MN Exam #1 Review Book

Which of the following skin changes should the nurse highlight for a pregnant woman's healthcare practitioner? A. Linea nigra B. melasma C. petechiae D. spider nevi

C. Petechiae Rationale: Petechiae are pinpoint red or purple spots on the skin; they are seen in hemorrhagic conditions

When a nurse is teaching a woman about her menstrual cycle, which of the following is the most important change that happens during the follicular phase of the menstrual cycle? A. Maturation of the graafian follicle B. Multiplication of the fimbriae C. Secretion of HCG D. Proliferation of the endometrium

A. Maturation of the graafian follicle

Which finding would the nurse view as normal when evaluating the laboratory reports of a 34-week gestation client? A. mild anemia B. thrombocytopenia C. Polycythemia D. Hyperbilirubinemia

A. Mild anemia

Which of the following findings in an 8 week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? (SATA) A. Body mass index 17 kg/m2 B. Rubella titer of 1:8 C. Blood pressure of 100/60 mm Hg D. Hematocrit of 30% E. Hemoglobin of 13.2 g/dL

A - Body mass index 17 (underweight) B - Rubella titer of 1:8 D - Hematocrit of 30% (below normal)

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? A. Avoid eating greasy foods. B. Drink orange juice before rising. C. Consume 1 teaspoon of nutmeg each morning. D. Eat 3 large meals plus a bedtime snack.

A. Avoid eating greasy foods

The nurse is providing counseling to a group of sexually active single women. Most of the women have expressed a desire to have children in the future but not within the next few years. Which of the following actions should the nurse suggest the women take to protect their fertility for the future. (Select All That Apply) A. Use condoms during intercourse B. Refrain from smoking ciggarettes C. Maintain an appropriate weight for height D. Exercise in moderation E. Refrain from drinking carbonated beverages

A, B, C, D Rationale: Wearing condoms to protect from STDs; smoking increases risk of infertility; overweight/underweight women have increased risk of infertility; exercise relates to BMI

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. A. Amenorrhea. B. Breast tenderness. C. Quickening. D. Frequent urination. E. Uterine growth.

A, B, C, D are all presumptive signs of pregnancy

A nurse is advising a pregnant woman about the danger signs of pregnancy. The nurse should teach the mother that she should notify the physician immediately if she experiences which of the following signs/symptoms? (SATA) A. Convulsions B. Double vision C. Epigastric Pain D. Persistent vomiting E. Polyuria

A. Convulsions B. Double vision C. Epigastric Pain D. Persistent vomiting

A nurse working in an infertility clinic should include which of the following in her discussions with the couple? A. Adoption as an alternative to infertility treatments B. The legal controversy surrounding intrauterine insemination C. The need to seek marriage counseling before undergoing infertility treatments D. Statistics regarding the number of couples who never learn why they are infertile

A. Adoption as an alternative to infertility treatments

A client has just had an amniocentesis to determine whether her baby has an inheritable genetic disease. Which of the following interventions is highest priority at this time? A. Assess the fetal heart rate B. Check the client's temperature C. Acknowledge the client's anxiety about the possible findings D. Answer questions regarding genetic abnormality

A. Assess the fetal heart rate Rationale: Although rare, the fetus may have been injured during the procedure

The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that within normal limits during the latter half of the pregnancy. Which of the following comments by the client indicates that teaching was successful? (SATA) A. During the 3rd trimester I may experience frequent urination B. During the 3rd trimester I may experience heartburn C. During the 3rd trimester I may experience nagging backaches D. During the 3rd trimester I may experience persistent headache E. During the 3rd trimester I may experience blurred vision

A. During the 3rd trimester I may experience frequent urination B. During the 3rd trimester I may experience heartburn C. During the 3rd trimester I may experience nagging backaches

The nurse is assessing the laboratory reports of a 40 week gestation client. Which of the following values would the nurse expect to find elevated above pregnancy levels? (SATA) A. Glucose B. Fibrinogen C. Hematocrit D. Bilirubin E. White Blood Cells

B - Fibrinogen; increase to help prevent excessive blood loss during delivery E - White Blood Cells; protects body from infection

Nurses working in a midwifery office have attended a conference to learn about factors that increase a woman's risk of becoming infertile. To evaluate the nurses' learning, the conference coordinator tests the nurses' knowledge at the conclusion of the seminar. Which of the following problems should the nurses state increase a client's risk of developing infertility problems? (SATA) A. Women who have menstrual cycles that are up to 30 days long B. Women who experience pain during intercourse C. Women who have had pelvic inflammatory disease D. Women who have excess facial hair E. Women who have menstrual periods that are over 5 days long

