Ch 11 and 12

Question 1

Ch 11
1.
During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding as:
A)
Hegar's sign
B)
Goodell's sign
C)
Chadwick's sign
D)
Ortolani's sign

Answer 1

Chadwick’s sign

Question 2

2.
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?
A)
Dysuria
B)
Dyspnea
C)
Constipation
D)
Urinary frequency

Answer 2

Urinary frequency

Question 3

3.
A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, ìI’ve never urinated as often as I have for the past three weeks.î Which response would be most appropriate for the nurse to make?
A)
ìHaving to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it.î
B)
ìYou shouldn’t be urinating this frequently now; it usually stops by the time you’re eight weeks pregnant. Is there anything else bothering you?î
C)
ìBy 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.î
D)
ìWomen having their second child generally don’t have frequent urination. Are you experiencing any burning sensations?î

Answer 3

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

Question 4

4.
In a client’s seventh month of pregnancy, she reports feeling ìdizzy, like I’m going to pass out, when I lie down flat on my back.î The nurse integrates which of the following in to the explanation?
A)
Pressure of the gravid uterus on the vena cava
B)
A 50% increase in blood volume
C)
Physiologic anemia due to hemoglobin decrease
D)
Pressure of the presenting fetal part on the diaphragm

Answer 4

Pressure of the gravid uterus on the vena cava

Question 5

5.
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?
A)
Ankle edema
B)
Urinary frequency
C)
Backache
D)
Hemorrhoids

Answer 5

urinary frequency

Question 6

6.
A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating which of the following?
A)
Iron-deficiency anemia
B)
A multiple gestation pregnancy
C)
Greater-than-expected weight gain
D)
Hemodilution of pregnancy

Answer 6

hemodilution of pregnancy

Question 7

7.
The nurse is discussing the insulin needs of a primaparous client with diabetes 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:
A)
hCG, which increases maternal glucose levels
B)
hPL, which deceases the effectiveness of insulin
C)
Estriol, which interferes with insulin crossing the placenta
D)
Relaxin, which decreases the amount of insulin produced

Answer 7

hPl, which decreases the effectiveness of insulin

Question 8

8.
When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect?
A)
Pancreatic function is affected by pregnancy.
B)
Glucose is utilized more rapidly during a pregnancy.
C)
The pregnant woman increases her dietary intake.
D)
Glucose moves through the placenta to assist the fetus.

Answer 8

glucose moves through the placenta to assist the fetus

Question 9

9.
When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find?
A)
Ambivalence
B)
Introversion
C)
Acceptance
D)
Emotional lability

Answer 9

ambivalence

Question 10

10.
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?
A)
The woman demonstrates concern for herself and her fetus as a unit.
B)
The client identifies what she must give up to assume her new role.
C)
The woman acknowledges the fetus as a separate entity within her.
D)
The client demonstrates unconditional acceptance without rejection.

Answer 10

The woman acknowledges the fetus as a separate entity within her

Question 11

11.
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

Answer 11

positive pregnancy test
bollottement
softening of cervix (Goodell’s Sign)

Question 12

12.
The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index 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?
A)
35 to 40 pounds
B)
25 to 35 pounds
C)
28 to 40 pounds
D)
15 to 25 pounds

Answer 12

15 to 25 lbs

Question 13

13.
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

Answer 13

mercury, which could harm the developing fetus if eaten in large amounts

Question 14

14.
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?
A)
Ligament tightening
B)
Decreased swayback
C)
Increased lordosis
D)
Joint contraction

Answer 14

increased lordosis

Question 15

15.
Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which of the following?
A)
Linea nigra
B)
Striae gravidarum
C)
Melasma
D)
Vascular spiders

Answer 15

linea nigra

Question 16

16.
A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply.)
A)
Hyperemic gums
B)
Increased peristalsis
C)
Complaints of bloating
D)
Heartburn
E)
Nausea

Answer 16

hyperemic gums, complaints of bloating, heartburn, nausea

Question 17

17.
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

Answer 17

palpable fetal movement

Question 18

18.
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? (Select all that apply.)
A)
Keep weight gain to 15 lb
B)
Eat three meals with snacking
C)
Limit the use of salt in cooking
D)
Avoid using diuretics
E)
Participate in physical activity

Answer 18

eat 3 meals w/ snacking
avoid using diuretics
participate in physical activity

Question 19

19.
Assessment of a pregnant woman reveals that she compulsively craves ice. The nurse documents this finding as which of the following?
A)
Quickening
B)
Pica
C)
Ballottement
D)
Linea nigra

