Question 1

During the initial prenatal visit, the nurse assesses the history of the father of the child for:

Accepted Answer

B,C,E

Question 2

The nurse is explaining clinical pelvimetry to a patient. The nurse explains that the anteroposterior diameters consist of the:

Accepted Answer

The anteroposterior diameters of the pelvis include the diagonal conjugate, conjugata vera (true conjugate), and obstetric conjugate. These measurements are important for assessing the size and shape of the pelvic inlet.

Question 3

While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts with "Why are you asking me all these questions? What difference does it make?" Which statement would best answer the patient's questions? "We ask these questions:

Accepted Answer

The purpose of asking about medical and surgical history during a prenatal visit is to identify any past medical or surgical conditions that may affect the current pregnancy. This information can help the healthcare provider anticipate potential risks and provide appropriate care to the patient and her developing fetus.

Question 4

The nurse is assessing a newly pregnant patient. Which finding does the nurse note as a normal psychosocial adjustment in this patient's first trimester?

Accepted Answer

Ambivalence about the pregnancy is a normal psychosocial adjustment in the first trimester. It is common for women to have mixed feelings when they first find out they are pregnant, as it is a major life change that can bring both excitement and anxiety. It is important for the nurse to provide emotional support and help the patient explore her feelings and concerns.

Question 5

The prenatal clinic nurse is designing a new prenatal intake information form for pregnant patients. Which is best to include on this form?

Accepted Answer

It is important to gather information about genetic diseases that may run in the baby's family. This can help healthcare providers assess the risk of the baby inheriting a genetic condition and plan for appropriate screening or prevention measures. The other options (A, C, D) are not relevant to the medical care of the patient and her baby.

Question 6

The nurse is seeing prenatal patients in the clinic. Which patient is exhibiting expected findings?

Accepted Answer

At 12 weeks, fetal heart tones can usually be heard by Doppler fetoscope, which is an expected finding.

Question 7

The nurse is explaining to a new prenatal patient that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the patient states, "The certified nurse-midwife will perform this examination because:

Accepted Answer

Clinical pelvimetry assesses the size and shape of the maternal pelvis to determine if a woman will be able to deliver a baby vaginally or if a cesarean delivery is necessary. It is important for the certified nurse-midwife to perform this exam to help plan for a safe delivery for both the mother and the baby.

Question 8

The nurse receives a phone call from a patient who claims she is pregnant. The patient reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10. What would the patient's estimated date of delivery (EDD) be?

Accepted Answer

The estimated date of delivery (EDD) can be calculated using Naegele's rule, which involves adding 7 days to the first day of the last menstrual period (LMP), subtracting 3 months, and adding 1 year. For an LMP of April 10, adding 7 days gives April 17, subtracting 3 months gives January 17, and adding 1 year results in an EDD of January 17.

Question 9

The nurse is assessing a primiparous patient who indicates that her religion is Judaism. This information is important for the nurse to assess because:

Accepted Answer

The answer of The nurse is assessing a primiparous patient...

Question 10

The patient has delivered her first child at 37 weeks. The nurse would describe this to the patient as what type of delivery?

Accepted Answer

A delivery at 37 weeks is considered term, as term pregnancies are defined as those that occur between 37 and 42 weeks of gestation.

Question 11

What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing?

Accepted Answer

Fundal height measurement is a routine part of a physical assessment for a second-trimester primiparous patient with ongoing prenatal care. It helps determine fetal growth and gestational age. Measurement of the diagonal conjugate is not a routine part of a physical assessment during pregnancy. Hepatitis B screening and complete blood count are important laboratory tests during prenatal care, but they are not part of a routine physical assessment.

Question 12

During a patient's initial prenatal visit, the nurse must assess and document the patient's current medical history, including:

Accepted Answer

The answer of During a patient's initial prenatal visit, the...

Question 13

The nurse working in an outpatient obstetric clinic assesses four primigravida patients. Which patient findings would the nurse tell the physician about?

Accepted Answer

At 24 weeks' gestation, the fundal height should be above the umbilicus, around 24 cm. A fundal height at the umbilicus suggests a discrepancy that may need further evaluation.

Question 14

A nurse is performing an assessment on four patients at 22 weeks' gestation. The nurse reports to the obstetrician that which patient might be carrying twins?

Accepted Answer

The fundal height measurement typically corresponds with the week of gestation, so a measurement of 27 cm at 22 weeks could indicate a possible multiple gestation pregnancy. Options A and B are subjective and not necessarily indicative of a twin pregnancy. Option D is within normal limits for maternal heart rate.

Question 15

The nurse in the OB-GYN clinic is working with a patient who is seeking her initial prenatal visit. The nurse will use the acronym TPAL to document the patient's number of:

Accepted Answer

TPAL stands for:

T - term infants born (delivered at 37+ weeks gestation) 
P - preterm infants born (delivered between 20 and 36 6/7 weeks gestation) 
A - pregnancies ended by abortion (whether induced or spontaneous/miscarriage) 
L - children currently living in the household

Therefore, the nurse will use TPAL to document the patient's number of term infants born, pregnancies ending in abortion, and preterm infants born.

Question 16

The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings?

Accepted Answer

The presence of spider nevi, edematous nasal mucosa, thyroid enlargement, mottled skin, pallor, and a heart murmur all suggest possible underlying medical conditions that require further evaluation by the physician. The nurse should not delay in having the physician see the patient today to ensure appropriate management and follow-up. Simply documenting the findings and analyzing previous lab results are not sufficient in this case, and sun exposure is not directly relevant to the findings presented.

Question 17

A woman gave birth last week to a fetus at 18 weeks' gestation after her first pregnancy. She is in the clinic for follow-up, and notices that her chart states she has had one abortion. The patient is upset over the use of this word. How can the nurse best explain this terminology to the patient?

Accepted Answer

Abortion is the medical term for any pregnancy that ends before 20 weeks, whether it is spontaneous (miscarriage) or induced (termination of pregnancy). It does not necessarily mean that the woman underwent a voluntary termination of pregnancy. It is important to use accurate medical terminology to avoid confusion or misunderstandings.

Question 18

The nurse is seeing a patient who asks about the accuracy of Nagele's rule. The nurse explains that accuracy can be compromised when:

Accepted Answer

Nagele's rule assumes regular menstrual cycles and a known last menstrual period. Amenorrhea, irregular cycles after stopping contraception, and months of amenorrhea can all lead to inaccurate calculations.

Question 19

The primigravida at 22 weeks' gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the patient why she needs to be seen by a physician today?

Accepted Answer

At 22 weeks' gestation, the fundal height should be approximately at the level of the umbilicus. A fundal height palpated slightly below the umbilicus could indicate that the baby is not growing as expected, which warrants immediate evaluation by a physician to assess fetal well-being and growth.

Question 20

The clinic nurse is compiling data for a yearly report. Which patient would be classified as a primigravida?

Accepted Answer

A primigravida is a woman who is pregnant for the first time. Choice D is the only option indicating that the patient has never been pregnant before.

Quiz 15: Antepartum Nursing Assessment