Deck 54: Prenatal Care

Question 1

Normal physiologic changes of pregnancy include which of the following?

A)Airway resistance is increased due to progesterone production.
B)Increased estrogen causes a loosening of connective tissue and an increase in vaginal secretions.
C)Maternal blood volume increases 50% to 75%.
D)Increased peristalsis contributes to heartburn and gastric reflux.

Answer 1

Increased estrogen causes a loosening of connective tissue and an increase in vaginal secretions.

Question 2

At her 36 weeks' gestation prenatal visit,a client complains of backaches and an "unstable" sensation in the pelvis.The nurse should explain to the client that these are normal discomforts of pregnancy primarily due to:

A)depletion of calcium from maternal bones to supply fetal skeletal development
B)engagement of the fetus in the pelvis
C)softening of the pelvic cartilages as a result of hormonal influence
D)posture changes as a result of the growing uterus

Answer 2

posture changes as a result of the growing uterus

Question 3

The nurse explains to the prenatal client that the implantation of the fertilized ovum begins on approximately what day after conception?

A)5th
B)7th
C)9th
D)11th

Answer 3

5th

Question 4

The obstetrician performed a vaginal examination on a client in her third trimester and gave a sudden push on the cervix.Later,the client asks the nurse what the procedure was and why it was done.The MOST appropriate response from the nurse would be:

A)ballottement (fetal rebound)
B)Braxton Hicks (contractions)
C)lightening (uterine reflex)
D)quickening (fetal movement)

Question 5

In the fetus,the foramen ovale causes the majority of blood to bypass which of these structures?

A)coronary sinus
B)left ventricle
C)right ventricle
D)superior vena cava

Question 6

Upon examination,a normal umbilical cord should contain:

A)one artery and one vein
B)one artery and two veins
C)two arteries and one vein
D)two arteries and two veins

Question 7

Functions of the placenta include serving as:

A)a barrier preventing all infectious and toxic substances from reaching the fetus
B)a source of equalizing pressure around the fetus
C)an organ of oxygen exchange between the fetus and mother
D)an organ controlling fetal development

Question 8

At her first prenatal visit a client discusses how her breasts have changed since she became pregnant.What are the normal breast changes that occur during the first trimester?

A)darkening of the areola,increased size,and enlarged Montgomery's tubercles
B)flattening of the nipple,decreased size,and tenderness
C)lightening of the areola,tingling sensation,and colostrum leakage
D)shrinking of the areola,throbbing sensation,and milk production

Question 9

In addition to auscultation of fetal heartbeat and visualization of the fetus,which of these is a positive sign of pregnancy?

A)positive urine pregnancy test
B)Braxton Hicks contractions
C)palpation of fetal movement
D)Goodell's sign

Question 10

Which of these terms would the nurse use when describing the fertilized ovum prior to implantation?

A)embryo
B)fertilized ovum
C)fetus
D)zygote

Question 11

A father asks when his baby's heart will start beating.The nurse should tell the father the primitive heart begins to beat at which of these times after conception?

A)21 days
B)week 8
C)week 12
D)week 16

Question 12

Which of these statements regarding prenatal risk factors is TRUE?

A)Fathers who smoke can contribute to decreased birth weight in their infants.
B)Fetal alcohol syndrome is associated with excessive intake of alcohol during the second trimester of pregnancy.
C)Illicit drug use is responsible for a majority of spontaneous abortions and stillbirths.
D)Mothers who are not immune to rubella should be immunized during the first trimester of pregnancy to prevent the fetus from being exposed to rubella.

Question 13

A prenatal client expresses concern about the irregular brown spotted areas she has recently noticed on her forehead and around her eyes.What should the nurse tell the client about the name and nature of these changes?

A)They are called chloasma and are temporary.
B)They are called linea nigra and are permanent.
C)They are called spider nevi and are permanent.
D)They are called striae gravidarum and are temporary.

Question 14

Which of these substances starts to form around week 16 and may be present in amniotic fluid if the fetus encounters hypoxic stress during the pregnancy,labor,or delivery?

A)blood
B)fetal hemoglobin
C)meconium
D)urine

Question 15

Which of these terms describes the developmental task of pregnancy that occurs as the mother incorporates the growing fetus into her body image?

A)fetal distinction
B)fetal embodiment
C)pregnancy validation
D)role transition

Question 16

In addition to syphilis and gonorrhea,prenatal laboratory work usually includes tests for which of these infectious diseases?

A)tuberculosis and pneumonia
B)herpes zoster and meningitis
C)influenza and bronchitis
D)chlamydia and human papillomavirus

Question 17

The fetus is surrounded by a fluid-filled cavity enclosed by which of these membranes?

