OB Test 1 Questions Flashcards
1
Q
The nurse expects to see which maternal cardiovascular finding during labor?
a. decreased BP
b. Dereased Pulse
c. Decreased WBC
d. Increased Cardiac Output
A
d. Increased Cardiac Output
2
Q
Regarding how the fetus moves through the birth canal, nurses should be aware that:
a. the transverse lie is preferred for vaginal birth
b. the fetal attitude describes the angle at which the fetus exits the uterus
c. of the 2 primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother.
D. the normal attitude of the fetus is called general flexion
A
D. the normal attitude of the fetus is called general flexion
3
Q
When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called the fetal ___.
A. Position
B. Presentation
C. Lie
D. Attitude
A
D. Attitude
4
Q
The nurse recognises that a woman is in true labor when she states:
a. my baby dropped and i have to urinate more frequently now
b. my water just broke
c. the contractions in my uterus are getting stronger and more close together now
D. I passes some thick, pink mucus when i urinated this morning
A
c. the contractions in my uterus are getting stronger and more close together now
5
Q
What position is least effective when gravity is desired to assist in fetal decent?
a. Lithotomy
b. Sitting
C. Walking
d. Kneeling
A
a. Lithotomy
6
Q
To adequately care for laboring women, the nurse should know which stage of labor varies the most in length?
a. third
b. first
c. fourth
d. second
A
b. first
7
Q
The factors that affect the process of labor and birth, known commonly as the 5 P’s include all but:
a. Passageway
b. Passenger
C. Powers
D. Pressure
A
D. Pressure
8
Q
The slight overlapping of the cranial bones or shaping of the fetal head during labor is called?
a. molding
b. lightening
c. furguson’s reflex
d. Valsava Maneuver
A
a. molding
9
Q
When assess a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective is:
a. dilation of the cervix
b. decent of the fetus
c. increase in bloody show
d, rupture of the amniotic membranes
A
a. dilation of the cervix
10
Q
Nurse alert to signs of the onset of the second stage of labor can be certain that the stage has begun when:
a. the woman has a sudden episode of vomiting
b. the nurse is unable to feel the cervix during a vaginal examination
c. the bloody show increases
d. the woman involuntarily tries to bear down
A
b. the nurse is unable to feel the cervix during a vaginal examination
11
Q
Which collection of risk factors will most likely result in damaging lacerations including episiotomies?
a. a first time mother with red hair whose rapid labor was overseen by an obsterrician
b. a red haired mother of 2 who is going through a breech birth
A
a. a first time mother with red hair whose rapid labor was overseen by an obsterrician
wasn’t typing all that shit out lol
12
Q
A 25 year old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9 pound 7 oz boy after agmentation of labor with pitocin. She puts on her call light and asks for her nurse right away stating that she is bleeding a lot. The most likely cause of her hemorrhage is this woman is:
a. retained placental fragments
b. un repaired vaginal lacerations
c. uterine atony
d. puerperal infection
A
c. uterine atony
13
Q
Emergency conditions during labor that require immediate nursing interventions can arise with startling speed. Examples of such emergencies include
A
vaginal bleeding
infection
prolapse of the cord
nonreassuring or abnormal fetal heart rate
inadequate uterine relaxation
14
Q
Which factors influence cervical dilation?
scaring of the cervix
the force of the presenting fetal part against the cervix
the pressure applied by the amniotic sac
the size of the female
strong uterine contractions
A
everything but the size of the female
15
Q
- The diagnosis of pregnancy is based on which positive signs of pregnancy? Choose all that apply,
A. Verification of fetal movement, B. identification of fetal heartbeat, C. Positive human chorionic gonadotropin hCG test, D. palpation of the fetal outline, E. visualization of the fetus
A
A. Verification of fetal movement,
B. identification of fetal heartbeat,
E. visualization of the fetus
16
Q
- A 31 year old women believes that she may be pregnant. She took an over-the-counter pregnancy test one week ago after missing her., The test was positive. During her assessment interview, the nurse inquires about the woman’s last menstrual period and asks whether she is taking any medications. The woman states that she takes medicine for epilepsy. She is under considerable stress lately at work and has not been sleeping well. She also has a history of irregular periods. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which reveals that she is not pregnant. What is the most likely cause of the of the false positive pregnancy test results?
