is teaching a couple about fetal development. Which statement by the nurse is correct about the morula stage of development? 1. The fertilized egg has yet to implant into the uterus 2. The lung fields are finally completely formed 3. The sex of the fetus can be clearly identified 4. The eyelids are unfused and can open and close.
1. In the morula stage, about 2-4 days after fertilization, the fertilized egg ha snot yet implanted into the uterus.
The nurse notes each of the following findings in a 10-week gestation client. Which of the findings would enable the nurse to tell the client that she is positively pregnant? 1. Fetal heart rate via Doppler 2. Positive pregnancy test 3. Positive Chadwick's sign 4. Montgomery gland enlargements
1. Hearing a fetal heart rate is a positive sign of pregnancy.
Which of the following vital sign changes should the nurse highlight for a pregnant woman's obstetrician? 1. Prepreg BP 100/60 and third trimester BP 140/90 2. Prepreg RR 16 rpm and third trimester RR 22 rpm 3. Prepreg HR 76 bpm and third trimester HR 88 bpm 4. Prepreg T 98.6 and third trimester T 99.2
1. The blood pressure should not elevate during pregnancy. The basal metabolis rate of a woman increases during pregnancy. As a result the nurse would expect to observe a RR of 20-24rpm. High levels of progesterone in the body results in a decrease in the contractility of the smooth musculature throughout the body. This results in an increase in the pulse rate. In addition, progesterone is thermogenic, resulting in a slight rise in the woman's core body temperature.
The nurse has taken a health history on four primigravid clients at their first prenatal visits. It is high priority that which of the clients receives nutrition counseling? 1. The woman diagnosed with phenylketonuria 2. The woman who has Grave's disease 3. The woman with Cushing's syndrome 4. The woman has Myasthenia Gravis.
1. The client with PKU must receive counseling from a registered dietician.
A pregnant client is lactose intolerant. Which of the following foods could this woman consume to meet her calcium needs? 1. Turnip Greens 2. Green beans 3. Cantaloupe 4. Nectarines
1. Turnip greens are high in calcium
During a preconception counseling session, the nurse encourages a couple to prepare a birth plan. Which of the following is the most important goal for this action? 1. Promote communication between the couple and health care professionals 2. Enable the couple to learn about the types of pain medicine used in labor. 3. Provide the couple with a list of items that they should take to the hospital for the labor and delivery 4. Give the high risk couple a sense of control over the likelihood of having a surgical delivery
1. Birth plans help to facilitate communication between couples and their health care providers.
Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? 1. Avoid eating greasy foods 2. Drink some orange juice before rising 3. Consume 1 teaspoon of nutmeg each morning 4. Eat 3 large meals plus a bedtime snack
1. Greasy foods should be avoided. Saltine crackers should be eaten before rising. Drinking orange juice has not been recommended. Ginger can help alleviate nausea and vomiting. It is also recommended that mothers eat small, frequent meals throughout the day.
A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant? 1. Chorionic gondotropic 2. Oxytocin 3. Prolactin 4. Luteinizing hormone
1. High levels of the hormone chorionic gonadotropin in the blood stream and urine of the woman is a probably sign of pregnancy.
The nurse is assisting a couple to develop decisions for their birth plan. Which of the following decisions should be considered nonnegotiable by the parents? 1. Whether or not the father will be present during labor 2. Whether or not the woman will have an episiotomy 3. Whether or not the woman will be able to have an epidural 4. Whether or not the father will be able to take pictures of the delivery
1. The presence of the father at delivery should be nonnegotiable.
The nurse asks a woman about how the woman's husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which of the following statements? 1. "My husband is ready for the pregnancy to end so that we can have sex again." 2. "My husband has gained quite a bit of weight during this pregnancy." 3. "My husband seems more worried about our finances now than before the pregnancy." 4. "My husband plays his favorite music for my belly so the baby will learn to like it."
1. The woman implies that she and her husband are not having sex. There is no need to refrain from sex during a normal pregnancy - so the woman and her husband need further counseling.
