Deck 13: Adaptations to Pregnancy

Question 1

A patient notices that the doctor writes "positive Chadwick's sign" on her chart.She asks the nurse what this means.The nurse's best response is

A) "It refers to the bluish color of the cervix in pregnancy."
B) "It means the cervix is softening."
C) "The doctor was able to flex the uterus against the cervix."
D) "That refers to a positive sign of pregnancy."

Answer 1

"It refers to the bluish color of the cervix in pregnancy."

Question 2

A pregnant woman's mother is worried that her daughter is not "big enough" at 20 weeks.The nurse palpates and measures the fundal height at 20 cm,which is even with the woman's umbilicus.What should the nurse report to the woman and her mother?

A) "The body of the uterus is at the belly button level, just where it should be at this time."
B) "You're right. We'll inform the practitioner immediately."
C) "When you come for next month's appointment, we'll check you again to make sure that the baby is growing."
D) "Lightening has occurred, so the fundal height is lower than expected."

Answer 2

"The body of the uterus is at the belly button level, just where it should be at this time."

Question 3

The multiple marker screen is used to assess the fetus for which condition?

A) Down syndrome
B) Diaphragmatic hernia
C) Congenital cardiac abnormality
D) Anencephaly

Answer 3

Down syndrome

Question 4

Physiologic anemia often occurs during pregnancy as a result of

A) Inadequate intake of iron
B) Dilution of hemoglobin concentration
C) The fetus establishing iron stores
D) Decreased production of erythrocytes

Question 5

Which finding in the urine analysis of a pregnant woman is considered a variation of normal?

A) Proteinuria
B) Glycosuria
C) Bacteria in the urine
D) Ketones in the urine

Question 6

While assessing her patient,what does the nurse interpret as a positive sign of pregnancy?

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

Question 7

A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis.What is the correct interpretation of these symptoms by the practitioner?

A) These conditions are abnormal. Refer the patient to an ear, nose, and throat specialist.
B) Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
C) Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and epistaxis are within normal limits.
D) Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds.

Question 8

A patient in her first trimester complains of nausea and vomiting.She asks,"Why does this happen?" The nurse's best response is

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."

Question 9

A woman in her first trimester of pregnancy can expect to visit her physician every 4 weeks so that

A) She develops trust in the health care team.
B) Her questions about labor can be answered.
C) The condition of the expectant mother and fetus can be monitored.
D) Problems can be eliminated.

Question 10

To relieve a leg cramp,the patient should be instructed to

A) Massage the affected muscle.
B) Stretch and point the toe.
C) Dorsiflex the foot.
D) Apply a warm pack.

Question 11

Alterations in hormonal balance and mechanical stretching are responsible for several changes in the integumentary system during pregnancy.Stretch marks often occur on the abdomen and breasts.These are referred to as

A) Chloasma
B) Linea nigra
C) Striae gravidarum
D) Angiomas

Question 12

A woman's last menstrual period was June 10.Her estimated date of delivery (EDD)is

A) April 7
B) March 17
C) March 27
D) April 17

Question 13

A woman is currently pregnant; she has a 5-year-old son and a 3-year-old daughter.She had one other pregnancy that terminated at 8 weeks.Her gravida and para are

A) Gravida 3 para 2
B) Gravida 4 para 3
C) Gravida 4 para 2
D) Gravida 3 para 3

Question 14

Which suggestion is appropriate for the pregnant woman who is experiencing nausea and vomiting?

A) Eat only three meals a day so the stomach is empty between meals.
B) Drink plenty of fluids with each meal.
C) Eat dry crackers or toast before arising in the morning.
D) Drink coffee or orange juice immediately on arising in the morning.

Question 15

Prenatal testing for the human immunodeficiency virus (HIV)is recommended for which women?

A) All women, regardless of risk factors
B) A woman who has had more than one sexual partner
C) A woman who has had a sexually transmitted infection
D) A woman who is monogamous with her partner

Question 16

A number of cardiovascular system changes occur during pregnancy.Which finding is considered normal for a woman during pregnancy?

A) Cardiac output rises by 25%
B) Increased pulse rate
C) Increased blood pressure
D) Decreased red blood cell (RBC) production

Question 17

The maternity nurse understands that vascular volume increases 40% to 60% during pregnancy to

A) Compensate for decreased renal plasma flow.
B) Provide adequate perfusion of the placenta.
C) Eliminate metabolic wastes of the mother.
D) Prevent maternal and fetal dehydration.

Question 18

While you are assessing the vital signs of a pregnant woman in her third trimester,the patient complains of feeling faint,dizzy,and agitated.Which nursing intervention is 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 lie supine for 5 minutes and recheck her blood pressure on both arms.
D) Have the patient turn to her left side and recheck her blood pressure in 5 minutes.

Question 19

Which statement related to changes in the breasts during pregnancy is the most accurate?

A) During the early weeks of pregnancy there is decreased sensitivity.
B) Nipples and areolae become more pigmented.
C) Montgomery tubercles are no longer visible around the nipples.
D) Venous congestion of the breasts is more visible in the multiparous woman.

Question 20

One of the most effective methods for preventing venous stasis is to

A) Wear elastic stockings in the afternoons.
B) Sleep with the foot of the bed elevated.
C) Rest often with the feet elevated.
D) Sit with the legs crossed.

Question 21

A patient who is 7 months pregnant states,"I'm worried that something will happen to my baby." The nurse's best response is

A) "There is nothing to worry about."
B) "The doctor is taking good care of you and your baby."
C) "Tell me about your concerns."
D) "Your baby is doing fine."

