EVOLVE TESTS - ch. 9, 13, 14

Question 1

1. A woman inquires about herbal alt methods for improving fertility. Which statement by the RN is the most approp when instructing the woman in which herbal preparations to avoid while trying to conceive?

A. You should avoid nettle leaf, dong quai, & vit E while you are trying to get pregnant.
B. You may want to avoid licorice root, lavender, fennel, sage, & thyme while you are trying to conceive.
C. You should not take anything with vit E, Ca, or Mg. They will make you infertile.”
D. “Herbs have no bearing on fertility.”

Answer 1

B

Question 2

2. Semen analysis is a common diagnostic procedure related to infertility. In instructing a male pt regarding this test, the RN would tell him to:

A. Ejaculate into a sterile container
B. Obtain the specimen after a period of abstinence from ejaculation of 2 to 5 days
C. Transport specimen w/container packed in ice
D. Ensure specimen arrives at the lab w/n 30 min of ejaculation

Answer 2

B

Question 3

3. RNs should be aware that infertility:

A. Is perceived differently by women & men
B. Has a relatively stable prevalence among the overall population & throughout a women’s potential reproductive years
C. Is more likely the result of a physical flaw in the woman than in her male partner
D. Is the same thing as sterility

Answer 3

A

Question 4

4. Although remarkable developments have occurred in reproductive medicine, assisted reproductive therapies are associated with a number of legal & ethical issues. RNs can provide accurate information about the risks & benefits of TX alternatives so couples can make informed decisions about their choice of TX. Which issue would not need to be addressed by an infertile couple before TX?

A. Risk of multiple gestation
B. Whether or how to disclose the facts of conception to offspring
C. Freezing embryos for later use
D. Financial ability to cover the cost of TX

Answer 4

D

Question 5

5. A couple presents for their first appointment at an infertility center. A noninvasive test done during initial diagnostic testing is:

A. Hysterosalpingogram
B. Endometrial biopsy
C. Sperm analysis
D. Laparoscopy

Answer 5

C

Question 6

6. An infertile woman is about to begin pharmacologic TX. As part of the regimen, she will take purified FSH (urofollitropin [Metrodin]). The RN instructs her that this med is administered in the form of a/an:

A. Intranasal spray
B. Vaginal suppository
C. Intramuscular injection
D. Tablet

Answer 6

C

Question 7

7. The rate of fertility declines dramatically after the age of 35. While explaining the cause of this rapid decline in fertility to the pt, the RN is aware that the primary reason for this is r/t:

A. Endometriosis
B. Abnormalities of oocytes
C. Infection
D. Metabolic disease

Answer 7

B

Question 8

CHAPTER 13

Answer 8

CHAPTER 13

Question 9

1. A woman is 6 wks pregnant. She has had a previous spontaneous abortion at 14 wks of gestation & a pregnancy that ended at 38 wks with the birth of a stillborn girl. What is her gravidity & parity using the GTPAL system?

A. 2-0-0-1-1
B. 2-1-0-1-0
C. 3-1-0-1-0
D. 3-0-1-1-0

Answer 9

c

Question 10

2. OTC pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)?

A. Radioimmunoassay
B. Radioreceptor assay
C. Latex agglutination test
D. ELISA

Answer 10

D.
The radioimmunoassay tests for the summit of hCG in serum or urine samples. This test must be performed in the lab,
The radioreceptor assay is a serum test that measures the ability of a blood sample to inhibit the binding of hCG to receptors.
The Latex agglutination test in no way determines pregnancy. Rather it is done to detect specific antigens and antibodies.
OTC pregnancy tests use ELISA for its one-step, accurate results.

Question 11

3. A nurse teaches a pregnant woman about the presumptive, probable, & positive signs of pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a positive sign of pregnancy is:

A. A positive pregnancy test
B. Fetal movement palpated by the nurse-midwife
C. Braxton Hicks contractions
D. Quickening

Answer 11

B

Question 12

4. During a pt’s physical exam, the RN notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:

A. Hegar sign
B. McDonald sign
C. Chadwick sign
D. Goodell sign

Answer 12

A
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occur; this is called the Hegar sign.
The McDonald sign indicates a fast-food restaurant.
The Chadwick sign is a blue-violet cervix caused by increased vascularity; this occurs around the fourth week of gestation.
Softening of the cervical tip is called the Goodell sign, which may be observed around the sixth week of pregnancy.

