Deck 4: Prenatal Care and Adaptations to Pregnancy

Question 1

At her initial prenatal visit,a woman asks,"When can I hear the baby's heartbeat?" At what gestational age can the fetal heartbeat be auscultated with a specially adapted stethoscope or fetoscope?

A) 4 weeks
B) 12 weeks
C) 18 weeks
D) 24 weeks

Answer 1

18 weeks

Question 2

A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy.She has a 2-year-old son and had one previous spontaneous abortion.How would the nurse document the patient's obstetric history using the TPALM system?

A) Gravida 2,para 20120
B) Gravida 3,para 10011
C) Gravida 3,para 10110
D) Gravida 2,para 11110

Answer 2

Gravida 3,para 10110

Question 3

In a routine prenatal visit,the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR)has dropped to 120 beats/minute from a rate of 160 beats/minute earlier in the pregnancy.What is the nurse's first action?

A) Ask if the patient has taken a sedative.
B) Notify the physician.
C) Turn the patient to her right side.
D) Record the rate as a normal finding.

Answer 3

Record the rate as a normal finding.

Question 4

A woman's prepregnant weight is determined to be average for her height.What will the nurse advise the woman regarding recommended weight gain during pregnancy?

A) 10 to 20 pounds
B) 15 to 25 pounds
C) 25 to 35 pounds
D) 28 to 40 pounds

Question 5

The patient remarks that she has heard some foods will enhance brain development of the fetus.The nurse replies that foods high in docosahexaenoic acid-omega 3 fatty acid (DHA)are thought to enhance brain development.What food can the nurse recommend?

A) Fried fish
B) Olive oil
C) Red meat
D) Leafy green vegetables

Question 6

After the examination is completed,the patient asks the nurse why Chadwick's sign occurs during pregnancy.What would the nurse explain as the cause of Chadwick's sign?

A) Enlargement of the uterus
B) Progesterone action on the breasts
C) Increasing activity of the fetus
D) Vascular congestion in the pelvic area

Question 7

A woman calls her health care provider to schedule prenatal visits in an uncomplicated pregnancy.How frequently will the nurse assist the patient to schedule these appointments?

A) Every 3 weeks until the 6th month,then every 2 weeks until delivery
B) Every 4 weeks until the 7th month,after which appointments will become more frequent
C) Monthly until the 8th month
D) Every 2 to 3 weeks for the entire pregnancy

Question 8

During the second prenatal visit,the nurse attempts to locate the fetal heartbeat with an electronic Doppler device.How early might fetal heart tones be detected with an electronic Doppler device?

A) 4 weeks
B) 8 weeks
C) 10 weeks
D) 14 weeks

Question 9

A woman tells the nurse that she is quite sure she is pregnant.The nurse recognizes which as a positive sign of pregnancy?

A) Amenorrhea
B) Uterine enlargement
C) HCG detected in the urine
D) Fetal heartbeat

Question 10

An ultrasound confirms that a 16-year-old girl is pregnant.How does the need for prenatal care and counseling for adolescents differ from other age populations?

A) A pregnant adolescent is experiencing two major life transitions at the same time.
B) Adolescents who get pregnant are more likely to have other chronic health problems.
C) Adolescents are at greater risk for multifetal pregnancies.
D) At this age,a pregnant adolescent will accept the nurse's advice.

Question 11

The patient who is 28 weeks pregnant shows a 10-pound weight gain from 2 weeks ago.What is the nurse's initial action?

A) Assess food intake.
B) Weigh the patient again.
C) Take the blood pressure.
D) Notify the physician.

Question 12

The nurse has explained physiological changes that occur during pregnancy.Which statement indicates that the woman understands the information?

A) "Blood pressure goes up toward the end of pregnancy."
B) "My breathing will get deeper and a little faster."
C) "I'll notice a decreased pigmentation in my skin."
D) "There will be a curvature in the upper spine area."

Question 13

During the physical examination for the first prenatal visit,it is noted that Chadwick's sign is present.What is Chadwick's sign?

A) Bluish or purplish discoloration of the vulva,vagina,and cervix
B) Presence of early fetal movements
C) Darkening of the areola and breast tenderness
D) Palpation of the fetal outline

Question 14

When the nurse tells a pregnant woman that she needs 1200 mg of calcium daily during pregnancy,the woman responds,"I don't like milk." What dietary adjustments could the nurse recommend?

A) Increase intake of organ meats.
B) Eat more green leafy vegetables.
C) Choose more fresh fruits,particularly citrus fruits.
D) Include molasses and whole-grain breads in the diet.