B, C, D Rationale: Pain could be an indicator for STIs/STDs or Endometriosis; PID could indicate a blocked fallopian tube; Excess facial hair could indicate PCOS

A female client seeks care at an infertility clinic. Which of the following tests may the client undergo to determine what, if any, infertility problem she may have? (SATA) A. CVS B. Endometrial biopsy C. Hysterosalpingogram D. Serum progesterone assay E. Postcoital test

B, C, D, E

A woman's temperature has just risen 0.4 degrees F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the changes? A. Estrogen B. Progesterone C. Luteinizing Hormone D. Follicle-Stimulating Hormone

B. Progesterone Rationale: Progesterone elevation occurs after ovulation and spikes at about 5-6 days after ovulation. Progesterone is thermogenic- that is, heat producing. estrogen begins to elevate before ovulation; LH spikes at the time of ovulation; FSH promotes the maturation of the ovum

The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the physician? (SATA) A. 17 weeks gestation; denies feeling fetal movement B. 24 weeks gestation; fundal height at the umbilicus C. 27 weeks gestation; salivates excessively D. 34 weeks gestation; experiences uterine cramping E. 37 weeks gestation; complains of hemorrhoidal pain

B. 24 weeks gestation; fundal height at the umbilicus *the fundal height should be 4 cm above the umbilicus D. 34 weeks gestation; experiences uterine cramping *the woman may be going into preterm labor

A 36-week gestation gravid client is complaining of dyspnea when lying flat. Which of the following is the likely clinical reason for this complaint? A. Maternal HTN B. Fundal height C. Hydramnios D. Congestive heart failure

B. Fundal height

A woman asks the nurse about the function of amniotic fluid. Which of the following statements by the woman indicates that the teaching was successful? (SATA) A. The fluid provides fetal nutrition B. The fluid cushions the fetus from injury C. The fluid provides the fetus with a stable thermal environment D. The fluid enables the fetus to grow E. The fluid enables the fetus to practice swallowing

B. The fluid cushions the fetus from injury C. The fluid provides the fetus with a stable thermal environment D. The fluid enables the fetus to grow E. The fluid enables the fetus to practice swallowing

A client states that she is a strong believer in vitamin supplements to maintain her health. The nurse advises the woman that is is recommended to refrain from consuming excess quantities of which of the following vitamins during pregnancy? A. Vitamin C B. Vitamin D C. Vitamin B 2 (Niacin) D. Vitamin B12 (Cobalamin)

B. Vitamin D - can be harmful during pregnancy

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? A. "Your period is probably just irregular." B. "We could do a blood test to check." C. "Home pregnancy test results are very accurate." D. "My recommendation would be to repeat the test in one week."

B. We could do a blood test to check Rationale: Serum pregnancy tests are more sensitive than urine pregnancy tests

It is discovered that a pregnant woman practices pica. Which of the following complications is most often associated with this behavior? A. Hypothyroidism B. Iron-Deficiency Anemia C. Hypercalcemia D. Overexposure to zinc

B. iron deficiency anemia

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? A. G4 P2121 B. G4 P1212 C. G5 P1122 D. G5 P2211

C. G5 P1122

A 20 year old client states that the at-home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time? A. Congratulations, you and your family must be so happy. B. Have you told the baby's father yet? C. How do you feel about the results? D. Please tell me when your last menstrual period was

C. How do you feel about the results? Rationale: It is important for the nurse to ask the young woman how she feels about being pregnant. She may decide not to continue with the pregnancy.

A nurse midwife has advised a 39-week gestation gravid to take evening primrose oil 2,500 mg daily as a complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions? A. Relieve back strain. B. Improve development of colostrum. C. Ripen the cervix. D. Reduce the incidence of hemorrhoids.

C. Ripen the cervix *readying the cervix for dilation *evening primrose has been shown to cause skin rash

A nurse is discussing sexual arousal during a preadolescent boys' sex education class. Which of the following should the nurse base the reply on when a boy asks, "What exactly happens when my body gets aroused, anyway?": A. The vas deferens thickens and expands B. The sympathetic nerves of the penis are stimulated C. The corpora of the penis become engorged D. The prepuce of the penis elongates

C. The corpora of the penis become engorged Rationale: When arousal occurs, the penile blood vessels become engorged and an erection is achieved

A 35-year-old client is being seen for her yearly gynecological examination. She states that she and her partner have been trying to become pregnant for a little over 6 months and that a friend had recently advised her partner to take ginseng to improve the potency of his sperm. The woman states that they have decided to take their friend's advise. On which of the following information should the nurse base his or her reply? A. Based on their history, the client and her partner have made the appropriate decision regarding their infertility B. Ginseng can cause permanent chromosomal mutations and should be stopped immediately C. It is unnecessary to become concerned about this womans infertility because she has tried to become pregnant for only a few months D. Although Ginseng may be helpful, it would be prudent to encourage the woman to seek fertility counseling

D.

