Maternity chapters 10,11,12 PrepU
Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks pregnant. The nurse would expect this woman's heart rate to be approximately: a) 100 beats per minute b) 95 beats per minute c) 90 beats per minute d) 85 beats per minute
85 beats per minute Explanation: During pregnancy, heart rate increases by 10 to 15 beats per minute between 14 and 20 weeks of gestation, and this elevation persists to term. Therefore, a prepregnancy heart rate of 72 would increase by 10 to 15 beats per minute to a rate of 82 to 87 beats per minute.
Amanda's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is Amanda experiencing? a) Positive b) No classification c) Presumptive d) Probable
resumptive Correct Explanation: The most common presumptive sign of pregnancy is a missed menstrual period, or amenorrhea. Other presumptive signs include nausea, fatigue, swollen, tender breasts, and frequent urination. (
Early in pregnancy, frequent urination results mainly from which of the following? a) Addition of fetal urine to maternal urine b) Increased concentration of urine c) Pressure on the bladder from the uterus d) Decreased glomerular selectivity
ssure on the bladder from the uterus Explanation: Early in pregnancy, the expanding uterus presses on the bladder. Later, it rises above the bladder so pressure is relieved.
A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify which of the following as normal? Select all that apply. a) One ligament b) Two ligaments c) One vein d) Two veins e) One artery f) Two arteries
• One vein • Two arteries Correct
While providing an education to a prenatal class for first time mothers and fathers during the first trimester, you include information that the father may experience which of the following as normal during the pregnancy: a) Physical symptoms similar to the mother b) No changes, only the mother has changes during pregnancy c) Desire to be the women and give birth d) Feeling distanced from the mother
A
The blood tests for a primigravida client indicate that the client is Rh-negative and her partner is Rh-positive. What is an appropriate nursing intervention for this client? a) Arrange for Rho immune globulin at 28 weeks' gestation b) Make necessary arrangements for blood transfusion c) Prepare the client for the possibility of a spontaneous abortion d) Inform the client about the possibility of a cesarean section
A) Arrange for Rho immune globulin at 28 weeks' gestation Explanation: The nurse should inform the client that Rh-negative mothers should receive Rho immune globulin at 28 weeks' gestation and with antepartum testing to prevent isoimmunization. Positive antibody screens need to be followed up to identify antibodies detected in the blood to prevent fetal complications. The nurse need not make arrangements for blood transfusions, inform the client about the possibility of a cesarean section, or prepare the client for the possibility of a spontaneous abortion.
Which of the following is a positive sign of pregnancy? a) Fetal movement felt by examiner b) Hegar's sign c) Uterine contractions d) Positive pregnancy tes
A) Fetal movement felt by examiner Correct Explanation: The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test may come back as a false positive. Hegar's sign is a softening of the uterine isthmus. Uterine contractions may occur at any time. (less)
A baby is born with what the physician believes is a diagnosis of trisomy 21. This means that the infant has three number 21 chromosomes. What factor describes this genetic change? a) The patient has a nondisjunction occurring during meiosis b) During meiosis, a reduction of chromosomes resulted in 23 c) The patient will have a single X chromosome and infertility d) The mother also has genetic mutation of chromosome 21
A) The patient has a nondisjunction occurring during meiosis During meiosis, a pair of chromosomes may fail to separate completely, creating a sperm or oocyte that contains either two copies or no copy of a particular chromosome. This sporadic event, called nondisjunction, can lead to trisomy. Down syndrome is an example of trisomy. The mother does not have a mutation of chromosome 21, which is indicated in the question. Also, Trisomy does not produce a single X chromosome and infertility. Genes are packaged and arranged in a linear order within chromosomes, which are located in the cell nucleus. In humans, 46 chromosomes occur in pairs in all body cells except oocytes and sperm, which contain only 23 chromosomes
A 24-year-old pregnant woman complains of excessive vaginal discharge. The discharge is not associated with a strong odor, itching, or irritation but she finds it messy and unpleasant. What do you advise her to do? a) Use sanitary pads b) Douche and wash frequently with mild soap and warm, not hot, water c) See her primary care provider to be tested for STIs d) Decrease her fluid intake
A) Use sanitary pads Vaginal discharge increases during pregnancy and is a concern for many women. Encourage the patient to keep clean and wear sanitary pads as needed. Douching may be dangerous for the mother. STI's are not indicated simply by discharge. Pregnant women should not decrease fluid intake. (
A friend tells you that she is going to use a home pregnancy test to determine whether she is pregnant. Which of the following precautions would you give her? a) Refrain from eating for 4 hours before testing. b) Arrange for prenatal care if the test is positive. c) Wait until after two missed menstrual periods. d) Use a diluted urine specimen
Arrange for prenatal care if the test is positive. Correct Explanation: Home pregnancy testing can be accurate as soon as a period is missed; it should not take the place of prenatal care. (l
A woman in the second trimester of pregnancy reports that she is "tired all the time." She appears pale and her hematocrit, though within the normal range, is low. Which recommendation would be most helpful for this woman? a) More meat in her diet b) An iron supplement c) More seafood and organ meats in her diet d) A calcium supplement
B) An iron supplement Iron is necessary for the formation of hemoglobin; therefore it is essential to the oxygen-carrying capacity of the blood. Women who have normal hematocrit may need increased iron to carry more oxygen. Calcium supplementation is essential for normal fetal development. Meat and seafood are not specifically needed.
