Ch.9, 10,11 OB
A woman in her second trimester comes to the clinic for a routine follow-up visit. The woman's prepregnancy blood pressure was 112/70 mm Hg. On this visit, the woman's blood pressure is 104/64 mm Hg. The nurse would interpret this finding as suggestive of which event? A. A normal pregnancy finding secondary to progesterone effects B. Indication that the woman is experiencing orthostatic hypotension C. Signal that the woman is developing gestational hypertension D. Sign that the woman is anemic
A
A pregnant woman undergoes a triple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's estriol and alpha-fetoprotein levels are decreased with high hCG levels? A. Down syndrome B. sickle-cell anemia C. cardiac defects D. respiratory disorders
A
Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which finding? A. linea nigra B. striae gravidarum (stretch marks) C. melasma (chloasma) D. vascular spiders
A
14. During a prenatal class, the nurse is describing what happens when the ovum is fertilized by the sperm. Which statement would the nurse most likely include? A. The zygote is transported into the uterine cavity. B. The embryo is transported into the uterine cavity. C. Genetic material is shared with the embryo upon implantation. D. The placenta begins to form in the fallopian tube.
A
A client asks about a child inheriting an autosomal recessive disorder. What must occur for an offspring to demonstrate signs and symptoms of the disorder with this type of inheritance? A. Both parents must be carriers. B. One parent must have the disease. C. One parent, usually the mother, must be a carrier. D. One parent, usually the father, must not be a carrier or have the disease.
A
A couple asks the nurse at a preconception class for information on becoming pregnant. Which response made by the nurse is correct? A. "The 200 million sperm in ejaculated semen are necessary for conception to take place." B. "The 1 million sperm in ejaculated semen are necessary for conception to take." C. "Fertilization will typically occur 2 weeks before your last normal menstrual period." D. "Fertilization will typically occur 1 week after the last normal menstrual period."
A
A couple attends genetic counseling. What are the chances that the couple will have a child with Down syndrome? A. Chromosomal abnormalities occur in about 1 in 150 live-born infants. B. Chromosomal abnormalities cannot be inherited and occur at random. C. If a woman is a carrier, there is a 25% chance that her daughter will be affected. D. If a man is a carrier, there is a 25% chance that he will have an unaffected son.
A
A nurse is assessing a pregnant woman and suspects that the woman may be experiencing pica. To help support this suspicion, the nurse evaluates the woman for signs and symptoms of which condition? A. Iron-deficiency anemia B. Urinary tract infection C. Diarrhea D. Heartburn
A
A nurse is monitoring a client's hCG levels because she has had a previous ectopic pregnancy and one spontaneous abortion. Which finding would the nurse interpret as indicating that the pregnancy is progressing appropriately? A. doubling of the level every 2 to 3 days B. plateauing of the level at 7 days C. gradually increasing levels every month D. abruptly declining levels after 60 days
A
A nurse teaching a couple says that when X-linked recessive inheritance is present in a family, the genogram will reveal that: A. mostly males in the family have the disorder. B. the parents of the affected man have the disorder. C. sons of an affected man are also affected. D. all daughters and no sons will inherit the condition.
A
At prenatal classes a client asks the nurse how long it takes to actually become pregnant after having sexual intercourse. What is the nurse's best response? A. "Conception happens immediately after fertilization of the ovum." B. "Conception happens about 12 hours after fertilization of the ovum." C. "Conception happens about 24 hours after fertilization of the ovum." D. "Conception happens about 72 hours after fertilization of the ovum."
A
In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down flat on my back." The nurse explains that this is due to: A. pressure of the gravid uterus on the vena cava. B. a 50% increase in blood volume. C. physiologic anemia due to hemoglobin decrease. D. pressure of the presenting fetal part on the diaphragm.
A
In order for conception to take place, it is most common for a woman to get pregnant: A. two weeks after her normal menstrual period. B. two weeks before her normal menstrual period. C. immediately after a normal menstrual period. D. during her menstrual period.