A. She took the pregnancy test too early.
B. She has been under considerable stress and has a hormone imbalance.
C. She takes anticonvulsants.
D. she has a fibroid tumor.
A
C. She takes anticonvulsants
17
Q
- What represents a typical progression through the phases of a woman’s establishing a relationship with the fetus?
A. Except the fetus as distinct from herself, except the biologic fact of pregnancy, has a feeling of caring and responsibility.
B. Views the child as a part of her self, has feelings of well-being, excepts the biologic factor pregnancy.
C. Fantasize about the child’s gender and personality, views the child as part of her self, becomes introspective.
D. I am pregnant, I am going to have a baby, I am going to be a mother.
A
D. I am pregnant, I am going to have a baby, I am going to be a mother.
18
Q
- For what reason is breast-feeding contraindicated?
A. Human immunodeficiency virus HIV positive
B. History of breast cancer three years ago.
C. Hepatitis B.
D. Everted nipples.
A
A. Human immunodeficiency virus HIV positive
19
Q
- Many pregnant women have questions regarding work in travel during pregnancy. The nurse should instruct clients that,
A. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.
B. Women should avoid seatbelt and shoulder restraints in the car because they press on the fetus.
C. metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times.
D. Women should sit for long periods and crossed her legs at the knees from time to time for exercise.
A
A. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.
20
Q
- Which time based description of a stage of development and pregnancy is accurate?
A. Postdate, pregnancy that extends beyond 38 weeks.
B. Preterm, pregnancy from 20 to 28 weeks.
C. Viability, 22 to 37 weeks since the last menstrual period Assuming a fetal weight greater than 500 g
D. Term, pregnancy from the beginning of week 38 of just Teish into the end of week 42.
A
D. Term, pregnancy from the beginning of week 38 of just Teish into the end of week 42.
21
Q
- A musculoskeletal system adapts to changes that occur during pregnancy. A woman can expect to experience what change?
A. She will have increased abdominal muscle tone.
B. She will notice decreased mobility and her pelvic joints.
C. Her center of gravity will shift backwards.
D. She will have increased lordosis.
A
D. She will have increased lordosis.
22
Q
- In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seem 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 protect the mother and fetus during pregnancy.
C. To ward off the evil eye.
D. To appease the gods of fertility.
A
B. to protect the mother and fetus during pregnancy
23
Q
- A nurse caring for a newly pregnant woman advises her that ideally prenatal care should begin,
A. after the first missed menstrual period
B. after the third missed menstrual period
C. Before the first missed menstrual period
D. After the second missed menstrual period.
A
A. after the first missed menstrual period
24
Q
- A woman’s obstetric history indicates that she is pregnant for a fourth time, and all of her children from previous pregnancies are living. One child was born at 39 weeks of just station, twins were burnt born at 34 weeks of gestation, and another child was born at 35 weeks of just station. What is her gravidity and parity using the GT PAL system?
A. 4-1-2-0-4
B. 3-0-3-0-3
C. 4-2-1-0-3
D. 3-1-1-1-3
A
A. 4-1-2-0-4
25
11. A woman arrived at the clinic for a pregnancy test. Her last menstrual period was February 14, 2013. Her expected date of birth was,
A. November 7, 2013
B. November 21, 2013
C. December 17, 2013
D. September 17, 2013
B. November 21, 2013
26
12. A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expected parents class. Which aspect of their birth plan would be considered unrealistic and require further discussion with the nurse?
A. We plan to use the technique taught in the Lamaze class to reduce pain experienced during labor.
B. My husband and I have agreed that my sister will be my coach because he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure that everything is okay.
