OB test 1
a pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and veggies. the nurse would be most concerned about this woman's intake of
vitamin b12
a nurse is describing advances in genetics to a group of students which of the following would the nurse least likely include
genetic diagnosis is now abailable as early as the second trimester
Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with: A. Spina bifida. B. Intrauterine growth restriction. C. Diabetes mellitus. D. Down syndrome.
intrauterine growth restriction (IUGR)
which minerals and vitamins are usually recommended to supplement a pregnant woman's diet
iron and folate
nurses should be aware that the biophysical profile
is an accurate indicator of impending fetal death
the nurse providing care for the antepartum woman should understand that contraction stress test
is considered negative if no late decelerations are observed with contractions
leukorrhea
is the mucus that forms the operculum
while working with the pregnant woman in her first trimester, the nurse is aware that chorionic villus sampling can be performed during pregnancy at
10 weeks
a 27 year old pregnant woman had a preconceptual BMI of 18.0. the nurse knows that this woman's total recommended weight gain during pregnancy should be at least
12.5 kg/27.5 lbs
the nurse is teaching a pregnant woman aobut recommended weight gain. the woman has a prepregnancy bmi of 26. the nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy
15 to 25 pounds
Nagele's Rule
1st day of last period + 7 days - 3 months sept 10,2013 +7 = sept 17, 2017 - 3 m = june 17, 2014
a mother brings her 12 year old daughter in for a well-visit checkup. during the visit, the nurse discusses the HPV vaccine for the daughter. the mother agrees and the duaghter receives the first dose. the nurse schedules the daughter for the next dose, which would be given at which time?
2 months
the nurse reviews the CD4 cells count of a client who is HIV positive. A result less than which of the following would indicate to the nurse that the client has AIDS
200 cells/mm3
in normal pregnancies, the uterus rises gradually to the level of the umbilicus at
22 to 24 weeks of gestation
at approximately _______ weeks of gestation, lecithin is forming on the alveolar surfaces, the eyelids open, and the fetus measures approximately 27 cm crown to rump and weighs appx 1110 g
28
A nurse measures a pregnant woman's fundal height and finds it to be 28 cm. The nurse interprets this to indicate which of the following? A) 14 weeks' gestation B) 20 weeks' gestation C) 28 weeks' gestation D) 36 weeks' gestation
28 weeks
The measurement of lecithin in relation to sphingomyelin (L/S ratio) is used to determine fetal lung maturity. Which ratio reflects maturity of the lungs? a. 1.4:1 b. 1.8:1 c. 2:1 d. 1:1
2:1
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system? _____.
3-1-0-1-0
A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as: A) 3 2 1 0 3 B) 3 1 2 2 3 C) 4 1 1 1 3 D) 4 2 1 3 1
4 1 1 1 3
a woman's obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. one was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. what is her gravidity and parity using the GTPAL sysytem
4-1-2-0-4
The nurse should know that once the human immunodeficiency virus (HIV) enters the body, seroconversion to HIV positivity usually occurs within: a. 6 to 10 days b. 2 to 4 weeks c. 6 to 12 weeks d. 6 months
c. 6 to 12 weeks
a couple comes to the clinic for preconception counseling and care. as part of the visit, the nurse teaches the couple about ferilization and initial development, stating that the zygote gormed by the union of the ovum and sperm consists of how many chromosomes
46
a biophysical profile has been completed on a pregnant woman. the nurse interprets which score as normal
9
while teaching the expectant mother about personal hygiene during pregnancy, maternity nurses should be aware that
tub bathing is permitted even in late pregnancy unless membranes are ruptured
which statement about multifetal pregnancy is inaccurate
twin pregnancies come to term with the same frequency as single pregnancies; often end in prematurity women with multifetal often develop anemia, suffer more or worse backache and need to gain more weight
after teaching a group of students about the discomforts of pregnancy, the students demonstrate understanding of the information when they identify which as common during the first trimester
urinary frequency breast tenderness cravings
a woman comes to the clinic complaining of vaginal discharge. the nurse suspects trichomoniasis based on which of the following?
