Quiz 1 Review Questions Flashcards
Which patient would require additional calories and nutrients?
a. A 36-year-old female gravida 2, para 1, in her first trimester of pregnancy
b. An 18-year-old female who delivered a 7-lb 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
d. A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding
A patient who is breastfeeding will require more calories and nutrients than women who are pregnant. The type of birth has no impact on nutrient intake. A patient who is bottle-feeding does not require additional calories.
A nurse at a prenatal clinic is caring for a client who is in her first trimester of pregnancy. The client tells the nurse that she is upset because, although she and her husband planned this pregnancy, she has been having many doubts and second thoughts about the upcoming changes in her life. Which of the following is an appropriate response by the nurse?
A. “Ambivalent feelings are quite common for women early in pregnancy.”
B. “Perhaps you should see a counselor to discuss these feelings further.”
C. “Have you spoken to your mother about these feelings?”
D. “Don’t worry. You’ll be fine once the baby is born.”
A. “Ambivalent feelings are quite common for women early in pregnancy.”
This response uses the therapeutic communication technique of providing information while addressing the client’s concerns and feelings. This statement is true and gives the client the information she needs; many antepartum women experience similar feelings in early pregnancy.
A nurse is providing teaching to a client who is at 30 weeks of gestation and is to have a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?
A. “I will have to lie on my back during the test.”
B. “My baby’s heart rate will be monitored during the test.”
C. “I should schedule the test when the baby is usually active.”
D. “It will take 20 to 30 minutes to complete the test.”
A. “I will have to lie on my back during the test.”
The client is placed in a Semi-Fowler’s position with one hip slightly elevated to promote uterine perfusion and prevent supine hypotension as a result of the uterus compressing the maternal vena cava.
Define Positive Signs of Pregnancy, Give Manifestations:
Signs that can be only explained by pregnancy.
- Fetal Heart Rate.
- Visualization of fetus on Ultrasound.
- Palpation of fetus.
A couple is undergoing genetic counseling and are very concerned about the possibility of having a child with a birth defect as a result of a strong family history on both sides of the family. Which statement made by the nurse is evidence of therapeutic communication?
A: “It is important to ask other members of your family for any information they can provide that will help obtain more insight into the health history.”
B: “Given what you have told me, there is little that anyone can do to improve outcomes.”
C: although you may feel that you have no options, I can’t really discuss these matters as only the physician can provide you with information.”
D: “Do you have all your forms filled out correctly? This will make the review easier to accomplish.
A: “It is important to ask other members of your family for any information they can provide that will help obtain more insight into the health history.”
Having as much information as possible will help analyze potential health outcomes. It also shows that the nurse is taking the patients’ concerns seriously. Telling the patients that there is little anyone can do does not provide any comfort or hope and is therefore self-defeating. Although the patients may have limited options based on their genetic and medical history, it is important to provide support and not defer all communication to the physician. The nurse must be able to provide support and counseling to patients. It is important to have completed forms, but asking patients about them does not address their psychological concerns.
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
D. Facial edema
To determine cultural influences on a patient’s diet, what is the nurse’s primary action?
a. Evaluate the patient’s weight gain during pregnancy.
b. Assess the socioeconomic status of the patient.
c. Discuss the four food groups with the patient.
d. Identify the food preferences and methods of food preparation common to the patient’s culture.
d. Identify the food preferences and methods of food preparation common to the patient’s culture.
Understanding the patient’s food preferences and how she prepares food will assist the nurse in determining whether the patient’s culture is adversely affecting her nutritional intake. Evaluating a patient’s weight gain during pregnancy should be included for all patients, not just for those who are culturally different. The socioeconomic status of the patients may alter the nutritional intake, but not the cultural influence. Teaching the food groups to the patient should come after assessing food preferences.
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
B: rest often with the feet elevated
Elevating the feet and legs improves venous return and prevents venous stasis. Sitting with the legs crossed will decrease circulation in the legs and increase venous stasis. Elevating the legs at night may cause pressure on the diaphragm and increase breathing problems. Elastic stockings should be applied before lowering the legs in the morning.
A nurse is teaching about fetal development to a group of clients in the antenatal clinic. Which of the following statements should the nurse include in the teaching?