Nondisjunction of a chromosome results in which of the following diagnoses? a) Huntingon disease b) Down syndrome c) Duchenne muscular dystrophy d) Marfan syndrome
B) Down syndrome When a pair of chromosomes fails to separate completely (nondisjunction) the resulting sperm or oocyte contains two copies of a particular chromosome. Nondisjunction can result in a fertilized egg having trisomy 21 or Down syndrome. Huntington disease is one example of a germ-line mutation. Duchenne muscular dystrophy, an inherited form of muscular dystrophy, is an example of a genetic disease caused by structural gene mutations. Marfan syndrome is a genetic condition that may occur in a single family member as a result of spontaneous mutation. (less)
A woman calls the clinic to schedule an appointment because "I think I might be pregnant." Upon further assessment gathering of information from the woman, which of the following would be a probable sign of pregnancy? a) Fatigue b) Positive home pregnancy test c) Nausea and vomiting d) Amenorrhea
B) Positive home pregnancy test A positive home pregnancy test is confirmed by hCG in the urine. This is considered a probable sign of pregnancy. Fatigue, amenorrhea, and vomiting can all have other causes. (
Which of the following is a genetic condition caused by a small gene mutation that affects protein structure, producing hemoglobin S? a) Tay-Sachs disease b) Sickle cell anemia c) Hemophilia d) Marfan syndrome
B) Sickle cell anemia Correct Explanation: Sickle cell anemia is an example of a genetic condition caused by a small gene mutation that affects protein structure, producing hemoglobin S. Marfan syndrome is an autosomal dominant inherited condition. Hemophilia is an X-linked recessiv
hen describing the characteristics of the amniotic fluid to a pregnant woman, which would the nurse include? a) It is composed primarily of organic substances. b) The amount gradually fluctuates during pregnancy. c) It limits fetal movement in utero. d) It is usually an acidic fluid
B) The amount gradually fluctuates during pregnancy. Amniotic fluid is alkaline. Amniotic fluid is composed of 98% water and 2% organic matter. Amniotic fluid volume gradually fluctuates throughout pregnancy. Sufficient amounts promote fetal movement to enhance musculoskeletal development.
Amanda is about 16 weeks pregnant and is concerned because she feels her "abdomen" contracting. She calls the doctors office and speaks to the nurse. What is the most appropriate response to Amanda's concern? a) "You need to come to the office to be examined." b) "What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy." c) "You have nothing to be concerned about. I am sure you are not feeling contractions at this point in your pregnancy." d) "You need to go to the emergency room right away."
B) What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy." Explanation: Braxton Hicks contractions are the painless, intermittent, "practice" contractions of pregnancy.
As a pregnant woman lies on the examining table, she grows very short of breath and dizzy. This phenomenon probably happens because a) Blood is trapped in the vena cava in a supine position b) The uterus requires more blood in a supine position c) Sympathetic nerve responses cause dyspnea when a woman lies supine d) Her cerebral arteries are growing congested with blood
Blood is trapped in the vena cava in a supine position Correct Explanation: Supine hypotension syndrome, or an interference with blood return to the heart, occurs when the weight of the fetus rests on the vena cava. Cerebral arteries should not be affected. Mean arterial pressure is high enough to maintain perfusion of the uterus in any orientation. The sympathetic nervous system will not be affected by the supine position.
After teaching a class on the various structures formed by the embryonic membranes, the nurse determines that the teaching was successful when the class identifies which structure as being formed by the mesoderm? a) Ears b) Stomach c) Bones d) Lung
C) Bones Explanation: The endoderm forms the structures of the respiratory system. The mesoderm forms the structures of the skeletal system. The ectoderm forms the structures of the special senses. The endoderm forms the structures of the digestive system
A pregnant woman enjoys exercising at a local health spa once a week. Which of the following comments would lead you to believe she needs additional health teaching? a) "I limit exercising to low-impact aerobics." b) "I'm learning to play table tennis." c) "Nothing feels nicer than a hot sauna after exercise." d) "The gym gets hot and stuffy by midmorning."