C. we want the labor and birth to take place in a birthing broom. My husband will come in the minute the baby is born.
D. We do not want the fetal monitor used during labor because it will interfere with movement and doing Effeurage.
D. We do not want the fetal monitor used during labor because it will interfere with movement and doing Effeurage.
27
13. Prenatal testing for the human immunodeficiency virus HIV is recommended for which women?
A. All women who is monogamous with their partner.
B. All women, regardless of the risk factors
C. A woman who has had more than one sexual partner.
D. A woman who has had a sexually transmitted infection.
B. All women, regardless of the risk factors
28
14. A nurse should be aware that a partners main role and pregnancy is,
A. To protect the pregnant woman from old wives tells
B. To provide financial support.
C. To make sure that the pregnant woman keeps prenatal appointments.
D. To support and nurture the pregnant woman.
D. To support and nurture the pregnant woman.
29
15. During the initial visit with the client who is beginning prenatal care, nurses should be aware that,
A. The first interview is relaxed, get acquainted affair in which nurses gather some general impressions.
B. If nurses observed handicapping conditions, they should be sensitive and not inquire about them because the client will do that on her own time.
C.Because of legal complications, nurses should not ask about illegal drug use, that is left to physicians.
D. The nurses should be alert to appearance a potential parenting problems, such as depression or lack of family support.
D. The nurses should be alert to appearance a potential parenting problems, such as depression or lack of family support
30
1. 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."
c. "They occur between the third and fifth weeks of development."
The cardiovascular system is the first organ system to function in the developing human. Blood vessel and blood formation begins in the third week, and the heart is developmentally complete in the fifth week.
31
A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate?
a. "Many women imagine what their baby is like."
b. "A baby in utero does respond to the mother's voice."
c. "You'll need to ask the doctor if the baby can hear yet."
d. "Thinking that your baby hears will help you bond with the baby."
b. "A baby in utero does respond to the mother's voice."
Fetuses respond to sound by 24 weeks. The fetus can be soothed by the sound of the mother's voice.
32
A maternity nurse should be aware of which fact about the amniotic fluid?
a. It serves as a source of oral fluid and as a repository for waste from the fetus.
B. The volume remains about the same throughout the term of a healthy pregnancy.
C. A volume of less than 300 ml is associated with gastrointestinal malformations.
D. A volume of more than 2 L is associated with fetal renal abnormalities.
a. It serves as a source of oral fluid and as a repository for waste from the fetus.
Amniotic fluid also cushions the fetus and helps maintain a constant body temperature.
33
Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that:
A. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing
B. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins
C. Identical twins are more common in Caucasian families
D. Fraternal twins are same gender, usually male
A. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing
If the parents-to-be are older and have taken fertility drugs, they would be very interested in this information.
34
The nurse caring for a pregnant woman knows that her health teaching regarding fetal circulation has been effective when the woman reports that she has been sleeping:
A. In a side-lying position
B. On her back with a pillow under her knees
C. With the head of the bed elevated
D. On her abdomen
A. In a side-lying position
Optimal circulation is achieved when the woman is lying at rest on her side. Decreased uterine circulation may lead to intrauterine growth restriction. Previously it was believed that the left lateral position promoted maternal cardiac output, thereby enhancing blood flow to the fetus. However, it is now known that either side-lying position enhances uteroplacental blood flow.
35
A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates:
A. The fetus is at risk for Down syndrome
B. The woman is at high risk for developing preterm labor
C. Lung maturity
D. Meconium is present in the amniotic fluid
C. Lung maturity
The detection of the presence of pulmonary surfactants, surface-active phospholipids, in amniotic fluid has been used to determine fetal lung maturity, or the ability of the lungs to function after birth. This occurs at approximately 35 weeks of gestation.
36
Which time span delineates the appropriate length for a normal pregnancy?
A. 9 lunar months, 8.5 calendar months, 39 weeks, 272 days
B. 10 lunar months, 9 calendar months, 40 weeks, 280 days
C. 9 calendar months, 10 lunar months, 42 weeks, 294 days
D. 9 calendar months, 38 weeks, 266 days
B. 10 lunar months, 9 calendar months, 40 weeks, 280 days
Pregnancy lasts approximately 10 lunar months, 9 calendar months, 40 weeks, 280 days. Length of pregnancy is computed from the first day of the last menstrual period (LMP) until the day of birth.