A
The nurse is assessing a 12-hour-old newborn and hears a heart murmur. What initial action should the nurse take? A. Document the finding as normal for age B. Report the finding to the health care provider C. Assess the infant every 2 hours for worsening symptoms D. Allow the infant to room in with the parents if temperature is stable
A
When describing genetic disorders to a group of couples planning to have children, the nurse would identify which as an example of an autosomal dominant inheritance disorder? A. Huntington disease B. sickle cell disease C. phenylketonuria D. cystic fibrosis
A
Which event will result in zygote formation? A. The nucleus of the ovum and sperm make contact and combine chromosomes. B. The nucleus of the ovum carries forth the genetic information at implantation. C. The nucleus of the sperm and the fallopian tube make contact and combines chromosomes. D. The nucleus of the sperm carries forth the genetic information at implantatioN
A
During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as :A. Hegar sign. B. Goodell sign. C. Chadwick sign. D. Ortolani sign.
A Rationale: Hegar sign refers to the softening of the lower uterine segment or isthmus. Bluish coloration of the cervix is termed Chadwick sign. Goodell sign refers to the softening of the cervix. Ortolani sign is a maneuver done to identify developmental dysplasia of the hip in infants.
A nurse is assessing a client who may be pregnant. The nurse reviews the client's history for presumptive signs. Which signs would the nurse most likely note? Select all that apply .A. amenorrhea B. nauseA C. abdominal enlargement D. Braxton-Hicks contractions E. fetal heart sounds
A, B Presumptive signs include amenorrhea, nausea, breast tenderness, urinary frequency and fatigue. Abdominal enlargement and Braxton-Hicks contractions are probable signs of pregnancy. Fetal heart sounds are a positive sign of pregnancy.
A nurse is teaching a pregnant woman about ways to prevent the development of the food- borne illness listeriosis. The nurse determines that the teaching was successful when the woman identifies the need to avoid which food(s)? Select all that apply. A. Soft cheeses B. Refrigerated meat spreads C. Canned tuna fish D. Store-made chicken salad E. Pasteurized milk
A, B, D
A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, what would the nurse expect to find? Select all that apply. A. hyperemic gums B. increased peristalsis C. reports of bloating D. heartburn E. nausea
Answer: A, C, D, E
A client who is six weeks' pregnant asks the prenatal nurse, "What development has taken place with my baby by now?" Which information should the nurse include in the response? Select all that apply .A. "By week 3 there would be the beginning development of the brain, spinal cord, and heart." B. "By week 4 the arms and legs begin to grow and develop." C. "By week 5 the heart now beats and the eyes and ears can be seen." D. "By week 6 the lungs begin forming and the baby circulation is established." E. "By week 6 the baby makes active movements with sucking motions made with the mouth."
Answer: A, B, C, D
Which processes that occur after fertilization would lead to a normal pregnancy? Select all that apply. A. The morula divides into specialized cells that will form fetal structures. B. Within the morula is a blastocyst that will form the embryo. C. The morula develops into the embryonic membranes, the chorion, and placenta. D. The morula enters the uterine cavity about 72 hours after fertilization. E. The blastocyst reaches the uterine cavity immediately after fertilization.
Answer: A, B, D
23. A nurse is providing nutritional counseling to a pregnant woman and gives her suggestions about consuming foods that are high in folic acid. As part of the plan of care, the client is to keep a food diary that the client and nurse will review at the next visit. When reviewing the client's diary, which meals would indicate to the nurse that the client is increasing her intake of folic acid? Select all that apply. A. chicken breast with baked potato and broccoli B. cheeseburger with spinach and baked beans C. pork chop with mashed potatoes and green beans D. strawberry walnut salad with romaine lettuce E. fried chicken sandwich with mayonnaise and avocado
Answer: A, B, D Rationale: Good food sources of folic acid include dark green vegetables, such as broccoli, romaine lettuce, and spinach; baked beans; black-eyed peas; citrus fruits; peanuts; and liver. So the meals containing chicken breast with baked potato and broccoli, cheeseburger with spinach and baked beans, and the strawberry walnut salad with romaine lettuce demonstrate an intake of foods high in folic acid.
A prenatal nurse is conducting a class on healthy pregnancy and explains the role of placental hormones. Which statements would the nurse make? Select all that apply. A. Human chorionic gonadotropin is the basis for pregnancy tests. B. Human placental lactogen participates in the development of maternal breasts for lactation. C. Thyroxin modulates fetal and maternal metabolism. D. Progesterone stimulates maternal metabolism and breast development. E. Relaxin causes enlargement of a woman's breasts, uterus, and external genitalia. F. Estrogen causes enlargement of a woman's breasts.