urinary frequency yellow/green discharge
a woman at 10 weeks of gestation who is seen in the hospital with presumptive signs and symptoms of pregnancy will likely have
amenorrhea
GTPAL system
G = gravidity (# of times pregnant) T = term (38-42 weeks) P = preterm birth (20-37 weeks) A = abortion (< 20 weeks) L = living children ex: woman who is pregnant now, has 2 children, one born @ 38 weeks, one @ 42 weeks = 32002
when evaluating a patient for sexually transmitted infection (STI) that affects most people in the US today is:
HPV
a group of students are reviwing the signs of pregnancy. the students demonstrate understanding of the info when they identify which as presumptive
amenorrhea nausea
after teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as essential for fetal lung development
amniotic fluid
A client's last menstrual period was April 11. Using Nagele's rule, her expected date of birth (EDB) would be: A) January 4 B) January 18 C) January 25 D) February 24
January 18
ginger
anti-inflammatory
which statement about a condition of pregnancy is accurate
N/V rarely have harmful effects on the fetus and may be beneficial
a pregnant woman is scheduled to undergo percutaneous umbilical blood sampling. when discussing this test with the woman, the nurse reviews what can be evaluated with the specimens collected. which fo the following would the nurse include
Rh compatibility fetal acid-base status coagulation studies
a nursing instructor is decribing various childbirth methods. which of the following would the nurse include as part of the lamaze method
use of specific breathing and relaxation techniques
valerian, wild yam
Uterine antispasmodic
when a nurse is counseling a woman for primary dysmenorrhea, which nonpharmacologic intervention might be recommended
using a heating pad on the abd to releive cramping
which patient is most at risk for fibroadenoma of the breast
a 16 y/o girl
during the first trimester, a woman can expect which of the following changes in her sexual desire
a decrease, because of N/fatigue
which nutritional recommendation about fluids is accurate
a woman's daily intake should be 8 - 10 glasses (2.3L) of water, milk, or juice
fennel, don quai
uterotonic
which s/x is considered a warning sign and should be reported immediately by the pregnant woman to her health care provider
vaginal bleeding
signs and symptoms that a woman should report immeditely to her health care provider include:
vaginal bleeding rupture of membranes heartburn accompanied by severe headache
A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially? A) The woman's beliefs and education B) The woman's financial situation and insurance C) The woman's activity level and nutrition D) The woman's family and living arrangements
a. the woman's beliefs and education
With regard to chromosome abnormalities, nurses should be aware that: a. They occur in approximately 10% of newborns. b. Abnormalities of number are the leading cause of pregnancy loss. c. Down syndrome is a result of an abnormal chromosome structure. d. Unbalanced translocation results in a mild abnormality that the child will outgrow.
abnormalities of number are the leading cause of pregnancy loss
the nurse caring for a newly pregnant woman would advise that ideally prenatal care should begin
after the first missed menstrual period
prenatal testing for HIV is recommended for
all women, regardless of r/f
a woman is 32 weeks' pregnent is informed by the nurse that a danger sign of pregnancy could be
alteration in the pattern of fetal movement
when assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find
ambivalence
As relates to the structure and function of the placenta, the maternity nurse should be aware that:
as one of its early functions, the placent acts as an endocrine gland
to prevent GI upset, patients should be instructed to take iron supplements
at HS
Three servings of milk, yogurt, or cheese plus two servings of meat, poultry, or fish will adequately supply the recommended amount of protein for the pregnant woman. Many clients are concerned about the increased levels of mercury in fish and may be afraid to include this source of nutrients in their diet. Sound advice by the nurse to assist the client in determining which fish is safe to consume includes: a. Canned white tuna is a preferred choice b. Avoid shark, swordfish, and mackerel c. Fish caught in local waterways is the safest d. Salmon and shrimp contain high levels of mercury
avoid shark, swordfish, and mackerel
A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse tells her: A. "Because you're in your second trimester, there's no problem with having one drink with dinner." B. "One drink every night is too much. One drink three times a week should be fine." C. "Because you're in your second trimester, you can drink as much as you like." D. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."
because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy
care management of a woman diagnosed with acute PID most likely would include
bed rest in a semi-Fowler position
pyrosis (acid indigestion)
begins in the first trimester and intensifies through the thrid trimester
a 41-week pregnant multigravida presents in the L & D unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. which diagnostic tool would yeield more info?
biophysical profile
which meal would provide the most absorbable iron
black bean soup, wheat crackers, orange sections, and prunes
chadwicks sign
blue-violet coloring of the cervix cause by increased vascularity; around the fourth week
with regard to medications, herbs, shots, and other substances normally encountered by pregnant women, the maternity nurse should be aware that:
both Rx and OTC drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus
A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, "I've never urinated as often as I have for the past three weeks." Which response would be most appropriate for the nurse to make? A) "Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it." B) "You shouldn't be urinating this frequently now; it usually stops by the time you're eight weeks pregnant. Is there anything else bothering you?" C) "By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy." D) "Women having their second child generally don't have frequent urination. Are you experiencing any burning sensations?"
by the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy
a pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. the nurse suspect vulvovaginal candidiasis based on which assessment finding
vaginal itching
with regard to nutritonal needs during lactation, a maternity nurse should be aware that:
caffeine consumed by the mother accumulates in the infact, who may be unusually active and wakeful
a pregnant woman's diet hx indicates that she likes the following list of foods. the nuse would encourage this woman to consume more of which food to increase her calcium intake
canned sardines
the drug of choice for treatment of gonorrhea is
ceftriaxone
during a vaginal exam, the nurse notes that the cervix has a bluish color.
