Family Exam 3-Antepartum

100. A client is having an ultrasound assessment done at her prenatal appointment at 8 weeks' gestation. She asks the nurse, "Can you tell what sex my baby is yet?" Which of the following responses would be appropriate for the nurse to make at this time? 1. "The technician did tell me the sex, but I will have to let the doctor tell you what it is." 2. "The organs are completely formed and present, but the baby is too small for any to be seen." 3. "The technician says that the baby has a penis. It looks like you are having a boy." 4. "I am sorry. It will not be possible to see which sex the baby is for another month or so."

"I am sorry, it won't be possible to see for another month or so" The GU system and genitalia are FORMED by 8 weeks but not VISUALIZED until 12

Using Naegele's rule, what is the EDD for a woman with an LMP of 7/10/2022? 1. 3/03/2023 2. 3/17/2023 3. 4/10/2023 4. 4/17/2023

04/17/2023

58. A gravid woman who recently emigrated from mainland China is being seen at her first prenatal visit. She was never vaccinated in her home country. An injection to prevent which of the following communicable diseases should be administered to the woman during her pregnancy? 1. Influenza. 2. Mumps. 3. Rubella. 4. Varicella.

1. Influenza but ONLY injectable--not the "live" nasal spray

15. When doing a psych assessment of an 8-week gravida, which would you expect to see signs of? 1. ambivalence 2. depression 3. anxiety 4. ecstasy

1. ambivalence may also be startled by news. depression and anxiety more likely in 3rd, ecstasy in 2nd

5. Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? 1. Avoid eating greasy foods. 2. Drink orange juice before rising. 3. Drink 2 glasses of water with each meal. 4. Eat 3 large meals plus a bedtime snack.

1. avoid greasy foods

55. During a preconception counseling session, the nurse encourages a couple to pre- pare a birth plan. Which of the following is the most important goal for this action? 1. Promote communication between the couple and health care professionals. 2. Enable the couple to learn about the types of medicine used in labor. 3. Provide the couple with a list of items that they should put in a bag for labor. 4. Give the high-risk couple a sense of control over having to have a cesarean.

1. birth plans facilitate communication between couple and health team

35. which of the following vital sign changes should the nurse highlight for a pregnant woman's obstetrician? 1. prepregnancy BP 100/60 and third trimester 140/90 2. Prepregnancy RR 16rpm and third trimester RR 22rpm 3. Prepregnancy HR 76 bpm and third trimester HR 88 4. Prepregnancy temp 98.6 and third trimester 99.2

1. blood pressure should not elevate

32. A woman states that she frequently awakens with "painful leg cramps" during the night. Which of the following assessments should the nurse make? 1. Dietary evaluation. 2. Goodell's sign. 3. Hegar's sign. 4. Posture evaluation.

1. dietary eval because painful leg cramps could indicate consuming too little calcium or too much phosphorous

Which of the following is true? SATA 1. surfactant is usually formed in the fetal lungs by the 36th week 2. the eyes open and close at 28 wks 3. fetal respiratory movement begins at 24wks 4. the spinal column is completely formed well before the end of the first trimester 5. Fetal heartbeats are not detectable until the 2nd trimester

1. surfactant is usually formed in the fetal lungs by 36 weeks

61. A woman is planning to become pregnant. Which of the following actions should she be counseled to take before stopping birth control? Select all that apply. 1. Take a daily multivitamin. 2. See a medical doctor. 3. Drink beer instead of vodka. 4. Stop all over-the-counter medications. 5. Stop smoking cigarettes.

1. take a multivitamin 2. See a medical doctor 5. stop smoking

In general, when are the three trimesters?

1st: conception-12 weeks 2nd: 13 - 27 weeks 3rd: 28 weeks - birth

30. A client who was seen in the prenatal clinic at 20 weeks' gestation weighed 128 lb at that time. Approximately how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks' gestation? 1. 129 lb. 2. 130 lb. 3. 131 lb. 4. 132 lb.

2. 130 lbs. By 20 weeks the woman should only be gaining 0.8-1lb/week

25. The nurse midwife tells a client that the baby is growing and that ballottement was evident during the vaginal examination. How should the nurse explain what the nurse midwife means by ballottement? 1. The nurse midwife saw that the mucus plug was intact. 2. The nurse midwife felt the baby rebound after being pushed. 3. The nurse midwife palpated the fetal parts through the uterine wall. 4. The nurse midwife assessed that the baby is head down.

2. the nurse midwife felt the baby rebound after being pushed

23. The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings would the nurse highlight for the physician? SATA 1. 17 weeks' gestation; denies feeling fetal movement. 2. 24 weeks' gestation; fundal height at the umbilicus. 3. 27 weeks' gestation; complains of excess salivation. 4. 34 weeks gestation; experiences uterine cramping 5. 37 weeks' gestation; complains of hemorrhoidal pain.

2. Fundal height at 24wks should be 4cm above umbilicus 4. the woman may be going into preterm labor

97. A woman who is seen in the prenatal clinic is found to be 8 weeks pregnant. She confides to the nurse that she is afraid her baby may be "permanently damaged be- cause I had at least 5 beers the night I had sex." Which of the following responses by the nurse would be appropriate? 1. "I would let the doctor know that if I were you." 2. "It is unlikely that the baby was affected." 3. "Abortions during the first trimester are very safe." 4. "An ultrasound will tell you if the baby was affected."

