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Maternity > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

What trimester will a pt have ambivalent feeling?

A

first trimester

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2
Q

Which comment made by a patient in her first trimester indicates ambivalent feeling?

A. My body is changing so quickly
B. I haven’t felt well since this pregnancy began
C. Im concerned about the amount of weight I’ve gained
D. I wanted to become pregnant but I’m scared about being a mother

A

D. I wanted to become pregnant but I’m scared about being a mother

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3
Q

When will mom feel quickening?

A

weeks 16-20

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4
Q

A patient who is 16 weeks pregnant with her first baby asks how long it will be before she feels the baby move. Which is the nurses best answer?

A. You should have felt the baby move by now.
B. The baby is moving, but you can’t feel it yet.
C. Some babies are quiet and you don’t feel them move. 
D. Within the next month you should start to feel fluttering sensations.

A

D. Within the next month you should start to feel fluttering sensations.

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5
Q

The healthcare provider reports that the primigravidae fundus can be palpated at the umbilicus. Which priority question will the nurse include in the patients assessment?

A. Have you noticed that it is easier for you to breathe now?
B. Would you like to hear the baby’s heartbeat for the first time?
C. Have you felt a fluttering sensation in your lower pelvic area yet?
D. Have you recently developed an unusual cravings such as for chalk or dirt?

A

C. Have you felt a fluttering sensation in your lower pelvic area yet?

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6
Q

A nurse is caring for a client who is at 6 weeks of gestation with her first pregnancy and asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make?

A. “This will occur during the last trimester of pregnancy.”
B. “This will happen by the end of the first trimester of pregnancy.”
C. “This will occur between the fourth and fifth months of pregnancy.”
D. “This will happen once the uterus begins to rise out of the pelvis.”

A

C. “This will occur between the fourth and fifth months of pregnancy.”

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7
Q

A nurse is instructing a woman who is contemplating pregnancy about nutritional needs. To reduce the risk of giving birth to a newborn who has a neural tube defect, which of the following information should the nurse include in the teaching?

a. limit alcohol consumption
b. increase intake of iron-rich foods
c. consume foods fortified with folic acid
d. avoid foods containing aspartame

A

c. consume foods fortified with folic acid

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8
Q

When does hyperpigmentation occur during pregnancy?

A

2nd trimester

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9
Q

What are the different types of hyperpigmentation?

A

chloasma (pregnancy)

melasma (nonpregnancy)

linea nigra

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10
Q

An expected change during pregnancy is a darkly pigmented vertical mid abdominal line. The nurse recognizes this alteration as

A. Epics
B. Linea nigra
C. Melasma
D. Striae gravidarum

A

B. Linea nigra

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11
Q

A pregnant woman notices that she is beginning to develop dark skin patches on her face. She denies using any different type of facial products as a cleansing solution or makeup. What would the priority nursing intervention be in response to this situation

A. Refer the patient to a dermatologist for further examination.
B. Ask the patient if she has been eating different types of foods.
C. Take a culture swab and send to the lab for culture and sensitivity C&S
D. Let the patient know that this is a common finding that occurs during pregnancy

A

D. Let the patient know that this is a common finding that occurs during pregnancy

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12
Q

A nurse in a prenatal clinic is completing a skin assessment of a client who is in the second trimester. Which of the following findings should the nurse expect? (SATA)

a. Eczema
b. Psoriasis
c. Linea nigra
d. Chloasma
e. Striae gravidarum

A

c. Linea nigra
d. Chloasma
e. Striae gravidarum

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13
Q

A pregnant woman complains of frequent heart burn. The patient states that she has never had these symptoms before and wonders why this is happening now. The most appropriate response by the nurse is. To:

A. Examine her dietary intake pattern and tell her to avoid certain foods
B. Tell her that this is a normal finding during early pregnancy and will resolve as she gets closer to term
C. Explain to the patient that physiologic changes caused by the pregnancy make her more likely to experience these types of symptoms
D. Refer her to her healthcare provider for additional testing because this is an abnormal
finding

A

C. Explain to the patient that physiologic changes caused by the pregnancy make her more likely to experience these types of symptoms

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14
Q

A nurse in a prenatal clinic is caring for a client who is at 12 weeks gestation. The client asks about the cause of her heartburn. Which of the following responses should the nurse make?