chadwick's sign
on the first prenatal visit, exam on the woman's internal fenitalia reveals a bluish coloration of the cervix and vaginal mucosa. the nurse records this finding as
chadwicks sign
to reassure and educate pregnant patients about changes in their cardio system, maternity nurses should be aware that:
changes in their heart size and position and increases in blood volume create auditory changes from 20 weeks to term
the nurse providing care in a women's health care setting must be aware regarding which sexually transmitted infection that can be successfully treated and cured
chlamydia
which congenital malformations result from multifactorial inheritance
cleft lip congenital heart disease anencephaly pyloric stenosis
The major source of nutrients in the diet of a pregnant woman should be composed of what? a.Simple sugars b.Fats c.Fiber d.Complex carbohydrates
complex carbohydrates
To reassure and educate their pregnant clients about changes in their blood pressure, maternity nurses should be aware that:
compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy
Some pregnant patients may complain of changes in their voice and impaired hearing. The nurse can tell these patients that these are common reactions to: a. A decreased estrogen level. b. Displacement of the diaphragm, resulting in thoracic breathing. c. Congestion and swelling, which occur because the upper respiratory tract has become more vascular. d. Increased blood volume.
congestion and swelling, which occur because the upper respiratory tract has become more vascular
when counseling a patient about getting enough iron in her diet, the maternity nurse should tell her that
constipation is common with iron supplements
a nurse is discussing fetal development with a pregnant woman. the woman is 12 weeks pregnant and asks, what's happening with my baby. which of the following would the nurse integrate into the response
continued sexual differentiation digestive system becoming active
a nursing instructor is teaching a class to a group of students about pregnancy, insulin, and glucose. which of the following would the instructor least likely include as opposing insulin
cortisol
colostrum
creamy, white to yellow premilk fluid that can be expressed from nipples before birth
a group of students are reveiwing information about genetic inheritance. the students demonstrate understanding of the information when they identify which of the following as an example of an autosomal recessive disorder
cystic fibrosis
a pregnant woman experiencing nausea and vomiting should
eat small, frequent meals (every 2 to 3 H)
In presenting to obstetric nurses interested in genetics, the genetic nurse identifies the primary risk(s) associated with genetic testing as:
denial of insurance benefits
chaste tree fruit
descreases prolactin levels
which statement regarding acronyms in nutrition is accurate
dietary reference intake (DRIs) consist of recommended dietary allowances
physiologic anemia often occurs during pregnancy as a result of
dilution of hgb concentration blood volume expansion can occur earlier than increase in RBC
Appendicitis may be difficult to diagnose in pregnancy because the appendix is
displaced upward and laterally, high and to the right
a pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild to moderate intensity. the nurse would recommend
do pelvic rock exercises strengthen the abd and lower back muscles and relieve low back pain stretching and other exercises to relieve back pain should be performed several times a day
The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool useful in confirming the diagnosis? A. Doppler blood flow analysis B. Contraction stress test (CST) C. Amniocentesis D. Daily fetal movement counts
doppler blood flow
a pregnant woman undergoes maternal serum alpha fetoprotein (MSAFP) testing at 16 to 18 weeks' gestation. which of the following would the nurse suspect if the woman's level is decreased
down syndrome
the multiple marker test is used to assess the fetus for which condition
down syndrome
With regard to follow-up visits for women receiving prenatal care, nurses should be aware that:
during the abdominal exam, the nurse should be alert for supine hypotension
a client is diagnosed with PID. when reviewing the clients medical record, which of the following would the nurse expect to find
dysmenorrhea dysuria lower abdominal tenderness discomfort with cervical motion
which finding would the nurse expect to find in a client with endometriosis
dysuria
a nurse is developing a teaching plan about nutrition for a group of pregnant women. which of the following would the nurse include in the discussion
eat 3 meals with snacking avoid using diuretics participate in physical activity
a woman in week 34 of pregnancy reports that she is very uncomfortable cecause of heartburn. the nurse would suggest that the woman
eat five small meals daily
Nutrition is one of the most significant factors in influencing the outcome of a pregnancy. Nutrition is alterable and an important preventive measure for a variety of potential problems such as low birth weight and prematurity. While completing the physical assessment of the pregnant client, the nurse can evaluate the client's nutritional status by observing a number of physical signs. Which sign indicates that the client has unmet nutritional needs? a. Normal heart rate, rhythm, and blood pressure b. Bright, clear, shiny eyes c. Alert, responsive, and good endurance d. Edema, tender calves, and tingling
edema, tender calves, and tingling
in repsonse to requests by the US public health service for new models of prenatal care, an innovtive new approach to prenatal care known as centering pregnancy was developed. which statement would accurately apply to the centering model of care
eight to twelve women are placed in getation-age cohorts
when preparing a woman for an amniocentesis, the nurse would instruct her to do which of the following
empty her bladder
woman complain of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. she also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. these symptoms are most likely related to
endometriosis
transvaginal US is often performed during the first trimester. while preparing your 6-week gestation patient for this procedure, she expresses concern over the necessity for this test. the nurse should explain that this diagnostic test may be indicated for a number of situations
est gestational age obesity fetal abnormality ectopic pregnancy
during a prenatal class for a group of new mothers, the nurse is describing the hormones produced by the placenta. which of the following would the nurse include
estriol relaxin progestrin human chorionic somatomammotropin
black cohosh
estrogen-like luteinizing hormone suppressant
the phenomenon of someone other than the mother to be experiencing pregnancy like sx's such as nausea and weight gain applies to the
expectant father
a nurse is preparing a presentation for a group of women at the cliinic who have been diagnosed with genital herpes. which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak
exposure to ultraviolet light use of corticosteroids emotional stress sexual intercourse
a woman arrives at the clinic seeking confirmation that she is pregnant. the following information is ovtained. she is 24 with a bmi of 17.5. she admits to using cocaine "several times" during the past year and drinks alcohol occasaionally. her BP is 108/70, her HR is 72 bpm, RR 16. the family hx is positive for DM and cancer. her sister recently gave birth to aninfant with a neural tube defect. which characteristics place the woman in the high risk category
family history, BMI, drug/alcohol abuse
the nurse is developing a presentation for a community group of yong adults discussing fetal development and pregnancy. the nurse would identify that the sex of offspring is determined at the time of
fertilization
After the nurse describes fetal circulation to a pregnant woman, the woman asks why her fetus has a different circulation pattern than hers. In planning a response, the nurse integrates understanding of which of the following? A) Fetal blood is thicker than that of adults and needs different pathways. B) Fetal circulation carries highly oxygenated blood to vital areas first. C) Fetal blood has a higher oxygen saturation and circulates more slowly. D) Fetal heart rates are rapid and circulation time is double that of adults.
