Exam 1: Maternity
A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every: A. 4 weeks. B. 1 week. C. 3 weeks. D. 2 weeks.
A
The nurse is required to assess a pregnant client who is reporting vaginal bleeding. Which nursing action is the priority? A. assessing the amount and color of the bleeding B. determining the amount of funneling C. assessing signs of shock D. monitoring uterine contractility
A
The nurse is assessing a client at 12 weeks' gestation at a routine prenatal visit who reports something doesn't feel right. Which assessment findings should the nurse prioritize? A. visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen B. gestational hypertension, hyperemesis gravidarum, absence of FHR C. vaginal bleeding, increased hPL levels D. elevated hCG levels, enlarged abdomen, quickening
B
A nurse is teaching a group of pregnant women about fetal development. When describing how the various organs form, the nurse describes the primary germ layers involved. Which organ(s) would the nurse explain as developing from the mesoderm? Select all that apply. A. heart B. bones C. brain D. kidneys E. lungs
B, D, A
The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which signs and symptoms would the nurse include? Select all that apply. A. backache during the second trimester B. urinary frequency in the third trimester C. lower abdominal pain with shoulder pain in the first trimester D. nausea with vomiting during the first trimester E. headache with visual changes in the third trimester F. sudden leakage of fluid during the second trimester
C, E, F
A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation? A. Preterm labor that was undiagnosed B. Possible fetal death or injury C. Placenta previa obstructing the cervix D. Premature separation of the placenta
D
A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect? A. alleviates strong uterine cramping B. suppresses the immune response to prevent isoimmunization C. halts the progression of the abortion D. ensures passage of all the products of conception
D
An 18-year-old pregnant woman asks the nurse why she has to have a routine alpha-fetoprotein serum level drawn. The nurse explains that this: A. is a screening test for placental function. B. measures the fetal liver function. C. tests the ability of her heart to accommodate the pregnancy. D. may reveal chromosomal abnormalities.
D
A pregnant woman has been admitted to the hospital due to preeclampsia with severe features. Which measure will be important for the nurse to include in the care plan? A. Admit the client to the middle of ICU where she can be constantly monitored. B. Plan for immediate induction of labor. C. Institute and maintain seizure precautions. D. Institute NPO status.
C
Which information provided by a client would be considered a presumptive sign of pregnancy? A. Breast tenderness B. Reports of increased hunger C. Ballottement D. Weight gain
A
A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as: A. hydramnios. B, placenta accrete. C. ectopic pregnancy. D. hydatidiform mole.
D
A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure? A. Contraction test B. Nonstress test C. Amniocentesis D. Biophysical profile
C
A woman at 35 weeks' gestation with severe polyhydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client? A. development of gestational trophoblastic disease B. development of eclampsia C. preterm rupture of membranes followed by preterm birth D. hemorrhaging
C
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? A. Place the client in the left lateral position. B. Keep the client's legs slightly elevated. C. Keep the head of the client's bed slightly elevated. D. Place the client in an orthopneic position.
A
A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements? A. gestational hypertension B. placental abruption (abruptio placentae) C. placenta previa D. preeclampsia
A
A pregnant client at 34 weeks' gestation reports a burning sensation in the lower esophagus. What action would the nurse recommend to increase her comfort? Select all that apply. A. Do not eat fried, fatty foods. B. Do not drink liquids with meals. C. Eat five to six small meals per day. D. Do not lie down immediately after eating. E. Eat a large amount of carbohydrates.
A, C, D
A nurse is teaching a client who is 30 weeks' pregnant about ways to deal with pyrosis (heartburn). The nurse determines a need for additional teaching based on which client statement? A. "I should chew my food slowly." B. "I should lie down for 1/2 hour after eating." C. "I need to raise the head of my bed about 15 to 30 degrees." D. "I need to cut out caffeine."
B
A pregnant client at 20 weeks' gestation arrives at the health care facility reporting excessive vaginal bleeding and no fetal movements. Which assessment finding would the nurse anticipate in this situation? A. placenta previa B. cervical insufficiency C. congenital malformations D. ectopic pregnancy
B
A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission? A. performing a vaginal examination to assess the extent of bleeding B. assessing fetal heart tones by use of an external monitor C. helping the woman remain ambulatory to reduce bleeding D. assessing uterine contractions by an internal pressure gauge
B
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? A. Fundal height is at its highest level at the xiphoid process. B. The fundus is at the level of the umbilicus and measures 20 cm. C. Fundal height has dropped since the last recording. D. The lower uterine segment and cervix have softened.
C
A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints? A. Ectopic pregnancy B. Molar pregnancy C. Healthy pregnancy D. Placenta previa
A
A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next? A. Palpate the fundus and check fetal heart rate. B. Measure fundal height. C. Obtain a voided urine specimen and determine blood type. D. Check deep tendon reflexes.
A
A nurse is providing discharge teaching for a pregnant client with preeclampsia who will be managed at home on bedrest. The nurse determines that the teaching was successful based on which client statement? A. "I should check my blood pressure about 3 times per week." B. "I need to drink about 8 glasses of water a day." C. "I should lie on my back as much as I can." D. "I will check how often my baby kicks once per week."
A
A pregnant client is scheduled to undergo chorionic villus sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed? A. 10 to 12 weeks' gestation B. 5 to 6 weeks' gestation C. 7 to 9 weeks' gestation D. 4 to 5 weeks' gestation
A
When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem? A. short neck B. low-set ears C. slanting of the palpebral fissure D. bowed legs
B
A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV? A. ability to sleep B. hemoglobin C. urine protein D. respiratory rate
D
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 information should the nurse offer? A. "You will be more conscious of the changes taking place in your body now." B. "You may feel physical discomfort as the baby inside grows." C. "You may have mood swings that could overwhelm your partner." D. "You will experience quickening, and you will actually feel the baby."
