Deck 65: Normal Labor, Delivery, and Postpartum Care

Question 1

A client has four children and is pregnant for the fifth time. What term would the nurse use to describe this client?

A) Primigravida
B) Primipara
C) Nullipara
D) Grand multipara

Answer 1

Grand multipara

Question 2

A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion. How would the nurse document this information on the client chart?

A) G4 P3115
B) G5 P3114
C) G5 P3115
D) G5 P1135

Answer 2

G5 P3114

Question 3

A client diagnosed with type 1 diabetes is planning to have her first baby comes to the healthcare facility for a preconceptual visit. Which instruction should the nurse give the client as part of preconceptional care?

A) Eat sweets at bedtime if the client wakes up feeling hungry.
B) Eat sour, salty foods (potato chips, lemonade) to prevent nausea.
C) Replace insulin with an oral diabetic agent.
D) Avoid prescription drugs once pregnancy is confirmed.

Answer 3

Eat sour, salty foods (potato chips, lemonade) to prevent nausea.

Question 4

The nurse is providing preconceptional care for a primigravida client. Which statements accurately represent areas that need to be addressed in preconceptional care? Select all that apply.

A) Eating a healthy diet, including 200 mcg (micrograms) of folic acid a day
B) Stopping harmful or addictive behaviors, such as smoking, drinking alcohol, and drugs
C) Obtaining prescriptions for alternate drugs that are safer during pregnancy
D) For the diabetic woman, changing to an oral diabetic agent instead of insulin
E) Referring a couple at risk of having a baby with a genetic defect for genetic testing
F) Referring a couple who is having difficulty getting pregnant to a fertility specialist

Question 5

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

A) G3 P0020
B) G2 P0020
C) G2 P1020
D) G3 P0021

Question 6

The school nurse is presenting a lecture to adolescents explaining how conception occurs. Which statement by the nurse would accurately describe this process?

A) "Human life begins with the union of two cells: the zygote and the sperm."
B) "At the time of conception, the ovum determines the sex of the baby."
C) "Conception usually occurs when the ovum is in the outer third of the fallopian tube."
D) "The ovum carries the Y chromosome and the sperm carries an X or Y chromosome."

Question 7

The nurse is explaining to a primigravida how the zygote becomes implanted into the uterus. How would the nurse describe the structure formed in this process known as the blastocyst?

A) A ball of about 16 identical cells is formed when the zygote divides.
B) The endometrium is enriched in nutrients in preparation for pregnancy.
C) A group of cells is forming what will become the embryo.
D) First one, then two layers of cells surround a fluid-filled space.

Question 8

In what period of development would the nurse explain to pregnant couple that most congenital defects occur?

A) The period of the zygote
B) The period of the embryo
C) The period of the fetus
D) All periods are equally vulnerable

Question 9

When is a fetus considered viable?

A) 20 weeks
B) 25 weeks
C) 30 weeks
D) 35 weeks

Question 10

Which statements accurately describe a function of the placenta? Select all that apply.

A) It protects the umbilical cord.
B) It permits blood to bypass the right ventricle.
C) It cushions the fetus against injury.
D) It slows the maternal immune response.
E) It produces hormones that help maintain the pregnancy.
F) It carries waste away for excretion by the mother.

Question 11

What response should the nurse make when asked the purpose of amniotic fluid?

A) "Amniotic fluid cushions your baby to prevent injury."
B) "Amniotic fluid provides fetal blood circulation."
C) "Amniotic fluid supplies the food your baby needs to grow."
D) "Amniotic fluid keeps the fetus from moving freely inside it to prevent injury."

Question 12

Which statement describes a process associated with a congenital heart defect?

A) The foramen ovale remains opens.
B) The ductus arteriosus expands.
C) The ductus venosus becomes a ligament.
D) The lungs expand with the first spontaneous breath.

Question 13

Which data collected by the nurse are presumptive signs of a pregnancy? Select all that apply.

A) Breast changes
B) Ultrasound pictures
C) Fetal heartbeat
D) Amenorrhea
E) Hydatidiform mole
F) Morning sickness

Question 14

The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell sign. Which describes this alteration?

A) The cervix looks blue or purple when examined.
B) The lower uterine segment softens.
C) The fundus enlarges.
D) The cervix softens.

Question 15

A primigravida client has to undergo an ultrasound examination. Which is the most appropriate time to perform an ultrasound?