fetal circulation carries highly oxygenated blood to vital areas first
the nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. the woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is
fetal movement palpated by the nurse-midwife
quickening
first recognition of fetal movements by the mother
when describing the structures involved in fetal circulation, the nursing instructor describes which structure as the opening between the right and left atrium
foramen ovale
a nurse is working with a pregnant woman to schedule follow up visits for her pregancy. which statement by the woman indicates that she understands the scheduling
from now until i'm 28 weeks, ill be coming once a month
Which time-based description of a stage of development in pregnancy is accurate?
full term: pregnancy from the beginning of week 39 of gestation to the end of week 40
when assessing a woman at follow up prenatal visits, the nurse would anticipate which of the followin to be performed
fundal height measurement
prenatal testing is used to assess for genetic risks and to identify genetic d/o. in explaining to a couple about an eleveated alph-fetoprotein screening test result, the nurse would discuss the need for
further, more definitive evaluations to conclude anyting
Identify a goal of a patient with the following nursing diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to diet choices inadequate to meet nutrient requirements of pregnancy. a. Gain a total of 30 lb. b. Take daily supplements consistently. c. Decrease intake of snack foods. d. Increase intake of complex carbohydrates.
gain a total of 30 lbs
when teaching a pregnant client about the phsyiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. which of the followingwould the nurse include as the underlying reason for the effect?
glucose move through the placenta to assis the fetus
Which finding in the urine analysis of a pregnant woman is considered a variation of normal?
glycosuria- "physiologic spilling" protein - kidney disease or pre e bacteria - UTI ketones - strenuous exercise or malnutrition
a pregnant woman's diet may not meet her need for folates. a good source of this nutrient is
green leagy veggies
the nurse is discussing the insulin needs of a primaparous client with DM who has been using insulin for the past few years. the nurse informs the client that her insulin needs will increase during pregnancy based on the nurse's understanding that the placenta produces:
hPL, which decreases the effectiveness of insulin
compared with contraction stress test, nonstress test for antepartum fetal assessment
has no known contraindications
While you are assessing the vital signs of a pregnant woman in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate?
have the patient turn on her left side and recheck her BP in 5 M
a pregnant client in her second trimester has a hgb level of 11. the nurse interprets this as indicating which of the following?
hemodilution of pregnancy
a pregnant woman needs an update in her immunizations. which of the following vaccinations would the nurse ensure that the woman receives
hep B
when developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging group for HIV infection
heterosexual women
hCG is an important biochemical marker for pregnancy and therefore the basis for many tests. Which statement regarding hCG is true? a.hCG can be detected as early as weeks after conception. b.hCG levels gradually and uniformly increase throughout pregnancy. c.Significantly lower-than-normal increases in the levels of hCG may indicate a postdate pregnancy. d.Higher-than-normal levels of hCG may indicate an ectopic pregnancy or Down syndrome.
higher than normal levels of hCG may indicate an ectopic pregnancy or Down syndrome
a woman is 3 months pregnant. at her prenatal visit, she tells the nurse that she does not know what is happening, one minute she is happy she is pregnant, and the next minute she cries for no reason. which response by the nurse is most appropriate
hormoonal changes during pregnancy commonly result in mood swings
when assessing a pregnant woman in her last trimester, which question would be most appropriate to use to gather info about weight gain and fluid retention
how swollen do your ankles appear before you go to bed
Along with gas exchange and nutrient transfer, the placenta produces many hormones necessary for normal pregnancy. These include
human chorionic gonadotropin estrogen progesterone
when describing genetic d/o to a group of childbearing couples, the nurse would identify which as an example of autosomal dominant inheritance d/o
huntington's
a nurse is assessing a pregnant woman on a routine checkup. when assessing the woman's GI tract, which of the following would the nurse expect to find
hyperemic gums complaints of bloating palpable fetal movement
what represents a typical progression through the phases of a woman's establishing a relationship with the fetus
i am pregnant i am going to have a baby i am going to be a mother
a nurse is teaching a woman with genital ulcers how to care for them. which statement by the client indicates a need for additional teaching
i need to abstain from intercourse primarily when the lesions are present
a pregnant woman is flying across the country to visit her family. after teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful
i will get up and walk around the airplane about every 2 H
after the nurse teaches a client about ways to reduce the symptoms of premenstrual syndrome, which client statement indicates a need for additional teaching
i will make sure to take my estrogen supplements a week before my period
The diagnosis of pregnancy is based on which positive signs of pregnancy?