A. Retained bile in the liver results in delayed digestion.
B. Increased estrogen production causes increased secretion of hydrochloric acid.
C. Pressure from the growing uterus displaces the stomach.
D. Increased progesterone production causes decreased motility of smooth muscle.

A

D. Increased progesterone production causes decreased motility of smooth muscle.

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15
Q

What does gravida and para mean?

A

gravida (G): # of pregnancies (nulligravida, primigravida, multigravida)

para (P): # of pregnancies that have ended at 20 weeks or more, regardless of whether infant was born alive or stillborn (nullipara, primipara, multipara)

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16
Q

What does GTPAL stand for?

A

G - gravidity (including current pregnancy)
T - total # of term pregnancies (over 37 weeks and delivered)
P - total # of preterm pregnancies
A - total # of abortions
L - total # of living children

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17
Q

A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy, terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client’s current status?

A. 4-0-1-2-2
B. 3-0-2-0-2
C. 2-0-0-2-0
D. 4-2-0-2-2

A

A. 4-0-1-2-2

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18
Q

Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one infant at 32 weeks’ gestation, and one infant at 38 weeks’ gestation.


a. G5T1P2A2L2

b. G5T1P1A1L2

c. G5T0P2A2L2

d. G5T1P1A2L2

A

d. G5T1P1A2L2

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19
Q

What is Naegele’s Rule?

A

Date of LMP - 3 months + 7 days (adjust for year) = EDD (estimated delivery date)

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20
Q

Use Nägele’s rule to determine the EDD (estimated day of birth) for a patient whose last menstrual period started on April 12.

a. February 19
b. January 19
c. January 21
d. February 7

A

b. January 19

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21
Q

What are presumptive signs of pregnancy?

A

amenorrhea
quickening
fatigue
N/V
urinary frequency
breast changes
uterine enlargement

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22
Q

What are probable signs of pregnancy?

A
  • abdominal enlargement
  • Chadwick’s sign (blue ish cervix/mucosa)
  • Hegar’s sign (softening and compressibility of lower uterus)
  • Goodell’s sign (softening of cervical tip)
  • ballottement (rebound of unengaged fetus)
  • positive preg test
  • fetal outline (felt by examiner)
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23
Q

What are positive signs of pregnancy?

A

fetal heart sounds
visualization of fetus by ultrasound
fetal movement

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24
Q

Which findings are presumptive signs of pregnancy? SATA

A. Quickening
B. Amenorrhea
C. Ballottement
D. Goodell’s sign

A

A. Quickening
B. Amenorrhea

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25
Q

A patient reports to the clinic nurse that she has not had a period in over 12 weeks. She is tired and her breasts are sore all the time. The patients urine test is positive for HCG. What is the correct nursing action related to this information?

A. Ask the patient if she has had any nausea or vomiting in the morning
B. Schedule the patient to be seen by a healthcare provider with the next 4 weeks.
C. Send the patient to the maternity screening area of the clinic for a routine ultrasound.
D. Determine if there are any factors that might prohibit her from seeking medical care.

A

D. Determine if there are any factors that might prohibit her from seeking medical care.

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26
Q

A nurse is looking over the health history of a client who is currently pregnant. The provider indicated that the client showed probable signs of pregnancy. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY)

a. Montgomery’s Glands
b. Goodell’s Sign
c. Ballottement
d. Chadwick’s sign
e. Quickening

A

b. Goodell’s Sign
c. Ballottement
d. Chadwick’s sign

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27
Q

A nurse in the hospital is caring for a patient who suspects she is pregnant. Which of the following signs of pregnancy would be considered presumptive?

a. abdominal enlargement
b. fetal heart sounds
c. positive pregnancy test
d. Amenorrhea

A

d. Amenorrhea

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28
Q

What is in vitro fertalization?