Question 15

A pregnant woman inquires about exercising during pregnancy.What information should the nurse include when planning to educate this woman?

A) Exercise elevates the mother's temperature and improves fetal circulation.
B) Exercise increases catecholamines,which can prevent preterm labor.
C) A regular schedule of moderate exercise during pregnancy is beneficial.
D) Pregnant women should limit water intake during exercise.

Question 16

A woman pregnant for the first time asks the nurse,"When will I begin to feel the baby move?" What is the nurse's best response?

A) "You may notice the baby moving around the 4th or 5th month."
B) "Quickening varies with every woman."
C) "You'll feel something by the end of the first trimester."
D) "The baby will be big enough for you to feel in your 8th month."

Question 17

At what age is a woman who becomes pregnant for the first time described as an "elderly primip"?

A) After 25 years old
B) After 28 years old
C) After 30 years old
D) After 35 years old

Question 18

A pregnant woman is experiencing nausea in the early morning.What recommendations would the nurse offer to alleviate this symptom?

A) Eat three well-balanced meals per day and limit snacks.
B) Drink a full glass of fluid at the beginning of each meal.
C) Have crackers handy at the bedside,and eat a few before getting out of bed.
D) Eat a bland diet and avoid concentrated sweets.

Question 19

The nurse encourages adequate intake of folic acid for women of childbearing age before and during pregnancy.What is folic acid thought to decrease the incidence of in fetal development?

A) Structural heart defects
B) Craniofacial deformities
C) Limb deformities
D) Neural tube defects

Question 20

A woman reports that her last normal menstrual period began on August 5,2013.What is this woman's expected delivery date using Nägele's rule?

A) April 30,2014
B) May 5,2014
C) May 12,2014
D) May 26,2014

Question 21

When obtaining a prenatal history on a pregnant patient the nurse notes a family history of sickle cell disease.Given this information,what lab test can the nurse anticipate the physician will order?

A) Endovaginal ultrasound
B) Pap test
C) Complete blood count
D) Hemoglobin electrophoresis

Question 22

A woman who is 37 weeks pregnant reports feeling dizzy when lying on her back.What does the nurse explain as the most likely cause of this symptom?

A) Supine hypotension syndrome
B) Gestational diabetes
C) Pregnancy-induced hypertension
D) Malnutrition

Question 23

The nurse cautions the patient that,because of hormonal changes in late pregnancy,the pelvic joints relax.What does this result in? (Select all that apply. )

A) Waddling gait
B) Joint instability
C) Urinary frequency
D) Back pain
E) Aching in cervical spine

Question 24

What nursing interventions are appropriate for the prenatal patient in terms of prenatal care? (Select all that apply. )

A) Offer nutritional counseling.
B) Reinforce responsibility of parenthood.
C) Reduce risk factors.
D) Improve health practices.
E) Make financial arrangements for delivery.

Question 25

The nurse recognizes which behavior characteristic(s)of women in their first trimester of pregnancy? (Select all that apply. )

A) Showing off her sonogram photos
B) Ambivalence about pregnancy
C) Emotional and labile mood
D) Focusing on her infant
E) Fatigue

Question 26

The nurse assesses the progress from the announcement stage of fatherhood to the acceptance stage when the patient reports which actions by the father? (Select all that apply. )

A) Goes fishing every afternoon.
B) Has revised his financial plan.
C) Spends leisure time with his friends.
D) Traded his sports car for a sedan.
E) Helped select a crib.

Question 27

The nurse explains that the softening of the cervix and vagina is a probable sign of pregnancy.What is the appropriate term for this sign?

A) Chadwick's
B) Hegar's
C) McDonald's
D) Goodell's

Question 28

A pregnant woman is attending her second prenatal visit.Prenatal lab work indicates she is not immune to the rubella virus.What is the most appropriate nursing intervention?

A) Provide the rubella vaccine as ordered by the physician immediately.
B) Inform the woman she should receive the vaccine in the hospital after delivery.
C) Hold all immunizations until 1 month postpartum.
D) Encourage the patient to decide whether or not to get the rubella vaccine prenatally.

Question 29

A woman who is 36 weeks pregnant tells the nurse she plans to take a 12-hour flight to Hawaii.What would the nurse recommend that the patient do during the flight? (Select all that apply. )

A) Wear tight-fitting clothing to promote venous return.
B) Eat a large meal before boarding the flight.
C) Request a seat with greater leg room.
D) Drink at least 4 ounces of water every hour.
E) Get up and walk around the plane frequently.

Question 30

The nurse reminds the prenatal patient that she should add ________ kcal to her daily intake to nourish the fetus.