Exam 1 Practice Questions

The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that a pregnant patient may have been using marijuana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate? "Did you smoke marijuana when pregnant with your other child?" "To avoid negative effects on your baby, you'll need to stop using marijuana during your last trimester." "Using marijuana while pregnant can have a negative effect on the neurological development of your baby." "Marijuana use while pregnant greatly increases your risk of miscarriage."

"using marijuana can affect your baby's neurological system" RATIONALE: think marijuana fries your brain and makes you dumb

A patient in the third trimester of pregnancy is instructed on how to perform daily fetal movement count. The nurse needs to inform the patient what to do if fetal movement is decreased. Which patient actions are appropriately recommended by the nurse? Select all that apply. 1. Eat something. 2. Recount movements the next morning. 3. Arrange for a period of rest. 4. Focus on movement for 1 hour. 5. Exercise or take a walk.

1 3 4

The nurse is providing pre-amniocentesis teaching for a patient who is at 18 weeks gestation. Which information does the nurse provide? Select all that apply. 1. Positioning on the left side will avoid injury to the fetus. 2. A full bladder will assist in ultrasound visualization. 3. Discomfort will be minimized with a local anesthetic. 4. Avoid lifting heavy objects for a period of 2 weeks. 5. Abdominal cramping and bleeding is normal for 24 hours.

2 3

A male patient is diagnosed with low sperm count as the cause of infertility. Which interventions will the nurse recommend to improve the patient's sperm count? Select all that apply. A. Yoga or relaxation techniques B. Surgical repair of an inguinal hernia C. Switch to underwear made from cotton D. Avoidance of showers with hot water temperature E. Consultation to change hypertension drugs

A, B, E stress can cause infertility, hernias can interfere, certain meds can affect that

The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, "I do not need to stop smoking my electronic cigarette because it will not harm my baby." Which is the best response by the nurse? "You are correct. Electronic cigarettes are not harmful during pregnancy." "Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity." "According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy." "Electronic cigarettes are considered harmful only in the first trimester."

2nd one

The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first? 1. Refer the patient to a drug abuse program. 2. Screen the infant for side effects associated with cocaine use. 3. Educate the patient of the risks associated with cocaine use during pregnancy.

3 RATIONALE: the reason its not 2 is because the fetus can not be tested for side effects of drug use during pregnancy until after being delivered.

A patient in the third trimester of pregnancy expresses concern to the nurse about changes to her muscles, joints, and bones. Which conditions does the nurse reassure the patient are normal changes of pregnancy? Select all that apply. A. Waddling gait B. Low back pain C. Increased risk of falls D. Fractures E. Severe muscle aches

A B C

The nurse is conducting a staff education session about preeclampsia and eclampsia complications. Which statements by the nurse are accurate about HELLP syndrome? Select all that apply. A. This syndrome destroys red blood cells. B. This syndrome impacts the amount of platelets. C. This syndrome decreases a patient's white blood cell (WBC) count. D. This syndrome decreases a patient's blood urea nitrogen (BUN). E. This syndrome increases liver enzymes.

A, B, E H- hemolysis EL -elevated liver enzymes LP - low platelet count

The nurse is providing care to a postpartum patient after an emergency cesarean due to eclampsia. The patient received spinal anesthesia prior to delivery. Magnesium sulfate is infusing 2 g/hr in 100 mL of IV fluid. Which assessment finding will cause the nurse to administer calcium gluconate to the patient via IV push? A. Serum magnesium level is 10 mg/dL. B. Patella reflexes are rated at zero. C. Respiratory rate is 18 breaths/min. D. Urinary output remains at 30 mL/hr.

A. a therapeutic level for mag sulfate is betwen 5-7 mg/dl

The nurse explains to a patient who has missed a second menstrual cycle that a combination of presumptive and probable signs is used to make a practical diagnosis of pregnancy. Which signs are expected by the nurse when making a practical diagnosis? Select all that apply. A. Elevated hCG levels in blood and urine B. Brownish pigmentation on the face C. Fetal movement detected by the examiner D. Bluish-purple coloration of vagina and cervix E. Occasional mild contractions

A. elevated HCG levels B. brownish pigmentation of the face E. occasional mild contractions

A patient at 34 weeks gestation is undergoing an ultrasound. The nurse notes that the amniotic fluid is estimated at between 500 and 600 mL. Which deduction does the nurse make from this finding? A. Oligohydramnios is present. B. Fluid is normal for gestation age. C. Polyhydramnios has formed. D. Follow-up ultrasound is warranted.