A

The procedure in which ova are removed by laparoscopy, mixed with sperm and the embryo returned to the woman’s user

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29
Q

A nurse is providing teaching to a client who is planning on becoming pregnant about the changes she should expect. Identify the sequence of maternal changes.

Quickening
Lightening
Goodell’s sign
Amenorrhea

A
  1. Amenorrhea
  2. Goodell’s Sign
  3. Quickening
  4. Lightening
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30
Q

A patient who is 32 weeks pregnant telephones the nurse at her obstetrician’s office and complains of constant backache. She asks what pain reliever is safe for her to take. The best nursing response is

a. “You should come into the office and let the doctor check you.”
B. “Acetaminophen is acceptable during pregnancy. You should not take aspirin, however.”
c. “Back pain is common at this time during pregnancy because you tend to stand with a sway back.” 
d. “Avoid medication because you are pregnant. Try soaking in a warm bath or using a heating pad on low before taking any medication.”

A

a. “You should come into the office and let the doctor check you.”

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31
Q

What is the recommended intake for calcium for pregnancy?

A

1000 mg/day (preg/nonpreg 19-50 years)

1300 mg/day (under 19 years)

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32
Q

The nurse is advising a lactose inolterant pregnant patient about calcium intake. Which calcium sources are approximately equivalent to 1 cup of milk? SATA

A. 3/4 cup yogurt
B. 1 cup of sherbet
C. 1 1/4 oz of hard cheese
D. 1 1/4 cups of ice cream
E. 3/4 cup of low fat cottage cheese

A

A. 3/4 cup yogurt
C. 1 1/4 oz of hard cheese
D. 1 1/4 cups of ice cream

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33
Q

The clinic nurse is reviewing breastfeeding with a pregnant patient. Which hormone will the nurse explain is responsible for milk production after the birth of the placenta?

A. Pitocin
B. Prolactin
C. Estrogen
D. Progesterone

A

B. Prolactin

34
Q

One of the assessments performed in the birth room is checking the umbilical cord for blood vessels. How many arteries and how many veins?

A

Two arteries and One vein

35
Q

What is the primary focus of fetal growth during the fetal period of development?

A

protect the baby from teratogens and allow the organ systems to grow

36
Q

When can a women have a rubella vaccination if she plans on becoming pregnant?

A

postpartum bc its a live virus

37
Q

If the rubella vaccine is indicated for a postpartum patient, which instructions should be provided?

A. No specific instructions
B. Drinking plenty of fluids to prevent fever
C. Recommendation to stop breastfeeding for 24 hours after the injection
D. Explanation of the risks of becoming pregnant within 28 days following injection

A

D. Explanation of the risks of becoming pregnant within 28 days following injection

38
Q

What is the recommendation for weight gain during pregnancy?

A

Normal: 25-35 lbs
Underweight: 28-40 lbs
Overweight: 15-25 lbs

39
Q

Describe BMI’s

A

normal: 18.5-24.9
overweight: 25-29.9
obese: >30

40
Q

What is indicated if the lower back begins to curve?

A

lordosis

41
Q

What are secondary sexual characteristics for females?

A
  • breast development
  • selective distribution of fat in breasts, buttock, thighs
  • pubic/axillary hair
  • higher pitched voice
  • menarche 2-2.5 years after breast development
  • primary amenorrhea (delayed onset)
  • secondary amenorrhea (absence)
42
Q

How many does does ovulation occur after the first day of period?

A

14 days

43
Q

If a woman’s menstrual cycle began on June 2, on which date should ovulation mostly likely have occurred?

A. June 10
B. June 16
C. June 29
D. July 5

A

B. June 16

44
Q

People who have two copies of the same abnormal autosomal dominant gene are generally

A. mildly affected with the disorder.
B. infertile and unable to transmit the gene.
C. carriers of the trait but not affected with the disorder.
D.more severely affected by the disorder than people with one copy of the gene. 