37
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?
A. 2-0-0-1-1
B. 2-1-0-1-0
C. 3-1-0-1-0
D. 3-0-1-1-0
C. 3-1-0-1-0
38
Over-the-counter (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. Enzyme-linked immunosorbent assay (ELISA)
D. Enzyme-linked immunosorbent assay (ELISA)
OTC pregnancy tests use ELISA for its one-step, accurate results.
39
A 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:
A. A positive pregnancy test
B. Fetal movement palpated by the nurse-midwife
C. Braxton Hicks contractions
D. Quickening
B. Fetal movement palpated by the nurse-midwife
Positive signs of pregnancy are those that are attributed to the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement.
40
During a client's physical examination, the nurse 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
A. Hegar sign
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occur; this is called the Hegar sign.
41
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?
A. Less audible heart sounds (S1, S2)
B. Increased pulse rate
C. Increased blood pressure
D. Decreased red blood cell (RBC) production
B. Increased pulse rate
Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term.
42
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
A. Primipara
B. Primigravida
C. Multipara
D. Nulligravida
A. Primipara
A primipara is a woman who has completed one pregnancy with a viable fetus.
43
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
C. Goodell sign-cervical polyps
Goodell sign might be the result of pelvic congestion, not polyps.
44
In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that:
A. A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high
B. Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit
C. The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant
D. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy
D. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy
This compression also leads to varicose veins in the legs and vulva.
45
Which hematocrit (HCT) and hemoglobin (HGB) 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
C. 33% HCT; 11 g/dl HGB
This represents the lowest acceptable value during the first and the third trimesters.
46
G:
Total number of times the woman has been pregnant
47
T:
Number of pregnancies carried to term
48
P:
Number of pregnancies that resulted in a preterm birth
49
A:
Abortions or miscarriages before the period of viability
50
L:
Number of children born who are currently living
51
Chadwick sign
The Chadwick sign is a blue-violet cervix caused by increased vascularity; this occurs around the fourth week of gestation.
52
Goodell sign
Softening of the cervical tip is called the Goodell sign, which may be observed around the sixth week of pregnancy.
53
Primipara
A primipara is a woman who has completed one pregnancy with a viable fetus.
54
Primigravida
A primigravida is a woman pregnant for the first time.
55
Multipara
A multipara is a woman who has completed two or more pregnancies with a viable fetus.
56
Nulligravida
A nulligravida is a woman who has never been pregnant.
57
Too little amniotic fluid (oligohydramnios) is associated with _______.
renal abnormalities.
58
Too much amniotic fluid (hydramnios) is associated with ____________.
gastrointestinal and other abnormalities.
59
Conjoined twins are __________; they are from a single fertilized ovum in which division occurred very late.
monozygotic
60
True or False
Fraternal twins can be different genders or the same gender.
True
61
True or False
Identical twins are the same gender.
true
62
True or False
If a woman lies on her back with the pressure of the uterus compressing the vena cava, blood return to the right atrium will be diminished.
true
63
Conception
is the union of a single egg and sperm, which marks the beginning of a pregnancy. The conception process includes:
♣ Gamete (or egg and sperm) formation
♣ Ovulation (or the release of the egg)
♣ Fertilization (or the union of the gametes)
♣ And implantation in the uterus.
64
Cell reproduction
occurs by two different methods: mitosis and meiosis.
♣ In mitosis, body cells replicate to yield two cells with the same genetic makeup as the parent cell. Mitotic cell division allows growth and development or cell replacement.
♣ In meiosis, germ cells divide and decrease their chromosomal number by half, producing gametes.
65
mitosis
In mitosis, body cells replicate to yield two cells with the same genetic makeup as the parent cell. Mitotic cell division allows growth and development or cell replacement.