identification of fetal heartbeat visualization of the fetus verification of fetal movement
To determine the cultural influence on a patient's diet, the nurse should first: a. Evaluate the patient's weight gain during pregnancy b. Assess the socioeconomic status of the patient c. Discuss the four food groups with the patient d. Identify the food preferences and methods of food preparation common to that culture
identify the food preferences and methods of food preparation common to that culture
the most important reason for evaluating the pattern of weight fain in pregnancy is to
identy potential nutritonal problems or complication of pregnancy
to provide the patient with accurate info about dental care during pregnancy, maternity nurses should be aware that
if dental tx is necessary, the woman will be most comfortable with it in the second trimester
which statement made by a lactating woman would lead the nurse to believe that the woman might have lactose intolerance
if i drink more than a cup of milk, i usually have abd cramps and bloating
a pregnant woman has a rubella titer drawn on her first prenatal visit. the nurse explains that this test measure which of the following
immunity to german measles
during a routine prenatal visit, a client, 36 weeks pregnant, states she has dificulty breath and feels like her pulse rate is really fast. the nurse finds her pulse to be 100 bpm (increased from baseine of 70 to 74 bpm, and irregular, with bilateral crackles in the lower lung bases. which nursing dx would be the priority for this client
impaired gas exchange r/t pulmonary congestion
The most basic information a maternity nurse should have concerning conception is: a. Ova are considered fertile 48 to 72 hours after ovulation b. Sperm remain viable in the woman's reproductive system for an average of 12 to 24 hours c. Conception is achieved when a sperm successfully penetrates the membrane surrounding the ovum d. Implantation in the endometrium occurs 6 to 10 days after conception
implantation in the endometrium occurs 6 to 8 days after conception
To reassure and educate pregnant clients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:
increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty
which of the following changes in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy
increased lordosis
cardiovascular system changes occur during pregnancy. which finding would be considered normal for a woman in her second trimester
increased pulse rate
to reassure and educate pregnant patients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that:
increased vasculalrity of the vagina increases sensitivity and may lead to a high degree of arousal, esp in the second trimester
a nursing instructor is preparing teaching plan for a group of nursing students about the potential for misuse of genetic discoveries and advances. which of the following would the instructor most likely include
individual risk profiling and confidentiality
congenital disorders refer to conditions that are present at birth. these disorders may be inheritied and caused by environmental factors or maternal malnutrition. toxic exposure have the greatest effect on development between 15 and 60 days of gestation. for the nurse to be able to conduct a complete assessment of the newly pregnant woman, she should understand the significance of exposure to human teratogens. these include
infections radiation maternal conditions drugs chemicals
when providing care to the prenatal patient, the nurse understands that pica is defined as
ingestion of nonfood substances
which nursing imtervention is necessary before a second-trimester transabdominal US
instruct the woman not void until after the test
maternal nutritional status is an esp significant factor of the many factors that influence the outcomes of pregnancy because
it is an important preventive measure for a variety of problems
As relates to dysfunctional uterine bleeding (DUB), the nurse should be aware that:
it is most commonly cased by anovulation
a woman in the 34th week of pregnancy says to the nurse, I still feel like having intercourse with my husband. the woman's pregnancy has been uneventful. the nurse responds based on the understanding that
it is sage to have intercourse at this time
a maternity nurse should be awate of which fact about amniotic fluid
it serves as a source of oral fluid and a respository for waste from the fluid
a woman arrives at the clinic for a pregnancy test. the first day of her last menstrual period was september 30, 2013. her expected day of birth would be
june 17, 2014 subtract 3 M from september 10, 2013 = june 10,2013 add 7 days = june 17, 2013 plus 1 yr to the day of LMP = june 17 2014
To reassure and educate pregnant clients about changes in their breasts, nurses should be aware that:
lactation is inhibited until estrogen levels decline after birth
a client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. the nurse expects to prepare the clinet for which of the following to confirm this suspicion?