2. It is unlikely the baby was affected The 2-week period between ovulation and implantation is an "all or nothing" period (embryo not dependent on mom yet)

13. A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? 1. Backache. 2. urinary frequency 3. Dyspnea. 4. Fatigue. 5. Diarrhea.

2. urinary frequency 4. fatigue

71. A client states that she is a strong believer in vitamin supplements to maintain her health. The nurse advises the woman that it is recommended to refrain from con- suming excess quantities of which of the following vitamins during pregnancy? 1. Vitamin C. 2. Vitamin D. 3. Vitamin B2 (niacin). 4. Vitamin B12 (cobalamin).

2. Vitamin D supplements can be harmful This is a fat-soluble vitamin so can build up. in megadoses it can be teratogenic

46. A 36-week gestation gravid lies flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe? 1. Hypertension. 2. Dizziness. 3. Rales. 4. Chloasma.

2. dizziness the pregnant uterus is compressing the great vessels when lying flat

2. The nurse is assessing the laboratory report of a 40-wk gestation client. Which values would the nurse expect to find elevated above prepregnancy levels? SATA 1. Glucose 2. Fibrinogen 3. Hematocrit 4. Bilirubin 5. WBCs

2. fibrinogen (to prevent blood loss during birth) 5. WBCs (to prevent infection after birth)

96. A mother has just experienced quickening. Which of the following developmental changes would the nurse expect to occur at the same time in the woman's pregnancy? 1. Fetal heart begins to beat. 2. Lanugo covers the fetal body. 3. Kidneys secrete urine. 4. Fingernails begin to form.

2. lanugo covers the fetal body by 20 weeks fetal heartbeat would have already been detected; quickening happens in 2nd trimester

51. The blood of a pregnant client was initially assessed at 10 weeks' gestation and re assessed at 38 weeks' gestation. Which of the following results would the nurse ex pect to see? 1. Rise in hematocrit from 34% to 38%. 2. Rise in white blood cells from 5,000 cells/mm3 to 15,000 cells/mm3. 3. Rise in potassium from 3.9 mEq/ L to 5.2 mEq/ L. 4. Rise in sodium from 137 mEq/ L to 150 mEq/ L.

2. rise in WBCs from 5000 to 15,000

41. a client, in her third trimester, is concerned she won't know the difference between labor contractions and normal aches/pains of pregnancy. how should you respond? 1. dont worry. you'll know the difference when the contractions start 2. the contractions may feel just like a backache, but they will come and go 3. contractions are a lot worse than your pregnancy aches and pains 4. i understand. you dont want to come to the hospital before you are in labor

2. the contractions may feel like just a backache but will come and go

6. A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to make at this time? 1. "Your period is probably just irregular." 2. "We could do a blood test to check." 3. "Home pregnancy test results are very accurate." 4. "My recommendation would be to repeat the test in one week."

2. we could do a blood test (serum pregnancy tests are more sensitive than urine)

95. A woman is carrying dizygotic twins. She asks the nurse about the babies. Which of the following explanations is accurate? 1. During a period of rapid growth, the fertilized egg divided completely. 2. When the woman ovulated, she expelled two mature ova. 3. The babies share one placenta and a common chorion. 4. The babies will definitely be the same sex and have the same blood type.

2. when the woman ovulated, she expelled two mature ova

21. A woman, 6 weeks pregnant, is having a vaginal examination. Which of the follow- ing would the practitioner expect to find? 1. Thin cervical muscle. 2. An enlarged ovary. 3. Thick cervical mucus. 4. Pale pink vaginal wall.

2. would expect to palpate enlarged ovary (the corpus luteum is still functional)

What should the fundal height be by the end of the second trimester? 1. 12 2. 14 3. 20 4. 27

27 (it matches the number of weeks)

When is Rhogam given?

28 weeks and within 72 hours of delivery

67. A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks' gestation; delivered a daughter, now 5 years old, at 39 weeks' gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman's gravidity and parity? 1. G4 P2121. 2. G4 P1212. 3. G5 P1122. 4. G5 P2211.

3. G5P1122 gravida = # pregnancies P (first number = to term, second = premies, third = abortions, fourth = living)

9. A client asks the nurse what was meant when the physician told her she had a positive Chadwick's sign. Which of the following would be appropriate for you to convey at this time? 1. It is a purplish stretch mark on your abdomen 2. It means you are having heart palpitations 3. It is a bluish coloration of your cervix and vagina 4. It means the doctor heard abnormal sounds when you breathed in

3. bluish coloration

70. When assessing the fruit intake of a pregnant client, the nurse notes that the client usually eats 1 piece of fruit per day and drinks 7 to 8 servings of fruit juice per day. Which of the following is the most important communication for the nurse to make? 1. "You are effectively meeting your daily fruit requirements." 2. "Fruit juices are excellent sources of folic acid." 3. "It would be even better if you were to consume more whole fruits and less fruit juice." 4. "Your fruit intake far exceeds the recommended daily fruit intake."