C) Nothing feels nicer than a hot sauna after exercise." Correct Explanation: Hyperthermia may be associated with fetal anomalies and should be avoided during pregnancy. Exercise should be limited to low-impact activities.
After teaching a class about autosomal dominant and recessive inheritance patterns, the nurse determines that the class needs additional teaching when they identify which condition as an example of an autosomal dominant disorder? a) Huntington disease b) Neurofibromatosis c) Tay-Sachs disease d) Achondroplasia
C) Tay-Sachs disease Explanation: Neurofibromatosis is an example of an autosomal dominant disorder. Achondroplasia is an example of an autosomal dominant disorder. Huntington disease is an example of an autosomal dominant disorder. Tay-Sachs disease is an example of an autosomal recessive disorder
A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which of the following information should the nurse offer? a) "You will experience quickening, and you will actually feel the baby." b) "You will be more conscious of the changes taking place in your body now." c) "You may feel physical discomfort as the baby inside grows." d) "You may have mood swings that could overwhelm your partner."
Correct response: "You will experience quickening, and you will actually feel the baby." Explanation: The nurse should inform the client that quickening occurs in the second trimester. The client will be able to physically feel the fetal movements, which will help her bond with her developing fetus. Physical discomfort actually starts to increase in the third trimester as the fetus grows rapidly. The client feels conscious of the changes taking place in her body due to her pregnancy primarily in the first trimester, not the second. The client is likely to have mood swings in the first trimester of the pregnancy, which can be very overwhelming for the client as well as her partner.
The nurse explains to a pregnant client, who is anemic, that she will need to take vitamins with iron during her pregnancy. What are food would you include on the patient's diet plan? a) Grains b) Meats c) Legumes d) Dairy
Correct response: Meats Explanation: Grains are a source of iron but not as good a source as the heme iron of meats. The other choices should be avoided when taking the iron and vitamin supplement as milk and legumes decrease the absorption of iron.
During the development of the fetus, its chorionic villi eventually meet with an area of uterine tissue to form the placenta. Which of the following statements accurately describes a function of the placenta? Select all answers that apply. a) It permits blood to bypass the right ventricle. b) It carries waste away for excretion by the mother. c) It protects the umbilical cord. d) It slows the maternal immune response. e) It produces hormones that help maintain the pregnancy. f) It cushions the fetus against injury.
Correct response: • It slows the maternal immune response. • It produces hormones that help maintain the pregnancy. • It carries waste away for excretion by the mother. Explanation: The placenta supplies the developing organism with food and oxygen, carries waste away for excretion by the mother, slows the maternal immune response so that the mother's body does not reject the fetal tissues, and produces hormones that help maintain the pregnancy. Wharton's jelly protects the umbilical cord and the foramen ovale permits most of the blood to bypass the right ventricle. The amniotic fluid cushions the fetus against injury.
The incidence of Down syndrome is 1:1600 in women older than 40 years of age, compared with 1:100 in women younger than 20 years. a) True b) Fals
False Explanation: The incidence of Down syndrome is 1:100 in women older than 40 years of age, compared with 1:1600 in women younger than 20 years
You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a probable sign of pregnancy? a) Amenorrhea b) Nausea and vomiting c) Fatigue d) A positive pregnancy test
D) A positive pregnancy test Correct Explanation: Most probable signs of pregnancy are objective signs; laboratory testing is probable, not positive, because error can occur.
You meet a family at the prenatal clinic. What is the most effective way to assess the woman's usual food intake during her pregnancy? a) Ask her to describe her total intake for a week. b) Assess her skin for hydration and color. c) Assess a list she makes describing a good diet. d) Ask her to describe her intake for the last 24 hours
D) Ask her to describe her intake for the last 24 hours. Correct Explanation: A 24-hour food intake history is the best method to assess food intake in all individuals.
A woman presents to the clinic in the first trimester of pregnancy. She has three children living at home. One of them was born prematurely at 34 weeks. The other two were full-term at birth. She has a history of one miscarriage. How do you record her obstetric history on the chart using the GTPAL format? a) G4 T3 P0 A1 L3 b) G3 T2 P1 A1 L3 c) G4 T2 P1 A1 L3 d) G5 T2 P1 A1 L3
D) G5 T2 P1 A1 L3 Correct Explanation: One of the most common methods of recording the obstetric history is to use the acronym GTPAL. "G" stands for gravida, the total number of pregnancies. "T" stands for term, the number of pregnancies that ended at term (at or beyond 38 weeks' gestation); "P" is for pre-term, the number of pregnancies that ended after 20 weeks and before the end of 37 weeks' gestation. "A" represents abortions, the number of pregnancies that ended before 20 weeks' gestation. "L" is for living, the number of children delivered who are alive at the time of history collection. (le
Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy? a) Premature ventricular contractions b) S4 (atrial gallop) c) Split S1S2 d) Soft systolic murmur
D) Soft systolic murmur Explanation: A soft systolic murmur is common in pregnancy secondary to the increased blood volume. The other findings are not normal and require further assessment by the nurse.