laparoscopy
a pregnant patient would like to know a good food sources of ca other than dairy products. your best answer is
legumes
a woman is at 20 weeks' gestatioin. the nurse would expect to find the fundus at which of the following
level of the umbilicus
assessment of a pregnant woman reveals a pigmented line down the middle of her abd. the nurse documents this as which of the following
linea nigra
in the first trimester, US can be used to gain info on
location of gestational sacs
a nurse is assessing a child with kinefelter's syndrome. which of the following would the nurse exect to assess
long arms gynecomastia
a woman has come to the clinic for preconception counseling because she want to start trying to get pregnant in 3 months. she can expect the following advice
make sure that you include adequate folic acid inyour diet
with regard to protein in the diet of pregnant women, nuses should be aware that
many protein rich foods are also good sources of ca, iron, and b vitamins
With regard to the development of the respiratory system, maternity nurses should be aware that: a. The respiratory system does not begin developing until after the embryonic stage b. The infant's lungs are considered mature when the L/S ratio is 1:1, at about 32 weeks c. Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity d. Fetal respiratory movements are not visible on ultrasound scans until at least 16 weeks
maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity
A patient in her first trimester complains of nausea and vomiting. She asks, "Why does this happen?" The nurse's best response is
may be due to a change in hormones
a 36 year old woman has been given a dx of uterine fibroids. when planning care for this patient, the nurse should know that
menorrhagia is a common finding
A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following? A) Excess folic acid, which could increase the risk for neural tube defects B) Mercury, which could harm the developing fetus if eaten in large amounts C) Lactose, which leads to abdominal discomfort, gas, and diarrhea D) Low-quality protein that does not meet the woman's requirements
mercury, which could harm the developing fetus if eatin in large amounts
A woman has thick, white lumpy cottage cheese like discharge, with patches on her labia and in her vagina. She complains of intense pruritus the nurse practitioner would order which preparation for treatment
miconazole
mammary glands are functionally complete by
midpregnancy
what type of cultural concern is the most likely deterrent to many women seeking prenatal care
modesty
A woman in her second trimester comes for a follow-up visit and says to the nurse, "I feel like I'm on an emotional roller-coaster." Which response by the nurse would be most appropriate? A) "How often has this been happening to you?" B) "Maybe you need some medication to level things out." C) "Mood swings are completely normal during pregnancy." D) "Have you been experiencing any thoughts of harming yourself?"
mood swings are completely normal during pregnancy
Which analysis of maternal serum may predict chromosomal abnormalities in the fetus? a. Multiple-marker screening b. Lecithin/sphingomyelin (L/S) ratio c. Biophysical profile d. Type and crossmatch of maternal and fetal serum
multiple marker screening
a woman is undergoing a nipple-stimulated contraction stress test. she is having contraction that occur every 3 min. the fhr has a baseline of appx 120 bpm without any deccelerations. the interpretation of this test is said to be
negative
a nurse is teaching a class on x-linked recessive d/o. which of the following statements would the nruse most likely include
no male to male transmission occurs
with regard to the initial visit with a patient who is beginning prenatal care, nurses should be aware that
nurses should be alert to the appearance of potential parenting problems, such as depression or lack of family support also attitude toward health care, info on drug use (drug testing requires consent)
a woman just delivered a healthy term newborn. upon assessing the umbilical cord, the nurse would identify which of the followin as normal (select all that apply)
one vein two arteries
A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which of the following? A) Fetal hypoxia B) Open spinal defects C) Down syndrome D) Maternal hypertension
open spinal defects
The mucous plug that forms in the endocervical canal is called the: a. Operculum b. Leukorrhea c. Funic souffle d. Ballottement
operculum
A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the client that this type of contraction: a. Is painless b. Increases with walking c. Causes cervical dilation d. Impedes oxygen flow to the fetus
painless, usually ease with walking or exercise do not increase in intensity or frequency or cause cervical dilation, also promote oxygen delivery to the fetus
A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The nurse would explain that which of the following would confirm the pregnancy? A) Absence of menstrual period B) Abdominal enlargement C) Palpable fetal movement D) Morning sickness
palpable fetal movement
after teaching a group of students about the different perinatal education methods, the instructor determines that the teaching was successful when the students identif which of the following as the bradley method
partner-coached method
assessment of a pregnant woman reveals that she compulsively craves ice. the nurse documents this finding as which of the following
pica
while take a diet hx, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. this represents a nutrional problem known as
pica
a patient at 24 weeks of gestation contacts the nurse at her ob office to explain that she has cravings for dirt and gravel. the nurse is aware that this condition is known as
pica and many indicate anemia
a pregnant woman diagnosed with syphillis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to hernewborn, explaining that this infection is transmitted to the newborn through the
placenta
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which of the following? A) Maternal diabetes B) Placental insufficiency C) Neural tube defects D) Fetal gastrointestinal malformations
placental insufficiency
Risk factors tend to be interrelated and cumulative in their effect. While planning the care for a laboring client with diabetes mellitus, the nurse is aware that she is at a greater risk for: a. Oligohydramnios. b. Polyhydramnios. c. Postterm pregnancy. d. Chromosomal abnormalities.
polyhydramnios
intrauterine grown restriction (IUGR) is associated with numberous pregnancy-related risk factors
poor material weight gain chronic maternal infections gentational hypertension smoking
a 39 year old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. she has a hx of smoking appx one pk per day, but she tells you that she is trying to cut down. her lab data are wnl. what diagnostic technique could be used with this pregnant woman at this time?
