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 nurse is taking vital signs on a pregnant woman.Preconception pulse was 76 beats/minute.Today the pulse is 97 beats/minute.What action by the nurse is best?

A) Inform the provider immediately.
B) Document findings in the chart.
C) Prepare to start an IV infusion.
D) Retake the pulse in 15 minutes.

Answer 2

Document findings in the chart.

Question 3

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.

Answer 3

dilution of hemoglobin concentration.

Question 4

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

Question 5

The nurse teaches a pregnant woman that 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 6

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 7

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 8

A nurse sees a woman in her first trimester of pregnancy.The nurse explains that the woman 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 mother and fetus can be monitored.
D) problems can be eliminated.

Question 9

A woman's last menstrual period was June 10.The nurse estimates the date of delivery (EDD)to be

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

Question 10

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 11

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."

Question 12

A woman is currently pregnant; she has a 5-year-old son and a 3-year-old daughter born at full term.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 13

A woman is at her first prenatal visit and is distressed at needing an HIV test.What response by the nurse is best?

A) "We ask all women to be tested for HIV during their pregnancy."
B) "This test is required by law for pregnant women."
C) "Infection with HIV will make your pregnancy very high risk."
D) "You could have been exposed and not know it."

Question 14

A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis.What action by the nurse is best?

A) Refer the patient to an ear, nose, and throat specialist.
B) Explain that nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
C) Attach the woman to a cardiac monitor, and draw blood for hemoglobin and hematocrit.
D) Teach that the increased blood supply to the mucous membranes and can result in congestion and nosebleeds.

Question 15

A student nurse reads a patient's chart and sees the term "striae gravidarum," The student asks the registered nurse what this means.What response by the nurse is accurate?

A) Stretch marks on the abdomen and breasts
B) Dark pigmentation on the woman's face
C) Bluish-purple discoloration of the vagina and labia
D) Reddened bleeding gums in a pregnant woman

Question 16

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 17

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 18

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

A) Proteinuria
B) Glycosuria
C) Bacteria
D) Ketonuria

Question 19

While the nurse assesses 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 20

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 21

A student nurse is teaching a pregnant woman ways to manage constipation.Which instruction by the student causes the nurse to provide a correction?

A) Drink at least 8 glasses of liquids a day.
B) The fat in cheese helps lubricate the bowels.
C) You do need to continue your iron pills.
D) Add extra fiber, which can be found in fruit.

Question 22

A couple ask the prenatal nurse to explain centering pregnancy.Which statement accurately applies to this model of care?

A) A way to control labor pain and remain centered during the process
B) A philosophy of making the pregnancy the center of the family's life
C) Education and support sessions are provided to small cohorts of women
D) Labor practice where the woman is surrounded by an extensive network of people

Question 23

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 24

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 will stay with the baby so I can take our son to the park."
D) "When we brought the baby home, we made our son stop sleeping in the crib."

Question 25

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 26

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 27

A nurse in labor and delivery is caring for a Muslim woman during the active phase of labor.You note that when you touch her,she quickly draws away.Which response by the nurse is best?

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 her.
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 28

Which of the following behaviors by a pregnant woman would be an example of mimicry?

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 29

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 require further discussion with the nurse?

A) "My husband and I have agreed that my sister will be my coach."
B) "We plan to use Lamaze to reduce the pain during labor."
C) "We want the labor and birth to take place in a birthing room with our son present.
D) "We will not use the fetal monitor during labor."

Question 30

The nurse is caring for a woman who had infibulation performed on her as a child.Which of the following actions by the perinatal nursing staff are appropriate for this patient? (Select all that apply.)

A) Obtaining frequent urinalysis collections
B) Providing larger equipment for exams
C) Astute assessments for pain during procedures
D) Monitoring for infections
E) Draping the woman maximally

Question 31

A nurse is encouraging a patient to attend an early pregnancy class for the second trimester.What topic would be inconsistent with the nurse's knowledge of topics presented in this class?

A) Fetal development
B) Body mechanics
C) Childbirth choices
D) Managing morning sickness

Question 32

The nurse in the OB triage area has four patients to see.Which patient should the nurse see first?

A) First trimester, vomiting for an hour
B) Second trimester, fingers swollen
C) Third trimester, painful urination
D) Third trimester, painful vaginal bleeding

Question 33

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 34

A pregnant patient of 28 weeks' gestation complains of pain in the right inguinal area.What action by the nurse is best?

A) Assess the woman for early labor.
B) Position the woman on the right side.
C) Palpate the woman's abdomen.
D) Document the findings in the chart.

Question 35

A 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 36

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

A) Spending more time with his siblings
B) Taking a nephew to the park to play
C) Reading books on newborn care
D) Exhibiting physical symptoms related to pregnancy

Question 37

The nurse is caring for a patient whose English is limited.When the nurse provides information,the patient smiles and nods her head.What action by the patient indicates that the goal for a primary nursing diagnosis for this patient has been met?

A) Keeps next appointment and brings a translator with her.
B) Gains an appropriate amount of weight at next visit.
C) Husband accompanies patient to appointments.
D) Continues to eat culturally appropriate foods.

Question 38

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) role playing.
C) fantasy.
D) grief work.

Question 39

A nurse is caring for patients in the prenatal clinical who are all 35 weeks along.Which patient should the nurse see first?

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

Question 40

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 41

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.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 42

A pregnant woman asks the nursing student what to do about her frequent heartburn.What suggestions can the student make that are appropriate? (Select all that apply.)

A) Try chewing gum during the day.
B) Take Alka-Seltzer or other antacid.
C) Drink a small sip of cream before meals.
D) Eat small amounts of dry crackers.
E) Wear loose-fitting clothing.

Question 43

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 these criteria? (Select all that apply.)

A) Leukorrhea
B) Development of a mucous plug
C) Quickening
D) Ballottement
E) Lightening