At 40 weeks gestation, a woman in for her prenatal visits states to the nurse "I am tired of being pregnant". What is the appropriate response by the nurse? a) "Most woman would have asked to be induced by this point, is that what you want?" b) "Do you need to speak with someone about your feelings?" c) "Are you getting enough rest? If you don't take time for rest, that is why you might be tired." d) "That is a very normal feeling, especially at this point in pregnancy."
D) That is a very normal feeling, especially at this point in pregnancy." Correct Explanation: During the third trimester, the patient is preparing for parenthood and is often tired and ready for a break. The woman may feel large and unable to do any normal activities and be ready to have her baby in her arms rather than in her uterus. This is not an abnormal statement and the provider should not overreact. Deciding to induce is something that should be done in consultation with the physician, and only when it failing to do so would have a negative impact on the mother or baby. (le
A patient who has just given a blood sample for pregnancy testing in the doctor's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. Which of the following should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy? a) Laboratory test of a blood serum specimen for hCG b) Absence of a period c) Laboratory test of a urine specimen for hCG d) Visualization of the fetus by ultrasound
D) Visualization of the fetus by ultrasound Explanation: There are only three documented or positive signs of pregnancy: 1) demonstration of a fetal heart separate from the mother's, 2) fetal movements felt by an examiner, and 3) visualization of the fetus by ultrasound. The absence of a period is an example of a presumptive symptom, which is a symptom that, when taken as a single entity, could easily indicate other conditions. Laboratory tests of either urine or blood serum for human chorionic gonadotropin (hCG) are examples of probable signs of pregnancy, which are objective and so can be verified by an examiner.
A pregnant woman is experiencing morning sickness. Which of the following responses indicates a need for further teaching? a) "I'll take antacid between meals." b) "I'll avoid an empty stomach." c) "I'll eat frequent small servings of bland foods." d) "I'll snack on unsalted cracker."
I'll take antacid between meals." Correct Explanation: The patient should avoid use of medications unless prescribed by the provider. Avoiding an empty stomach, snacking on a cracker, or eating small servings of bland food are better options and may manage the morning sickness.
A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. The nurse should mention which of the following as the primary function of progesterone?
Maintains the endometrial lining of the uterus during pregnancy Correct Explanation: Progesterone is necessary to maintain the endometrial lining of the uterus during pregnancy. It is human chorionic gonadotropin (hCG) that acts to ensure the corpus luteum of the ovary continues to produce estrogen and progesterone. Estrogen contributes to mammary gland development, and human placental lactogen regulates maternal glucose, protein, and fat levels. (less)
During her 12 week prenatal check-up, the patient informs you on interview she has developed bumps on the dark part of her nipples. She wants to know what these bumps are. What is the appropriate answer? a) Montgomery's tubercles, secrete lubricant for the nipples b) Might be sign of cancer, need to speak with provider c) Striae, stretching of the breast tissue d) Normal bumps of pregnancy, they do nothin
Montgomery's tubercles, secrete lubricant for the nipples Correct Explanation: All woman have Montgomery's tubercles, they become more prominent during pregnancy and help to prepare the nipples for breastfeeding. The bumps are not specific to pregnancy, and are not a sign of cancer. They are not the result of stretching.
The hormone responsible for the initiation of lactation is what? a) Oxytocin b) Prolactin c) Estrogen d) Progesterone
Prolactin Correct Explanation: Prolactin is the hormone responsible for the initiation of lactation, the production of breastmilk. Oxytocin is responsible for the let down of milk and contraction, estrogen and progesterone are responsible for uterine and pregnancy maintenance
The placenta is the site where antibodies in the mother's blood pass into the fetal circulation. These antibodies give passive immunity to the fetus for several common childhood diseases. There are some infections for which the mother does not provide antibodies to the fetus. What infection is the fetus not protected from?