A. “The baby’s heart beat is audible by a Doppler stethoscope at 12 weeks of pregnancy.”
B. “The sex of the baby is determined by week 8 of pregnancy.”
C. “Very fine hairs, called lanugo, cover your baby’s entire body by week 36 of pregnancy.”
D. “You will first feel your baby move in week 24 of pregnancy.”
A. “The baby’s heart beat is audible by a Doppler stethoscope at 12 weeks of pregnancy.”
The fetal heartbeat is audible by Doppler stethoscope between 8 to 17 weeks of gestation.
Be able to interpret the results of a nonstress test.
HR 120 bpm w/ minimal accel.
2 variable decels during fetal movement, lasting 20 sec each
Non-reactive test
The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick’s sign. When the patient asks the nurse what this means, how would the nurse respond?
A: “Chadwick’s sign signifies an increased 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 a mucus plug has formed in the cervical canal to help protect you from uterine infection.”
D: “This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix.”
D: “This sign occurs normally in pregnancy, when estrogen causes increased blood flow in the area of the cervix.”
Increasing levels of estrogen cause hyperemia (congestion with blood) of the cervix, resulting in the characteristic bluish purple color that extends to include the vagina and labia. This discoloration, referred to as Chadwick’s sign, is one of the earliest signs of pregnancy. Although Chadwick’s sign occurs with hyperemia (congestion with blood), the sign does not signify an increased risk of blood clots. The softening of the cervix is called Goodell’s sign, not Chadwick’s sign. Although the formation of a mucus plug protects from infection, it is not called Chadwick’s sign.
A nurse is providing teaching to a patient planning on becoming pregnant about the changes she should expect. Identify the sequence of maternal changes.
a) Goodell’s sign
b) lightening
c) quickening
d) amenorrhea
1) amenorrhea
2) Goodell’s sign
3) quickening
4) lightning
Amenorrhea is the absence of a period which occurs early in the first trimester. Goodell’s sign is the softening of the cervix occuring in the first trimester. Quickening is the mother feeling the baby move which first occurs in the 2nd trimester around 16-20 weeks. Lightning is the baby settling into the cavity around 38 weeks.
People who have two copies of the same abnormal autosomal dominant gene will usually be
a. more severely affected by the disorder than will people with one copy of the gene.
b. infertile and unable to transmit the gene.
c. carriers of the trait but not affected with the disorder.
d. mildly affected with the disorder.
a.more severely affected by the disorder than will people with one copy of the gene.
People who have two copies of an abnormal gene are usually more severely affected by the disorder because they have no normal gene to maintain normal function. Infertility may or may not be caused by chromosomal defects. A carrier of a trait has one recessive gene. Those mildly affected with the disorder will have only one copy of the abnormal gene.
A nurse is teaching a client who is at 23 weeks of gestation and will return to the facility in 2 days for an amniocentesis. Which of the following instructions should the nurse give the client?
A. Food and fluids should not be consumed the day of the procedure.
B. Complete a bowel prep protocol the day before the procedure.
C. Empty her bladder immediately prior to the procedure.
D. Wash her abdomen with soap and water the morning of the procedure.
C. Empty her bladder immediately prior to the procedure.
Rationale: Emptying the bladder before amniocentesis prevents possible puncture of the bladder and displacement of the uterus and fetus.
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.
d. Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms.
Which statement best describes the changes that occur during the fetal period of development?
A. maturation of organ systems
B. development of basic organ systems
C. resistance of organs to damage from external agents
D. development of placental oxygen-carbon dioxide exchange
A. maturation of organ systems
During the fetal period, the body systems grow in size and mature in function to allow independent existence after birth. Basic organ systems are developed during the embryonic period. The organs are always at risk for damage from external sources; however, the older the fetus, the more resistant will be the organs. The greatest risk is when the organs are developing. The placental system is complete by week 12, but that is not the best description of the fetal period.
A nurse is assessing a client who is in the third trimester of pregnancy. The nurse should recognize which of the following findings as an expected physiologic during pregnancy?
A. Gradual lordosis
B. Increased abdominal muscle tone
C. Posterior neck flexion
D. Decreased mobility of pelvic joints
A. Gradual lordosis
Clients who are pregnant can develop a gradual, forward curving of the spine as the growth of the fetus pulls the pelvis forward. This lordosis resolves after delivery.
A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make?
A. “It’s a minor inconvenience, which you should ignore.”
B. “In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone.”
C. “There is no way to predict how long it will last in each individual client.”
D. “It occurs during the first trimester and near the end of the pregnancy.”
D. “It occurs during the first trimester and near the end of the pregnancy.”
