Deck 20: Assessment of the Pregnant Patient

Question 1

A nurse instructs the patient about which expected skin changes during pregnancy?

A) Nipples becoming thicker
B) Hands and feet becoming pale and cool
C) Blotchy, brown pigmentation of the abdomen
D) Stretch marks on the expanding abdomen

Answer 1

Stretch marks on the expanding abdomen

Question 2

How does a nurse determine the Goodell sign?

A) Assesses the softening of the lower uterine segment
B) Palpates for softening of the cervix
C) Assesses the breasts for fullness and tenderness
D) Inspects the cervix for a bluish coloration

Answer 2

Palpates for softening of the cervix

Question 3

The nurse recognizes which clinical manifestation as a positive sign of pregnancy?

A) Cessation of menstruation
B) Visualization of the fetus by ultrasound
C) Nausea and increased abdominal girth
D) Positive pregnancy test (hCG)

Answer 3

Visualization of the fetus by ultrasound

Question 4

What is the meaning of "G5, T1, P0, A3, L1" found in a patient's history?

A) One birth at term
B) Three living children
C) Five grown children
D) One delivery not at term

Question 5

To perform Leopold maneuvers, the nurse uses which assessment technique?

A) Percussing over the symphysis pubis
B) Auscultating all four abdominal quadrants
C) Palpating the fundus
D) Measuring from symphysis pubis to the umbilicus

Question 6

A nurse documents as abnormal which finding of a pregnant patient?

A) Facial swelling in a woman who is 20 weeks pregnant
B) 1+ pitting ankle edema in a woman who is 26 weeks pregnant
C) Pinkish-red blotches of the hands in a woman at 32 weeks gestation
D) Blotchy, brownish pigmentation of the face in a woman at 36 weeks gestation

Question 7

Using Nägele's rule, what is the estimated delivery date of a patient whose last menstrual period started on December 1?

A) August 1
B) August 10
C) September 4
D) September 8

Question 8

A woman who is 16 weeks pregnant with her first child is concerned because she has not felt the fetus move. What is the most appropriate explanation for a nurse to give this patient?

A) Movement of a fetus in the first pregnancy often does not occur until the twenty-fourth week of pregnancy.
B) A referral to an obstetrician should be made for further evaluation of this finding.
C) Movement of the fetus is not expected until the nineteenth week of pregnancy.
D) Movement of the fetus is related to fundal height; the greater the fundal height, the sooner the fetal movement.

Question 9

A nurse assesses fetal heart rates when patients are examined in the maternity clinic. The nurse determines which fetus needs further assessment?

A) The fetus with a heart rate of 150 beats/min
B) The fetus with a heart rate of 140 beats/min
C) The fetus with a heart rate of 130 beats/min
D) The fetus with a heart rate of 110 beats/min

Question 10

A nurse refers which pregnant patient for additional assessment?

A) A woman at 36 weeks of gestation who has 30% effacement of the cervix
B) A woman at 19 weeks of gestation who has noticed fetal movement every day this week
C) A woman at 20 weeks of gestation who has gained 4 lb in the last 2 weeks
D) A woman at 28 weeks of gestation who has a systolic blood pressure of 40 mg Hg over baseline

Question 11

The nurse documents which clinical finding as an expected change associated with advancing pregnancy?

A) Slight persistent ankle edema
B) Hypoplasia of the thyroid gland
C) Increased diaphragmatic excursion
D) Heart murmur after 20 weeks of gestation

Question 12

In prioritizing patient care, the nurse would give immediate attention to the pregnant patient with which clinical manifestation?

A) Darkened eyelids
B) Seeing spots
C) Excessive eye dryness
D) Pale conjunctiva

Question 13

In measuring fundal height, the nurse documents which finding as abnormal?

A) 29 cm at week 30
B) 28 cm at week 26
C) 34 cm at week 38
D) 26 cm at week 24

Question 14

The nurse correlates which clinical manifestation with the diagnosis of polyhydramnios?

A) Difficulty palpating fetal parts
B) Increased fetal movement
C) Weight gain of less than estimated by gestational age
D) Increase of 2 cm in fundal height in 1 week

Question 15

A pregnant woman who drinks alcoholic beverages while pregnant increases the risk for which disorder?