Answer: A, B, D, F
Which processes, if they occur during the formation of the placenta, would lead to a successful pregnancy? Select all that apply. A. Implantation of the trophoblast occurs in the upper uterus. B. Three days after conception, the trophoblast makes human chorionic gonadotropin (hCG). C. The trophoblast attaches to the fallopian tube for nourishment. D. The placenta is fully developed by the end of fourth week. E. The trophoblast develops into the placenta.
Answer: A, B, E
Which characteristics about amniotic fluid would alert the prenatal nurse to further investigate? Select all that apply. A. Oligohydramnios is noted on assessment. B. The amount of amniotic fluid fluctuates at each checkup. C. Polyhydramnios is noted on assessment. D. The client has approximately 2 L of amniotic fluid at term. E. The client has approximately 1 L of amniotic fluid at term.
Answer: A, C, D
A woman visits the prenatal clinic and is noted to have oligohydramnios. The client asks, "Why is this fluid important anyway?" Which statements would be included in the nurse's response? Select all that apply. A. "Amniotic fluid helps maintain your baby's body temperature." B. "The fetus ingests amniotic fluid for its nourishment." C. "Too little amniotic fluid is linked with placental problems." D. "Amniotic fluid keeps your baby free from any teratogens." E. "It acts like a cushion protecting your baby from trauma that may occur."
Answer: A, C, E
A woman comes to the prenatal clinic for an evaluation because she thinks that she may be pregnant. The nurse is assisting the health care provider with the vaginal examination. The exam reveals a vaginal mucosa and cervix that are bluish-purple in color. Based on this information, the nurse suspects that the client is most likely how many weeks pregnant? A. 5 weeks B. 6 weeks C. 14 weeks D. 16 weeks
Answer: B Rationale: The finding indicates Chadwick's sign, a bluish-purple discoloration of the vaginal mucosa and cervix. This typically occurs between 6 to 8 weeks
A client's recent prenatal ultrasound assessment reveals a normal placenta. Which outcomes would the nurse expect? Select all that apply. A. The placenta will filter out toxins that the mother ingests. B. The hormones made by the placenta support fetal growth. C. The placenta removes the fetal waste products such as stool. D. The placenta protects the fetus from an immune attack created by the mother. E. The placenta produces hormones that ready the fetus for extrauterine life.
Answer: B, D, E
A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which recommendations would the nurse include in the discussion? Select all that apply.\ A. Keep weight gain to 15 lb (6.8 kg). B. Eat three meals with snacking. C. Limit the use of salt in cooking. D. Avoid using diuretics. E. Participate in physical activity.
Answer: B, D, E
A pregnant woman asks the nurse, "I've heard that I should avoid eating certain types of fish. So what fish can I eat?" Which type of fish would the nurse recommend? Select all that apply. A. sharkB. tilefish C. shrimp D. salmon E. catfish
Answer: C, D, E
Which mother is in the fetal stage of development? A. a pregnant mother who is one week pregnant B. a pregnant mother who is five weeks' pregnant C. a pregnant mother who is seven weeks' pregnant D. a pregnant mother who is thirty weeks' pregnant
Answer: D Rationale: The fetal stage of development during pregnancy occurs at the end of the eighth week and continues through to birth. The mother at one week gestation is in the preembryonic stage. The mothers at five weeks and seven weeks are in the embryonic stage.
3. The nurse is teaching a couple about X-linked disorders because they are concerned that they might pass on hemophilia to their children. Which response indicates the need for further teaching? A. "The father can't be a carrier if he doesn't have hemophilia." B. "If the father doesn't have it, then his kids won't either." C. "If the mother is a carrier, her daughter could be one too." D. "If the mother is a carrier, her sons will have hemophilia."
B
5. A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which possible effect would the nurse include? A. ankle edema abirbcom/test B. urinary frequency C. backacheD. hemorrhoids
B
A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which component? A. excess folic acid, which could increase the risk for neural tube defects B. mercury, which could harm the developing fetus if eaten in large amounts C. lactose, which leads to abdominal discomfort, gas, and diarrhea D. low-quality protein that does not meet the woman's requirements
B
A physically abused pregnant woman reports to the nurse that her spouse has stopped hitting her and promises never to hurt her again. Which response by the nurse would be most appropriate? A. "That's great. I wish you both the best." B. "Remember, the cycle of violence often repeats itself." C. "He probably didn't mean to hurt you." D. "You need to consider leaving him."