Question 13

5. CV system changes occur during preg. Which finding would be considered normal for a woman in her 2nd trimester?

A. Less audible heart sounds (S1, S2)
B. Increased pulse rate
C. Increased blood pressure
D. Decreased red blood cell (RBC) production

Answer 13

B
Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term.
In the first trimester blood pressure usually remains the same as the prepregnancy level, but it gradually decreases up to about 20 weeks of gestation. During the second trimester both the systolic and diastolic pressures decrease by about 5 to 10 mm Hg.

Question 14

7. Which presumptive sign (felt by woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause?

A. Amenorrhea-stress, endocrine problems
B. Quickening-gas, peristalsis
C. Goodell sign-cervical polyps
D. Chadwick sign-pelvic congestion

Answer 14

C

Goodell sign might be the result of pelvic congestion, not polyps.

Question 15

8. In order to reassure & educate pregnant pts about changes in their BP, maternity nurses should be aware that:

A. a BP cuff that’s too small produces a reading that’s too low; if too large, produces a reading that is too high
B. Shifting pt’s position & changing from arm to arm for different measurements produces the most accurate composite BP reading at each visit
C. The SBP increases slightly as pregnancy advances; the diastolic pressure remains constant
D. Compression of the iliac veins & IVC by the uterus contributes to hemorrhoids in later stage of term preg

Answer 15

D
Because maternal positioning affects readings, blood pressure measurements should be obtained in the same arm and with the woman in the same position.
The systolic blood pressure generally remains constant but may decline slightly as pregnancy advances. The diastolic blood pressure first drops and then gradually increases.
This compression also leads to varicose veins in the legs and vulva.

Question 16

9. Which H&H results represent the lowest acceptable values for a woman in the third trimester of pregnancy?

A. 38% HCT; 14 g/dl HGB
B. 35% HCT; 13 g/dl HGB
C. 33% HCT; 11 g/dl HGB
D. 32% HCT; 10.5 g/dl HGB

Answer 16

C -represents the lowest acceptable value during the first and the third trimesters.
Rationale: A, B: This result is WNL in a nonpregnant woman. D: This represents the lowest acceptable value for the second trimester, when the hemodilution effect of blood volume expansion is at its peak.

Question 17

1. Which suggestion about weight gain is not an accurate recommendation?

A. Underweight women should gain 12.5 to 18 kg.
B. Obese women should gain at least 7 kg.
C. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale.
D. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.

Answer 17

D

Question 18

2. A pregnant woman experiencing nausea and vomiting should:

A. Drink a glass of water with a fat-free carb before getting out of bed in the morning
B. Eat small, frequent meals (every 2 to 3 hours)
C. Increase her intake of high-fat foods to keep the stomach full and coated
D. Limit fluid intake throughout the day

Answer 18

B

Question 19

3. A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the most important?

A. Several glasses of fluid
B. Extra protein sources, such as peanut butter
C. Salty foods to replace lost sodium
D. Easily digested sources of carbohydrate

Answer 19

A

Question 20

4. 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

Answer 20

B

Question 21

5. Which minerals & vitamins usually are recommended to sup a pregnant woman’s diet?

A. Fat-soluble vitamins A and D
B. Water-soluble vitamins C and B6
C. Iron and folate
D. Calcium and zinc

Answer 21

C

Question 22

6. With regard to nutritional needs during lactation, a maternity nurse should be aware that:

A. The mother’s intake of vitamin C, zinc, and protein now can be lower than during pregnancy
B. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful
C. Critical iron & folic acid lvls must be maintained
D. Lactating women can go back to their prepregnant calorie intake

Answer 22

B

Question 23

7. When counseling a pt about getting enough iron in her diet, the maternity RN should tell her that:

A. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron
B. Iron absorption is inhibited by a diet rich in vitamin C
C. Iron supplements are permissible for children in small doses
D. Constipation is common with iron supplements

Answer 23

D

Question 24

8. A 22-y/o woman preg with a single fetus has a preconception BMI of 24. When seen in the clinic at 14 wk of gest, she had gained 1.8 kg (4 lb) since conception. How would the RN interpret this?

A. This wt gain indicates possible gestational HTN.
B. This weight gain indicates that the woman’s infant is at risk for IUGR.
C. This wt gain cannot be evaluated until she has been observed for several more weeks.
D. Her wt gain is approp for this stage of pregnancy.

Answer 24

D

Question 25

9. With regard to protein in the diet of pregnant women, nurses should be aware that:

A. Many protein-rich foods are also good sources of calcium, iron, and B vitamins
B. Many women need to increase their protein intake during pregnancy
C. As with carbs & fat, no specific recommendation exist for the amount of protein in the diet
D. High-protein supplements can be used without risk by women on macrobiotic diets

Answer 25

A