A) Between 12 and 14 weeks
B) Between 10 and 12 weeks
C) Between 16 and 20 weeks
D) Between 6 and 8 weeks

Question 16

What equipment is most appropriate to use when auscultating fetal heart sounds at 12th week of a pregnancy?

A) Doppler
B) Fetoscope
C) Tocodynometer
D) Stethoscope

Question 17

A nurse is assessing a pregnant client. Which finding would the nurse document as an abnormal finding in a pregnancy?

A) Lordosis
B) Pedal edema
C) Linea nigra
D) Visual changes

Question 18

Which hormonal actions accurately represent those that occur during pregnancy? Select all that apply.

A) Maintaining the endometrium so that the embryo can implant
B) Causing changes in the mother's metabolism so that nutrients are available for both
C) Decreasing the mother's blood volume and red blood cell mass to increase oxygen
D) Decreasing the blood supply to the gastrointestinal tract and slowing peristaltic waves
E) Relaxing the ligaments that connect the pelvic bones, allowing them to spread slightly
F) Preparing the breasts for lactation, keeping the milk from coming in until birth occurs

Question 19

What information should the nurse provide a newly pregnant woman?

A) Avoid wearing high heels, especially during late pregnancy.
B) Inform healthcare provider if bleeding is more than just spotting.
C) Avoid consuming too much fiber in the diet.
D) Eat sweets at bedtime to avoid waking up feeling hungry.

Question 20

The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy?

A) Dyspnea
B) Lower abdominal pressure
C) Swelling of extremities
D) Excessive vomiting

Question 21

A woman who is 26 weeks' pregnant is brought to the ER reporting vaginal bleeding with severe abdominal pain. What complication of pregnancy is associated with this assessment data?

A) Placenta previa
B) Placental abruption
C) Preterm labor
D) Pregnancy-induced hypertension

Question 22

A pregnant client reports a variety of discomforts associated with her pregnancy. Which should the nurse assure her is a common discomfort of pregnancy?

A) Persistent vomiting
B) Burning micturition
C) Frequent urination
D) Severe headaches

Question 23

The nurse is determining a pregnant client's estimated date of delivery (EDD) using Nägele Rule. The date of the first day of the woman's last normal menstrual period (LNMP) was April 20. What would be her EDD?

A) December 20
B) December 27
C) January 20
D) January 27

Question 24

A primigravida client has come to the clinic for a prenatal checkup. What teaching topics would help to promote a healthy pregnancy for this client?

A) Douching is recommended to decrease the risk of vaginal infections.
B) More frequent tooth brushing is recommended to prevent caries related to ptyalism.
C) Applying lanolin ointment to the breasts is recommended to prevent cracked nipples.
D) Swimming in a pool is a recommended exercise during pregnancy.

Question 25

The nurse is teaching a pregnant client in her last trimester about interventions to help reduce risks of complications during pregnancy. Which guidelines are recommended?

A) Take a daily shower, but avoid a tub bath because this could harm the fetus.
B) If planning to breastfeed, bathe as normal using soap and water on the nipples.
C) During the last month, rest on the left side for at least an hour, morning and afternoon.
D) Sleep on your back to avoid supine hypotension syndrome.

Question 26

The nurse is advising an active pregnant woman on nutritional needs to maintain a healthy pregnancy. What would the nurse state is the average total additional energy (calorie) requirement during pregnancy?

A) 1,500 to 2,000 calories per day
B) 2,000 to 2,500 calories per day
C) 2,500 to 3,500 calories per day
D) 3,500 to 4,000 calories per day

Question 27

Which precaution should a pregnant client take regarding her nutritional requirements?

A) Limit folic acid intake
B) Limit caffeine intake
C) Limit fluid intake
D) Avoid starchy food

Question 28

A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during her pregnancy. Which client statement alerts the nurse to the need for further teaching?

A) "I should substitute intercourse with nonsexual touch to avoid harming the fetus."
B) "I will experience a heightened need for touch throughout my pregnancy."
C) "If I experience bleeding, I will abstain from vaginal intercourse."
D) "I will avoid having intercourse following the rupture of the membranes."

Question 29

The nurse is teaching a prenatal class about preparing for their expanding families. What statement should the nurse include?

A) "Expect your other children to react positively to their new brother/sister."
B) "Your old coping methods will adequately get you through this period of adjustment."
C) "The hormones of pregnancy may cause anxiety or depression postpartum."
D) "Caring for your new infant is instinctual and will come naturally to you."