A

D.more severely affected by the disorder than people with one copy of the gene. 


45
Q

Which information should the nurse include when discussing the prenatal diagnosis of genetic disorders with an expectant couple?

a. The diagnosis may be slow and could be inconclusive.
b. A comprehensive evaluation will result in an accurate diagnosis.
c. Common disorders can be quickly diagnosed through blood tests.
d. Diagnosis can be obtained promptly through most hospital laboratories.

A

a. The diagnosis may be slow and could be inconclusive.

46
Q

Which statement best reflects the correct actions of the health care professional who is providing genetic counseling?

A. “We are going to perform this testing because you asked for it and it won’t affect your family in anyway.”
B. “This test will tell us everything about you!”
C. “I’m here to provide information so that you can make an informed decision about genetic testing.”
D. “The results of this genetic testing will be sent to your health insurance company immediately.”

A

C. “I’m here to provide information so that you can make an informed decision about genetic testing.”

47
Q

If a client presents with curly hair and blue eyes, these findings are consistent with what?

A

phenotype

48
Q

The nurse assesses the amniotic fluid. Which characteristic presents the lowest risk of fetal complications?

a. Bloody
b. Clear with bits of vernix caseosa
c. Green and thick
d. Yellow and cloudy with foul odor

A

b. Clear with bits of vernix caseosa

49
Q

An expectant mother says to the nurse, “When my sister’s baby was born, it was covered in a cheese-like coating. What is the purpose of this coating?” The correct response by the nurse is to explain that the purpose of vernix caseosa is to


a. regulate fetal temperature.
b. protect the fetal skin from amniotic fluid.
c. promote normal peripheral nervous system development.
d. allow the transport of oxygen and nutrients across the amnion. 


A

b. protect the fetal skin from amniotic fluid.

50
Q

The nurse is explaining the function of the placenta to a pregnant patient. Which statement indicates to the nurse that further clarification is necessary?

a. “My baby gets oxygen from the placenta.”
b. “The placenta functions to help excrete waste products.”
c. “The nourishment that I take in passes through the placenta.”
D. “The placenta helps maintain a stable temperature for my baby.”

A

D. “The placenta helps maintain a stable temperature for my baby.”

51
Q

During vital sign assessment of a pregnant patient in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is most appropriate?

a. Have the patient stand up and retake her blood pressure.
b. Have the patient sit down and hold her arm in a dependent position.
c. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.
d. Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms.

A

c. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.

52
Q

A patient in her first trimester complains of nausea and vomiting. The patient asks, “Why is this happening?” What is the nurse’s best response?

a. “It is due to an increase in gastric motility.”
b. “It may be due to changes in hormones.”
c. “It is related to an increase in glucose levels.”
d. “It is caused by a decrease in gastric secretions.”

A

b. “It may be due to changes in hormones.”

53
Q

The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick’s sign. When the patients asks the nurse what this means, how would the nurse respond?

A. Chadwicks sign signifies an increase risk of blood clots in pregnant women because of a congestion of blood
B. That sign means the Cervix has softened as the result of tissue changes that naturally occur with pregnancy
C. This means that mucus plug has formed in the cervical canal to help protect from uterine infection.
D. This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix.

A

D. This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix.

54
Q

What is the best explanation that the nurse can provide to a patient who is concerned that she has pseudo anemia of pregnancy?

A. Have her write down her concerns and tell her that you will ask the physician to respond once the lab results have been evaluated
B. Tell her that thesis a benign self limiting condition that can be easily corrected by switching to a high iron diet.
C. Inform her that because of the pregnancy, her blood volume has increased , leading to a substantial dilution effect on her serum blood levels, and that most women experience this condition.
D. Contact the physicians and get a prescription for iron pills to correct the condition.

A

C. Inform her that because of the pregnancy, her blood volume has increased , leading to a substantial dilution effect on her serum blood levels, and that most women experience this condition.

55
Q

What is couvade syndrome?