B
A pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis based on which assessment finding? A. fever B. vaginal itching C. urinary frequency D. incontinence
B
Assessment of a pregnant woman reveals that she compulsively craves ice. The nurse documents this finding as: abirbcom/test A. quickening. B. pica. C. ballottement. D. linea nigra.
B
At a routine visit, a pregnant woman nearing the end of her second trimester tells the nurse, "It is so strange. I lie down to go to sleep and then I have to get up to go to the bathroom. This always happens when I am trying to sleep." Which response by the nurse would be appropriate? A. "You might be developing a urinary tract infection. Let's get a urine sample." B. "Your kidneys increase their activity when you lie down causing you to urinate." C. "Lying on your side instead of lying on your back will help stop this problem." D. "Maybe you are drinking too much fluid before you go to bed."
B
The nurse is conducting a presentation for a young adult community group about fetal development and pregnancy. The nurse determines that the teaching was successful when the group identifies that the sex of offspring is determined at which time? A. during meiosis cell division B. at fertilization C. when the morula forms D. during oogenesis
B
The nurse is discussing the insulin needs of a primiparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse's understanding that the placenta produces: A. hCG, which increases maternal glucose levels. B. hPL, which deceases the effectiveness of insulin. C. estriol, which interferes with insulin crossing the placenta. D. relaxin, which decreases the amount of insulin produced.
B
The nurse is presenting a class at a local community health center on violence during pregnancy. Which possible complication would the nurse include? A. gestational hypertension B. chorioamnionitis C. placenta previa D. postterm labor
B
7. Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition? A. maternal diabetes B. placental insufficiency C. neural tube defects D. fetal gastrointestinal malformations
B A deficiency of amniotic fluid, oligohydramnios, is associated with uteroplacental insufficiency and fetal renal abnormalities. Excess amniotic fluid is associated with maternal diabetes, neural tube defects, and malformations of the gastrointestinal tract and central nervous system.
At a prenatal class, the participants ask the nurse who would benefit from genetic counseling. Which responses by the nurse are correct? Select all that apply. A. "A woman who is a grand multigravida." B. "A woman whose husband is age 50 years or older." C. "A woman who has been exposed to teratogens." D. "A young teenager experiencing her first pregnancy." E. "A woman who receives an abnormal alpha-fetoprotein result."
B, C, E
A client at a prenatal class requests information on how the gender of a baby is determined. Which statement made by the nurse would be most accurate? A. "Gender is determined by week 20 of gestation and depends on whether the ovum is fertilized by a Y-bearing or an X-bearing sperm." B. "Gender is determined as the embryo is fertilized by a Y-bearing or an X-bearing sperm." C. "Gender is determined at conception and depends on whether the ovum is fertilized by a Y- bearing or an X-bearing sperm." D. "Gender is determined at conception and depends on whether the sperm is fertilized by a Y- bearing or X-bearing ovum."
C
A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, "I've never urinated as often as I have for the past three weeks." Which response would be most appropriate for the nurse to make? abirbcom/test A. "Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it." B. "You shouldn't be urinating this frequently now; it usually stops by the time you're eight weeks pregnant. Is there anything else bothering you?" C. "By the time you are 12 weeks pregnant, this frequent urination should really decrease, but it is likely to return toward the end of your pregnancy." D. "Women having their second child generally don't have frequent urination. Are you experiencing any burning sensations?"
C
A nurse is conducting a class for a group of pregnant women in their first trimester about the emotional responses that occur during pregnancy. Which response would the nurse identify as being seen commonly during the second trimester? A. Introversion B. Ambivalence C. Acceptance D. Emotional balance
C
A woman in her second trimester comes for a follow-up visit and says to the nurse, "I feel like I'm on an emotional roller-coaster." Which response by the nurse would be most appropriate? A. "How often has this been happening to you?" B. "Maybe you need some medication to level things out." C. "Mood swings are completely normal during pregnancy." D. "Have you been experiencing any thoughts of harming yourself?"