The nurse is caring for a pregnant client who is vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods? 1. Tofu, legumes, broccoli 2. Corn, yams, green beans 3. Potatoes, parsnips, turnips 4. Cheese, yogurt, fish
1. Tofu, legumes, and broccoli are great substitutes for the restricted foods.
A pregnant client is scheduled to undergo chorionic villus sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed? 10 to 12 weeks' gestation 7 to 9 weeks' gestation 5 to 6 weeks' gestation 4 to 5 weeks' gestation
10 to 12 weeks' gestation
The nurse is caring for a prenatal client who states that she is prone to developing anemia. Which of the following foods should the nurse advise the gravida is the best source of iron? 1. Raisins 2. Hamburger 3. Broccoli 4. Molasses
2. Hamburger contains the most iron.
The nurse is interviewing a 38-week gestation Muslim woman. Which of the following questions would be inappropriate for the nurse to ask? 1. "Do you plan to breastfeed your baby?" 2. "What do you plan to name the baby?" 3. "Which pediatrician do you plan to use?" 4. "How do you feel about having an episiotomy?"
2. It is inappropriate to ask the Muslim client about the name of her baby.
A mother has just experienced quickening. Which of the following developmental changes would the nurse expect to occur at the same time in the woman's pregnancy? 1. Fetal heart begins to beat 2. Lanugo covers the fetal body 3. Kidneys secrete urine 4. Fingernails begin to form
2. Lanugo does not cover fetal body at approximately 20 weeks gestation.
A woman in the third trimester advises the nurse that she wishes to breastfeed her baby, "but I don't think my nipples are right." Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time? 1. Advise the client that it is unlikely that she will be able to breastfeed 2. Refer the client to a lactation consultant for advice 3. Call the labor room and notify them that a client with inverted nipples will be admiteed. 4. Teach the woman exercises to evert her nipples
2. The client should be referred to a lactation consultation. The lactation consultant would probably recommend that the client wear breast shields in her bra. The shields are made of hard plastic and have a small hole through which the nipple everts.
A 36-week gestation gravid client is complaining of dyspnea when lying flat. Which of the following is the likely clinical reason for this complaint? 1. Maternal hypertension 2. Fundal height 3. Hydramnios 4. Congestive Heart Failure
2. The fundal height is the likely cause of the woman's dyspnea. As the uterus enlarges, the woman's organs are affected. At 36 weeks, the fundus is at the level of the xiphoid process. The diaphragm is elevated and the lungs are displaced. Whenever caring for a pregnant woman, the nurse should elevate the head of the bed.
A 16-year old, GI P000, is being seen at her 10-week gestation visit. She tells the nurse that she felt the baby move in the morning. which of the following responses by the nurse is appropriate? 1. "That is very exciting. The baby must be very healthy." 2. "Would you please describe what you felt for me?" 3. "That is impossible. The baby is not big enough yet." 4. "Would you please let me see if I can feel the baby?"
2. The other statements are inappropriate.
The nurse is evaluating the 24-hourintake of four gravid clients. Which of the following clients consumed the highest number of dairy servings during 1 day? The client who consumed: 1. 4oz whole milk, 2 oz hard cheese, 1 cup of pudding made with milk and 2 oz cream cheese 2. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 1 1/2 oz hard cheese 3. 1 cup cottage cheese, 8 oz whole milk, 1 cup buttermilk, and 1/2 oz hard cheese 4. 1/2 cup frozen yogurt, 8 oz skim milk, 4 oz cream cheese, and 1 1/2 cup cottage cheese
2. This client consumed 3 1/2 servings: 1 cup of yogurt = 1 serving, 8 oz chocolate milk = 1 serving; 1 cup of cottage cheese = 1/2 serving, and 1 1/2 oz hard cheese = 1 serving.
A woman, 26-weeks gestation calls the triage nurse stating, "I'm really scared. I tried not to but I had an orgasm when we were making love. I just know that I will go into preterm labor now." Which of the following responses by the nurse's appropriate? 1. "Lie down and drink a quart of water. If you feel any back pressure at all call me back right away." 2. "Although oxytocin was responsible for your orgasm, it is very unlikely that it will stimulate preterm labor." 3. "I will inform the doctor for you. What I want you to do is to come to the hospital right now to be checked." 4. "The best thing for you to do right now is to take a warm shower, and then do a fetal kick count assessment."
