OB Prep U Ch 11 questions

Hormone levels of a woman indicate that the corpus luteum stopped functioning and releasing progesterone after 5 weeks. The nurse would recognize that which scenario is the expected outcome?

A spontaneous abortion (miscarriage) would occur

A 17-year-old client arrives for an annual examination and reports no changes since the last exam; however, the nurse assesses a postive Chadwick sign, slightly enlarged uterus, and subsequent positive urine pregnancy test. Which task should the nurse prioritize to assist this client who is denying any possibility that she is pregnant?

Accepting the pregnancy

The nurse is assessing a pregnant client at her 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are?

Montgomery tubercles; secrete lubricant for the nipples

The nurse is presenting a nutritional plan to a primigravida client who is questioning the addition of iodized salt to her diet. Which explanation should the nurse prioritize in answering this client?

Thyroid activity, which depends on iodine intake, increases during pregnancy

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

Visualization of the gestational sac or fetus

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

bruising

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to:

detect fetal heart sounds with a Doppler

What is a positive sign of pregnancy?

fetal movement felt by examiner

A pregnant client is concerned because she has noticed that she is developing brown blotches on her forehead and nose. The nurse realizes that the client understood the teaching about this problem when the client makes which statement?

"These spots are from hyperpigmentation caused by the pregnancy and may be permanent."

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

"This discharge is normal during pregnancy."

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

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

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

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

What physical changes take place when a woman becomes pregnant? Select all that apply.

- Heart rate increases 10 to 15 beats per minute. - The areola becomes more prominent. - Nasal congestion increases due to edema.

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

1 lb (.45 kg)

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

24

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

Blood pressure decreases

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

Chadwick's sign

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

Chloasma (melasma)

A pregnant client is concerned she may develop preeclampsia, so she has stopped adding any salt to her food and is now questioning the nurse about avoiding prepared foods. The nurse should point out some salt is very beneficial and can help prevent which negative outcome for her baby?

Congenital hypothyroidism

A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy?

FSH and LH

A client arrives to the clinic very excited and reporting a postive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy?

Fetal movement felt by examiner

The nurse is appraising the laboratory results of a pregnant client who is in her second trimester and notes the following: TSH slightly elevated, glucose in the urine, complete blood count low normal, and normal electrolytes. The nurse prioritizes further testing to rule out which condition?

Gestational diabetes

A 28-year-old client states she did not have her menses for the past 3 months and suspects she is pregnant. Which should the nurse do next?

Have the client take a pregnancy test.

A woman comes to the prenatal clinic and undergoes a pelvic exam. The doctor notes a softening of the uterine isthmus. The nurse recognized that this finding is known as what sign?

Hegar sign

A student nurse is preparing for a presentation which will illustrate the various physiologic changes in the woman's body during pregnancy. Which cardiovascular changes up through the 26th week should the student point out?

Increased pulse rate and decreased blood pressure

A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next?

Inform the client this is a normal response to pregnancy that many women experience

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

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

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy?

Positive home pregnancy test

During a routine antepartal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse do next?

Tell the woman that this is entirely normal.

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

The cervix softens.

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

couvade syndrome

The nursing instructor is teaching a class on the nutritional needs of the pregnant client. The instructor determines the session is successful when the students correctly choose which supplement as being known to prevent up to 70% of CNS birth defects?

folic acid

A nurse who has been caring for a pregnant client understands that the client has pica and has been regularly consuming soil. For which condition should the nurse monitor the client?

iron-deficiency anemia

The nurse is explaining the latest laboratory results to a pregnant client who is in her third trimester. After letting the client know she is anemic, which heme iron-rich foods should the nurse encourage her to add to her diet?

meats

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

relaxin

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

visualization of the fetus by ultrasound

A woman in a prenatal clinic tells the nurse that her pregnancy was unplanned and unwanted. At what point in pregnancy does the average woman change her mind about an unwanted pregnancy?

when quickening occurs

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

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

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

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

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply.