A)amnion and chorion
B)cotyledons and funis
C)decidua basalis and decidua capsularis
D)ectoderm and endoderm

Question 18

A pregnant client expresses concern that she will develop varicose veins toward the end of her pregnancy.The nurse should recognize that varicose veins are the result of:

A)a genetic defect in the valves of lymph ducts in the lower extremities
B)compression of the abdominal veins by the progressively enlarging uterus
C)increased cardiac volume that normally occurs in the last half of the pregnancy
D)increased fluid volume resulting from the placental filtering of maturing fetal systems

Question 19

When a primigravida comes for her 20-week prenatal visit,which of these presumptive signs of pregnancy would the nurse expect the client to report?

A)Chadwick's sign
B)Hegar's sign
C)lightening
D)quickening

Question 20

At 34 weeks' gestation,a normal prenatal client should have a hematocrit of:

A)less than 25%
B)25% to 35%
C)34% to 40%
D)more than 40%

Question 21

A client asks why she must provide a urine specimen at each of her prenatal visits.The nurse should explain that it is necessary to:

A)check for an excess of protein or sugar,which may indicate a complication of pregnancy
B)check for urinary tract infections,which are more prevalent as the pregnancy progresses
C)increase comfort during examination by emptying her bladder first
D)prevent bladder damage in the event a pelvic examination is performed

Question 22

A client at 30 weeks' gestation asks about her allowable weight gain for the remainder of her pregnancy.A weight gain of how many pounds would be the most acceptable?

A)1 pound per week over the remainder of the pregnancy
B)5 pounds total over the next 10 weeks
C)15 pounds total over the next 10 weeks
D)20 pounds total over the next 10 weeks

Question 23

A nurse should instruct a prenatal client to report any warning signs during pregnancy,such as:

A)dizziness and visual disturbances
B)urinary frequency and diarrhea
C)weight gain of more than 30 pounds
D)itchy skin and bleeding gums

Question 24

Which of the following are the most common reasons for why a pregnant client does not seek prenatal care in a timely manner? (Select all that apply. )

A)underlying mental illness issues
B)substance abuse problems
C)unaware of pregnancy
D)health care provider does not do prenatal care
E)denial of pregnancy

Question 25

A pregnant client tells the nurse that she is having leg cramps.Which of these suggestions should the nurse offer?

A)Wear low-heeled shoes.
B)Apply ice packs to the legs.
C)Pull toes toward the knees.
D)Avoid fluids containing caffeine.

Question 26

A prenatal Pap smear is done on cervical secretions to diagnose which of these conditions?

A)cervical carcinoma
B)chronic cervicitis
C)gonorrhea
D)primary syphilis

Question 27

During a physical examination,the fetal heart rate is considered to be tachycardia.How many beats per minute would the nurse expect to hear?

A)60 to 90
B)91 to 100
C)110 to 160
D)170 to 180

Question 28

A client's last menstrual period began on June 16.Using Naegele's rule,the nurse calculates the client's estimated date of delivery (EDD)as:

A)March 9
B)April 23
C)March 23
D)April 6

Question 29

In addition to telling the client to report any warning signs,a nurse should provide anticipatory guidance for a pregnant client that includes which of these topics?

A)avoiding environmental hazards
B)how to maintain or increase a physical exercise program
C)how to reduce kilocalorie intake
D)cultural variations and views of pregnancy

Question 30

A client of normal prepregnancy weight asks what her total weight gain during the pregnancy should be.The MOST appropriate answer for the nurse is:

A)10 to 12 pounds
B)14 to 16 pounds
C)20 to 25 pounds
D)25 to 35 pounds

Question 31

A client's last menstrual period began on July 13.Using Naegele's rule,the nurse calculates the client's estimated date of delivery (EDD)as:

A)March 6
B)March 20
C)April 6
D)April 20

Question 32

Assessment of fetal position is routinely performed during a client's prenatal visits using:

A)an abdominal ultrasound
B)extroversion
C)Leopold's maneuvers
D)a vaginal ultrasound

Question 33

A client's fundal height has increased 4 centimeters since her last prenatal exam 1 month ago.The nurse should recognize that this measurement indicates:

A)excessive amniotic fluid
B)fetal growth retardation
C)need for further examination because of the possibility of twins
D)normal fetal growth

Question 34

Couvade is BEST described as the:

A)development of physical symptoms of pregnancy by the expectant father
B)fluid that contains antibodies and is secreted by the breasts prior to breast milk
C)motion of rebound that the floating fetus experiences when pushed upward through the vagina or abdomen
D)soft blowing sound occurring at the same rate as the maternal heart rate when the abdomen of a pregnant mother is auscultated

Question 35

Which of the following factors place a woman at risk of nutritional inadequacy during pregnancy?

A)adolescence
B)anxiety
C)multiple gestation
D)previous pregnancies

Question 36

A pregnant client tells the nurse,"I don't know what's the matter with me.I am happy about my pregnancy but seem to cry a lot." Which of these responses should the nurse make?

A)"Everyone has these feelings."
B)"What does your husband have to say about this?"
C)"You ought to see a counselor."
D)"Normal hormonal changes contribute to these mood swings."