A. oligiohydramnios ... the AFI should be between 800 ml and 1000 ml by 34 weeks

A patient at 37 weeks gestation arrives at the labor and delivery unit and reports a rupture of her membranes. Which factor causes the nurse to anticipate the HCP will prescribe a medical method of labor induction? A. The fetus is viable and the barrier for a sterile uterine environment is breached. B. The fetus is at risk for "drying out" and causing the mother to have a dry birth. C. The mother must be maintained on complete bedrest until contractions begin. d. The mother is at risk for developing an infection and passing it to the fetus.

A. once the membranes rupture, the baby is now at higher risk for infection so we want to get them out

The nurse is planning an assessment on a patient in the second trimester of pregnancy. For which assessments will the nurse plan? Select all that apply. A. Urine testing with a dipstick. B. Presence of dependent edema. C. Determine EDD by Naegele's rule. D. Antibody screening for Rh?2- patient. E. Check for chromosomal abnormalities.

A. urine testing for glucose, albumin, ketones B. upper body edema is abnormal D. RH testing

A patient at 33 weeks gestation with a first pregnancy arrives at the labor and delivery unit with contractions. After monitoring the patient, the nurse determines the woman is in active labor and calls the health care provider (HCP), who prescribes a sleeping medication and sends the patient home. Which action does the nurse take? Questions the HCP's prescribed treatment Administers the medication and keeps the patient Calls another HCP for a different prescription Follows the HCP's instructions as prescribed

A. you must advocate for the patient by questioning the orders

The nurse is experiencing an ethical dilemma when confronted with a situation in which either the mother or fetus is predicted to die. The nurse feels bound by the ANA Code of Ethics to protect both patients. Which aspect of care during an ethical dilemma will guide the nurse? A. Maternity nurses are bound to advocate first and foremost for the well-being of the mother B. The nurse is ethically bound to provide the best care for both the mother and fetus. C. If the fetus is viable and healthy, its survival is the priority of the maternity nurse. D. The survival of the mother is solely based on both patient and family decision making.

ANS: A because the nurses obligation is to save the mother before the child.

An adolescent patient who is 15 weeks pregnant refuses to have an alpha-fetoprotein test performed because, "I don't like needles." Which initial approach does the nurse take to achieve the testing? 1. Insist that testing will be done with or without her cooperation. 2. Explain the testing is important in detecting serious birth defects. 3. Ask an accompanying parent to help persuade the patient. 4. Notify the health care provider of the patient's refusal.

B

A patient arrives for her fourth month prenatal visit and expresses concern because of a leakage of yellow fluid from her breasts. Which topic does the nurse discuss during this visit? A. Signs of infection B. Breast changes C. A change in EDD D. Support bras

B Breast changes This is correct. The leakage of yellow fluid from the patient's breasts is a normal change during pregnancy. The patient is experiencing a leakage of colostrum, which is rich in antibodies for the neonate. This manifestation can begin as early as 16 weeks.

The nurse is assessing a patient at 26 weeks gestation. The patient has chronic hypertension and exhibited hypertension and proteinuria prior to 20 weeks gestation. Previous blood pressure (BP) readings have been in the range of 130 to 140/88 to 90 mm Hg. Due to superimposed preeclampsia, for which additional manifestations will the nurse immediately contact the health care provider? Select all that apply. A. Laboratory report that shows an elevation of liver enzymes B. Current blood pressure reading of 162/102 mm Hg C. Evident pulmonary edema noted with auscultation. D. Subjective report of severe headache and photophobia E. Lack of response to verbal and tactile stimulation

B, C, D, E high bp pulmonary edema headach and photophobia lack of response to stimuli

A patient arrives at a maternal health client and tells the nurse she has missed a period and thinks she is pregnant. Which information shared with the nurse is a presumptive sign of pregnancy? A. Positive results on a home pregnancy test2. B. Breast enlargement, tenderness, and tingling C. First awareness of fetal movements D. Increased appetite

B.