C
A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The nurse would explain that which sign would confirm the pregnancy? A. absence of menstrual period B. abdominal enlargement C. palpable fetal movement D. morning sickness
C
During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important, but can you tell me more about it?" When describing amniotic fluid to a pregnant woman, which description would the nurse most likely include? A. "This fluid acts as transport mechanism for oxygen and nutrients." B. "The fluid is mostly protein to provide nourishment to your baby." C. "This fluid acts as a cushion to help to protect your baby from injury." D. "The amount of fluid remains fairly constant throughout the pregnancy."
C
When describing an episode of intimate partner violence, the victim reports attempting to calm the partner down to keep things from escalating. The nurse interprets this behavior as reflecting which phase of the cycle of violence? A. battering B. honeymoon C. tension-building D. reconciliation
C
9. Which change in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy? A. ligament tightening B. decreased swayback C. increased lordosis D. joint contraction
C Rationale: With pregnancy, the woman's center of gravity shifts forward, requiring a realignment of the spinal curvatures. There is an increase in the normal lumbosacral curve (lordosis). Ligaments of the sacroiliac joints and pubis symphysis soften and stretch.
woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which area? A. just above the symphysis pubis B. midway between the pubis and umbilicus C. at the level of the umbilicus D. midway between the umbilicus and xiphoid process
C The uterus, which starts as a pear-shaped organ, becomes ovoid as length increases over width. By 20 weeks' gestation, the fundus, or top of the uterus, is at the level of the umbilicus and measures 20 cm. A monthly measurement of the height of the top of the uterus in centimeters, which corresponds to the number of gestational weeks, is commonly used to date the pregnancy.
7. When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which underlying reason for the effect would the nurse include? A. Pancreatic function is affected by pregnancy. B. Glucose is utilized more rapidly during a pregnancy. C. The pregnant woman increases her dietary intake. D. Glucose moves through the placenta to assist the fetus.
D
A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes? A. 22 B. 23 C. 44 D. 46
D
After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests? A. human placental lactogen (hPL) B. estrogen (estriol) C. progesterone (progestin) D. human chorionic gonadotropin (hCG)
D
After teaching a refresher class to a group of prenatal clinic nurses about pregnancy, insulin, and glucose, the nurse determines that additional teaching is needed when the group identifies which hormone as being involved with opposing insulin? A. prolactin B. estrogenC. progesterone D. aldosterone
D
The nurse is assessing a pregnant woman who is at 12 weeks' gestation. The woman's BMI was 18 prior to becoming pregnant. Her prepregnancy weight was 98 lb (44.5 kg). Which measurement would the nurse determine as appropriate weight gain for the woman during the first trimester? A. 99 lb (45 kg) B. 100 lb (45.5 kg) C. 102 lb (46 kg) D. 104 lb (47 kg)
D
The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. What would be most important for the nurse to do when working with this family? A. Gather information for three generations. B. Inform the family of the need for information. C. Maintain the confidentiality of the information. D. Present the information in a factual, nondirective manner.
D
The nurse is teaching a couple about the pros and cons of genetic testing. Which statement by the nurse best describes the limits of genetic testing? A. "Various genetic tests help the primary care provider choose appropriate treatments." B. "Genetic testing helps couples avoid having children with fatal diseases." C. "Genetic tests identify people at high risk for preventable conditions." D. "Some genetic tests can give a probability for developing a disorder."
D
When describing gender determination at a prenatal class, the nurse would include which statement? A. "Gender is determined when the primary oocyte completes its first mitotic division." B. "Gender is determined when the sperm and the oocyte undergo the process of mitosis." C. "Gender is determined when the ovum and the spermatozoon undergo the process of meiosis." D. "Gender is determined at fertilization when the ovum is fertilized."
D
Which approach would be most appropriate when counseling a client who is a suspected victim of intimate partner violence?A. Offer the client a pamphlet about the local shelter for victims of intimate partner violence. B. Call the client at home to ask some questions about the marriage. C. Wait until the client comes in a few more times to make a better assessment. D. Ask, "Have you ever been physically hurt by your partner?"
D
hile talking with a woman in her third trimester, the nurse understands that which behavior indicates that the woman is learning to give of oneself? A. showing concern for self and fetus as a unit B. unconditionally accepting the pregnancy without rejection C. longing to hold infant D. questioning ability to become a good mother
D
The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. What will the mother likely experience at that time? A. dysuria B. dyspnea C. constipation D. urinary frequency
D Lightening refers to the descent of the fetal head into the pelvis and engagement.
