Practice Questions 1

Question 1

The nurse should teach a pregnant woman that which substances are teratogens? (Select all that apply.)

A) Rubella

B) Isotretinoin (Retin A)

C) Salicylic acid

D) Cigarette smoke

E) Vitamin C

Answer 1

A) Rubella

B) Isotretinoin (Retin A)

D) Cigarette smoke

Question 2

A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). The nurse’s most appropriate response is?

A) “The lubricant prevents vaginal irritation.”

B) “Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions.”

C) “Nonoxynol-9 improves penile sensitivity.”

D) “The additional lubrication improves sex.”

Answer 2

B) “Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions.”

Question 3

During the preconception phase, the nurse should teach about which infectious diseases as risk factors for maternal complications? (Select all that apply.)

A) Rubella

B) Hepatitis B

C) Diabetes

D) HIV/AIDS

E) Anemia

Answer 3

A) Rubella

B) Hepatitis B

D) HIV/AIDS

Question 4

When obtaining a reproductive health history from a female patient, the nurse should?

A) Limit the time spent on the exploration of intimate topics.

B) Explain the purpose for the questions asked and how the information will be used.

C) Avoid asking questions that may embarrass the patient.

D) Use only acceptable medical terminology when referring to body parts and functions.

Answer 4

B) Explain the purpose for the questions asked and how the information will be used.

Question 5

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman would indicate a correct understanding of the test?

A) “I should have my husband drive me home after the test because I may be nauseous.”

B) “This test will help to determine if the baby has Down syndrome or a neural tube defect.”

C) “I will need to have a full bladder for the test to be done accurately.”

D) “This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby.”

Answer 5

D) “This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby.”

Question 6

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how she should be gaining weight during pregnancy. The nurse’s BEST response would be to tell the woman that her pattern of weight gain should be approximately.

A) A pound a week throughout pregnancy.

B) A total of 25 to 35 lb.

C) 2 to 5 lb during the first trimester, then a pound each week until the end of pregnancy.

D) A pound a week during the first two trimesters, then 2 lb per week during the third trimester.

Answer 6

C) 2 to 5 lb during the first trimester, then a pound each week until the end of pregnancy.

Question 7

Which opiate causes euphoria, relaxation, drowsiness, and detachment from reality and has possible effects on the pregnancy, including preeclampsia, intrauterine growth restriction, and premature rupture of membranes?

A) Phencyclidine palmitate (PCP)

B) Heroin

C) Alcohol

D) Cocaine

Answer 7

B) Heroin

Question 8

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 would be.

A) “This is normal behavior and should begin to subside by the second trimester.”

B) “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.”

C) “She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know.”

D) “You seem impatient with her. Perhaps this is precipitating her behavior.”

Answer 8

B) “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.”

Question 9

If exhibited by a pregnant woman, what represents a positive sign of pregnancy?

A) Positive pregnancy test

B) Fetal heartbeat auscultated with Doppler

C) Morning sickness

D) Quickening

Answer 9

B) Fetal heartbeat auscultated with Doppler

Question 10

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be.

A) Constipation.

B) Edema in the ankles and feet at the end of the day.

C) Heart palpitations.

D) Alteration in the pattern of fetal movement.

Answer 10

D) Alteration in the pattern of fetal movement.

Question 11

When assessing the fetal heart rate (FHR) of a woman at 30 weeks of gestation, the nurse counts a rate of 82 beats/min. Initially the nurse should.

A) Recognize that the rate is within normal limits and record it.

B) Allow the woman to hear the heartbeat.

C) Assess the woman’s radial pulse.

D) Notify the physician.

Answer 11

C) Assess the woman’s radial pulse.

Question 12

A maternal serum alpha-fetoprotein (MSAFP) test is performed at 16 to 18 weeks of gestation. An elevated level has been associated with.

A) Sickle cell anemia.

B) Cardiac defects.

C) Down syndrome.

D) Open neural tube defects such as spina bifida.

Answer 12

D) Open neural tube defects such as spina bifida.

Question 13

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) Lung maturity.

C) The woman is at high risk for developing preterm labor.

D) Meconium is present in the amniotic fluid.

Answer 13

B) Lung maturity.