Question 22

In some Middle Eastern and African cultures,female genital mutilation is a prerequisite for marriage.Women who now live in North America need care from nurses who are knowledgeable about the procedure and comfortable with the abnormal appearance of her genitalia.When caring for this woman,the nurse can formulate a diagnosis with the understanding that the woman may be at risk for (select all that apply)

A) Obstructed labor
B) Increased signs of pain response
C) Laceration
D) Hemorrhage
E) Infection

Question 23

Early pregnancy classes offered in the first and second trimesters cover

A) Phases and stages of labor
B) Coping with common discomforts of pregnancy
C) Methods of pain relief
D) Predelivery and postdelivery care of the patient having a cesarean delivery

Question 24

Which situation best describes a man "trying on" fathering behaviors?

A) Spending more time with his siblings
B) Coaching a Little League baseball team
C) Reading books on newborn care
D) Exhibiting physical symptoms related to pregnancy

Question 25

Which comment by a woman in her first trimester indicates ambivalent feelings?

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

Question 26

Centering pregnancy is an example of an alternative model of prenatal care.Which statement accurately applies to the centering model of care?

A) Group sessions begin with the first prenatal visit.
B) At each visit blood pressure, weight, and urine dipsticks are obtained by the nurse.
C) Eight to 12 women are placed in gestational-age cohort groups.
D) Outcomes are similar to traditional prenatal care.

Question 27

A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parent's class.Which aspect of their birth plan would be considered unrealistic and require further discussion with the nurse?

A) "My husband and I have agreed that my sister will be my coach since he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is OK."
B) "We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labor."
C) "We want the labor and birth to take place in a birthing room. My husband will come in the minute the baby is born."
D) "We do not want the fetal monitor used during labor, since it will interfere with movement and doing effleurage."

Question 28

While providing education to a primiparous woman regarding the normal changes of pregnancy,it is important for the nurse to explain that the uterus undergoes irregular contractions.These are known as _____________ contractions.

Question 29

Mimicry refers to observing and copying the behaviors of other mothers.An example might be

A) Babysitting for a neighbor's children
B) Wearing maternity clothes before they are needed
C) Daydreaming about the newborn
D) Imagining oneself as a good mother

Question 30

During pregnancy many women become increasingly concerned about their ability to protect and provide for the fetus.This concern is often manifested as _____________.

Question 31

During pregnancy there are a number of changes that occur as a direct result of the presence of the fetus.Which of these adaptations meet this criteria? Select all that apply.

A) Leukorrhea
B) Development of the operculum
C) Quickening
D) Ballottement
E) Lightening

Question 32

The nurse who practices in a prenatal clinic understands that a major concern of lower socioeconomic groups is to

A) Maintain group health insurance on their families.
B) Meet health needs as they occur.
C) Practice preventive health care.
D) Maintain an optimistic view of life.

Question 33

What comment by a new mother exhibits understanding of her toddler's response to a new sibling?

A) "I can't believe he is sucking his thumb again."
B) "He is being difficult, and I don't have time to deal with him."
C) "My husband is going to stay with the baby so I can take our son to the park tomorrow."
D) "When we brought the baby home, we made our son stop sleeping in the crib."

Question 34

A gravida patient at 32 weeks of gestation reports that she has severe lower back pain.The nurse's assessment should include

A) Observation of posture and body mechanics
B) Palpation of the lumbar spine
C) Exercise pattern and duration
D) Ability to sleep for at least 6 hours uninterrupted

Question 35

A 36-year-old divorcee with a successful modeling career finds out that her 18-year-old married daughter is expecting her first child.What is a major factor in determining how the woman will respond to becoming a grandmother?

A) Her career
B) Being divorced
C) Her age
D) Age of the daughter

Question 36

A step in maternal role attainment that relates to the woman giving up certain aspects of her previous life is termed

A) Looking for a fit
B) Roleplaying
C) Fantasy
D) Grief work

Question 37

As a nurse in labor and delivery,you are caring for a Muslim woman during the active phase of labor.You note that when you touch her,she quickly draws away.You should

A) Continue to touch her as much as you need to while providing care.
B) Assume that she doesn't like you and decrease your time with.
C) Limit touching to a minimum, as this may not be acceptable in her culture.
D) Ask the charge nurse to reassign you to another patient.

Question 38

Which complaint by a patient at 35 weeks of gestation requires additional assessment?

A) Shortness of breath when climbing stairs
B) Abdominal pain
C) Ankle edema in the afternoon
D) Backache with prolonged standing

Question 39

The maternal task that begins in the first trimester and continues throughout the neonatal period is called

A) Seeking safe passage for herself and her baby
B) Securing acceptance of the baby by others
C) Learning to give of herself
D) Developing attachment with the baby

Question 40

A pregnant woman reports that she works in a long-term care setting and is concerned about the impending flu season.She asks about receiving the flu vaccine.As the nurse,you are aware that some immunizations are safe to administer during pregnancy,whereas others are not.Which vaccines could this patient receive? Select all that apply.

A) Tetanus
B) Hepatitis A and B
C) Measles, mumps, rubella (MMR)
D) Influenza
E) Varicella

Question 41

In order to prevent neural tube defects,updated recommendations include an intake of 0.4 mg to 0.8 mg of ___________________ each day from one month prior to conception until 8 to 10 weeks of pregnancy.

Question 42

Pregnancy is a hypercoagulable state,where the mother's blood clots more readily.Is this statement true or false?

Question 43

Pelvic congestion during pregnancy may lead to heightened sexual interest and increased orgasmic experiences.Is this statement true or false?