Deck 30: Pregnancy

Question 1

The nurse auscultates a functional systolic murmur,grade II/IV,in a woman in week 30 of her pregnancy.The remainder of her physical assessment is within normal limits.The nurse would:

A)consider this an abnormal finding and refer her for additional consultation.
B)ask the woman to run in place and then assess for an increase in the intensity of the murmur.
C)know that this is a normal finding resulting from the increase in blood volume during pregnancy.
D)ask the woman to restrict her activities and return to the clinic in 1 week for reevaluation.

Answer 1

know that this is a normal finding resulting from the increase in blood volume during pregnancy.

Question 2

The nurse knows that the best time to assess a woman's blood pressure during an initial prenatal visit is:

A)at the end of history-taking,before the physical exam,when she will be the most relaxed.
B)at the beginning of the interview,as a nonthreatening method of establishing rapport.
C)during the middle of the physical examination,when she is the most comfortable.
D)before beginning the pelvic examination,because her blood pressure will be higher after the pelvic examination.

Answer 2

at the end of history-taking,before the physical exam,when she will be the most relaxed.

Question 3

A patient who is 20 weeks pregnant tells the nurse that she feels more short of breath as her pregnancy progresses.The nurse recognizes that which of the following is true?

A)High levels of estrogen cause shortness of breath.
B)Feelings of shortness of breath are abnormal during pregnancy.
C)The hormones of pregnancy cause an increased respiratory effort.
D)The patient should get more exercise in an attempt to increase her respiratory reserve.

Answer 3

The hormones of pregnancy cause an increased respiratory effort.

Question 4

When performing the examination of a woman who is 8 weeks pregnant,the nurse notes that her cervix is a bluish colour.The nurse would document this finding as:

A)Hegar's sign.
B)Homan's sign.
C)Chadwick's sign.
D)Goodell's sign.

Question 5

A woman who is 8 weeks pregnant is visiting the clinic for a checkup.Her systolic blood pressure is 30 mm Hg higher than her prepregnancy blood pressure.The nurse would:

A)consider this a normal finding.
B)expect the blood pressure to decrease as the estrogen levels increase throughout the pregnancy.
C)consider this an abnormal finding,because blood pressure is typically lower at this point in the pregnancy.
D)recommend that she decrease her salt intake in an attempt to decrease her peripheral vascular resistance.

Question 6

When auscultating the anterior thorax of a pregnant woman,the nurse notes the presence of a murmur over the second,third,and fourth intercostal spaces.It is continuous but can be obliterated by pressure with the stethoscope or finger on the thorax just lateral to the murmur.The nurse knows that this is:

A)the murmur of aortic stenosis.
B)most likely a mammary souffle.
C)associated with aortic insufficiency.
D)an indication of a patent ductus arteriosus.

Question 7

When performing an examination of a woman who is 34 weeks pregnant,the nurse notes that as the woman raises her head and shoulders off of the bed,there is a midline linear protrusion in the abdomen over the area of the rectus abdominis muscles.The nurse would:

A)document the presence of diastasis recti.
B)discuss this condition with the physician,because it will most likely need to be surgically repaired.
C)suspect that the woman has a hernia from the increased pressure within the abdomen from pregnancy.
D)tell the woman that she may have a difficult time with delivery because of the weakness in her abdominal muscles.

Question 8

A woman in her second trimester of pregnancy complains of heartburn and indigestion.The nurse should offer which of the following explanations for these problems?

A)Tone and motility of the gastrointestinal tract increase during the second trimester.
B)Sluggish emptying of the gallbladder,resulting from the effects of progesterone,often causes heartburn.
C)Lower blood pressure at this time decreases blood flow to the stomach and gastrointestinal tract.
D)The enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.

Question 9

When palpating the fundus,the nurse knows that:

A)it should be hard and slightly tender to palpation during the first trimester.
B)fetal movement should be felt by the examiner at the beginning of the second trimester.
C)after 20 weeks' gestation,the number of centimetres should approximate the number of weeks of gestation.
D)fundal height is usually less than the number of weeks of gestation,unless there is an abnormal condition such as the presence of too much amniotic fluid.

Question 10

A woman who is 28 weeks pregnant has edema in her lower legs bilaterally after working 8 hours a day as a cashier at a local grocery store.What should the nurse tell her?

A)"You will be at risk for development of varicose veins when your legs are edematous."
B)"I would like to listen to your heart sounds.Edema can indicate a problem with your heart."
C)"Edema is usually the result of too much salt and fluids in your diet.You may need to try to cut down on salty foods."
D)"As your baby grows,it slows blood return from your legs,causing the swelling.This often occurs with prolonged standing."

Question 11

A patient is being seen at the clinic for her 10-week prenatal visit.She asks when she will be able to hear the baby's heartbeat.The nurse should reply:

A)"The baby's heartbeat is not usually heard until the second trimester."
B)"The baby's heartbeat may be heard anywhere from the ninth to the twelfth week."
C)"It is often difficult to hear the heartbeat at this point,but we can try."
D)"It is normal to hear the heartbeat at 6 weeks.We may be able to hear it today."

Question 12

When the nurse is assessing the deep tendon reflexes (DTRs)of a woman who is 32 weeks pregnant,which of the following findings would be considered normal,on a 0-4+ scale?

A)Absent DTRs
B)2+
C)4+
D)Brisk reflexes and the presence of clonus

Question 13

A patient who is in her first trimester of pregnancy tells the nurse that she is experiencing significant nausea and vomiting,and asks when it will improve.The nurse should reply:

A)"Did your mother have significant nausea and vomiting?"
B)"Many women experience nausea and vomiting until the third trimester."
C)"Usually,by the beginning of the second trimester,the nausea and vomiting improve."
D)"At about the time you begin to feel the baby move,the nausea and vomiting will subside."