D
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. A. morning sickness B. fetal heartbeat C. amenorrhea D. ultrasound pictures E. breast changes F. hydatidiform mole
A, C, E
A 44-year-old client has lost several pregnancies over the last 10 years. For the past 3 months, she has had fatigue, nausea, and vomiting. She visits the clinic and takes a pregnancy test; the results are positive. Physical examination confirms a uterus enlarged to 13 weeks' gestation; fetal heart tones are heard. Ultrasound reveals that the client is experiencing some bleeding. Considering the client's prenatal history and age, what does the nurse recognize as the greatest risk for the client at this time? A. premature birth B. spontaneous abortion C. preterm labor D. hypertension
B
A multigravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? A. The end of the fourth trimester B. The end of the second trimester C. The end of the third trimester D. The end of the first trimester
B
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 (dilatation) and enlargement of the birth canal. What is this hormone? A. human placental lactogen B. relaxin C. progesterone D. estrogen
B
The health care provider has prescribed a karyotype for a newborn. The mother questions the type of information that will be provided by the test. What information should be included in the nurse's response? A. The karyotype will determine the treatment needed for the infant. B. The karyotype will assess the baby's chromosomal makeup. C. A karyotype is useful in determining the potential complications the baby may face as a result of its condition. D. The karyotype will provide information about the severity of your baby's condition.
B
A client with preeclampsia is receiving magnesium sulfate to suppress or control seizures. Which nursing intervention should a nurse perform to determine the effectiveness of therapy? A. Assess the client's skin turgor. B. Monitor intake and output. C. Assess deep tendon reflexes. D. Assess the client's mucous membrane.
C
A nurse has been assigned to assess a pregnant client for placental abruption (abruptio placentae). For which classic manifestation of this condition should the nurse assess? A. painless bright red vaginal bleeding B. generalized vasospasm C. "knife-like" abdominal pain with vaginal bleeding D. increased fetal movement
C
A nurse is caring for a pregnant client with eclamptic seizure. Which is a characteristic of eclampsia? A. Respiration fails after the seizure. B. Respirations are rapid during the seizure. C. Coma occurs after seizure. D. Muscle rigidity is followed by facial twitching.
C
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? A. inefficient protein metabolism B. constipation C. iron-deficiency anemia D. tooth fracture
C
A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records? A. G3 T2 P2 A0 L1 B. G2 T2 P1 A0 L2 C. G3 T0 P1 A1 L2 D. G2 T1 P1 A1 L1
C
A client has come to the office for a prenatal visit during her 24th week of gestation. On examination, it is noted that her blood pressure has increased to 146/94 mm Hg. Her urine is negative for proteinuria. Blood pressure assessment at 20 weeks' gestation was 142/92 mm Hg and urine was negative for protein. Blood pressure readings at previous visits ranged from 120/76 mm Hg to 126/80 mm Hg. The nurse suspects which condition? A. chronic hypertension B. preeclampsia C. gestational hypertension D. HELLP
C
A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy? A. high number of pregnancies B. use of oral contraceptives C. history of endometriosis D. multiple gestation pregnancy
C
A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilation (dilatation) to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point? A. Notification of social support for loss of pregnancy B. Education on causes of cervical insufficiency for the future C. Give birth vaginally D. Bed rest to maintain pregnancy as long as possible
D
A pregnant woman is diagnosed with placental abruption (abruptio placentae). When reviewing the woman's physical assessment in her medical record, which finding would the nurse expect? A. gradual onset of symptoms B. fetal heart rate within normal range C. absence of pain D. firm, rigid uterus on palpation
D
A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? A. Specific gravity of 1.010 B. Trace of glucose C. Straw-like color D. 2+ Protein in urine
D
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? A. Amenorrhea B. Fatigue C. Nausea and vomiting D. Positive home pregnancy test
D
Which change related to the vital signs is expected in pregnant women? A. Temperature decreases. B. Lung space increases. C. Pulse decreases. D. Blood pressure decreases.
D
A pregnant client at 24 weeks' gestation 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? A. The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual. B. She may have a bleeding disorder so she needs to come back to the clinic for blood work. C. Some bleeding during pregnancy is not uncommon and this finding is expected. D. It is possible she is losing her mucus plug, which can cause bloody show.
A
A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client? A. diminished reflexes B. seizures C. serum magnesium level of 6.5 mEq/L D. elevated liver enzymes
A
The nursing student is preparing a pamphlet that 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? A. Oxytocin B. Prolactin C. Estrogen D. Progesterone
A
While in utero, a fetus swallows many substances that are deposited in the fetal intestinal system as meconium. What problem can arise from this occurrence? A. Abdominal distension occurs and infection can set in. B. The fetus can become constipated following birth. C. Meconium-stained fluids cause an increased risk of jaundice. D. If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia.
D
Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation. A. 3, 2, 1, 1, 1 B. 4, 1, 1, 1, 1 C. 3, 2, 1, 2, 1 D. 4, 2, 2, 1, 1
B
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? A. Her body is changing and she may be angry about it. B. What you are describing may be normal but we need to talk to her more in depth. C. Pregnant women often experience mood swings and self-centeredness but this is normal. D. Moodiness and irritability are not usual responses to pregnancy.
C