• This result reveals the fetal lungs are mature and in no way indicates risk for preterm labor. 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. Meconium should not be present in the amniotic fluid.

Question 14

The nurse is reviewing laboratory values to determine Rh incompatibility between mother and fetus. The nurse should assess which specific lab result?

A) Maternal serum alpha-fetoprotein (MSAFP)

B) Indirect Coombs’ test

C) hCG (human chorionic gonadotrophin) level

D) Hemoglobin level

Answer 14

B) Indirect Coombs’ test

Question 15

Thalassemia is a relatively common anemia in which?

A) There are inadequate levels of vitamin B12.

B) An insufficient amount of hemoglobin is produced to fill the red blood cells (RBCs).

C) Folate deficiency occurs.

D) RBCs have a normal life span but are sickled in shape.

Answer 15

B) An insufficient amount of hemoglobin is produced to fill the red blood cells (RBCs).

• Thalassemia is a hereditary disorder that involves the abnormal synthesis of the á or â chains of hemoglobin. An insufficient amount of hemoglobin is produced to fill the RBCs. This is the underlying description for sickle cell anemia. Folate deficiency is the most common cause of megaloblastic anemias during pregnancy. B12 deficiency must also be considered if the pregnant woman presents with anemia.

Question 16

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that?

A) Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects.

B) MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

C) Percutaneous umbilical blood sampling (PUBS) is one of the quad-screen tests for Down syndrome.

D) Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis.

Answer 16

B) MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

• CVS does provide a rapid result, but it is declining in popularity because of advances in noninvasive screening techniques. MSAFP screening is recommended for all pregnant women. MSAFP, not PUBS, is part of the quad-screen tests for Down syndrome. This is correct. MSAFP is a screening tool, not a diagnostic tool. Further diagnostic testing is indicated after an abnormal MSAFP.

Question 17

A pregnant woman with cardiac disease is informed about signs of cardiac decompensation. She should be told that the earliest sign of decompensation is most often.

A) Moist frequent cough and frothy sputum.

B) Decreasing energy levels.

C) Orthopnea.

D) Crackles (rales) at the bases of the lungs on auscultation.

Answer 17

B) Decreasing energy levels.

• Orthopnea is a finding that appears later when a failing heart reduces renal perfusion and fluid accumulates in the pulmonary interstitial space, leading to pulmonary edema. Decreasing energy level (fatigue) is an early finding of heart failure. Care must be taken to recognize it as a warning rather than a typical change of the third trimester. Cardiac decompensation is most likely to occur early in the third trimester, during childbirth, and during the first 48 hours following birth. A moist, frequent cough appears later when a failing heart reduces renal perfusion and fluid accumulates in the pulmonary interstitial space, leading to pulmonary edema. Crackles and rales appear later when a failing heart reduces renal perfusion and fluid accumulates in the pulmonary interstitial space, leading to pulmonary edema.

Question 18

The nurse is developing a dietary teaching plan for a patient on a vegetarian diet. The nurse should provide the patient with which examples of protein containing foods? (Select all that apply.)

A) Bagel

B) Seeds

C) Peanut butter

D) Eggs

E) Dried beans

Answer 18

B) Seeds

C) Peanut butter

D) Eggs

E) Dried beans

• All of the foods listed except a bagel provide protein. A bagel is an example of a whole grain food, not protein.

Question 19

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) “Thinking that your baby hears will help you bond with the baby.”

B) “A baby in utero does respond to the mother’s voice.”

C) “Many women imagine what their baby is like.”

D) “You’ll need to ask the doctor if the baby can hear yet.”

Answer 19

B) “A baby in utero does respond to the mother’s voice.”

Question 20

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned if this woman consumes which food during and after tennis matches?

A) Salty foods to replace lost sodium

B) 64 ounces of fluid

C) Extra protein sources, such as peanut butter

D) Easily digested sources of carbohydrate

Answer 20

B) 64 ounces 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 and carbohydrate intake should be sufficient to meet the increased needs of pregnancy and the demands of exercise. All pregnant women should consume the necessary amount of protein in their diet, regardless of level of activity. Many pregnant women of this gestation tend to retain fluid, possibly contributing to hypertension and swelling. An adequate fluid intake prior to and after exercise should be sufficient without trying to replace sodium.