Rubella Explanation: The fetus does not receive immunity to rubella, cytomegalovirus (CMV), varicella, or measles. If the woman encounters these pathogens during her pregnancy, fetal infection may ensue
During an examination, a client who's 32 weeks pregnant becomes dizzy, lightheaded, and pale while supine. What should the nurse do first? a) Listen to fetal heart tones. b) Turn the client on her left side. c) Take the client's blood pressure. d) Ask the client to breathe deeply
Turn the client on her left side. Correct Explanation: As the enlarging uterus increases pressure on the inferior vena cava, it compromises venous return, which can cause dizziness, light-headedness, and pallor when the client is supine. The nurse can relieve these symptoms by turning the client on her left side, which relieves pressure on the vena cava and restores venous return. Although they're valuable assessments, fetal heart tone and maternal blood pressure measurements don't correct the problem. Because deep breathing has no effect on venous return, it can't relieve the client's symptoms
ome women contract with other women to provide support during pregnancy and delivery, to provide emotional support during labor and delivery, and to aid in establishing breastfeeding. What is the name of the woman who is contracted? a) Doula b) Pregnancy aide c) Partera d) Midwif
a )Doula Explanation: The woman may contract with a doula to provide support for labor and birth and help with establishing breastfeeding. A doula can also provide support for the postpartum period.
nurse is counseling a couple who have a 5-year-old daughter with Down syndrome. The nurse recognizes that their daughter's genome is represented by which of the following? a) 47XX21+ b) 46XX c) 47XY21+ d) 46XX5p-
a) 47XX21+ In Down syndrome, the person has an extra chromosome 21, so this is abbreviated as 47XX21+ (for a female) or 47XY21+ (for a male). 46XX is a normal genome for a female. The abbreviation 46XX5p- is the abbreviation for a female with 46 total chromosomes but with the short arm of chromosome 5 missing (Cri-du-chat syndrome).
During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which of the following would the nurse identify as an abnormal finding? a) Bruising b) Striae c) Darkening of the umbilicus d) Linea nigra
a) Bruising Explanation: Bruising would not be a normal finding. Evidence of bruising might suggest domestic violence. Linea nigra, striae, and
While assessing a client's breast during the third trimester, which of the following would the nurse expect to find? a) Colostrum from the nipples b) Breasts becoming soft c) Pain in the nipple area d) Pink colored nipples
a) Colostrum from the nipples During the third trimester, the nipples express colostrum. Areolae and nipples appear enlarged with darker pigmentation during the third trimester. The nurse assesses for the softness of the breast, color, and pain in the nipple area in nursing mothers.
Which of the following is a positive sign of pregnancy? a) Fetal movement felt by examiner b) Uterine contractions c) Positive pregnancy test d) Hegar's sign
a) Fetal movement felt by examiner Correct Explanation: The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. (less)
The nurse teaches a pregnant woman about breastfeeding, stating that stimulation of the breast through sucking or touching stimulates the secretion of which hormone? a) Oxytocin b) Follicle stimulating hormone c) Cortisol d) Antidiuretic hormone
a) Oxytocin Explanation: Oxytocin is responsible for milk ejection during breastfeeding. Its secretion is stimulated by stimulation of the breasts via sucking or touching. Secretion of follicle-stimulating hormone is inhibited during pregnancy. The secretion of antidiuretic hormone has no effect on breastfeeding. Cortisol secretion regulates carbohydrate and protein metabolism and is helpful in times of stress.
The fetus receives blood flow from the mother via the placenta and umbilical cord. What is the route of fetal circulation through the umbilical cord? a) The one umbilical vein carries oxygen rich blood to the fetus from the placenta b) The two umbilical arteries carry waste products from the placenta to the fetus c) The two umbilical veins carry waste products from the fetus to the placenta d) The one umbilical artery carries oxygen rich blood to the fetus from the placenta
a) The one umbilical vein carries oxygen rich blood to the fetus from the placenta here are two umbilical arteries and one umbilical vein. The arteries carry waste from the fetus to the placenta; the vein carries oxygenated blood to the fetus from the placenta. (less)
A baby is born with what the physician believes is a diagnosis of trisomy 21. This means that the infant has three number 21 chromosomes. What factor describes this genetic change? a) The patient has a nondisjunction occurring during meiosis b) The patient will have a single X chromosome and infertility c) The mother also has genetic mutation of chromosome 21 d) During meiosis, a reduction of chromosomes resulted in 23
a) The patient has a nondisjunction occurring during meiosis During meiosis, a pair of chromosomes may fail to separate completely, creating a sperm or oocyte that contains either two copies or no copy of a particular chromosome. This sporadic event, called nondisjunction, can lead to trisomy. Down syndrome is an example of trisomy. The mother does not have a mutation of chromosome 21, which is indicated in the question. Also, Trisomy does not produce a single X chromosome and infertility. Genes are packaged and arranged in a linear order within chromosomes, which are located in the cell nucleus. In humans, 46 chromosomes occur in pairs in all body cells except oocytes and sperm, which contain only 23 chromosomes
Implantation generally occurs at which place on the uterus? a) The upper posterior surface b) Directly over an opening to a fallopian tube c) The lower anterior surface d) Directly over the cervical os
a) The upper posterior surface mplantation occurs most commonly on the upper posterior surface of the uterus. This position allows the fetus to deliver before the placenta.