The nurse is caring for a 14-year-old patient who is 32 weeks pregnant. After complaining of genital sores and discomfort, the patient tests positive for syphilis. The fetus is at increased risk of which condition? 1. Diabetes 2. Blindness 3. Pneumonia 4. Hypertension

B. Blindness RATIONALE → syphilis during pregnancy puts mom and baby at risk for death or puts baby at risk for blindness

The nurse works in a prenatal clinic and interacts with multiple patients from various socioeconomic backgrounds. Which patient does the nurse assess most carefully for a mental health issue? A. A woman who chooses single parenthood B. A military veteran who was deployed twice C. The pregnant partner of a lesbian relationship D. The mother who is multigestational with triplets

B. military people are at higher risk for depression

The nurse works in an infertility clinic and is interviewing a male patient whose partner has been unable to conceive. Which finding obtained during a health history will cause the nurse greatest concern? A. The patient is a passionate gardener. B. The patient had a vasectomy reversed. c. The patient rides a bicycle daily to work. D. The patient is concerned about infertility.

B. reverssed vesectomy can cause sperm antibodies that decreases sperm motility

The nurse is providing care for a patient at 30 weeks gestation. Which topic related to patient concern or discomfort is most important for the nurse to address? A. Increased breast enlargement B. Dizziness when lying supine C. Dependent edema and varicosities D. Hyperpigmentation on the face

B. supervena cava syndrome

The nurse is counseling a patient regarding pregnancy. The patient lost her first two pregnancies in the second trimester of gestation for undetermined reasons. Which initial advice does the nurse provide for this patient? A. Consider adoption. B. Seek genetic studies. C. Plan for fertility tests. D. Attend grief counseling.

B.. She should see if there are any genetic markers causing this

A patient is scheduled for transvaginal ultrasound testing. Which preparation by the nurse is appropriate? 1. Place the patient supine with a pillow beneath her head. 2. Explain that pain at 4 or less on a 0 to10 scale is expected. 3. Ascertain whether the patient has a latex or banana allergy. 4. Request that the patient's partner leave the testing room.

Because the transvaginal ultrasound probe is covered by a latex sheath, the nurse needs to ascertain whether the patient has a latex allergy or has exhibited an allergic response to specific foods such as bananas.

The nurse is providing care for a patient in the third trimester of pregnancy. Which topic of patient education is most likely to be needed during this time? A. Update on fetus growth and behavioral patterns B. Management for commonly experienced discomforts C. General health maintenance and promotion topics D. Counseling and guidance about diet and exercise

C. General discomforts.... The rest of them are appropriate for all trimesters of pregnancy

A patient undergoes chorionic villa sampling to rule out the presence of a genetic disorder. Following the procedure, the patient experiences iatrogenic PPROM. Which explanation does the nurse provide to promote patient understanding? A. The rupture of the membranes is from a bacterial infection. B. The membranes ruptured because the test caused fetal death. C. The premature rupture of the membranes is a known risk to the test. D. The membranes ruptured due to the presence of a genetic disorder.

C. Iatrogenic PPROM is associated with a medical intervention such as the patient's procedure, chorionic villus sampling. The preterm rupture of membranes is a known risk and unpreventable complication related to invasive testing.

A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility? A. The patient works as a ballroom dance instructor. B. The patient is turning 37 years old this year. C. The patient has hot flashes and mood swings. D. The patient was treated for a pelvic inflammatory disease while in college.

C. These are signs of menopause

The nurse is teaching a class about embryonic and fetal development to couples in the early stage of pregnancy. For which reason does the nurse emphasize the first 8 weeks of gestation? A. Pregnancies often abort before or at this time of development. B. Lack of size and movement prevents confirmation of pregnancy. C. All organ systems are developing during this period. D. Factors that can interrupt the pregnancy are no longer a concern.

C. all organ systems are developing Rationale: At 8 weeks the primary germ layers have transformed into a clearly defined human. The embryo is now a fetus with all major organ systems formed. The nurse emphasizes this period because interfering factors for development should be avoided up to this point.