2. This is an accurate statement.
A woman who is seen in the prenatal clinic is found to be 8 weeks pregnant. She confides to the nurse that her baby may be prematurely damaged because she had 5 beers the night she had sex. Which response is appropriate? 1. I would let the doctor know if I were you. 2. It is unlikely that the baby was affected 3. Abortions during the first trimester are very safe 4. An ultrasound will tell you if the baby was affected
2. This statement is true.
A client states that she is a strong believer in vitamin supplements to maintain her health. The nurse advises the woman that it is recommended to refrain from consuming excess quantities of which of the following vitamins during pregnancy? 1. Vitamin C 2. Vitamin D 3. Vitamin B2 (niacin) 4. Vitamin B12 (cobalmin)
2. Vitamin D supplementation can be harmful during pregnancy. The other vitamins have shown to not be harmful.
A couple is preparing to interview obstetric primary care providers to determine who they will go to for care during their pregnancy and delivery. To make the best choice, which of the following actions should the couple perform first? 1. Take a tour of hospital delivery areas 2. Develop a preliminary birth plan 3. Make appointments with three or four obstetric care providers 4. Search the Internet for the malpractice histories of the providers
2. Developing a birth plan is the first step
A 36-week gestation gravid lies flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe? 1. Hypertension 2. Dizziness 3. Rales 4. Cholasma
2. Dizziness is an expected finding. Because the weight of the gravid uterus compresses the great vessels, the nurse would expect the client to complain of dizziness when lying supine. The blood supply to the head and other parts of the body is diminished when the great vessels are compressed.
The nurse plans to provide anticipatory guidance to a 10 week gravid client who is being seen in the prenatal clinic. Which of the following information should be a priority for the nurse to provide? 1. Pain management during labor 2. Methods to relieve backaches 3. Breastfeeding positions 4. Characteristics of a newborn
2. It is too early in the pregnancy to educate the patient on the other options.
An 18-week gestation client telephones the obstetrician's office stating, "I'm really scared. I think I have breast cancer." My breasts are filled with tumors." The nurse should base the response on which of the following? 1. Breast cancer is often triggered by pregnancy 2. Nodular breast tissue is normal during pregnancy 3. The woman is exhibiting signs of a psychotic break 4. Anxiety attacks are especially common in the second trimester
2. Nodular breast tissue is normal in pregnancy.
A woman, 6 weeks pregnant, is having a vaginal examination. Which of the following would the nurse practitioner expect to find? 1. Thin cervical muscle 2. An enlarged ovary 3. Thick cervical muscles 4. Pale pink vaginal wall
2. The practitioner should expect to palpate an enlarged ovary.
The nurse midwife tells a client that the baby is growing and that ballottement was evident during the vaginal examination. How should the nurse explain what the nurse midwife means by ballottement? 1. The nurse midwife saw that the mucous plug was intact 2. The nurse midwife felt that the baby rebound after being pushed. 3. The nurse midwife palpated the fetal parts through the uterine wall 4. The nurse midwife assessed that the baby is head down
2. This is the definition of ballottement.
A client, in the third trimester, is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy. How should the nurse respond? 1. "Don't worry. You'll know the difference when the contractions start." 2. "The contractions may feel like a backache, but they will come and go." 3. "Contractions are a lot worse than your pregnancy aches and pains." 4. "I understand. You don't want to come to the hospital before you are in the labor."
2. This statement is correct.
The glucose challenge screening test is performed at or after 24 weeks' gestation to assess for the maternal physiological response to which of the following pregnancy hormones? 1. Estrogen 2. Progesterone 3. Human placental lactogen 4. Human chorionic gonadotropin
3. Human placental lactogen is an insulin antagonist. HPL HOLDS GLUCOSE
A 34-week gestation woman calls the obstetric office stating, "Since last night I have had three nosebleeds." Which of the following responses by the nurse is appropriate? 1. "You should see the doctor to make sure you are not becoming severely anemic." 2. "Do you have a temperature?" 3. "One of the hormones of pregnancy makes the nasal passages prone to bleeds." 4. "Do you use any inhaled drugs?"
3. This is accurate. Hormonal changes in pregnancy make the nasal passages prone to bleeds. Estrogen, one of the important hormones of pregnancy, promotes vasocongestion of the mucous membranes of the body. Increased vascular perfusion of the mucous membranes of the gynecologicial system is essential for the developing fetus to survive. The vasocongestion occurs in all of the mucous membranes of the body, however, leading to many complains, including nosebleeds and gingival bleeding.
The nurse discusses sexual intimacy with a pregnant couple. Which of the following should be included in the teaching plan? 1. Vaginal intercourse should cease by the beginning of the third trimester 2. Breast fondling should be discouraged because of the potential for preterm labor 3. The couple may find it necessary to experiment with alternate positions 4. Vaginal lubricant should be used sparingly throughout the pregnancy
3. With increasing size of the uterine body, the couple may need counseling regarding alternate options for sexual intimacy.
