Question 1

A patient in the prenatal clinic believes she is pregnant because she has not menstruated for 3 months, and her breasts are getting bigger. What response by the nurse is best?

Accepted Answer

While lack of menses and breast enlargement can be indicative of pregnancy, it is important to confirm with a pregnancy test. This is because there may be other reasons for missing a period, such as stress or changes in weight, and breast changes can also be caused by hormonal fluctuations or other conditions. It's important to rule out other possibilities and confirm the pregnancy before making any assumptions or providing further advice.

Question 2

The manager notes that a neonatal intensive care unit (NICU) nurse is practicing culturally competent care. What did the manager observe to make this decision? Select all that apply.

Accepted Answer

The manager observed that the nurse respected the rituals of an ethnic group, spoke a few phrases in the client's language, and contacted an interpreter to facilitate communication. These actions show that the nurse is practicing culturally competent care by acknowledging and respecting the client's culture and language. Explaining processes that are followed in an American hospital and discussing odd practices do not necessarily indicate cultural competence.

Question 3

The nurse is reviewing the assessment findings of a patient who is at 35 weeks' gestation. Which data suggest the need for further investigation?

Accepted Answer

Glycosuria may suggest gestational diabetes and requires further investigation. Funic souffle, pseudoanemia, and melasma gravidarum are all normal findings during pregnancy.

Question 4

An adolescent patient reports that her period is late but that her home pregnancy test is negative. Which response is most appropriate?

Accepted Answer

Home pregnancy tests can sometimes give false negative results if taken too early in the pregnancy, so the patient might still be pregnant even if the test is negative. It is important to follow up with a healthcare provider for further testing and evaluation.

Question 5

A client in labor is a Lebanese immigrant, and she explains that in the Islamic faith, the baby's name is selected after the baby is born. Which nursing response is appropriate?

Accepted Answer

The appropriate nursing response is to acknowledge and appreciate the client's cultural beliefs and values. This will help in building a trusting and respectful relationship with the client, which is essential for providing culturally competent care. Option A is inappropriate and insensitive. Option B is irrelevant to the client's concern. Option C is not respectful of the client's cultural beliefs.

Question 6

The nurse is preparing an educational program on the different types of pregnancy tests. What should the nurse include about the β-subunit radioimmunoassay (RIA) test? Select all that apply.

Accepted Answer

The β-subunit RIA test is able to detect trophoblastic disease and ectopic pregnancies, which are important diagnostic considerations. It does not involve a color change and takes longer to perform than over-the-counter tests. Therefore, options A and E are incorrect.

Question 7

The nurse is presenting an in-service to nursing staff regarding the provision of culturally competent client care. Which statement should the nurse include in the presentation?

Accepted Answer

This statement highlights the increasing diversity in developed countries and emphasizes the importance of providing culturally competent care in response to this demographic shift.

Answer: D
 This statement acknowledges the tendency of immigrants to adopt the beliefs and practices of the dominant culture. However, it is important to recognize that this may not always be the case and healthcare providers should aim to understand and respect each client's unique cultural background.

Therefore, both options A and D should be included in the presentation.

Question 8

During an interview the nurse asks the partner of a woman in the second trimester of pregnancy what changes they have noticed during the pregnancy. Which answer would indicate a typical response to pregnancy?

Accepted Answer

Daydreaming about parenthood is a typical response as it reflects the psychological adaptation and anticipation of becoming a parent.

Question 9

While auscultating fetal heart tones, a client who is at 37 weeks' gestation and is in the supine position is experiencing dizziness, lightheadedness, and clammy skin. Which nursing action is the most appropriate?

Accepted Answer

Placing a wedge beneath the patient's right hip alleviates pressure from the inferior vena cava, which can be compressed by the uterus in the supine position, causing symptoms like dizziness and lightheadedness. This is known as supine hypotensive syndrome.

Question 10

The mother of a client who is 14 weeks pregnant is uncertain about how to be a good grandmother to this baby due to working full time and being so busy. How should the nurse respond in this situation?

Accepted Answer

By asking the mother how she envisions her role as a grandmother, the nurse can help the mother explore her expectations and responsibilities as a grandmother. This can lead to a discussion about how much time and energy she can realistically devote to her grandchild, and what other supports (such as co-grandparents or alternate childcare arrangements) may be available. This approach is respectful of the mother's concerns and empowers her to make informed decisions about her role as a grandmother. Option B is dismissive of the mother's concerns and does not provide any helpful information. Option C assumes that there is another grandmother available, which may not be the case. Option D is not respectful of the mother's autonomy and does not take into account her personal circumstances.

Question 11

A client at 30 weeks' gestation is tearful at the time of her follow-up visit. She tells the prenatal clinic nurse that she is excited to finally become a mother and that she has been thinking about what kind of parent she will be. However, she is upset because her mother has told her that she does not want to be a grandmother because she does not feel old enough. Meanwhile, the client's husband has said that the pregnancy does not feel real to him yet, and that he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family?