66
meiosis
In meiosis, germ cells divide and decrease their chromosomal number by half, producing gametes.
67
In women, ______ in the ovarian follicles produces an egg (or ovum). At ovulation, the ovum is released and moves down the uterine tubes toward the uterus.
A. meiosis
B. mitosis
A. meiosis
68
If sperm reach the ovum in the outer third of the uterine tube within 24 hours of ovulation, _______ occurs.
A. meiosis
B. mitosis
C. fertilization
fertilization
When the nuclei of the sperm and ovum fuse, their chromosomes combine, restoring the number of chromosomes to 46.
69
After Fertilization, and the Chromosomes Combine,
| At this point, a _______ has formed and this is the first cell of the new individual.
zygote
Within 3 to 4 days, the zygote reaches the uterus. Mitotic division occurs, creating a 16-cell morula, which eventually becomes a trophoblast.
70
Six to ten days after conception, _______ occurs. At this stage, the trophoblast burrows into the endometrium until it is completely covered.
implantation
71
Pregnancy lasts about ______ days after the last menstrual period, or 266 days (or 38 weeks) after conception.
280
72
Intrauterine development is divided into three stages: ______ _____ and ______.
ovum, embryo, and fetus.
73
The ovum stage lasts from conception until day _____ and includes the development of the primary germ layers.
14
74
The embryo stage lasts from day 15 until about ______ weeks after conception, when the embryo measures 3 cm from crown to rump.
8
This stage is the most critical time in the development of the organ systems and the main external features. Developing areas with rapid cell division are the most vulnerable to malformation caused by environmental teratogens, which are substances or exposures that cause abnormal development.
♣ By the end of the eighth week, all organ systems and external structures are present, and the embryo is unmistakably human.
75
The fetal stage lasts from ______ weeks after conception until the pregnancy ends.
9
♣ Changes during this stage are not as dramatic, because structures and functions are being refined.
♣ The fetus is less vulnerable to teratogens, except for those affecting central nervous system functioning.
76
Viability refers to
the ability of the fetus to survive outside the uterus. Infants who are at 22 to 25 weeks of gestation are now considered to be on the threshold of viability
77
_____________ are conditions that are present at birth. They may be inherited or caused by environmental factors or inadequate maternal nutrition. Compared to other forms of developmental disabilities, those caused by teratogens are theoretically totally preventable.
Congenital disorders
78
Gravidity
refers to pregnancy.
79
Parity
refers to the number of pregnancies in which the fetus or fetuses reached 20 weeks of gestation when they were born.
80
term pregnancy
is one that is from the end of week 37 to the end of week 42 of gestation.
81
A preterm pregnancy
is one that has reached week 20 of gestation but ends before the completion of week 37 of gestation.
82
A postterm (or postdate) pregnancy
is one that goes beyond week 42 of gestation.
83
True or False
Early detection of pregnancy allows care to begin early.
true
84
__________ is the earliest biochemical marker for pregnancy, and pregnancy tests are based on recognition of ____ or its beta subunit.
Human chorionic gonadotropin (or hCG)
85
Many different pregnancy tests are available. __________ testing is the most popular method. It uses monoclonal antibody technology and is the basis for most over-the-counter home pregnancy tests.
Enzyme-linked immunosorbent assay (or ELISA)
86
Presumptive signs
are those noticed by the woman, such as amenorrhea, fatigue, nausea, vomiting, and breast changes.
87
Probable signs
are those noted by the examiner, such as Hegar sign, ballottement, and pregnancy tests.
88
Positive signs
are those that are attributable only to the fetus, such as hearing fetal heart tones, visualizing the fetus, and palpating fetal movements. Only positive signs can establish the diagnosis of pregnancy.
89
The biochemical, physiologic, and anatomic adaptations that occur during pregnancy are profound and revert to the ______ state after birth and lactation.
nonpregnant
90
Maternal physiologic adaptations are attributed to the __________ of pregnancy and to mechanical pressures exerted by the enlarging uterus and other tissues.
hormones
The adaptations:
♣ Protect the woman’s normal physiologic functioning.