A 20-year old client states that the at-home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time? 1. "Congratulations, you and your family must be so happy." 2. "Have you told the baby's father yet?" 3. "How to you feel about the results." 4. "Please tell me when your last menstrual period was."
3. It is important for the nurse to ask the young woman how to feels about being pregnant. She may decide on now to continue with the pregnancy.
Which of the following skin changes should the nurse highlight for a pregnant woman's health care practitioner? 1. Linea nigra 2. Melasma 3. Petechiae 4. Spider nevi
3. Petechiae are pinpoint red or purple spots on the skin. They are seen in hemorrhagic conditions. Linea nigra is the darkened area on the skin from the symphysis to the umbilicus is normal. Melasma is the "mask" of pregnancy is normal. Spider nevi-benign radiating blood vessels are normal in pregnancy.
When analyzing the need for health teaching of prenatal multigravida, the nurse should ask which of the following questions? 1. "What are the ages of your children?" 2. "What is your marital status?" 3. "Do you ever drink alcohol?" 4. "Do you have any allergies?"
3. This question is important to ask to determine a prenatal client's health teaching needs
The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor? 1. "My first child has cerebral palsy." 2. "My first child has hypertension." 3. "My first child has asthma." 4. "Mt first child has cystic fibrosis."
4. Cystic Fibrosis is an autosomal recessive genetic disease, so the client with a family history of CF should be referred to a genetic counselor.
A woman asks the nurse about consuming herbal supplements during pregnancy. Which of the following responses is appropriate? 1. Herbals are natural substances so they are safely ingested during pregnancy 2. It is safe to take licorice and cat's claw, but no other herbs are safe. 3. A federal commission has established the safety of herbals during pregnancy 4. The woman should discuss everything she eats with a health care practitioner
4. Every woman should advise her health care practitioner of what she is consuming, including food, medicines, herbals, and other substances. Some herbals are unsafe during pregnancy (licorice and cat's claw)
A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? 1. Nausea 2. Dyspnea 3. Urinary frequency 4. Leg cramping
4. Leg cramping is often a complaint of clients in the second trimester.
A nurse has identified the following nursing diagnosis for a prenatal client: Altered nutrition: less than body requirements related to poor folic acid intake. Which of the following foods should the nurse suggest the client consume? 1. Potatoes and grapes 2. Cranberries and squash 3. Apples and corn 4. Oranges and spinach
4. Oranges and spinach have high folic acid.
A client asks the nurse, "Could you explain how the baby's blood and my blood separate at delivery?" Which of the following responses is appropriate for the nurse to make? 1. "When the placenta is born, the circulatory systems separate." 2. "When the doctor clamps the cord, the blood stops mixing." 3. "The separation happens after the baby takes the first breath. The baby's oxygen no longer has to come from you." 4. "The blood actually never mixes. Your blood supply and baby's blood supply are completely separate."
4. The blood supplies are completely separate.
The partner of a gravida accompanies her to her prenatal appointment. The nurse notes that the fater of the baby has gained weight since she last saw him. Which of the following comments is most appropriate for the nurse to make to the father? 1. "I see that you are gaining weight right along with your partner." 2. "You and your partner will be able to go on a diet together after the baby is born." 3. "I can see that you are bad influence on your partner's eating habits." 4. "I am so glad to see that you are taking so much interest in your partner's pregnancy."
4. This is an appropriate comment to make at this time.
A 28-year-old client states that she has not had her menstrual period for the past 3 months and suspects she is pregnant. Which should the nurse do next? Determine at what age the client began menstruating. Have the client take a pregnancy test. Assess the client for a fetal heart tone. Ask the client the date her last period ended.
Have the client take a pregnancy test. C is to extreme. She probably just has amenorrhea
A client at 24 weeks' gestation is seen for a routine monthly check up. She reports concerns to the nurse about rest periods. She states that when she awakens she feels weak and lightheaded. What is the most appropriate initial action by the nurse? Inquire about the client's sleeping positions. Make a referral for a cardiac evaluation. Request testing to assess the client's serum glucose levels. Assess the client for manifestations of preeclampsia. Complete neurological assessment.
Inquire about the client's sleeping positions.