A client has been notified that because of fallopian tube obstruction, her best option for becoming pregnant is through in-vitro fertilization. The client asks the nurse about the procedure. Which of the following responses is correct? A. During the stimulation phase of the procedure, the physician will make sure only one egg reaches maturation B. Preimplantation genetic diagnosis will be performed on your partner's sperm before they are mixed with your eggs C. After ovarian stimulation, you will be artificially inseminated with your partner's sperm D. Any extra embryos will be preserved for you if you wish to conceive again in the future

D. Any extra embryos will be preserved for you if you wish to conceive again in the future

A nurse teaches a woman who wishes to become pregnant that if she assesses for spinnbarkeit she will be able to closely predict her time of ovulation. Which technique should the client be taught to assess for spinnbarkeit? A. Take her temperature each morning before rising B. Carefully feel her breasts for glandular development C. Monitor her nipples for signs of tingling and sensitivity D. Assess her vaginal discharge for elasticity and slipperiness

D. Assess her vaginal discharge for elasticity and slipperiness Rationale: Spinnbarkeit is defined as the "thread" that is created when the vaginal discharge is slippery and elastic at the time of ovulation. The changes are in response to high estrogen levels. The woman inserts her index and middle fingers into her vagina and touches her cervix. After removing her fingers, she separates her fingers and "spins a thread" between her fingers. When she is not in her fertile period, the mucus is thick and gluey.

A woman is menstruating. If hormonal studies were to be done at this time, which of the following hormonal levels would the nurse expect to see? A. Both estrogen and progesterone are high B. Estrogen is high, progesterone is low C. Estrogen is low, progesterone is high D. Both estrogen and progesterone are low

D. Both estrogen and progesterone are low Rationale: When the ovum is not fertilized, both estrogen and progesterone levels drop. The hormonal drop is followed by menstruation

A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? A. Nausea. B. Dyspnea. C. Urinary frequency. D. Leg cramping.

D. Leg cramping Rationale: Often the complaint of clients in the 2nd trimester

An Orthodox Jewish couple is seeking infertility counseling. The woman states that her menstrual cycle is 21 days long. After testing, no physical explanation is found for the infertility. Which of the following may explain why the woman has been unable to conceive? A. Her kosher diet is lacking the essential nutrients needed for achieving optimal reproductive health B. The positions allowed Orthodox Jewish couples during intercourse hinder the process of fertilization C. Orthodox Jewish couples are known to have a high rate of infertility because of inborn genetic diseases D. Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends

D. Orthodox Jewish couples refrain from intercourse during menses and for seven days after it ends Rationale: With such a short cycle, the woman is ovulating during the time it is prohibited to have intercourse

The nurse asks a 31-week gestation client to lie on the examining table during a prenatal examination. In which of the following positions should the client be placed? A. Orthopneic. B. Lateral-recumbent. C. Sims'. D. Semi-Fowler's.

D. Semi-fowler's

A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? (SATA) A. Pap smear B. Mammogram C. Glucose tolerance test D. Biophysical profile E. Complete blood count

A - pap smear E - complete blood count

A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant? A. Chorionic Gonadotropin B. Oxytocin C. Prolactin D. Luteinizing Hormone

A. Chorionic Gonadotropin

A client asks the nurse about the gamete intrafallopian transfer (GIFT) procedure. Which of the following responses would be appropriate for the nurse to make? A. Fertilization takes place in the woman's body B. Zygotes are placed in the fallopian tubes C. Donor sperm are placed in a medium with donor eggs D. A surrogate carries the infertile woman's fetus

A. Fertilization takes place in the woman's body Rationale: Although the gametes are placed in the fallopian tubes artificially, fertilization does occur within the woman's body

A woman has just completed her first trimester. Which of the following fetal structures can the nurse tell the woman are well formed at this time? (SATA) A. Genitals B. Heart C. Fingers D. Alveoli E. Kidneys

A. Genitals B. Heart C. Fingers E. Kidneys

An infertile woman has been diagnosed with endometriosis. She asks the nurse why that diagnosis has made her infertile. Which of the following explanations is appropriate for the nurse to make? A. Scarring surrounds the ends of your tubes, preventing your eggs from being fertilized by your partners sperm B. You are producing insufficient quantities of FSH that is needed to mature an egg every month C. Inside your uterus is a benign tumor that makes it impossible for the fertilized egg to implant D. You have a chronic infection of the vaginal tract that makes the secretions hostile to your partner's sperm

A. Scarring surrounds the ends of your tubes, preventing your eggs from being fertilized by your partner's sperm

A gravida's fundal height is noted to be at the xiphoid process. The nurse is aware that which of the following fetal changes is likely to be occurring at the same time in the pregnancy? A. Surfactant is formed in the fetal lungs. B. Eyes begin to open and close. C. Respiratory movements begin. D. Spinal column is completely formed.