Smoking may be a cause of ectopic (tubal) pregnancy. a) True b) False
a) True
An 18-year-old pregnant woman asks why she has to have a routine alpha-fetoprotein serum level drawn. You explain that this a) may reveal chromosomal abnormalities. b) is a screening test for placental function. c) measures the fetal liver function. d) tests the ability of her heart to accommodate the pregnancy.
a) may reveal chromosomal abnormalities. An alpha-fetoprotein analysis is a cost-effective screening test to detect chromosomal and open-body-cavity disorders
mplantation generally occurs at which place on the uterus? a) The lower anterior surface b) The upper posterior surface c) Directly over the cervical os d) Directly over an opening to a fallopian tube
b )The upper posterior surface Explanation: Implantation occurs most commonly on the upper posterior surface of the uterus. This position allows the fetus to deliver before the placenta.
A woman is to undergo chorionic villus sampling as part of a risk assessment for genetic disorders. Which of the following would the nurse include when describing this test to the woman? a) "An intravaginal ultrasound measures fluid in the space between the skin and spine." b) "A small amount of amniotic fluid will be withdrawn and collected for analysis." c) "A small piece of tissue from the fetal placenta will be removed and analyzed." d) "A needle will be inserted directly into your fetus's umbilical vessel to collect blood for testing."
b) "A small amount of amniotic fluid will be withdrawn and collected for analysis." Percutaneous umbilical cord sampling involves the insertion of a needle into the umbilical vessel. An amniocentesis involves the collection of amniotic fluid from the amniotic sac. Fetal nuchal translucency involves the use of intravaginal ultrasound to measure fluid collected in the subcutaneous space between the skin and cervical spine of the fetus. Chorionic villus sampling involves the removal of a small tissue specimen from the fetal portion of the placenta.
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? a) Chadwick's sign b) Chloasma c) Ballotment d) Linea rubria
b) Chloasma Explanation: The so-called mask of pregnancy, chloasma can appear as brown blotchy areas on the forehead, cheeks, and nose of the pregnant woman. This condition may be permanent, or it may regress between pregnancies.
For which of the following clients is preimplantation genetic diagnosis (PGD) a viable option? a) Prevention of DiGeorge syndrome b) Clients carrying cystic fibrosis gene c) Client in the second week of pregnancy d) Prevention of Pyloric stenosis
b) Clients carrying cystic fibrosis gene Preimplantation genetic diagnosis (PGD) is a viable option for clients carrying the cystic fibrosis gene.
A client who is 37 years of age presents to the health care clinic for her first prenatal check up. Due to her advanced age, the nurse should prepare to talk with the client about her increased risk for what complication? a) Gestational diabetes b) Genetic disorders c) Incompetent cervix d) Preterm labor
b) Genetic disorders Women over the age of 35 are at increased risk of having a fetus with an abnormal karyotype or other genetic disorders. Gestational diabetes, an incompetent cervix, and preterm labor are risks for any pregnant woman. (less)
A nurse is preparing a patient for rhythm strip testing. She places the woman into a semi-Fowler's position. What is the appropriate rationale for this measure? a) To aid the woman as she pushes during labor b) To prevent supine hypotension syndrome c) To decrease the heart rate of the fetus d) To prevent the woman from falling out of bed
b) To prevent supine hypotension syndrome The term "rhythm strip testing" means assessment of the fetal heart rate for whether a good baseline rate and long- and short-term variability are present. For this, help a woman into a semi-Fowler's position (either in a comfortable lounge chair or on an examining table or bed with an elevated backrest) to prevent her uterus from compressing the vena cava and causing supine hypotension syndrome during the test. Placing her in this position does not decrease the heart rate of the fetus. It is not done to aid the woman as she pushes in labor, as she is not in labor yet. It is not done to prevent her from falling out of bed. (less)
A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week? a) 1.5 lb b) 2/3 lb c) 1 lb d) 2 lb
c ) 1 lb Correct Explanation: The recommended weight gain pattern for a woman whose prepregnant weight is within the normal range would be 1 lb per week during the second and third trimesters. Underweight women should gain slightly more than 1 lb per week. Overweight women should gain about 2/3 lb per week.