♣ Meet the metabolic demands pregnancy imposes on her body.
♣ And provide a nurturing environment for fetal development and growth.
91
Changes in the reproductive system and breasts are likely to be the most noticeable during pregnancy.
♣ The uterus enlarges greatly and changes in shape and position.
♣ Although the pH of vaginal secretions becomes more acidic, the pregnant woman is more vulnerable to some vaginal infections, especially yeast infections.
♣ Increased vascularity and sensitivity of the vagina and other pelvic viscera may lead to a high degree of sexual interest and arousal.
♣ Fullness, heightened sensitivity, tingling, and heaviness of the breasts begin in the early weeks of gestation. Colostrum may be expressed from the nipples as early as 16 weeks of gestation.
92
Changes occur in other body systems during pregnancy, affecting everything from the pulse rate and blood pressure to the basal metabolic rate and acid-base balance.
♣ Some adaptations to pregnancy result in discomforts, such as fatigue, urinary frequency, nausea, and breast discomfort.
♣ As pregnancy progresses, changes in the woman’s joints and center of gravity affect her balance and coordination.
93
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.
D. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.
Women bearing twins need to gain more weight (usually 16 to 20 kg) but not necessarily twice as much.
94
A pregnant woman experiencing nausea and vomiting should:
A. Drink a glass of water with a fat-free carbohydrate 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
B. Eat small, frequent meals (every 2 to 3 hours)
This is a correct suggestion for a woman experiencing nausea and vomiting.
95
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
A. Several glasses of fluid
If no medical or obstetric problems contraindicate physical activity, pregnant women should get 30 minutes of moderate physical exercise daily. Liberal amounts of fluid should be consumed before, during, and after exercise, because dehydration can trigger premature labor. Also the woman’s calorie intake should be sufficient to meet the increased needs of pregnancy and the demands of exercise.
96
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
B. Intrauterine growth restriction
Both normal-weight and underweight women with inadequate weight gain have an increased risk of giving birth to an infant with intrauterine growth restriction.
97
Which minerals and vitamins usually are recommended to supplement 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
C. Iron and folate
Iron generally should be supplemented, and folic acid supplements often are needed because folate is so important.
98
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 and folic acid levels must be maintained
D. Lactating women can go back to their prepregnant calorie intake
B. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful
A lactating woman needs to avoid consuming too much caffeine.
99
When counseling a client about getting enough iron in her diet, the maternity nurse 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
D. Constipation is common with iron supplements
Constipation can be a problem.
100
A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lb) since conception. How would the nurse interpret this?
A. This weight gain indicates possible gestational hypertension.
B. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR).
C. This weight gain cannot be evaluated until the woman has been observed for several more weeks.
D. The woman's weight gain is appropriate for this stage of pregnancy.
D. The woman's weight gain is appropriate for this stage of pregnancy.
This is an accurate statement. This woman's BMI is within the normal range. During the first trimester, the average total weight gain is only 1 to 2.5 kg.
101
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 carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet
D. High-protein supplements can be used without risk by women on macrobiotic diets
A. Many protein-rich foods are also good sources of calcium, iron, and B vitamins
Good protein sources such as meat, milk, eggs, and cheese have a lot of calcium and iron.
102
True or False
A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the day or when nauseated.
true
A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the morning or when nauseated but should compensate by drinking fluids at other times.
103
True or False
A pregnant woman experiencing nausea and vomiting should reduce her intake of fried foods and other fatty foods.
true
104
An adequate amount of folic acid has been shown to reduce the incidence of this condition…..
Spina bifida
105
True or False
A gestational diabetic mother is more likely to give birth to a large-for-gestational age infant.
true
106
__________ is the result of a trisomy 21
Down syndrome
107
Fat-soluble vitamins A and D
Fat-soluble vitamins should be supplemented as a medical prescription, as vitamin D might be for lactose-intolerant women.
108
Water-soluble vitamins C and B6
Water-soluble vitamin C sometimes is consumed in excess naturally; vitamin B6 is prescribed only if the woman has a very poor diet.
