Chapter 31: Pregnancy (Practice Questions)

Question 1

Which of these statements best describes the action of the hormone progesterone during pregnancy?

a. Progesterone produces the hormone human chorionic gonadotropin.
b. Duct formation in the breast is stimulated by progesterone.
c. Progesterone promotes sloughing of the endometrial wall.
d. Progesterone maintains the endometrium around the fetus.

Answer 1

d. Progesterone maintains the endometrium around the fetus.

Question 2

A female patient has nausea, breast tenderness, fatigue, and amenorrhea. Her last menstrual period was 6 weeks ago. The nurse interprets that this patient is experiencing __________ signs of pregnancy.

a. Positive
b. Possible
c. Probable
d. Presumptive

Answer 2

D. Presumptive

Question 3

A woman who is 8 weeks pregnant is visiting the clinic for a checkup. Her systolic blood pressure is 30 mm Hg higher than her prepregnancy systolic blood pressure. The nurse should:

a. consider this a normal finding
b. Expect the blood pressure to decrease as the estrogen levels increase throughout the pregnancy.
c. Consider this an abnormal finding because blood pressure is typically lower at this point in the
pregnancy.
d. Recommend that she decrease her salt intake in an attempt to decrease her peripheral vascular
resistance.

Answer 3

c. Consider this an abnormal finding because blood pressure is typically lower at this point in the
pregnancy.

Question 4

A patient is being seen at the clinic for her 10-week prenatal visit. She asks when she will be able to hear the baby’s heartbeat. The nurse should reply:

a. The baby’s heartbeat is not usually heard until the second trimester.
b. The babys heartbeat may be heard anywhere from the ninth to the twelfth week.
c. It is often difficult to hear the heartbeat at this point, but we can try.
d. It is normal to hear the heartbeat at 6 weeks. We may be able to hear it today.

Answer 4

b. The baby’s heartbeat may be heard anywhere from the ninth to the twelfth week.

Question 5

A patient who is in her first trimester of pregnancy tells the nurse that she is experiencing significant nausea and vomiting and asks when it will improve. The nurse should reply:

a. Did your mother have significant nausea and vomiting?
b. Many women experience nausea and vomiting until the third trimester.
c. Usually, by the beginning of the second trimester, the nausea and vomiting improve.
d. At approximately the time you begin to feel the baby move, the nausea and vomiting will subside.

Answer 5

c. Usually, by the beginning of the second trimester, the nausea and vomiting improve.

Question 6

During the examination of a woman in her second trimester of pregnancy, the nurse notices the presence of a small amount of yellow drainage from the nipples. The nurse knows that this is:

a. An indication that the woman’s milk is coming in.
b. A sign of possible breast cancer in a pregnant woman.
c. Most likely colostrum and considered a normal finding at this stage of the pregnancy.
d. Too early in the pregnancy for lactation to begin and refers the woman to a specialist.

Answer 6

c. Most likely colostrum and considered a normal finding at this stage of the pregnancy.

Question 7

A woman in her second trimester of pregnancy complains of heartburn and indigestion. When discussing this with the woman, the nurse considers which explanation for these problems?

a. Tone and motility of the gastrointestinal tract increase during the second trimester.
b. Sluggish emptying of the gallbladder, resulting from the effects of progesterone, often causes heartburn.
c. Lower blood pressure at this time decreases blood flow to the stomach and gastrointestinal tract.
d. Enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.

Answer 7

d. Enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.

Question 8

A patient who is 20 weeks pregnant tells the nurse that she feels more shortness of breath as her pregnancy progresses. The nurse recognizes which statement to be true?
a. High levels of estrogen cause shortness of breath.
b. Feelings of shortness of breath are abnormal during pregnancy.
c. Hormones of pregnancy cause an increased respiratory effort.
d. The patient should get more exercise in an attempt to increase her respiratory reserve.

Answer 8

c. Hormones of pregnancy cause an increased respiratory effort.

Question 9

The nurse auscultates a functional systolic murmur, grade II/IV, on a woman in week 30 of her pregnancy.
The remainder of her physical assessment is within normal limits. The nurse would:

a. Consider this finding abnormal, and refer her for additional consultation.
b. Ask the woman to run briefly in place and then assess for an increase in intensity of the murmur.
c. Know that this finding is normal and is a result of the increase in blood volume during pregnancy.
d. Ask the woman to restrict her activities and return to the clinic in 1 week for re-evaluation.

Answer 9

c. Know that this finding is normal and is a result of the increase in blood volume during pregnancy.