Two parents with two recessive genes each for six toes have what chance they will have a child with six toes? a) 50% b) 75% c) 25% d) 100%
c) 25% When two carrier parents have children together, they have a 25% chance of having a child who inherits the gene mutation from each parent and who will have the condition. The other answers are incorrect because these parents chance of having a child with six toes are not 50%, 75%, or 100%
A woman in her third trimester has just learned that her fetus has been diagnosed with cri-du-chat syndrome. The nurse recognizes that this child will likely have which of the following characteristics? a) Rounded soles of the feet (rocker-bottom) b) Cleft lip and palate c) An abnormal, cat-like cry d) Small and nonfunctional ovaries
c) An abnormal, cat-like cry Cri-du-chat syndrome is the result of a missing portion of chromosome 5. In addition to an abnormal cry, which sounds much more like the sound of a cat than a human infant's cry, children with cri-du-chat syndrome tend to have a small head, wide-set eyes, a downward slant to the palpebral fissure of the eye, and a recessed mandible. They are severely cognitively challenged. Rounded soles of the feet are characteristic of trisomy 18 syndrome. Cleft lip and palate are characteristic of trisomy 13 syndrome. Small and nonfunctional ovaries are characteristic of Turner syndrome. (less)
A woman who is 4 months pregnant has pyrosis. Which of the following suggestions would you give her? a) Take 30 mL of milk of magnesia after every meal. b) Try to include complex carbohydrates in meals. c) Eat small meals and do not lie down after meals. d) Increase vitamin intake by adding more citrus fruit.
c) Eat small meals and do not lie down after meals. Correct Explanation: Pyrosis, or heartburn, occurs in pregnancy because the uterine pressure against the stomach causes regurgitation into the esophagus. Eating small meals and remaining upright limits the possibility of regurgitation.
When preparing a lecture for a group of students about fetal circulation, which structure would the nurse explain as being primarily responsible for ensuring that highly oxygenated blood reaches the fetal brain? a) Ductus venosus b) Umbilical vein c) Foramen ovale d) Ductus arteriosus
c) Foramen ovale The ductus venosus provides a passageway for oxygenated blood from the umbilical vein to reach the inferior vena cava. The ductus arteriosus is a shunt that receives deoxygenated blood and transports it to the descending aorta. The umbilical vein carries oxygenated blood from the placenta to the fetus. The foramen ovale deflects blood from the vena cava into the left atrium, then left ventricle, into the ascending aorta and into the head and upper body so that the brain receives blood with the highest level of oxygenation. (less)
A couple wants to start a family. They are concerned that their child will be at risk for cystic fibrosis because they each have a cousin with cystic fibrosis. They are seeing a nurse practitioner for preconceptual counseling. What would the nurse practitioner tell them about cystic fibrosis? a) It is an X-linked inherited disorder b) It is passed by mitochondrial inheritance c) It is an autosomal recessive disorder d) It is an autosomal dominant disorder
c) It is an autosomal recessive disorder Cystic fibrosis is autosomal recessive. Nurses also consider other issues when assessing the risk for genetic conditions in couples and families. For example, when obtaining a preconception or prenatal family history, the nurse asks if the prospective parents have common ancestors. This is important to know because people who are related have more genes in common than those who are unrelated, thus increasing their chance for having children with autosomal recessive inherited condition such as cystic fibrosis. Mitochondrial inheritance occurs with defects in energy conversion and affects the nervous system, kidney, muscle, and liver. X-linked inheritance, which has been inherited from a mutant allele of the mother, affects males. Autosomal dominant is an X-linked dominant genetic disease. (less)
When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem? a) Slanting of the palpebral fissure b) Bowed legs c) Low-set ears d) Short neck
c) Low-set ears A number of common chromosomal disorders, such as trisomies, include low-set ears
Which of the following is a genetic condition caused by a small gene mutation that affects protein structure, producing hemoglobin S? a) Tay-Sachs disease b) Hemophilia c) Sickle cell anemia d) Marfan syndrome
c) Sickle cell anemia Sickle cell anemia is an example of a genetic condition caused by a small gene mutation that affects protein structure, producing hemoglobin S. Marfan syndrome is an autosomal dominant inherited condition. Hemophilia is an X-linked recessive inherited condition. Tay-Sachs disease is an autosomal recessive inherited condition. (less)
An African American couple presents for a genetic counseling appointment. They are pregnant and are concerned about their child. What would a patient of African American heritage have genetic carrier testing for? a) Rubella b) Meckel's diverticulum c) Sickle cell anemia d) Asthma
c) Sickle cell anemia ssessing ancestry and ethnicity is important to help identify individuals and groups who could benefit from genetic testing for carrier identification, such as African Americans routinely offered testing for sickle cell anemia. The other answers are incorrect because they are not identified with the African American race. (less)