The nurse is counseling a female patient who has unsuccessfully attempted to become pregnant through a variety of methods and treatments for infertility. Which psychosocial manifestation is the nurse most likely to recognize? A. Close connections with extended family B. Strong intimate relationship with her partner C. Difficulty accepting pregnancy if it does occur D. Greater focus on career and job opportunities

C. hard time accepting pregnancy Once pregnancy is achieved, the woman often has difficulty perceiving herself as a pregnant woman.

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits. Which patient does the nurse identify as having the highest-risk pregnancy? A. The patient who is 16 years of age just diagnosed with gestational diabetes B. The patient with preexisting hypertension who is currently pregnant with twins C. The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension D. The patient who is 28 years of age who delivered a premature neonate 3 years prior

C. obese patient

The nurse is providing care for a patient who is 42 years of age and in the first trimester of her pregnancy. For which possible complication will the nurse closely monitor the patient and fetus? A. Elevated blood pressure and proteinuria B. Indications of maladaptation to pregnancy. c. Alterations in fetal chromosomal studies D. Subtle indicators of menopause occurring

C. older moms are at higher risk for chromosomal abnormalities in the fetus

When performing a physical assessment on a patient during the initial prenatal visit, the nurse notes spongy gums prone to bleeding during the oral exam. Which comment by the nurse is appropriate? A. "Oral bleeding can contribute to anemia." B. "Dental problems can interfere with nutrition." C. "Periodontal disease is a risk factor for preterm labor" D. "You need dental care because pregnancy causes dental problems."

C.Infection is considered a risk factor for preterm labor and birth. This is especially true for genitourinary infections and periodontal disease.

A patient in the third trimester of pregnancy reports having heartburn nearly every day. Which recommendations does the nurse make to alleviate the problem? Select all that apply. A. Consume three moderate-sized meals daily. B. Sip clear, carbonated beverages when eating. C. Assume a low Fowler position after meals. D. Avoid eating 3 hours prior to bedtime. E. Avoid consuming spicy, fatty, or fried food.

D and E avoid eating 3 hours before bed and avoid spicy food

A patient expresses a desire to become pregnant for a second child. The nurse notes that the patient's first child was born with a serious neural tube defect (NTD) and died of complications at 18 months of age. Which recommendation does the nurse make to this client? A. Folic acid 0.6 mg/day orally 1 month before conception and throughout pregnancy. B. Folic acid 0.4 mg/day orally started when pregnant and continued throughout pregnancy C. Folic acid 4 mg/day orally started when pregnant and continued throughout pregnancy D. Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

D. youre supposed to start it prior to conception

A patient who has just received confirmation that she is pregnant is distressed because she has a seizure disorder that she manages with carbamazepine. Which is the nurse's greatest concern? A. The carbamazepine may be discontinued. B. The pregnancy is likely to end with fetal demise. C. The fetus will experience loss of vision and hearing. D. Carbamazepine is teratogenic and causes neural and facial defects.

D. A teratogenic drugs will cause neural and facial defects

An infertile couple learns that the female is unable to produce viable eggs. The male partner suggests the use of a surrogate as a means of having a child. The female states, "I don't want your baby with another woman!" The nurse is aware of which psychosocial issue with this couple? A. The male blames the female for the infertility. B. . The female is jealous of the surrogate's fertility. C. The male needs to have a child with his genes. D The female is experiencing self-esteem issues.

D. self esteem issues

The nurse in a prenatal clinic is assessing a patient who is at 37 weeks gestation for twins. The patient reports increased discomfort and increased lower pelvic pressure. Which action does the nurse take with this patient? A. After examination, assures the patient of the absence of contractions B. Explains to the patient that increased discomfort is expected with twins C. Performs a digital cervical examination to determine if dilation is occurring D. Sends the patient to the hospital to be checked for possible signs of labor

D. send then to the hospital to see if they are in labor

A patient at 13 weeks gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother? A. Fetal waste products and CO2 pass through the placenta to the mother. B. The placenta is a special organ developed to create nutrients and oxygen. C. The mother's blood and fetus's blood mix for an exchange of nutrients. D. Glucose, amino acids, and oxygen pass through the placenta from mother to baby.