ultrasound
A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply.) A) Positive pregnancy test B) Ultrasound visualization of the fetus C) Auscultation of a fetal heart beat D) Ballottement E) Absence of menstruation F) Softening of the cervix
positive pregnancy test ballotement softening of the cervix
probable signs of pregnancy
positive pregnancy test; Goodell's sign; Hegar sign; Chadwick sign; Braxton Hicks contractions; ballottment
Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. There are times when the nurse or midwife should refer a client to a registered dietitian for in-depth nutritional counseling. These pregnant women include those with: (Select all that apply) a. Preexisting or gestational illness such as diabetes b. Ethnic or cultural food patterns c. Obesity d. Vegetarian diets
preexisting or gestational illness such as DM ethnic or cultural food patterns obesity vegetarian diet
a nurse is reviewing the medical record of a pregnant woman and notes that she is gravid II. the nurse implements this to indicate the number of
pregnancies
in a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, while I lie down on my back." the nurse integrates which of the following in to the explanation
pressure of the gravid uterus on the vena cava
a woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
primipara
the nurse caring for the pregnant patient must understand that the hormone essential for maintaining pregnancy is
progesterone
a nurse is preparing a class for a group of women at a family planning clinic about contraceptives. when describing the health benefits of oral contraceptives, which of the following would the nurse most likely include? SATA
protection against PID reduced risk for endometrial cancer improvement in acne
After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so that you can assess her understanding of the instructions given. Which statement indicates that she understands the role of protein in her pregnancy? a. "Protein will help my baby grow." b. "Eating protein will prevent me from becoming anemic." c. "Eating protein will make my baby have strong teeth after he is born." d. "Eating protein will prevent me from being diabetic."
protein will help my baby grow
vascular volume increases 40-45% during pregnancy to
provide adequate perfusion of the placenta
when describing perinatal education to a pregnant woman and her partner, the nurse emphasizes the primary goal of these classes it to
provide knowledge and skills to actively participate in birth and parenting
while talking with a woman in her third trimester, which behavior indicates to the nurse that the woman is learning to give of oneself
questioning ability to become a good mother
durinig pregnancy, many changes occur as a result of the presence of the fetus. which of these adaptations meet this criterion
quickening ballotement lightening
the nurse recognizes that a nonstress test in which two or more fhr accelerations of 15 bpm or more occur with fetal movement in a 20 min period
reactive
During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as: A) Variable decelerations B) Fetal tachycardia C) A nonreactive pattern D) Reactive pattern
reactive pattern
a man's wife is pregnant for the third time. one child was born with cystic fibrosis, and the other child is healthy. the man wonders what the chance is that this child will have cystic fibrosis. this type of testing is know as
reoccurence risk
a primiparous client is being seen in the clinic for her first prenatal visit. it is determined that she is 11 weeks pregnant. the nurse develops a teaching plan to educate the client about what she will most likely experience during this period. which of the following would the nurse include
urinary frequency
a pregnant woman reports that she is still playing tennis at 32 W. the nurse would be most concerned that during and after tennis matches this woman consumes
several glasses of fluid
while interviewing a 31 y/o woman before her routine gynecologic exam, the nurse collects data about the patient's recent menstrual cycles. the nurse should collect additional information associated with which patient statement
she descrives her flow as very heavy
which behavior indicates that a woman is seeking safe passage for herself and her infant
she keeps all prenatal appts
a 31-year-old woman believes that she may be pregnant. she took an OTC pregnancy test 1 week ago after missinig her period; the test was positive. during her assessment interview, the nurse enquies about the woman's last menstrual period and asks whether she is taking any meds. the woman states that she takes medicine for epilepsy. she has been under considerable stress lately at work and has not been sleeping well. she also has a hx of irregular periods. her physical exam does not indicate that she is pregnant. she has an ultrasound scan that reveals she is not pregnant. what is the most likely cause of the false-positive pregnancy test?
she takes anticonvulsants
the musculoskeletal system adapts to the changes that occur during pregnancy. a woman can expect to experience what change
she will have increased lordosis
A woman is at 14 weeks gestation, the nurse would expect to palpate the fundus at which level
slightly above the symphysis pubis
hegar's sign
softening and compressibility of lower uterus
goodells sign
softening of the cervical tip; 6th week of timing
funic souffle
sound of blood flowing through the umbilical vessels
nurmerous changes in the integumentary system occur during pregnancy. which change persists after birth
striae gravidarum
the nurse should be aware that the partner's main role in pregnancy is to
support and nurture the pregnant woman
a client is to receive animplantable contraceptive. the nurse describes this contraceptive as containing:
synthetic progestin
ballottement is
teachnique for palpating the fetus
a woman has just moved to the US from mexico. she is 3 M preg and has arrived for her first prenatal visit. during her assessment interview, you discover that she has not had any immunizations. which immunizations should she receive at this point in her pregnancy
tetanus diphtheria hep B
the nurse who is teaching a group of women about breast cancer would tell the women that
the exact cause of breast cancer is unknown
as r/t to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that:
the father goes through three phases of acceptance of his own the announcement phase the moratorium phase focusing phase
When nurses help their expectant mother assess the daily fetal movement counts, they should be aware that:
the fetal alarm signal should go off when fetal movements stop entirely for 12 H
sally comes in for her first prenantal exam. this is her first chhild. she asks you, how does my baby get air inside my uterus
the placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream
the nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. the mother will most likely experience which of the following at that time?