Answer 19

pica

Question 20

20.
A woman in her second trimester comes for a follow-up visit and says to the nurse, ìI feel like I’m on an emotional roller-coaster.î Which response by the nurse would be most appropriate?
A)
ìHow often has this been happening to you?î
B)
ìMaybe you need some medication to level things out.î
C)
ìMood swings are completely normal during pregnancy.î
D)
ìHave you been experiencing any thoughts of harming yourself?î

Answer 20

mood swings are completely normal during pregnancy

Question 21

21.
While talking with a woman in her third trimester, which behavior indicates to the nurse that the woman is learning to give of oneself?
A)
Showing concern for self and fetus as a unit
B)
Unconditionally accepting the pregnancy without rejection
C)
Longing to hold infant
D)
Questioning ability to become a good mother

Answer 21

questioning the ability to become a good mother

Question 22

22.
A group of students are reviewing the signs of pregnancy. The students demonstrate understanding of the information when they identify which as presumptive signs? (Select all that apply.)
A)
Amenorrhea
B)
Nausea
C)
Abdominal enlargement
D)
Braxton-Hicks contractions
E)
Fetal heart sounds

Answer 22

amenorrhea

nausea

Question 23

24.
A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which of the following?
A)
Just above the symphysis pubis
B)
Mid-way between the pubis and umbilicus
C)
At the level of the umbilicus
D)
Mid-way between the umbilicus and xiphoid process

Answer 23

at the level of the umbilicus

Question 24

25.
A pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis based on which assessment finding?
A)
Fever
B)
Vaginal itching
C)
Urinary frequency
D)
Incontinence

Answer 24

vaginal itching

Question 25

Chapter 12
1.
A woman in the 34th week of pregnancy says to the nurse, ìI still feel like having intercourse with my husband.î The woman’s pregnancy has been uneventful. The nurse responds based on the understanding that:
A)
It is safe to have intercourse at this time.
B)
Intercourse at this time is likely to cause rupture of membranes.
C)
There are other ways that the couple can satisfy their needs.
D)
Intercourse at this time is likely to result in premature labor.

Answer 25

it is safe to have intercourse at this time

Question 26

2.
On the first prenatal visit, examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse records this finding as:
A)
Hegar's sign
B)
Goodell's sign
C)
Chadwick's sign
D)
Homans' sign

Answer 26

Chadwick’s sign

Question 27

3.
When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes that the primary goal of these classes is to:
A)
Equip a couple with the knowledge to experience a pain-free childbirth
B)
Provide knowledge and skills to actively participate in birth and parenting
C)
Eliminate anxiety so that they can have an uncomplicated birth
D)
Empower the couple to totally control the birth process

Answer 27

provide knowledge and skills to actively participate in birth and parenting

Question 28

4.
When assessing a woman at follow-up prenatal visits, the nurse would anticipate which of the following to be performed?
A)
Hemoglobin and hematocrit
B)
Urine for culture
C)
Fetal ultrasound
D)
Fundal height measurement

Answer 28

fundal height measurement

Question 29

5.
During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute. and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client?
A)
Ineffective tissue perfusion related to supine hypotensive syndrome
B)
Impaired gas exchange related to pulmonary congestion
C)
Activity intolerance related to increased metabolic requirements
D)
Anxiety related to fear of pregnancy outcome

Answer 29

impaired gas exchange related to pulmonary congestion

Question 30

6.
When preparing a woman for an amniocentesis, the nurse would instruct her to do which of the following?
A)
Shower with an antiseptic scrub.
B)
Swallow the preprocedure sedative.
C)
Empty her bladder.
D)
Lie on her left side.

Answer 30

empty her bladder

Question 31

7.
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

Answer 31

4 1 1 1 3

Question 32

8.
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

Answer 32

January 18

Question 33

9.
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

Answer 33

reactive pattern (fetal heart rate accelerates 15 bpm above baseline)

Question 34

10.
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

Answer 34

open spinal defects

Question 35

11.
When assessing a pregnant woman in her last trimester, which question would be most appropriate to use to gather information about weight gain and fluid retention?
A)
ìWhat’s your usual dietary intake for a typical day?î
B)
ìWhat size maternity clothes are you wearing now?î
C)
ìHow puffy does your face look by the end of a day?î
D)
ìHow swollen do your ankles appear before you go to bed?