A woman comes to the clinic and informs the nurse that she missed her first menstrual period and took a positive pregnancy test. What stage of fetal development does the nurse understand is occurring at this time? a) The pre-embryonic phase b) The corpus leuteum phase c) The embryonic phase d) The fetal stag
c) The embryonic phase The embryonic stage lasts from the end of the second week after fertilization until the end of the eighth week. During this stage, the woman misses her first menstrual period, and the developing conceptus becomes an embryo. (less)
A nursing student correctly identifies that a person's outward appearance or expression of genes is referred to as which of the following? a) allele b) genotype c) phenotype d) genome
c) phenotype Alleles are two like genes. Phenotype refers to a person's outward appearance or the expression of genes. Genotype refers to his or her actual gene composition. Genome is the complete set of genes present in a person. (less)
Girls with Turner Syndrome will usually exhibit a) progressive dementia b) painful joints c) short stature d) chorealike movements
c) short stature Girls with Turner syndrome usually have a single X chromosome, causing them to have short stature and infertility
A young woman comes in for her annual exam. She reports missing her last two periods but she is confident that she cannot be pregnant, because she took a home pregnancy test and the result was negative. If all of the following were present, which one would positively confirm a pregnancy? a) Chadwick's sign b) A positive result on EIA c) Changes in the size and shape of the uterus d) A fetal heartbeat
d) A fetal heartbeat Explanation: The only positive sign of pregnancy is a sign or symptom that could only be attributable to the fetus, thus fetal heartbeat can have no other origin. Chadwick's sign is a color change in the cervix, vagina, and perineum. EIA only tests for HCG. A change in the size and shape of the uterus can occur due to other causes.
Which type of genetic test would be used to detect the possibility of Down syndrome? a) Hemoglobin electrophoresis b) DNA analysis c) Complete blood count (CBC) d) Chromosomal analysis
d) Chromosomal analysis Chromosomal analysis is part of the genetic testing for Down syndrome. DNA analysis may be used in the detection of Huntington disease. Hemoglobin electrophoresis may be used in genetic testing for sickle cell anemia. A complete blood count (CBC) may be used as part of testing for a thalassemia.
A nurse is conducting prenatal classes and is reviewing the stages of fetal development. When discussing the pre-embryonic stage, what should the nurse inform the group about when this stage begins and ends? a) It begins approximately 2 weeks after fertilization and ends at the conclusion of the eighth week after fertilization. b) It begins at 9 weeks after fertilization and ends at birth. c) It begins at 6 weeks after fertilization and ends at the 8th week after fertilization. d) It begins at fertilization and lasts through the end of the second week after fertilization.
d) It begins at fertilization and lasts through the end of the second week after fertilization. The pre-embryonic stage begins at fertilization and lasts through the end of the second week after fertilization.
A couple has just learned that their unborn son has a chromosome disorder that results in an extra X chromosome. The physician explains that secondary sex characteristics will not develop in this child at puberty and that his testes will remain small and produce ineffective sperm. The nurse recognizes that this child likely has which of the following conditions? a) Down syndrome b) Fragile X syndrome c) Turner syndrome d) Klinefelter syndrome
d) Klinefelter syndrome Infants with Klinefelter syndrome are males with an extra X chromosome. At puberty, secondary sex characteristics do not develop; the child's testes remain small and produce ineffective sperm. Turner syndrome occurs in females and is characterized by only one functional X chromosome. Fragile X syndrome is an X-linked disorder in which one long arm of an X chromosome is defective, which results in inadequate protein synaptic responses; it results in cognitive challenges in males. Down syndrome (trisomy 21) is characterized by an extra chromosome at chromosome 21. (l
Down syndrome may occur because of a translocation defect. This means the a) parents are such close relatives that their genes are incompatible. b) infant inherits chromosomal material from only one parent. c) parents have a chromosomal pattern that is exactly alike. d) additional chromosome was inherited because it was attached to a normal chromosome.
d) additional chromosome was inherited because it was attached to a normal chromosome.
A patient, 31 years old, at 28 weeks gestation with her second pregnancy is in the clinic for a prenatal check-up. She informs you of frequent low back pain and ankle edema by the end of the day. What interventions should you suggest to relieve these discomforts? a) Rest when possible with feet elevated at or above the heart. b) Sit semi-fowlers with feet below for breaks at work. c) Lie on right side with feet elevated and a heating pad on her back. d) Soak feet every night and perform pelvic rocks.
est when possible with feet elevated at or above the heart. Correct Explanation: Rest in the recumbent position helps alleviate stress on the back and elevating the legs will help relieve the edema. Soaking the feet or lying on the right side will not alleviate the edema. Sitting semi-fowlers is not enough to alleviate the edema. (l