A

partner gets pregnancy related symptoms

56
Q

A patient relates a story of how her boyfriend is feeling her aches and pains associated with her pregnancy. She is concerned that her boyfriend is making fun of her concerns. How would you respond to this patient statement?

A. Tell her not to worry because it is natural for her boyfriend to make her feel better by identifying with her pregnancy
B. Refer the patient to a psychologist for counseling to deal with this problem because it is clearly upsetting her
C. Explain that her boyfriend make be experiencing couvade syndrome and that this is normal finding seen with male partners.
D. Ask the patient specifically to define her concerns related to her relationship with her boyfriend and suggests methods to stop this type of behavior by her significant other.

A

C. Explain that her boyfriend make be experiencing couvade syndrome and that this is normal finding seen with male partners.

57
Q

Which finding is a positive sign of pregnancy?

A. Amenorrhea
B. Breast changes
C. Fetal movement felt by the woman
D. Visualization of fetus by ultrasound

A

D. Visualization of fetus by ultrasound

58
Q

A nurse is caring for a client who states, “I think I am pregnant.” Which of the following findings should the nurse identify as a positive sign of pregnancy?”
A. Positive serum pregnancy test
B. Amenorrhea
C. Fetal heart tones auscultated by Doppler
D. Chadwick signs

A

C. Fetal heart tones auscultated by Doppler

59
Q

Which nursing measure would be most appropriate to prevent thrombophlebitis in the recovery period following a cesarean birth?

a. Limit the patient’s oral intake of fluids for the first 24 hours.
b. Assist the patient in performing leg exercises every 2 hours.
c. Ambulate the patient as soon as her vital signs are stable.
d. Roll a bath blanket and place it firmly behind the patient’s knees.

A

b. Assist the patient in performing leg exercises every 2 hours.

60
Q

Which advice to the patient is one of the most effective methods for preventing venous stasis?

a. Sit with the legs crossed.
b. Rest often with the feet elevated.
c. Sleep with the foot of the bed elevated.
d. Wear elastic stockings in the afternoon.

A

b. Rest often with the feet elevated.

61
Q

The abdominal circumference (AC) is the:

A. Diameter of the fetal abdomen
B. Measurement at the level of the stomach, left portal vein, and left umbilical vein
C. Diameter of the fetal abdomen at the level of the kidneys and diaphragm
D. Measurement at the level of the kidneys and bladder

A

B. Measurement at the level of the stomach, left portal vein, and left umbilical vein

62
Q

What does a birth plan help the parents accomplish?

A. avoidance of an episiotomy
B. Determine the outcome of the birth
C. Assuming complete control of the situation
D. Taking an active part in planning the birth experience

A

D. Taking an active part in planning the birth experience

63
Q

What are interventions for heartburn?

A
  • Encourage small meals
  • sit upright for 30 minutes or more after eating
  • avoid spicy fatty foods
  • Drink hot herbal tea
64
Q

A nurse is caring for a client who is in the first trimester of pregnancy and asks how to manage heartburn. Which of the following responses should the nurse make?

a. Reduce the amount of food you eat during meals
b. Sip carbonated beverages between meals
c. Lie down and rest immediately after meals
d. Drink iced tea with meals

A

a. Reduce the amount of food you eat during meals

65
Q

What is the rationale for a woman in her first trimester of pregnancy to expect to visit her healthcare provider every 4 weeks?

A. Problems can be eliminated
B. She delis trust in the healthcare team
C. Her questions about labor can be answered
D. The conditions of the expectant mother and fetus can be monitored

A

D. The conditions of the expectant mother and fetus can be monitored

66
Q

What indicates facial edema?

A

hypertension

not normal

67
Q

A nurse is caring for a client who has a positive pregnancy test. The nurse is teaching the client about common discomforts in the first trimester of pregnancy as well as warning signs of potential danger. The nurse should instruct the client to call the clinic if she experiences which of the following manifestations?