D. stuff passes through the placenta

A patient is in her first trimester of her second pregnancy. The patient's first child was born with a trisomy 21 defect. The patient is requesting testing to determine whether the current fetus has the same defect. Which initial testing does the nurse expect the HCP to prescribe? 1. Fetal ultrasound 2. Magnetic resonance imaging 3. Chorionic villa sampling 4. Amniocentesis

Fetal ultrasound in the first trimester of pregnancy can be performed for nuchal translucency, which measures the midsagittal plane with the neck of the fetus to assess the amount of fluid behind the neck. An elevated measurement is associated with trisomy 21. This is the initial test the nurse can expect; results may require further diagnostic testing.

A patient with a history of hypertension is giving birth. During delivery, the staff was not able to stabilize the patient's blood pressure. As a result, the patient died shortly after delivery. This is an example of what type of death? Early Direct Late indirect

RATIONALE Types of deaths: Direct → happens during the delivery or postpartum period Indirect → happens from a pre-existing disease or a disease that is developed during gestation but is aggravated by the pregnancy Late → happens after 42 days

A pregnant patient is at the prenatal clinic for a routine visit at 30 weeks gestation. The nurse monitors the patient for indications of physiological demands by the fetus on the patient. Which finding causes the nurse concern? A. Hgb of 9.5 g/dL and Hct. of 30% B. PT of 16.5 seconds C. WBCs of 16,000 mm3 D. . Heart rate up 20 bpm

The patient's hemoglobin and hematocrit are below normal for the patient. This finding causes the nurse concern because the increased demand

A patient has experienced an uneventful pregnancy but begins to have vaginal spotting at 38 weeks gestation. The health care provider (HCP) suspects placenta previa initiated by cervical thinning. Which testing does the nurse expect the HCP to schedule? 1. Doppler flow studies 2. Nonstress testing 3. Magnetic resonance imaging 4. Ultrasonography studies

Ultrasonography studies are appropriate in determining placental placement and possible abnormalities.

The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence? Hypertension Diabetes Alcohol abuse Intraventricular bleeding

alcohol abuse

The nurse is providing care for a 45-year-old patient who has just learned she is in the second trimester of pregnancy. The patient thought she was experiencing manifestations of menopause until she recognized fetal movement. Which diagnostic test does the nurse expect to be prescribed for this patient? 1. Amniocentesis 2. Ultrasonography 3. Daily fetal movement count 4. Chorionic villi sampling

amniocentesis because of her age

A patient who is at 30 weeks gestation is involved in a car crash. The nurse recognizes that which initial testing will be used to assess fetal well-being? 1. Ultrasonography 2. Nonstress testing 3. Contraction stress test 4. Fetal movement counting

b non stress test evaluates fetal wellbeing

A patient in the second trimester of pregnancy becomes upset when the health care provider (HCP) schedules several screening tests. The patient voices concern that something is wrong with her baby. Which statement by the nurse will reduce the patient's anxiety? 1. "Multiple screening tests are ordered for every pregnancy." 2. "It is better to identify problems before birth than afterward." 3. "Screening tests are primarily to identify those without disease or abnormality." 4. "Diagnostic testing is a reason for worry because they indicate fetal problems."

c

Premature rupture of membranes is defined as rupture of the ____________________ membranes before the onset of labor but at term.

chorioamniotic

The nurse is educating the pregnant patient with a body mass index (BMI) of 33. The nurse knows that teaching has been effective when the patient states which of the following? 1. "My child may be at increased risk for birth injury." 2. "My child may have a decreased risk of developing childhood diabetes." 3. "I will probably give birth vaginally." 4. "I have a lower risk of developing gestational hypertension."

my child may be at increased risk for birth injury RATIONALE: More likely to have cessarean, baby can get diabetes, baby may have injuries

The more prepared a pregnant woman feels for the birth of her baby will lower her anxiety and fear. The behavior is referred to as ____________________.

nesting behavior

A patient in the second trimester of pregnancy is scheduled for a Doppler flow study because the health care provider (HCP) is concerned about an assessment finding during a routine prenatal visit. Which finding of concern does the nurse suspect? 1. Fetal movement count is less than 8 per hour. 2. Patient shows no weight gain in 2 weeks. 3. Patient exhibits mild lower extremity edema. 4. Fetal growth is below expectation for gestational age.

no weight gain

When a patient is diagnosed with preeclampsia, one sign that the fetus is at risk for hypoxia is a change in amniotic fluid called ____________________.

oligiohydramnios