Question 10

A woman who is 28 weeks pregnant has bilateral edema in her lower legs after working 8 hours a day as a cashier at a local grocery store. She is worried about her legs. What is the nurses best response?

a. You will be at risk for development of varicose veins when your legs are edematous.
b. I would like to listen to your heart sounds. Edema can indicate a problem with your heart.
c. Edema is usually the result of too much salt and fluids in your diet. You may need to cut down on salty foods.
d. As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with prolonged standing.

Answer 10

D. As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with prolonged standing.

Question 11

When assessing a woman who is in her third trimester of pregnancy, the nurse looks for the classic symptoms associated with preeclampsia, which include:

a. Edema, headaches, and seizures.
b. Elevated blood pressure and proteinuria.
c. Elevated liver enzymes and high platelet counts.
d. Decreased blood pressure and edema.

Answer 11

b. Elevated blood pressure and proteinuria.

Question 12

The nurse knows that the best time to assess a woman’s blood pressure during an initial prenatal visit is:

a. At the end of the examination when she will be the most relaxed.
b. At the beginning of the interview as a nonthreatening method of gaining rapport.
c. During the middle of the physical examination when she is the most comfortable.
d. Before beginning the pelvic examination because her blood pressure will be higher after the pelvic examination.

Answer 12

a. At the end of the examination when she will be the most relaxed.

Question 12

When examining the face of a woman who is 28 weeks pregnant, the nurse notices the presence of a butterfly-shaped increase in pigmentation on the face. The proper term for this finding in the documentation is:

a. Striae.
b. Chloasma.
c. Linea nigra.
d. Mask of pregnancy.

Answer 12

b. Chloasma.

Question 13

Which finding is considered normal and expected when the nurse is performing a physical examination on a pregnant woman?

a. Palpable, full thyroid
b. Edema in one lower leg
c. Significant diffuse enlargement of the thyroid
d. Pale mucous membranes of the mouth

Answer 13

A. Palpable, full thyroid

Question 14

When auscultating the anterior thorax of a pregnant woman, the nurse notices the presence of a murmur over the second, third, and fourth intercostal spaces. The murmur is continuous but can be obliterated by pressure with the stethoscope or finger on the thorax just lateral to the murmur. The nurse interprets this finding to be:

a. Murmur of aortic stenosis.
b. Most likely a mammary souffle.
c. Associated with aortic insufficiency.
d. Indication of a patent ductus arteriosus.

Answer 14

b. Most likely a mammary souffle.

Question 15

When the nurse is assessing the deep tendon reflexes (DTRs) on a woman who is 32 weeks pregnant, which of these would be considered a normal finding on a 0 to 4+ scale?

a. Absent DTRs
b. 2+
c. 4+
d. Brisk reflexes and the presence of clonus

Answer 15

B. 2+

Question 16

When performing an examination of a woman who is 34 weeks pregnant, the nurse notices a midline linear protrusion in the abdomen over the area of the rectus abdominis muscles as the woman raises her head and shoulders off of the bed. Which response by the nurse is correct?

a. The presence of diastasis recti should be documented.
b. This condition should be discussed with the physician because it will most likely need to be surgically repaired.
c. The possibility that the woman has a hernia attributable to the increased pressure within the abdomen from the pregnancy should be suspected.”
“d. The woman should be told that she may have a difficult time with delivery because of the weakness in her abdominal muscles.

Answer 16

a. The presence of diastasis recti should be documented.

Question 17

The nurse is palpating the fundus of a pregnant woman. Which statement about palpation of the fundus is
true?

a. The fundus should be hard and slightly tender to palpation during the first trimester.
b. Fetal movement may not be felt by the examiner until the end of the second trimester.
c. After 20 weeks gestation, the number of centimeters should approximate the number of weeks gestation.
d. Fundal height is usually less than the number of weeks gestation, unless an abnormal condition such as excessive amniotic fluid is present.

Answer 17

c. After 20 weeks gestation, the number of centimeters should approximate the number of weeks gestation.

Question 18

The nurse is palpating the abdomen of a woman who is 35 weeks pregnant and notices that the fetal head is facing downward toward the pelvis. The nurse would document this as fetal:

a. Lie.
b. Variety.
c. Attitude.
d. Presentation.

Answer 18

D. Presentation

Question 19

The nurse is palpating the uterus of a woman who is 8 weeks pregnant. Which finding would be considered to be most consistent with this stage of pregnancy?

a. The uterus seems slightly enlarged and softened.
b. It reaches the pelvic brim and is approximately the size of a grapefruit.
c. The uterus rises above the pelvic brim and is approximately the size of a cantaloupe.
d. It is about the size of an avocado, approximately 8 cm across the fundus.