Accepted Answer

It is common for family members to have varying levels of adjustment to a pregnancy and impending role changes. The client's mother may need time to adjust to the idea of being a grandparent, while the client's husband may need the presence of the baby to feel more real. It is important to offer support and encouragement to all family members during this process.

Question 12

The nurse is reviewing with a pregnant client the skin changes that she might experience during gestation. What should the nurse include in this discussion? Select all that apply.

Accepted Answer

A) Linea nigra is a dark vertical line that appears on the abdomen during pregnancy.
B) Spider nevi are small, spider-like blood vessels that may appear on the face, chest, or arms during pregnancy.
C) Psoriatic lesions are not common during pregnancy.
D) Striae gravidarum, also known as stretch marks, are common during pregnancy due to rapid changes in weight and hormonal changes.
E) Melasma gravidarum, also known as the "mask of pregnancy," is a darkening of the skin on the face due to hormonal changes during pregnancy.

Question 13

A 20-year-old client who is at 10 weeks' gestation confides that the pregnancy was unplanned and is unsure about continuing it or sharing news about it with her partner. How should the nurse respond to this client?

Accepted Answer

Option B provides appropriate reassurance that the client's feelings are not uncommon during the first trimester. It also validates the client's feelings without judgment or imposing personal beliefs. Options A, C, and D are inappropriate, dismissive, and/or invalidating.

Question 14

A patient who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the patient has a correct understanding of her condition?

Accepted Answer

Hearing the baby's heartbeat is a clear indicator of pregnancy, as it confirms the presence of a viable fetus. Option A is incorrect because the size of the uterus may increase for other reasons, such as tumors or fibroids. Option C is incorrect because fetal movement is typically not felt until around 18-20 weeks of pregnancy. Option D is incorrect because the timing of the last menstrual period is used to estimate the due date, but it does not confirm the presence of a pregnancy.

Question 15

The nurse has completed a presentation for newly pregnant women about the changes of pregnancy. Which participant's statement reflects accurate comprehension of the information?

Accepted Answer

Goodell sign is a probable sign of pregnancy which indicates the softening of the cervix due to increased vascularity. Uterine souffle is a soft blowing sound heard over the uterus, which is also a probable sign of pregnancy. Changes in the pelvic organs are presumptive signs of pregnancy, as they can also occur due to other conditions. Three positive pregnancy tests in a 1-week period is a confirmatory sign of pregnancy.

Question 16

A 28-year-old client who is pregnant with her first child reports increased dental caries (cavities) since becoming pregnant. How should the nurse explain the likely cause for this change?

Accepted Answer

During pregnancy, hormonal changes can affect the gums and teeth. Frequent vomiting, which can occur due to morning sickness, can expose teeth to stomach acid, leading to tooth enamel erosion and increased susceptibility to cavities. This is why paying extra attention to dental care during pregnancy is important.

Question 17

A patient with a normal prepregnancy weight asks why she has been told to gain 25 to 35 pounds during her pregnancy, but her underweight friend was told to gain 28 to 40 pounds. What should the nurse explain as being the recommended weight gain during pregnancy?

Accepted Answer

The recommended weight gain during pregnancy varies depending on the woman's prepregnancy weight. Underweight women are advised to gain more weight (28 to 40 pounds) to support a healthy pregnancy, whereas normal-weight women are recommended to gain 25 to 35 pounds. This is to ensure both the mother and baby have adequate nutrients and energy for a healthy pregnancy and birth.

Question 18

The nurse suspects that a pregnant client is experiencing effects to the gastrointestinal system because of elevated progesterone levels. What did the nurse assess to make this clinical determination? Select all that apply.

Accepted Answer

Elevated progesterone levels during pregnancy can lead to gastrointestinal effects such as bloating and constipation due to the relaxation of smooth muscles and slowed gastrointestinal motility.

Question 19

The partner of a pregnant client at 16 weeks' gestation accompanies her to the clinic. The partner tells you that the baby just does not seem real to him, and he is having a hard time relating to his partner's fatigue and food aversions. Which statement would be best for the nurse to make?

Accepted Answer

This response acknowledges the partner's feelings while offering a helpful suggestion for feeling more connected to the pregnancy. It is important to validate the partner's concerns and offer support and resources rather than dismissing or belittling their feelings. Option B is not helpful and even potentially harmful by comparing the partner to someone else and asking about their childhood. Option C is premature and inappropriate without more information and evaluation. Option D is dismissive and blaming.

Question 20

The nurse notes that a client who is 10 weeks pregnant is experiencing changes to the upper respiratory system. What should the nurse explain as being the reason for these changes? Select all that apply.

Accepted Answer

Estrogen-induced edema, hypersecretion of mucus, and vascular congestion of the nasal mucosa are all common changes to the upper respiratory system during pregnancy. These changes are due to increased hormonal levels and increased blood flow to the mucous membranes. Decreased white blood cell production and amniotic fluid reducing total fluid volume are not related to upper respiratory changes during pregnancy.

Quiz 8: Physical and Psychologic Changes of Pregnancy