urinary frequency
a pregnant woman's biophysical profile score is 8. she asks the nurse to explain the results.
the test results are wnl
in comparing the abd and transvaginal methods of US exam, nurses should explain to their patients that
the transvaginal exam allows pelvic anatomy to be evaluated in greater detail
the nurse is assessing a pregnant woman in the second trimester. which of the following tasks would indicate to the nurse that the client is incorporating the maternal role into her personality
the woman acknowledges the fetus as a separate entitiy within her
a 22 year old woman pregnant with a single fetus has a preconception BMI of 24. when she was seen in the clinic at 14 weeks, she had gained 1.8 kg/4 lbs since conception. how would the nurse interpret this
the woman's weight gain is appropriate for this stage of pregnancy
to reassure and educate pregnant patients about changes in the uterus, nurses should be aware that
the womans increased urinary frequency in the first trimester is the result of exaggerated uterine anteflexion caused by softening
A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? A. "We don't really know when such defects occur." B. "It depends on what caused the defect." C. "They occur between the third and fifth weeks of development." D. "They usually occur in the first 2 weeks of development."
they occur between the third and fifth weeks of development
a woman is in her seventh month of pregnancy. she has been reporting nasal congestion and occasional epistaxis. the nurse suspects that
this is a normal respiratory change in pregnancy caused by elevated levels of estrogen
In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose? a. To promote family unity b. To ward off the "evil eye" c. To appease the gods of fertility d. To protect the mother and fetus during pregnancy
to protect the mother and fetus during pregnancy
the US centers for disease control and prevention recommends that HPV be treated with patient-applied
topical podofilox 0.5% solution or gel
a 40-y/o woman is 10 weeks pregnant. which diagnostic tool would be appropriate to suggest to her at this time?
transvaginal US
To help a woman reduce the severity of nausea caused by morning sickness, the nurse might suggest that she: a. Try a tart food or drink, such as lemonade, or salty foods, such as potato chips b. Drink plenty of fluids early in the day c. Brush her teeth immediately after eating d. Never snack before bedtime
try a tart food or drink, such as lemonade, or salty food, such as potato chips
a pregnant woman in the 36th week of gestation complains that her feet are quite swollen at the end of the day. after careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. which intervention would be most appropriate for the nurse to suggest
try elevating your legs when you sit
which vitamiins or mineral can lead to congenital malformations of the fetus if taken in excess by the mother
vit a
a pregnant woman in her 2nd trimester tells the nurse, I've been passing a lot of gas and feel bloated. which of the following suggestions would be helpful for the woman
watch how much beans and onions you eat try exercising a little more some say that eating mints may help
a 22 year old woman pregnant with a single fetus has a preconception BMI of 24. when she was seen in the clinic at 14 week gestation, she had gained 1.8 kg/4 lbs. since conception. how would the nurse interpret this
weight gain is appropriate for this stage of pregnancy
a 3 y/o girls mother is 6 M pregnant. what concern is the child likely to verbalize
what will the baby eat *school age kids take a more clinical interest, how did the baby get in there and how will it get out
when discussing work and travel during pregnancy with a pregnant patient, nurses should instruct them that
while working or traveling in a car or on a plane, women should arrange to walk around at least every 2 H or so
woman is 15 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is:"Within the next month, you should start to feel fluttering sensations."
within the next month, you should start to feel fluttering sensations
which pregnant woman should restrict her weight gain durng pregnancy
woman who was 20 lbs overweight before pregnancy
With regard to a woman's reordering of personal relationships during pregnancy, the maternity nurse should be aware that: a. Because of the special motherhood bond, a woman's relationship with her mother is even more important than with the father of the child b. Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other c. Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father d. The woman's sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier
women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father
a pregnant woman at 10 weeks of gestation jogs three or four times per week. she is concerned about the effect of exercise on the fetus. the nurse should inform her
you may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month
which of the following would the nurse includ when teaching a pregnant woman about chorionic villus sampling
you will have an ultrasound first and then the test
A woman is scheduled to undergo fetal nuchal translucency testing. Which of the following would the nurse include when describing this test? A) "A needle will be inserted directly into the fetus's umbilical vessel." B) "You'll have an intravaginal ultrasound to measure fluid in the fetus." C) "The doctor will take a sample of fluid from your bag of waters." D) "A small piece of tissue from the fetal part of the placenta is taken."
you'll have an intravaginal ultrasound to measure fluid in the fetus
a woman who is 8 months pregnant asks the nurse, does my baby have any antibodies to fight infection? the most appropriate response by the nurse is
your baby has IgG and IgM
a woman asks the nurse, what protects my baby's umbilical cord from being squashed while the baby's inside of me?
your baby's umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby
a patient asks her nurse, my dr told me that he is concerned with the grade of my placenta bc I am overdue. what does that mean?
your placenta changes as your preg progesses, and it is given a score that indicates the amount of ca depositis it has. the more ca deposits, the higher the grade, or number, that is assigned to the placenta. it also means that less blood and o2 can be delivered to your baby
after teaching a gorup of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as providing the barrier to other sperm after fertilization
zona pellucida