A. Surfactant is formed in the fetal lungs. *usually forming in the fetal lungs by the 36th week

A pregnant client is lactose intolerant. Which of the following foods could this woman consume to meet her calcium needs? A. Turnip greens B. Green beans C. Cantaloupe D. Nectarines

A. Turnip greens

A client informs the nurse that she is very constipated. Which of the following foods would be best for the nurse to recommend to the client? A. Pasta B. Rice C. Yogurt D. Celery

D. Celery - excellent source to reverse constipation and is high fiber

Infertility increases a client's risk of which of the following? A. Diabetes mellitus B. Nystagmus C. Cholecystitis D. Ovarian Cancer

D. Ovarian Cancer

Once oogenesis is complete, the resultant gamete cell contains how many chromosomes? A. 23 B. 46 C. 47 D. 92

A. 23

Which of the following client responses indicates that the nurse's teaching about care following chorionic villus sampling has been successful? A. If the baby stops moving, the woman should immediately go to the hospital B. The woman should take oral terbutaline every 2 hours for the next day C. If the woman starts to bleed or to contract, she should call her physician D. The woman should stay on complete bedrest for the next 48 hours

C. if the woman starts to bleed or to contract, she should call her physician

An infertility specialist is evaluating whether a woman's cervical mucus contains enough estrogen to support sperm motility. Which of the following tests is the physician conducting? A. Ferning capacity B. Basal body temperature C. Colposcopy D. Hysterotomy

A. Ferning Capacity

The nurse notes each of the following findings in a woman at 10 weeks' gestation. Which of the findings would enable the nurse to tell the woman that she is positively pregnant? a. Fetal heart rate via Doppler b. Positive pregnancy test c. Positive Chadwick sign d. Montgomery gland enlargements

A. Fetal heart rate via doppler Rationale: fetal heart rate via doppler is a POSITIVE sign; the rest are probable signs

A nurse is working in the prenatal clinic. Which of the following findings seen in 3rd trimester pregnant women would the nurse consider to be within normal limits? (SATA) A. Leg cramps B. Varicose Veins C. Hemorrhoids D. Fainting spells E. Lordosis

A. Leg cramps B. Varicose Veins C. Hemorrhoids E. Lordosis (change in the curvature of the spine) All are normal, although additional teaching may be required

A 54 year old client calls her healthcare provider complaining of frequency and burning when she urinates. Which of the following factors that occurred within the preceding 3 days likely contributed to this client's problem? A. She had intercourse with her partner B. She returned from a trip abroad C. She stopped taking hormone replacement therapy D. She started a weight-lifting exercise program

A. She had intercourse with her partner Rationale: Intercourse led to the symptoms of a UTI

The nurse has taken a health history on four primigravid clients at their first prenatal visits. It is high priority that which of the clients receives nutrition counseling? A. The woman diagnosed with phenylketonuria B. The woman who has Graves disease C. The woman with Cushing syndrome D. The woman diagnosed with myasthenia gravis

A. The woman diagnosed with phenylketonuria

The nurse is caring for a pregnant client who is vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods? A. Tofu, legumes, broccoli B. Corn, yams, green beans C. Potatoes, parsnips, turnips D. Cheese, yogurt, fish

A. Tofu, legumes, broccoli

A couple is seeking infertility counseling. The practitioner has identified the factors listed below in the woman's healthy history. Which of these findings may be contributing to the couple's infertility? A. The client is 36 years old B. The client was 13 when she started to menstruate C. The client works as a dental hygienist 3 days a week D. The client jogs 2 miles every day

A. the client is 36 years old

A couple is seeking infertility counseling. During the history, it is noted that the man is a cancer survivor, drinks one beer every night with dinner, and takes a sauna every day after work. The response provided by the nurse should be based on which of the following? A. It is unlikely that any of these factors is affecting his fertility B. Daily alcohol consumption could be altering his sperm count C. Sperm may be malformed when exposed to the heat of the sauna D. Cancer survivors have the same fertility rates as healthy males

C. Sperm may be malformed when exposed to the heat of the sauna Rationale: Heat affects sperm count

A couple is seeking advice regarding what they can do to increase the chances of becoming pregnant. What recommendation can the nurse give to the couple? A. The couple could use vaginal lubricants during intercourse. B. The couple should delay having intercourse until the day of ovulation. C. The woman should refrain from douching. D. The woman should be on top during intercourse.

