Deck 10: Promoting a Healthy Pregnancy

Question 1

A new patient is being assessed by the perinatal nurse.For exercise,the woman practices yoga five times a week,walks her dog,and swims.What action should the nurse do first?

A)Ask if any yoga positions involve arching the back.
B)Explain that swimming is a great exercise for all women.
C)Instruct the woman to stop exercising if she gets fatigued.
D)Tell her that no extra water is needed if she is swimming.

Answer 1

Ask if any yoga positions involve arching the back.

Question 2

A 21-year-old pregnant woman smokes 8 to 10 cigarettes per day.The clinic nurse reviews the patient's diet with her and notes that she does not eat fruits or vegetables.Which action should the nurse recommend to this patient?

A)Cut down on smoking and eventually quit.
B)Eat non-produce sources of vitamin C
C)Take an over-the-counter vitamin C supplement.
D)Try to drink one glass of orange juice daily.

Answer 2

Take an over-the-counter vitamin C supplement.

Question 3

A 24-year-old pregnant woman at 26 weeks' gestation is experiencing her third pregnancy.The patient's obstetric history includes one full-term birth and one preterm birth;both children are alive and well.Today,the patient arrives at the clinic with complaints of fatigue,insomnia,and continuous backache.She reports that she is a nurse on an oncology unit and is worried about continuing to work her 12-hour shifts.What advice by the nurse would be most appropriate?

A)"Can you ask your manager about light-duty work at your job?"
B)"See if you can take more breaks at work to rest and drink water."
C)"With your previous premature birth,you might need to reduce your working hours."
D)"You can continue to work as long as you want to and feel able to."

Answer 3

"With your previous premature birth,you might need to reduce your working hours."

Question 4

The perinatal nurse recommends muscle-strengthening exercises to a woman who is pregnant for the first time.The woman states that she does not want to be "muscle-bound and masculine." What response by the nurse is best?

A)"As long as you use lighter weights,you won't get muscle-bound."
B)"OK,what do you think about swimming for exercise then?"
C)"Strengthening muscles will decrease risks of ligament and joint injury."
D)"Stronger muscles will make the labor process much easier on you."

Question 5

A woman in the perinatal clinic is upset that her impending childbirth will cause her to lose her job.What assessment question by the nurse would yield the most important information regarding this situation?

A)"After you give birth,you will probably want to quit your job anyway."
B)"Can you make an appointment with human resources to discuss this?"
C)"Where do you work and how long have you been there?"
D)"Why do you think you will be fired after your baby is born?"

Question 6

The prenatal clinic nurse visits with a 32-year-old man.His partner is pregnant with her first child and is now at 12 weeks of gestation.The man states that he has been experiencing nausea and vomiting,fatigue,and weight gain.Which action by the nurse is most appropriate?

A)Ask the woman's health-care provider to prescribe the man anti-nausea medication.
B)Assess for cancer risk factors,as weight gain and vomiting are unusual together.
C)Encourage the man to make an appointment with his primary health-care provider.
D)Explain that these symptoms are normal and often seen in men with pregnant partners.

Question 7

An 18-year-old woman at 18 weeks' gestation is being seen in the prenatal clinic.Her weight gain is 25 pounds over her prepregnant weight.Which is the perinatal nurse's best approach to care at this visit?

A)Ask the patient to complete a 3-day dietary recall while she is in the clinic.
B)Explain the possible concerns related to excessive weight gain in pregnancy
C)Explain to the patient that weight gain is not a concern in pregnancy.
D)Teach the patient about the expected normal weight gain during pregnancy.

Question 8

A student nurse asks the faculty about the importance of preconception counseling.Which response by the faculty is best?

A)"It is the best time to find any conditions that could have a negative effect on a pregnancy."
B)"It's a good time to educate women about birth control options before they need them."
C)"Reproductive care is an important part of any woman's health care."
D)"The Centers for Disease Control mandates that all women get preconception care."

Question 9

The clinic nurse is assessing a woman in her 30th week of pregnancy.Her fundal height is 23 centimeters.What other assessment finding would the nurse correlate with this condition?

A)Blood glucose 112 mg/dL
B)Hemoglobin 9.2 g/dL
C)Leukorrhea
D)Platelet count elevated

Question 10

After questioning a pregnant woman about her fluid intake,the nurse discovers that the patient is drinking four glasses of diet cola per day.Which response by the nurse is best?

A)"As long as you get enough fluid,soda is all right to drink."
B)"Less than two cups of caffeine a day is probably OK."
C)"The major worry with soda is the sugar content."
D)"You really should switch to decaffeinated colas."

Question 11

The perinatal nurse would assess which newborn system as a priority after birth if a woman admitted to cocaine use during her pregnancy?

