chapter 4 OB

____ 16. 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. 1. Elevated hCG levels in blood and urine 2. Brownish pigmentation on the face 3. Fetal movement detected by the examiner 4. Bluish-purple coloration of vagina and cervix 5. Occasional mild contractions

1. Elevated hCG levels in blood and urine 2. Brownish pigmentation on the face 4. Bluish-purple coloration of vagina and cervix

____ 10. A patient who is pregnant does not remember the last date of her menstrual period. In which manner does the nurse expect the estimated date of delivery (EDD) to be determined for this patient? 1. Having an ultrasound examination 2. Using the gestational wheel 3. Asking when previous babies were born 4. Obtaining a history of gestational length

1. Having an ultrasound examination

____ 2. 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? 1. Hgb of 9.5 g/dL and Hct. of 30% 2. PT of 16.5 seconds 3. WBCs of 16,000 mm3 4. Heart rate up 20 bpm

1. Hgb of 9.5 g/dL and Hct. of 30%

____ 15. The nurse is providing dietary teaching to a patient in the first trimester of pregnancy who is overweight. Which daily dietary suggestions does the nurse make? Select all that apply. 1. One cup of 100% juice and cup of dried fruit. 2. Three cups of raw leafy and 1 cup cooked vegetables 3. One and a half cups of cooked pasta, rice, or cereal 4. Six ounces of lean meat, 2 eggs, and cup of beans 5. One cup of milk, 1 cup of yogurt, and oz of cheese

1. One cup of 100% juice and cup of dried fruit. 5. One cup of milk, 1 cup of yogurt, and oz of cheese

____ 17. The nurse is preparing a prenatal plan of care for a patient who is in the first trimester of pregnancy. Which long-range goals does the nurse include in the plan of care? Select all that apply. 1. Perform an ongoing assessment of risk status 2. Determine parental outlook on immunizations 3. Build rapport with the childbearing family 4. Make referral to specific resources as needed 5. Implement a risk-appropriate intervention

1. Perform an ongoing assessment of risk status 3. Build rapport with the childbearing family 4. Make referral to specific resources as needed 5. Implement a risk-appropriate intervention

____ 7. The nurse is collecting health information from a patient who is early in the first trimester of pregnancy. Which topic is most important for the nurse to discuss with the patient after learning that the patient works for a commercial cleaning company? 1. Risk related to exposure to environmental toxins 2. Weight limit for lifting during the patient's pregnancy 3. Importance of resting with feet up during the day 4. Reasons for the patient to look for a safer job

1. Risk related to exposure to environmental toxins

____ 3. A patient in the first trimester of pregnancy states, "I don't understand how a term baby can be accommodated by my uterus." Which information by the nurse specifically addresses the patient's comment? 1. The uterus size increases in size 20 times over a nonpregnant uterus. 2. The weight of the uterus increases from 7 g to 1,100 g during pregnancy. 3. About 80% of the increased capacity of the uterus is related to uteroplacental content. 4. About 75% of the increase in uterus size during pregnancy is related to stretching.

1. The uterus size increases in size 20 times over a nonpregnant uterus.

____ 18. 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. 1. Urine testing with a dipstick. 2. Presence of dependent edema. 3. Determine EDD by Naegele's rule. 4. Antibody screening for Rh?2- patient. 5. Check for chromosomal abnormalities.

1. Urine testing with a dipstick. 2. Presence of dependent edema. 4. Antibody screening for Rh?2- patient.

____ 14. 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. 1. Waddling gait 2. Low back pain 3. Increased risk of falls 4. Fractures 5. Severe muscle aches

1. Waddling gait 2. Low back pain 3. Increased risk of falls

____ 1. 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? 1. Signs of infection 2. Breast changes 3. A change in EDD 4. Support bras

2. Breast changes

____ 8. 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? 1. Positive results on a home pregnancy test 2. Breast enlargement, tenderness, and tingling 3. First awareness of fetal movements 4. Increased appetite

2. Breast enlargement, tenderness, and tingling

____ 4. 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? 1. Increased breast enlargement 2. Dizziness when lying supine 3. Dependent edema and varicosities 4. Hyperpigmentation on the face

2. Dizziness when lying supine

____ 11. A patient is confirmed to be pregnant. Obstetric history includes two sets of twins born at 30 and 32 weeks gestation, respectively, a singleton birth born at 39 weeks gestation, and two pregnancies lost in the first trimester. In which way will the nurse define the patient's obstetrical history? 1. G4, T3, P2, A2, L3 2. G6, T1, P4, A2, L5 3. G5, T1, P2, A2, L5 4. G6, T4, P0, A4, L3

2. G6, T1, P4, A2, L5

____ 13. 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? 1. Update on fetus growth and behavioral patterns 2. Management for commonly experienced discomforts 3. General health maintenance and promotion topics 4. Counseling and guidance about diet and exercise

2. Management for commonly experienced discomforts

____ 5. The nurse is counseling a patient who shares the intention to become pregnant. Which finding during the collection of health information will the nurse feel the least concern to address? 1. The patient smokes a pack of cigarettes a week. 2. The patient lives in a recently renovated house. 3. The patient travels outside the country for work. 4. The patient has a family history of diabetes mellitus.

2. The patient lives in a recently renovated house.

____ 12. A patient who is pregnant shares details of being in a physically and psychologically abusive relationship with her baby's father. Which statement by the nurse is indicative of AWHONN's standing regarding intimate partner violence (IPV)? 1. "If you are all alone, you need to make arrangements for someone to stay with you." 2. "Your partner needs to come to the office so that we can confront his behavior." 3. "I will call a women's shelter to make arrangement for you to move in immediately." 4. "Let's explore ways to protect you and stop the abuse you have been enduring."

4. "Let's explore ways to protect you and stop the abuse you have been enduring."

____ 19. 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. 1. Consume three moderate-sized meals daily. 2. Sip clear, carbonated beverages when eating. 3. Assume a low Fowler position after meals. 4. Avoid eating 3 hours prior to bedtime. 5. Avoid consuming spicy, fatty, or fried food.

4. Avoid eating 3 hours prior to bedtime. 5. Avoid consuming spicy, fatty, or fried food.

____ 6. 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? 1. Folic acid 0.6 mg/day orally 1 month before conception and throughout pregnancy. 2. Folic acid 0.4 mg/day orally started when pregnant and continued throughout pregnancy 3. Folic acid 4 mg/day orally started when pregnant and continued throughout pregnancy 4. Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

4. Folic acid 4 mg/day orally for 1 month prior to conception through first trimester of pregnancy

____ 9. A patient who is pregnant asks the nurse when her baby is due to be born. The patient reports her last menstrual period (LMP) date as April 14. Using Naegele's rule, the nurse will set the estimated date of delivery (EDD) as what date? 1. July 21 2. January 7 3. July 14 4. January 21

4. January 21