C. The woman should refrain from douching Rationale: Douching can change the normal flora and the pH in the vagina, making the environment hostile to the sperm

The nurse plans to provide anticipatory guidance to a 10-week gravid client who is being seen in the prenatal client. Which of the following information should be a priority for the nurse to provide? A. Pain management during labor B. Methods to relieve backaches C. Breastfeeding positions D. Characteristics of a newborn

B. Methods to relieve backaches

Which of the following exercises should be taught to a pregnant woman who complains of backaches? A. kegeling B. pelvic tilting C. Leg lifting D. Crunching

B. Pelvic Tilting

A woman, 6 weeks pregnant, is having a vaginal examination. Which of the following would the practitioner expect to find? A. Thin cervical muscle. B. An enlarged ovary. C. Thick cervical mucus. D. Pale pink vaginal wall.

B. an enlarged ovary

A woman, whose menstrual cycle is 35 days long, states that she often has a slight pain on one side of her lower abdomen on day 21 of her cycle. She wonders whether she has ovarian cancer. Which of the following is the nurse's best response? A. Women often feel a slight twinge when ovulation occurs B. You should seek medical attention as soon as possible since ovarian cancer is definitely a possibility C. Ovarian cancer is unlikely because the pain is not a constant pain D. It is more likely that such pain indicates an ovarian cyst because pain is more common with that problem

A. Woman often feel a slight twinge when ovulation occurs Rationale: This statement is true, and the discomfort at the location of the ovary when ovulation occurs is called mittelschmerz. Ovulation usually occurs 14 days before the first day of the menses

It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long Which of the following is an appropriate reply by the nurse? A. You're probably ovulating B. Your hormone levels should be checked C. You will probably menstruate early D. Your breast changes are a worrisome sign

A. You're probably ovulating

A client who was seen in the prenatal clinic at 20 weeks' gestation weighed 128 lb at that time. Apprx. how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks' gestation? A. 129-130 lb B. 131-132 lb C. 133-134 lb D. 135-136 lb

B. 131-132 lb Rationale: At this stage of pregnancy, the woman is expected to gain about 0.8 to 1 lb a week

A 3rd trimester client is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the visit? (SATA) A. Blood glucose B. Blood pressure C. Fetal heart rate D. Urine Protein E. Pelvic Ultrasound

B. Blood pressure C. Fetal heart rate D. Urine Protein *urine glucose is tested at each prenatal visit, NOT blood glucose

A gravid client is counseled by her primary healthcare provider to have a vaccination during her 3rd trimester of pregnancy. The client questions the healthcare provider's recommendations. Which of the following statements would be appropriate for the nurse to give the client? A. When received during pregnancy, the rotavirus vaccine helps to prevent dehydration in newborns B. If you receive the tetanus, diphtheria, and acellular pertussis vaccine, your baby will be protected against whooping cough C. When received during pregnancy, the HPV vaccine helps to prevent newborns from acquiring the sexually transmitted infection D. If you receive the varicella vaccine, your baby will be protected from the chickenpox virus

B. If you receive the tetanus, diphtheria, and acellular pertussis vaccine, your baby will be protected against whooping cough

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? A. Fetal heart begins to beat. B. Lanugo covers the fetal body. C. Kidneys secrete urine. D. Fingernails begin to form.

B. Lanugo covers the fetal body *occurs at apprx. 20 weeks gestation

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

C. It is a bluish coloration of your cervix and vagina *probable sign of pregnancy*

A woman is 36 weeks gestation. Which of the following tests will be done during her prenatal visit? A. Oral glucose tolerance test B. Amniotic fluid volume assessment C. Vaginal and rectal cultures D. Karyotype analysis

C. Vaginal and rectal cultures to test for GBS

In analyzing the need for teaching regarding sexual health in a client who is sexually active, which of the following questions is the most important for a nurse to ask? A. How old are your children? B. Did you have intercourse last evening? C. With whom do you have intercourse? D. Do you use vaginal lubricant?

C. With whom do you have intercourse? Rationale: This question is important for the nurse to learn if the client is having intercourse with more than one partner

The following four changes occur during pregnancy. Which of them usually increases the father's interest and involvement in the pregnancy? A. learning the results of the pregnancy test B. attending childbirth education classes C. hearing the fetal heartbeat D. meeting the obstetrician or midwife

C. hearing the fetal heartbeat