A) Low infant birth weight
B) Birth defects
C) Abruptio placentae
D) Gestational diabetes mellitus

Question 16

A pregnant patient presents to the clinic with a 3 lb/week weight gain for 2 successive weeks. The nurse is most concerned that this patient is demonstrating signs of which condition?

A) Gestational diabetes mellitus
B) Preeclampsia
C) Placenta enlargement
D) Multiple gestations

Question 17

A pregnant woman's weight before becoming pregnant was 137 lb. What weight is expected for this woman during her second trimester?

A) 149 lb
B) 151 lb
C) 155 lb
D) 164 lb

Question 18

A patient at 20 weeks of gestation is concerned about a discharge from her nipples. What is the nurse's appropriate response to this patient?

A) "That is expected. It is milk production that begins at the onset of pregnancy."
B) "A nipple discharge is unusual. I advise you to consult your obstetrician."
C) "I suggest you decrease your fluid intake for several days to see if this makes a difference."
D) "After the first trimester a thin, yellow fluid called colostrum may be secreted from the nipples."

Question 19

A patient's prepregnant weight was 131 lb, within the desirable range for her height. What is the expected weight for this pregnant patient?

A) 131 lb at 1 week postpartum
B) 140 lb at the end of the first trimester
C) 145 lb at the end of the second trimester
D) 176 lb at the beginning of the third trimester

Question 20

A patient who is 30 weeks pregnant tells the nurse, "I have had low blood pressure all my life, and now it is 136/74. What's wrong with me?" What is the most appropriate response by this nurse?

A) "A woman's blood pressure usually drops several points during pregnancy, but yours hasn't."
B) "The blood pressure increases because your blood volume increases to supply you and the baby with enough blood."
C) "Yes, this is a significant change from your baseline, and I advise you to see your obstetrician at your earliest convenience."
D) "If you spend more time lying down, I think your blood pressure should return to normal in a few days."

Question 21

A pregnant patient's weight before pregnancy was 148 lb. Her expected weight during the first trimester is ______ to ______ lb.

Question 22

How does a nurse describe abruptio placentae when teaching a class to pregnant women?

A) A premature separation of the implanted placenta before birth of the fetus
B) An accumulation of amniotic fluid associated with decreased fetal movement
C) An attachment of the placenta in the lower uterine segment near the cervical os
D) Related to premature rupture of membranes with purulent vaginal discharge

Question 23

In reviewing the results of physical examination of a 25-year-old pregnant patient, a nurse recognizes which finding as expected?

A) Small, round, oval cervix
B) Pale, symmetrical cervix
C) Smooth, bluish-colored cervix
D) Slit-shaped, pink cervix

Question 24

Which physiologic changes are associated with pregnancy? (Select all that apply.)

A) Increase in brittleness of fingernails
B) 1500 mL increase in blood volume
C) Periodic shortness of breath later in pregnancy
D) Edematous and bleeding gums
E) Painless vaginal bleeding
F) Waddling gait

Question 25

What manifestations does a nurse anticipate when assessing a patient with preeclampsia? (Select all that apply.)

A) Systolic blood pressure greater than 140 mm Hg
B) Increase in systolic blood pressure of 20 mm Hg over baseline
C) Diastolic blood pressure greater than 90 mm Hg
D) Increase in diastolic blood pressure of 15 mm Hg over baseline
E) 2 lb increase in weight in 1 week
F) 9 lb increase in weight in 1 month

Question 26

A pregnant patient's weight before pregnancy was 163 lb. The nurse expects the patient to weigh ______ to ______ lb during the second trimester.

Question 27

In assessing a patient for modifiable risk factors, the nurse correlates which finding with a high-risk pregnancy?

A) 15-year-old mother
B) Low socioeconomic status
C) Previous birth of infant with isoimmunization
D) Weight less than 100 lb

Question 28

If a patient's last menstrual period was May 13, her estimated date of birth is ________.

Question 29

Which complication of pregnancy does a nurse suspect when the patient reports painless vaginal bleeding at 32 weeks of gestation?

A) Placenta previa
B) Eclampsia
C) Abruptio placentae
D) Premature rupture of membranes

Question 30

What does a nurse teach pregnant patients about the effects of smoking while pregnant? (Select all that apply.)

A) Fluid retention increases.
B) Prematurity risk increases.
C) Low infant birth weight risk increases.
D) Anemia develops.
E) Vitamin C deficiency develops.
F) Craving of starch, baking soda, or clay develops.