A)Cardiovascular system
B)Endocrine system
C)Integumentary system
D)Respiratory system

Question 12

The prenatal nurse has reviewed a patient's 3-day diet recall and notes that the patient typically eats a deli meat sandwich or hot dog,chips,and an apple for lunch.Breakfast consists of cereal,milk,and juice;and dinner contains meat,a starch,vegetables,and a salad.What action by the nurse is most important? .

A)Advise the woman to obtain more calories from protein.
B)Assess the woman's knowledge of proper food handling.
C)Discuss adding fish such as tuna or swordfish to the diet.
D)Weigh the woman and document her weight in the chart.

Question 13

Which patient would the perinatal nurse assess as being most at risk for maternal attachment problems?

A)18 year-old married woman with a supportive family who lives nearby
B)20-year-old woman with remote history of chlamydia and gonorrhea
C)22-year-old alcoholic who has been sober for 10 years
D)52-year-old unemployed divorced woman who thought she was in menopause

Question 14

The perinatal nurse notes that a patient has the diagnosis of ptyalism.What topic should the nurse include in the patient's teaching plan?

A)The benefits of acupuncture
B)The need to eat more red meat
C)The importance of strict vulvar hygiene
D)The suggestion to suck on hard candy

Question 15

A perinatal nurse is assessing a pregnant woman's medications and finds that one of them is categorized as Category D.What information should the nurse provide this patient?

A)"Studies have not found human fetal risk,although animal fetuses are harmed by it."
B)"There are no associated fetal risks with this drug and it is safe to take in pregnancy."
C)"There haven't been any studies of this drug in human fetuses;I wouldn't take it."
D)"We have to decide if the benefits of this drug outweigh the risk,as it can harm the fetus."

Question 16

The prenatal clinic nurse meets with a 30-year-old woman who is experiencing her first pregnancy.The patient's quadruple-marker screen result is positive at 17 weeks of gestation.Which action by the nurse is most important?

A)Call the social worker for a consultation.
B)Document the findings in the woman's chart.
C)Facilitate a referral to a genetics counselor.
D)Prepare the woman for intrauterine death.

Question 17

A nurse is teaching a nonsmoking pregnant woman about the iron tablets she was just prescribed.What information is most important for the nurse to teach the patient?

A)Calling the doctor right away for dark,tarry stools
B)Drinking at least one glass of orange juice a day
C)Stopping the prenatal vitamins while taking iron
D)Taking the medication between meals and with milk

Question 18

A woman comes to the clinic for her 24-week prenatal visit.This is her second pregnancy.The patient does not wish to know her weight and when her clinic record is reviewed,her total weight gain for this pregnancy is 5 pounds.She is very concerned about her changing body shape.What disorder does the nurse suspect?

A)Anemia
B)Anorexia nervosa
C)Gestational diabetes
D)Gestational hypertension

Question 19

The nurse explains to the prenatal class attendees that at full term about 10 to 11% of the maternal weight gain is attributed to which of the following?

A)Blood,uterine,and breast tissue
B)Fetal tissue
C)Maternal reserves
D)Placental fluid

Question 20

The nurse in a family practice clinic is working with a woman of childbearing age who recently was married and has no plans to have children yet.Which action by the nurse is most important?

A)Asking the woman when the couple plans to get pregnant
B)Encouraging the woman to review her birth control plan
C)Instructing the woman to get 0.4 mg of folic acid daily
D)Reviewing the woman's family history for genetic defects

Question 21

An expectant couple complains of dyspareunia.Which action by the nurse is best?

A)Assess the woman's family history and genetic background.
B)Explain that this condition is a normal finding during pregnancy.
C)Instruct the couple that sex during pregnancy is not advised.
D)Suggest sexual positions that might be more comfortable.

Question 22

A patient who has a previous diagnosis of round ligament pain is in the clinic for a follow-up visit.Which statement by the patient would indicate that teaching objectives for this problem have been met?

A)"I have been supporting my uterus with a pillow when resting."
B)"I have been trying all sorts of over-the-counter medications."
C)"I haven't had any black,tarry stools at all since I was here."
D)"That black cohosh has really helped with my abdominal pain."

Question 23

A woman in her third trimester is complaining of numbness and tingling in her fingers.Which action should the nurse take first?

A)Assess the woman for hyperventilation.
B)Educate her about a thermoskin carpal tunnel glove.
C)Facilitate an appointment for a nerve conduction study.
D)Reassure her that the condition is temporary.

Question 24

A nurse is describing various childbirth options to an expectant couple.The woman states "I want to do Lamaze because I hear you will have no pain with this method." Which response by the nurse is best?

A)"If done right,you will have no childbirth pain."
B)"Lamaze empowers you to cope with the pain."
C)"No,Lamaze emphasizes epidural pain control."
D)"Pain is a natural and normal part of childbirth."