A. Leukorrhea
B. Urinary frequency
C. Nausea and vomiting
D. Facial edema

A

D. Facial edema

68
Q

An increase in urinary frequency and leg cramps after the 36th week of pregnancy are an indication of

A. Lightening
B. Breech presentation
C. UTI
D. Onset of Braxton hicks contraction

A

A. Lightening

69
Q

When can you hear the baby’s heart rate with a doppler?

A

12 weeks

70
Q

A nurse is teaching a client during the client’s first prenatal visit. Which of the following instructions should the nurse include?

A. “A fetal stethoscope can first detect your baby’s heart rate at 22 weeks.”
B. “After week 16, we can see if your baby is a boy or a girl.”
C.”A Doppler device can detect your baby’s heart rate at 12 weeks.”
D. “You will first feel the baby move at about 8 weeks.”

A

C.”A Doppler device can detect your baby’s heart rate at 12 weeks.”

71
Q

Does a breastfeeding mom require additional calories and nutrients after delivery?

A

yes

72
Q

does a breastfeeding mom t require additional calories and nutrients after delivery Which patient would require additional calories and nutrients?

A. A 36 year old female gravid 2, para 1 , in her first trimester of pregnancy
B. An 18 year old female who delivered a 7 l baby and is bottle feeding
C. A 23 year old female who had a cesarean birth and is bottle feeding
D. A 20 year old female who had a vaginal birth 5 months ago and is breastfeeding

A

D. A 20 year old female who had a vaginal birth 5 months ago and is breastfeeding

73
Q

To determine cultural influences on a clients diet, what should the nurse do first?

A

Identify the food preferences and methods of food preparation common to the clients culture

74
Q

Describe a non stress test

A
  • reactive vs non reactive
  • reassuring vs non reassuring
  • contraction stress test are negative or positive
  • don’t lie on back
  • semi fowler
75
Q

In a biophysical profile (BPP), what are we measuring?

A

FHR (fetal HR)
- reactive = 2
- nonreactive = 0

Fetal breathing movements
- @ least 1 episode >30 secs on 30 min = 2
- absent or < 30 secs = 0

Gross body movements
- @ least 3 body or limb extensions with return to flex in 30 min = 2
- < 3 episode = 0

Fetal tone
- @ least 1 episode of extension with return to flex = 2
- slow, lack or absent movement = 0

Qualitative amniotic fluid volume
- @ least 1 pocket of fluid 2cm in 2 perpendicular planes = 2
- pockets absent or < 2 cm = 0

76
Q

A nurse is reviewing findings of a client’s BBP. The nurse should expect which of the following variables to be included in this test? (SATA)

A) Fetal weight
B) Fetal Breathing movement
C) Fetal tone
D) Fetal position
E) Amniotic Fluid volume

A

B) Fetal Breathing movement
C) Fetal tone
E) Amniotic Fluid volume

77
Q

A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following should the nurse include in teaching?

A) “you will lay on the right side during procedure”
B) “you should not eat anything for 24hr prior to procedure”
C) “you should empty the bladder prior”
D) “test is done to determine gestational age”

A

C) “you should empty the bladder prior”

78
Q

The primary reason for evaluating alpha-fetoprotein AFP levels in maternal serum is to determine whether the fetus has which condition?

A. Hemophilia
B. Sickle cell anemia
C. A neural tube defect
D. Abnormal lecithin to sphingomyelin ratio

A

C. A neural tube defect

79
Q

The results of a contraction stress test CST are positive. Which intervention is necessary based on this test result?

A. Repeat the test 1 week so that results can be trended based on this baseline result
B. Contact the healthcare provider to discuss birth options for the patient
C. Send the patient out for a meal and repeat the test to confirm that the results are valid
D. Ask the patient to perform a fetal kick count assessment for the next 30 minutes and then reassess the patient

A

B. Contact the healthcare provider to discuss birth options for the patient

80
Q

What do negative CST parameters indicate?

A

no late decelerations of FHR within a 10 min period with 3 uterine contractions

Maternity (6 decks)

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