Answer 19

d. It is about the size of an avocado, approximately 8 cm across the fundus.

Question 20

Which of these correctly describes the average length of pregnancy?

a. 38 weeks
b. 9 lunar months
c. 280 days from the last day of the last menstrual period
d. 280 days from the first day of the last menstrual period

Answer 20

d. 280 days from the first day of the last menstrual period

Question 21

22. A patients pregnancy test is positive, and she wants to know when the baby is due. The first day of her last menstrual period was June 14, and that period ended June 20. Using the Ngele rule, what is her expected date of delivery?

a. march 7
b. March 14
c. March 21
d. March 27

Answer 21

C. March 21

Question 22

During the assessment of a woman in her 22nd week of pregnancy, the nurse is unable to hear fetal heart tones with the fetoscope. The nurse should:

a. Immediately notify the physician, then wait 10 minutes and try again.
b. Ask the woman if she has felt the baby move today.
c. Wait 10 minutes, and try again.
d. Use ultrasound to verify cardiac activity.

Answer 22

d. Use ultrasound to verify cardiac activity.

Question 23

A patient who is 24 weeks pregnant asks about wearing a seat belt while driving. Which response by the nurse is correct?

a. Seat belts should not be worn during pregnancy.
b. Place the lap belt below the uterus and use the shoulder strap at the same time.
c. Place the lap belt below the uterus but omit the shoulder strap during pregnancy.
d. Place the lap belt at your waist above the uterus and use the shoulder strap at the same time.

Answer 23

b. Place the lap belt below the uterus and use the shoulder strap at the same time.

Question 24

During a health history interview, a 38-year-old woman shares that she is thinking about having another baby. The nurse knows which statement to be true regarding pregnancy after 35 years of age?

a. Fertility does not start to decline until age 40 years.
b. Occurrence of Down syndrome is significantly more frequent after the age of 35 years.
c. Genetic counseling and prenatal screening are not routine until after age 40 years.
d. Women older than 35 years who are pregnant have the same rate of pregnancy-related complications as those who are younger than 35 years.

Answer 24

b. Occurrence of Down syndrome is significantly more frequent after the age of 35 years.

Question 25

A 25-year-old woman is in the clinic for her first prenatal visit. The nurse will prepare to obtain which laboratory screening test at this time?

a. Urine toxicology
b. Complete blood cell count
c. Alpha-fetoprotein
d. Carrier screening for cystic fibrosis

Answer 25

b. Complete blood cell count

Question 26

A woman at 25 weeks gestation comes to the clinic for her prenatal visit. The nurse notices that her face and lower extremities are swollen, and her blood pressure is 154/94 mm Hg. The woman states that she has had headaches and blurry vision but thought she was just tired. What should the nurse suspect?

a. Eclampsia
b. Preeclampsia
c. Diabetes type 1
d. Preterm labor

Answer 26

b. Preeclampsia

Question 27

During auscultation of fetal heart tones (FHTs), the nurse determines that the heart rate is 136 beats per minute. The nurses next action should be to:

a. Document the results, which are within normal range.
b. Take the maternal pulse to verify these findings as the uterine souffle.
c. Have the patient change positions and count the FHTs again.
d. Immediately notify the physician for possible fetal distress.

Answer 27

a. Document the results, which are within normal range.

Question 28

During a woman’s 34th week of pregnancy, she is told that she has preeclampsia. The nurse knows which statement concerning preeclampsia is true?

a. Preeclampsia has little effect on the fetus.
b. Edema is one of the main indications of preeclampsia.
c. Eclampsia only occurs before delivery of the baby.
d. Untreated preeclampsia may contribute to restriction of fetal growth.

Answer 28

d. Untreated preeclampsia may contribute to restriction of fetal growth.

Question 29

During a group prenatal teaching session, the nurse teaches Kegel exercises. Which statements would be appropriate for this teaching session? Select all that apply.

a. Kegel exercises help keep your uterus strong during the pregnancy.
b. Kegel exercises should be performed twice a day.
c. Kegel exercises should be performed 50 to 100 times a day.
d. To perform Kegel exercises, slowly squeeze to a peak at the count of eight, and then slowly release to a count of eight.
e. To perform Kegel exercises, rapidly perform alternating squeeze-release exercises up to the count of eight.

Answer 29

c. Kegel exercises should be performed 50 to 100 times a day.
d. To perform Kegel exercises, slowly squeeze to a peak at the count of eight, and then slowly release to a count of eight.