Question 25

A nurse is helping a pregnant woman prepare for a planned home birth.What action by the nurse takes priority?

A)Advising the woman to get a prescription for pain medication filled beforehand
B)Attempting to convince the woman that giving birth at the hospital is a better choice
C)Ensuring the woman has safe,rapid,and available transportation to a nearby hospital
D)Giving the woman a list of local obstetricians who will assist at a home birth

Question 26

A pregnant woman has been brought to the emergency department by the rescue squad with symptoms of heat exhaustion after competing in an outdoor race on a hot day.Before discharge,the nurse teaches about appropriate exercise during pregnancy.The husband asks if the woman's having heat exhaustion will harm the baby.Which response by the nurse is most accurate?

A)"Definitely;that's why pregnant women should not do aerobic exercise."
B)"Fetal temperature depends on mom's temperature,so the fetus may be affected."
C)"The baby is in a fluid environment and won't get overheated."
D)"Yes,but if we rapidly cool mom down,there won't be any problems."

Question 27

A nurse is reviewing the care plan for a woman in the third trimester of her first pregnancy.Which action by the patient best indicates positive adaptation to the pregnancy and impending motherhood?

A)Attended three prenatal classes with her partner to learn about labor
B)Continues to exercise,maintains a healthy diet,quit smoking recently
C)Educated about pregnancy,fetal growth and development,and motherhood
D)Has prepared a well-stocked nursery complete with stimulating toys

Question 28

A woman who is 26 weeks pregnant has a blood pressure of 158/100 mm Hg.Which action by the nurse is most appropriate?

A)Assess the woman's risk for other cardiovascular problems.
B)Have her rest for 20 minutes,then reassess her blood pressure.
C)Obtain a urine dipstick for proteinuria and assess for headache.
D)Prepare to teach the woman about anti-hypertensive medication.

Question 29

A pregnant woman is complaining of urinary frequency and is worried about incontinence.Which teaching strategy should the nurse use when counseling this woman?

A)Minimize fluid intake during the day.
B)Perform sit-ups to strengthen the abdomen.
C)Teach the woman how to perform Kegel exercises.
D)Void infrequently to train the bladder.

Question 30

A pregnant woman is being discharged from the hospital after an episode of preterm labor that has resolved.She asks the nurse if she can now return to her low-impact aerobics class.Which response by the nurse is best?

A)"As long as it's low impact,it should be OK to return."
B)"Make sure you can talk while you are exercising."
C)"Preterm labor is a contraindication for aerobic exercise."
D)"Wait 72 hours;if you don't have more contractions,it's OK."

Question 31

A woman in her second trimester wants to continue her weight-lifting and exercise plan.Which exercise would the nurse advise against participating in?

A)Calf stretches
B)Weight lifting
C)Pelvic tilts
D)Walking lunges

Question 32

A pregnant woman in her third trimester presents to the emergency department after fainting upon rising from a supine position.Which activity should the nurse perform first?

A)Call the cardiology department for an EKG.
B)Determine the fetal heart rate.
C)Obtain a blood glucose reading.
D)Teach her to rise slowly from a reclining position.

Question 33

A nurse is planning to teach a prenatal class on the Dick-Read method of childbirth.Which information should the nurse plan to include?

A)After birth,the newborn is placed in a tub of warm water.
B)Consciously controlled breathing is the main coping strategy.
C)Relaxation is vital because pain is caused by fear and tension.
D)The Dick-Read method means a totally medication-free birth.

Question 34

A woman's birth plan specifies the Odent method of childbirth.Early in her admission,the woman asks about having an epidural for pain control.Which action by the nurse is best?

A)Advise the woman that this will change her birth plan
B)Ask why she wants pain control with natural childbirth
C)Facilitate having the epidural catheter placed
D)Review the breathing techniques for managing pain

Question 35

A patient in the prenatal clinic had a negative rubella titer.Which action by the nurse is most appropriate?

A)Have the laboratory draw rubella titers as a double-check.
B)Instruct the woman to avoid anyone who may have the disease.
C)Prepare to administer a rubella vaccination to the woman.
D)Reassure the woman that rubella has few fetal consequences.

Question 36

A perinatal clinic nurse educated a pregnant woman about basic prenatal exercises.On a return visit,which statement by the patient indicates that teaching goals have been met?

A)"I have learned to isolate the right muscle for Kegel exercises."
B)"It's hard to find 30 minutes a day for exercise,but I have done it."
C)"Jumping rope is great exercise and keeps my weight in control."
D)"When I get fatigued with these exercises,I just push through it."

Question 37

A patient on the postpartum floor of the hospital has a body mass index (BMI)of 38 and just gave birth to a healthy baby girl by Cesarean section.Which action by the nurse takes highest priority?