- breast changes - amenorrhea - morning sickness

A pregnant client arrives at the maternity clinic reporting constipation. Which factors could be the cause of constipation during pregnancy? Select all that apply.

- decreased activity level - use of iron supplements - intestinal displacement

The nurse is counseling a young woman who has just entered her second trimester, after an uneventful first trimester. She tells the nurse, "It still doesn't seem real. It's just hard to believe that I will really have a baby." Which future events should the nurse point out that will help the young woman come to believe it is real? Select all that apply.

- feeling the baby kick - seeing an ultrasound image of the baby

A client who is in her sixth week of gestation is being seen for a routine prenatal care visit. The client asks the nurse about changes in her eating habits that she should make during her pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that she has to monitor the client for which risks arising from her vegetarian diet? Select all that apply.

-decreased mineral absorption -low gestational weight gain -iron-deficiency anemia

A woman comes to the clinic for her first prenatal checkup. The woman has a body mass index (BMI) of 22. The nurse would anticipate that this client should gain approximately how much weight during her pregnancy?

25 to 35 lbs (11 to 16 kg)

Which would be a normal finding by the nurse during a physical exam of a woman in her third trimester?

Dyspnea

A pregnant woman's husband does not voice concerns at prenatal visits. Which observation would lead the nurse to suspect that the husband is emotionally involved in the pregnancy?

He walks around furniture as if his abdomen is enlarged

A new mother voices concerns about breast-feeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are:

prolactin and oxytocin.

A pregnant client comes to the prenatal clinic complaining of urinary frequency and lower back pain on the right, stating that this has never happened before. An exam validates the diagnosis of pyelonephritis. What factors would contribute to this condition?

Decreased peristalsis of urinary tract

At her 16-week checkup, a client's blood pressure is slightly decreased from her prepregnancy level. The nurse evaluates this change based on which statements concerning blood pressure during pregnancy?

A decrease in the second trimester may occur because of placental growth

Place the following events in the sequence the pregnant woman would experience them, from first to last. All options must be used.

1. amennorhea 2. uterine enlargement 3. quickening 4. Braxton Hicks contractions 5. labor

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:

85 beats per minute.

A pregnant client in her third trimester, lying supine on the examination table, suddently grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize?

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

Which information provided by a client would be considered a presumptive sign of pregnancy?

Breast tenderness

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

Fundal height has dropped since the last recording.

A client at 24 weeks' gestation is seen for a routine monthly check up. She reports concerns to the nurse about rest periods. She states that when she awakens she feels weak and lightheaded. What is the most appropriate initial action by the nurse?

Inquire about the client's sleeping positions.

A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition?

Place the client in the left lateral position.

A woman is 10 weeks pregnant and tells the nurse that this pregnancy was unplanned and she has no real family support. The nurse's most therapeutic response would be to:

encourage her to identify someone that she can talk to and share the pregnancy experience

What is the major concern for a lactose intolerant woman who is pregnant?

Calcium deficiency

The nursing student is preparing a pamphlet which will illustrate the various hormones involved with a pregnancy. Which hormone should the nurse indicate is responsible for the let-down of breast milk in this pamphlet?

Oxytocin

A client in her third trimester reports sleeping poorly: sleeping on her back results in lightheadedness and dizziness and lying on her side results in no sleep. Which suggestion for sleeping should the nurse prioritize for this client?

With a pillow under her right hip

A 24-week pregnant client calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding?

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

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

1,500 mL

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her?

Arrange for prenatal care if the test is positive.

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

Ask the woman if she is having any itching or irritation

A client in her second trimester of pregnancy reports discomfort during sexual activity. Which instruction should a nurse provide?

Modify sexual positions to increase comfort.

The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns?

Pregnant women often experience mood swings and self-centeredness but this is normal

The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse?

The intestines are displaced by the growing fetus.

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

oxytocin

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response?

physical symptoms similar to the mother