109
True or False
High-protein supplements are not recommended because they have been associated with an increased incidence of preterm births.
true
110
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:
A. "You don't need to modify your exercising any time during your pregnancy."
B. "Stop exercising, because it will harm the fetus."
C. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."
D. "Jogging is too hard on your joints; switch to walking now."
C. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."
"You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month."
111
A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be:
A. Constipation
B. Alteration in the pattern of fetal movement
C. Heart palpitations
D. Edema in the ankles and feet at the end of the day
b. Alteration in the pattern of fetal movement
An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy.
112
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."
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."
A safe level of alcohol consumption during pregnancy has not yet been established. Although the consumption of occasional alcoholic beverages may not be harmful to the mother or her developing fetus, complete abstinence is strongly advised.
113
Which behavior indicates that a woman is "seeking safe passage" for herself and her infant?
A, She keeps all prenatal appointments.
B. She "eats for two."
C. She drives her car slowly.
D. She wears only low-heeled shoes.
A. She keeps all prenatal appointments.
The goal of prenatal care is to foster a safe birth for the infant and mother. Keeping all prenatal appointments is a good indication that the woman is indeed seeking "safe passage."
114
```
What type of cultural concern is the most likely deterrent to many women seeking prenatal care?
A. Religion
B. Modesty
C. Ignorance
D. Belief that physicians are evil
```
B. Modesty
A concern for modesty is a deterrent to many women seeking prenatal care. For some women, exposing body parts, especially to a man, is considered a major violation of their modesty.
115
In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that:
A. Nonacceptance of the pregnancy very often equates to rejection of the child
B. Mood swings most likely are the result of worries about finances and a changed lifestyle, as well as profound hormonal changes
C. Ambivalent feelings during pregnancy usually are seen only in emotionally immature or very young mothers
D. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth
b. Mood swings most likely are the result of worries about finances and a changed lifestyle, as well as profound hormonal changes
Mood swings are natural and are likely to affect every woman to some degree.
116
With regard to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that:
A. The father goes through three phases of acceptance of his own
B. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth
C. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home
D. Typically men remain ambivalent about fatherhood right up to the birth of their child
A. The father goes through three phases of acceptance of his own
A father typically goes through three phases of acceptance: accepting the biologic fact, adjusting to the reality, and focusing on his role.
117
With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that:
A. Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus
B. The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester
C. Killed-virus vaccines (e.g., tetanus) should not be given during pregnancy, but live-virus vaccines (e.g., measles) are permissible
D. No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus
A.Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus
This is especially true for new medications and combinations of drugs.
118
Which statement about multifetal pregnancy is not accurate?
A. The expectant mother often develops anemia because the fetuses have a greater demand for iron.
B. Twin pregnancies come to term with the same frequency as single pregnancies.
C. The mother should be counseled to increase her nutritional intake and gain more weight.
D. Backache and varicose veins are often more pronounced.
B. Twin pregnancies come to term with the same frequency as single pregnancies.
Twin pregnancies often end in prematurity. Serious efforts should be made to bring the pregnancy to term.
119
The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that:
A. She will have to give birth at home
B. She must see an obstetrician as well as the midwife during pregnancy
C. She will not be able to have epidural analgesia for labor pain
D. She must be having a low risk pregnancy
D .She must be having a low risk pregnancy
Midwives usually see low risk obstetric clients. Care is often noninterventional with active involvement from the woman and her family. Nurse-midwives must refer clients to physicians for complications.
120
An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. The nurse should tell the couple that:
A. Intercourse should be avoided if any spotting from the vagina occurs afterward
B. Intercourse is safe until the third trimester
C. Safer-sex practices should be used once the membranes rupture
D. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present
D. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present
Uterine contractions that accompany orgasm can stimulate labor and would be problematic if the woman were at risk for or had a history of preterm labor.