A)Administering pain medication promptly when requested
B)Assisting the woman to begin breastfeeding the infant
C)Educating the woman about healthy weight loss
D)Monitoring the incision site and using strict hand-washing technique

Question 38

A woman admitted in labor asks if she can have a doula present with her.The nurse understands that a doula is which of the following?

A)A massage therapist with a specialty in labor massage
B)A trained labor coach standing in for the woman's partner
C)A woman who is experienced in labor and provides support to the woman
D)Someone who is trained and licensed to deliver babies in the hospital

Question 39

A pregnant woman lifts weights regularly with a partner.What modification to this activity should the nurse suggest?

A)Adjust the weight bench so that it is tilted,not flat.
B)Do fewer repetitions by using heavier weights.
C)Do not hold your breath for more than 30 seconds.
D)Use free weights instead of resistance bands.

Question 40

A woman in her second trimester continues to smoke a pack of cigarettes a day despite stating that she understands why smoking is bad for her and for her fetus.Which action by the nurse is best?

A)Assess the patient for past trauma and abuse.
B)Document the information in the patient's chart.
C)Review prior teaching done regarding smoking.
D)Show photos of babies born with abnormalities.

Question 41

A nurse is explaining childbirth education choices to an expectant couple.The nurse explains that although each method is different,all methods emphasize some similar concepts.Which concepts does the nurse describe as similar across different methodologies? (Select all that apply.)

A)Biological
B)Financial
C)Psychosocial
D)Relational
E)Social

Question 42

An expectant father seems to be ambivalent about the impending birth of his child.Which actions by the nurse are most important? (Select all that apply.)

A)Ask the father if he has fears for his partner.
B)Assess the woman for intimate partner violence (IPV).
C)Call the social worker to assess the father's financial situation.
D)Give the father written information about childbirth.
E)Reassure the father that conflicting emotions are normal.

Question 43

A nurse is conducting a class on the Lamaze method of childbirth.Which core values does this nurse plan to teach? (Select all that apply.)

A)A woman's ability to give birth can be diminished by the care provider.
B)Conscious breathing is the main coping strategy in Lamaze.
C)Lamaze birthing is medication free and epidurals are not given.
D)The birth coach is only present to provide comfort to the laboring woman.
E)Women are capable of and have the wisdom to give birth.

Question 44

A nurse is educating a pregnant woman who has a history of pica about healthier eating.Which nutrients should the nurse include in the teaching plan? (Select all that apply.)

A)Calcium
B)Folic acid
C)Iron
D)Vitamin C
E)Vitamin D

Question 45

For which diseases does the prenatal nurse recommend a newly pregnant woman be screened? (Select all that apply.)

A)Chlamydia
B)Hepatitis A
C)Mumps
D)Rubella
E)Varicella

Question 46

A student nurse is working in the OB clinic as part of a preceptorship.The student is counseling a woman in her first trimester who complains of insomnia due to nasal congestion.Which action by the student warrants intervention by the student's preceptor?

A)Advises the woman to use over-the-counter nasal saline spray
B)Assesses the patient for other allergy and cold symptoms
C)Instructs the woman to use decongestants and antihistamines
D)Suggests the woman take a hot,steamy bath at bedtime

Question 47

A 22-year-old woman is experiencing her third pregnancy.Her obstetrical history includes one first-trimester elective abortion and one first-trimester spontaneous abortion.The patient is a semi-vegetarian who drinks milk and eats yogurt and fish as part of her daily intake.Which of the following should the nurse include in the patient's dietary teaching plan? (Select all that apply.)

A)Consuming red meat
B)Eating foods high in zinc
C)Increasing calcium intake
D)Restricting sodium
E)Taking an iron supplement

Question 48

The nurse teaches the prenatal class attendees about herbal medications that may cause uterine contractions and preterm labor.Which of the following herbal preparations should be avoided because they act as uterine stimulants? (Select all that apply.)

A)Black cohosh
B)Dong quai
C)Ephedra
D)Mugwort
E)Senna

Question 49

A woman is admitted to the hospital with a birth plan that specifies the Bradley method of childbirth.Which actions by the nurse are most appropriate for this patient? (Select all that apply.)

A)Assist the woman in conserving energy for childbirth.
B)Call the anesthesiologist to place an epidural.
C)Ensure the patient has a quiet environment.
D)Establish a relationship with the husband-coach.
E)Turn the lights down in the patient's room.

Question 50

A nurse is assessing a woman pregnant with her third child.She has a history of pregnancy-related varicosities.Which action by the nurse takes priority?

A)Advising the woman not to cross her legs while pregnant
B)Assessing the woman's pedal pulses and circulation
C)Having the woman rate her leg pain on a 1-to-10 scale
D)Teaching the woman to wear knee-high stockings