3. eat more whole fruits rather than juice

101. which of the following developmental features would the nurse expect to be absent in a 41-week gestation fetus? 1. fingernails 2. eyelashes 3. lanugo 4. milia

3. lanugo it begins to disappear by about 38 weeks

63. Which of the following skin changes should the nurse highlight for a pregnant woman's provider? 1. linea nigra 2. melasma 3. petechiae 4. spider nevi

3. petechiae. concerning because they are seen in hemorrhagic conditions

Which is the best resting position for mom to attain maximum uteroplacental bloodflow? 1. Flat on back 2. Dorsal-Recumbent 3. Side-lying left side 4. Semi-Fowler's

3. side-lying left side

48. A woman is 36-weeks' gestation. Which of the following tests will be done during her prenatal visit? 1. Glucose challenge test. 2. Amniotic fluid volume assessment. 3. Vaginal and rectal cultures. 4. Karyotype analysis.

3. vaginal and rectal cultures

18. The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor? 1. "My first child has cerebral palsy." 2. "My first child has hypertension." 3. "My first child has asthma." 4. "My first child has cystic fibrosis."

4. cystic fibrosis.

26. A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? 1. Nausea. 2. Dyspnea. 3. Urinary frequency. 4. Leg cramping.

4. leg cramping is a complaint of the second trimester

52. A client is 35 weeks' gestation. Which of the following findings would the nurse ex pect to see? 1. Nausea and vomiting. 2. Maternal ambivalence. 3. Fundal height 10 cm above the umbilicus. 4. Use of three pillows for sleep comfort.

4. use of three pillows for sleep comfort by 35 weeks the fundus should be 15 cm above umbilicus

4. A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time? 1. "We expect you to gain about 1 lb per week, so your weight is a little low at this time." 2. "Most women gain no weight during the first trimester, so I would suggest you eat fewer desserts for the next few weeks." 3. "You entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need." 4. "Your weight gain is exactly what we would expect it to be at this time."

4. weight gain is normal for first trimester expect 3-5lbs for second and third trimesters expect 0.8-1 lb/week (21.5-27 lbs)

1. An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? Select all that apply. 1. Amenorrhea. 2. Breast tenderness. 3. Quickening. 4. Frequent urination. 5. Uterine growth.

Amenorrhea, breast tenderness, quickening, frequent urination NOT uterine growth (this is a probable sign)

What are warning signs of preeclampsia?

Persistent headaches, generalized swelling of hands, face, and feet, epigastric pain not relieved by antacids, and vision changes

38. A 37-week gravid client states that she noticed a "white liquid" leaking from her breasts during a recent shower. Which of the following nursing responses is appro- priate at this time? 1. Advise the woman that she may have a galactocele. 2. Encourage the woman to pump her breasts to stimulate an adequate milk supply. 3. Assess the liquid because a breast discharge is diagnostic of a mammary infection. 4. Reassure the mother that this is normal in the third trimester.

Reassure mother that this is normal. the white liquid is colostrum. This late in the pregnancy, the oxytocin release stimulated by expression of breastmilk may be enough to cause uterus to contract and initiate labor

When is group B strep screened for during pregnancy? 1. First trimester 2. Second trimester 3. Third trimester 4. Postpartum

Third trimester

T/F a 16 year old pregnant female who receives early prenatal care is at no greater risk for pregnancy complications than women 20+

True! the reason teen pregnancies can be high risk is because they usually do NOT seek prenatal care so miss warning signs/dont make healthy choices (drugs, alcohol, STIs, poor diet) *support your teen moms!*

What are key features of Taegyo? SATA 1. Avoiding red meat and substitute with raw fish 2. Stress relief 3. Rest 4. Regular exercise

all but 1 women should eat a healthy diet that avoids MSG (high sodium) and raw fish

Which teens are at a higher risk for becoming pregnant? SATA 1. Girl failing algebra 1 2. Daughter of a teen mom 3. Girl partying every weekend 4. Girl with single parent 5. Girl not taking birth control

all but 5

Which are functions of amniotic fluid? 1. Protection 2. Thermal regulation 3. Lung maturation 4. GI/GU system 5. Limb development 6. Immunity

all but 6

Which are probable signs of pregnancy? 1. Positive pregnancy test 2. Braxton hicks contractions 3. Ballottment 4. Chadwick's sign 5. Hegar's sign 6. Amenorrhea

all but 6.

Which lab values would you expect to change for a pregnant woman? SATA 1. increased plasma levels 2. increased RBCs 3. increased WBCs 4. decreased HgB 5. decreased Hct

all true!

40. the nurse is providing anticipatory guidance to a woman in her second trimester regarding s/s within normal limits during the third trimester. Which indicates successful teaching? SATA 1. during the third trimester i may experience frequent urination 2. during the third trimester i may experience heartburn 3. during the third trimester i may experience nagging backaches 4. during the third trimester i may experience a persistent headache 5. during the third trimester i may experience blurred vision

in the third trimester I may experience frequency in urination, heartburn, and backaches.