121
A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she:
A Wiggles and points her toes during the cramp
B Applies cold compresses to the affected leg
C Extends her leg and dorsiflexes her foot during the cramp
D Avoids weight bearing on the affected leg during the cramp
C. Extends her leg and dorsiflexes her foot during the cramp
Extending the leg and dorsiflexing the foot is the appropriate relief measure for a leg cramp.
122
An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's best response is:
A. "This is normal behavior and should begin to subside by the second trimester."
B "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor I know."
C "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant."
D "You seem impatient with her. Perhaps this is precipitating her behavior."
C. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy. The mood swings will eventually subside as she adjusts to being pregnant."
This is the most appropriate response because it gives an explanation and a time frame for when the mood swings may stop.
123
The prenatal period is a preparatory phase both physically, in terms of fetal growth and parental adaptations, and psychologically, in terms of anticipation of parenthood.
Pregnancy affects all family members, and each family member must adapt to the pregnancy and interpret its meaning in light of his or her own needs.
124
Women of all ages use the months of pregnancy to adapt to the maternal role.
The first step in adaptation is accepting the idea of pregnancy and assimilating the pregnancy into the woman’s life. However, most women have some ambivalent feelings, even if the pregnancy was planned.
o Although the woman’s relationship with her mother is significant to her adaptation, it is usually more important to her to feel loved and valued by the father of her child and to have the child accepted by him.
o The woman’s emotional attachment to the fetus begins during the prenatal period.
o Many women actively prepare for childbirth by reading books, viewing films, attending parenting classes, and talking to other women and their caregiver.
125
Fathers adjust to the parental role in different ways. However, most men use pregnancy as a time to prepare for the parental role with intense learning.
o In accepting the pregnancy, some men experience couvade syndrome, developing pregnancy-like symptoms, such as nausea and weight gain.
o The partner’s main role in pregnancy is to nurture and respond to the pregnant woman’s feelings of vulnerability. He also deals with the reality of the pregnancy, identifies with the father role, establishes a relationship with the fetus, and prepares for childbirth.
Siblings and grandparents must also adapt to the pregnancy.
126
The purpose of prenatal care is to identify existing risk factors and other deviations from normal to enhance pregnancy outcomes. The nurse emphasizes preventive aspects of care to motivate optimal self-management and the early reporting of unusual changes so problems can be avoided or minimized.
Important components of the initial prenatal visit include detailed and carefully recorded findings from the interview, a comprehensive physical examination, and selected laboratory tests.
127
Follow-up visits are shorter than the initial visit and are important for monitoring the health of the mother and fetus and providing anticipatory guidance, as needed.
Even in normal pregnancy, the nurse must remain alert to hazards, such as supine hypotension, potential complications, and family maladaptation.
128
The nurse must evaluate blood pressure measurements based on absolute values and the length of gestation and must interpret them in light of modifying factors.
The likelihood of physical abuse increases during pregnancy.
129
The expectant mother needs information on many subjects.
o Discomforts and changes of pregnancy can cause anxiety to the woman and her family and require sensitive attention and a plan for teaching self-management measures.
o The nurse should teach the woman about healthy ways of using her body, such as appropriate exercise and body mechanics. This is essential because of her anatomic and physiologic responses to pregnancy.
o Each pregnant woman needs to learn how to recognize and report signs of potential complications, such as preterm labor.
130
Culture, age, parity, and multiple pregnancy can affect prenatal care and can have a significant effect on the course and outcome of the pregnancy
♣ The nurse must be knowledgeable about practices and customs related to childbearing to provide culturally sensitive care.
♣ Culture regulates the pregnant woman’s emotional response, clothing, physical activity and rest, sexual activity, and dietary practices.
131
Expectant mothers age 15 or younger or age 35 or older have special needs.
When a pregnancy involves more than one fetus, the mother and fetuses are at increased risk for adverse outcomes.
132
Childbirth education teaches tuning in to the body’s inner wisdom and using coping strategies that enhance the woman’s ability to know how to give birth.
Childbirth education strives to promote healthier pregnancies and family lifestyles. Its goal is to help women and their families make informed, safe decisions about pregnancy, birth, and early parenthood.