Answer 35

how swollen are your ankles before you go to bed

Question 36

12.
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?
A)
ìLimit your intake of fluids.î
B)
ìEliminate salt from your diet.î
C)
ìTry elevating your legs when you sit.î
D)
ìWear Spandex-type full-length pants.î

Answer 36

try elevating your legs when you sit

Question 37

13.
A pregnant woman needs an update in her immunizations. Which of the following vaccinations would the nurse ensure that the woman receives?
A)
Measles
B)
Mumps
C)
Rubella
D)
Hepatitis B

Answer 37

Hep B

Question 38

14.
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?
A)
ìI’ll sit in a window seat so I can focus on the sky to help relax me.î
B)
ìI won’t drink too much fluid so I don’t have to urinate so often.î
C)
ìI’ll get up and walk around the airplane about every 2 hours.î
D)
ìI’ll do some upper arm stretches while sitting in my seat.î

Answer 38

Ill get up and walk around the airplane every 2 hours

Question 39

15.
Which of the following would the nurse include when teaching a pregnant woman about chorionic villus sampling?
A)
ìThe results should be available in about a week.î
B)
ìYou’ll have an ultrasound first and then the test.î
C)
ìAfterwards, you can resume your exercise program.î
D)
ìThis test is very helpful for identifying spinal defects.î

Answer 39

you’ll have an ultrasound first and then the test

Question 40

16.
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 of the following would the nurse include? (Select all that apply.)
A)
Rh incompatibility
B)
Fetal acidñbase status
C)
Sex-linked disorders
D)
Enzyme deficiencies
E)
Coagulation studies

Answer 40

Rh incompatibility
fetal acid-base status
coagulation studies

Question 41

17.
A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal?
A)
9
B)
7
C)
5
D)
3

Answer 41

9

Question 42

18.
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? (Select all that apply.)
A)
Urinary frequency
B)
Breast tenderness
C)
Cravings
D)
Backache
E)
Leg cramps

Answer 42

urinary frequency
breast tenderness
cravings

Question 43

19.
A nurse is reviewing the medical record of a pregnant woman and notes that she is gravid II. The nurse interprets this to indicate the number of:
A)
Deliveries
B)
Pregnancies
C)
Spontaneous abortions
D)
Pre-term births

Answer 43

pregnancies

Question 44

20.
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

Answer 44

28 weeks (weeks = cm until 36 weeks in which it drops)

Question 45

21.
A pregnant woman has a rubella titer drawn on her first prenatal visit. The nurse explains that this test measures which of the following?
A)
Platelet level
B)
Rh status
C)
Immunity to German measles
D)
Red blood cell count

Answer 45

immunity to German measles

Question 46

22.
A nurse is working with a pregnancy woman to schedule follow-up visits for her pregnancy. Which statement by the woman indicates that she understands the scheduling?
A)
ìI need to make visits every 2 months until I’m 36 weeks pregnant.î
B)
ìOnce I get to 28 weeks, I have to come twice a month.î
C)
ìFrom now until I’m 28 weeks, I’ll be coming once a month.î
D)
ìI’ll make sure to get a day off every 2 weeks to make my visits.”

Answer 46

from now until I am 28 weeks, Ill be coming once/month

Question 47

23.
A nursing instructor is describing the various childbirth methods. Which of the following would the instructor include as part of the Lamaze method?
A)
Focus on the pleasurable sensations of childbirth
B)
Concentration on sensations while turning on to own bodies
C)
Interruption of the fear-tension-pain cycle
D)
Use of specific breathing and relaxation techniques

Answer 47

use of specific breathing and relaxation techniques

Question 48

24.
After teaching a group of students about the different perinatal education methods, the instructor determines that the teaching was successful when the students identify which of the following as the Bradley method?
A)
Psychoprophylactic method
B)
Partner-coached method
C)
Natural childbirth method
D)
Mind prevention method

Answer 48

partner coached method

Question 49

25.
A pregnant woman in her second trimester tells the nurse, ìI've been passing a lot of gas and feel bloated.î Which of the following suggestions would be helpful for the woman?
A)
ìWatch how much beans and onions you eat.î
B)
ìLimit the amount of fluid you drink with mealsî
C)
ìTry exercising a little more.î
D)
ìSome say that eating mints can help.î
E)
ìCut down on your intake of cheeses.î

Answer 49

Watch how much beans and onions you eat.
Try exercising a little more
Some say that eating mints can help
cut down on your intake of cheese