Question 14

Which of the following best describes the action of the hormone progesterone during pregnancy?

A)It produces the hormone human chorionic gonadotropin.
B)It stimulates duct formation in the breast.
C)It promotes sloughing of the endometrial wall.
D)It maintains the endometrium around the fetus.

Question 15

Which of the following findings is considered normal and expected when the nurse is performing a physical examination on a pregnant woman?

A)A palpable,full thyroid
B)Spontaneously bleeding gingiva
C)Significant,diffuse enlargement of the thyroid
D)Pale,hypertrophied mucous membranes of the mouth

Question 16

During the examination of a woman in her second trimester of pregnancy,the nurse notes the presence of a small amount of yellow drainage from the nipples.The nurse knows that this is:

A)an indication that the woman's milk is coming in.
B)a sign of possible breast cancer in a pregnant woman.
C)most likely colostrum,which is considered a normal finding at this stage of the pregnancy.
D)an early stage in the pregnancy for lactation to begin.The woman should be referred to a specialist.

Question 17

When examining the face of a woman who is 28 weeks pregnant,the nurse notes the presence of a butterfly-shaped increase in pigmentation on her face.When documenting,the correct term for this finding is:

A)striae.
B)chloasma.
C)linea nigra.
D)the mask of pregnancy.

Question 18

The nurse knows that classic symptoms associated with pre-eclampsia include:

A)proteinuria,headaches,and seizures.
B)elevated blood pressure and proteinuria.
C)elevated liver enzymes and high platelet count.
D)neurological signs,elevated blood pressure,and edema.

Question 19

A female patient is experiencing nausea,breast tenderness,fatigue,and amenorrhea.Her last menstrual period was 6 weeks ago.The nurse recognizes that this patient is experiencing:

A)positive signs of pregnancy.
B)possible signs of pregnancy.
C)probable signs of pregnancy.
D)presumptive signs of pregnancy.

Question 20

The nurse is palpating the abdomen of a woman who is 35 weeks pregnant,and notes that the fetal head is facing downward toward the pelvis.The nurse would document this as:

A)fetal lie.
B)fetal variety.
C)fetal attitude.
D)fetal presentation.

Question 21

Which of the following findings would be most consistent with an 8-week pregnant uterus?

A)The uterus seems slightly enlarged and softened.
B)It reaches to the pelvic brim and is about the size of a grapefruit.
C)It rises above the pelvic brim and is about the size of a cantaloupe.
D)It is approximately 8 cm across the fundus and is about the size of an avocado.

Question 22

During an internal examination of a woman during her first prenatal visit,the nurse notes that the cervix is soft.This is known as:

A)Hegar's sign.
B)Chadwick's sign.
C)Homan's sign.
D)Goodell's sign.

Question 23

Which of the following statements is true regarding pregnancy after 35 years of age?

A)Women over 35 years of age deliver most often by vaginal delivery.
B)The occurrence of having a child with Down syndrome is much more frequent after 35 years of age.
C)Genetic counselling and prenatal screening are not routine until after 40 years of age.
D)Women over 35 years of age who are pregnant have the same rate of pregnancy-related complications as those who are under 35 years of age.

Question 24

In week 34 of pregnancy,a woman is told that she has pre-eclampsia.The nurse knows that which of the following statements about pre-eclampsia is true?

A)Pre-eclampsia has little effect on the fetus.
B)Edema is one of the main indications of pre-eclampsia.
C)Eclampsia only occurs before delivery of the baby.
D)Untreated pre-eclampsia may progress to eclampsia,which is manifested by generalized tonic-clonic seizures

Question 25

Which of the following time periods correctly describes the average length of pregnancy?

A)38 weeks
B)9 lunar months
C)280 days from the last day of the last menstrual period
D)280 days from the first day of the last menstrual period

Question 26

A woman who is in week 25 of her pregnancy comes to the clinic for her prenatal visit.The nurse notes that her face is swollen and that her blood pressure is 144/94 mm Hg.She states that she has had headaches and blurry vision,but thought she was just tired.What should the nurse suspect?

A)Eclampsia
B)Pre-eclampsia
C)Diabetes type 1
D)Premature labour

Question 27

During a group prenatal teaching session,the nurse teaches Kegel exercises.Which of the following statements would be appropriate for this teaching session? (Select all that apply. )

A)"Kegel exercises help to keep your uterus strong during the pregnancy."
B)"Kegel exercises should be performed twice a day."
C)"Kegel exercises should be performed 50 to 100 times a day."
D)"To perform Kegel exercises,squeeze slowly to a peak at the count of eight,then release slowly to a count of eight."
E)"To perform Kegel exercises,perform rapidly alternating squeeze-release exercises up to the count of eight."

Question 28

During auscultation of fetal heart tones (FHTs),the nurse determines that the rate is 136 beats per minute.The nurse's next action should be to:

A)document the results,which are within normal range.
B)take the maternal pulse to verify these findings as the uterine souffle.
C)have the patient change positions and count the FHTs again.
D)notify the physician immediately for possible fetal distress.

Question 29

During the assessment of a woman in week 22 of her pregnancy,the nurse is unable to hear fetal heart tones with the Doppler device.The nurse should:

A)wait 10 minutes and try again.
B)notify the physician immediately.
C)use a fetoscope to identify fetal heart tones.
D)use ultrasonography to verify cardiac activity.

Question 30

A 25-year-old woman is visiting the clinic for her first prenatal visit.Which laboratory screening is appropriate at this time?

A)Human chorionic gonadotropin
B)Complete blood cell count
C)a-Fetoprotein
D)Carrier screening for cystic fibrosis

Question 31

During the health history of a woman who is pregnant with her first child,the woman states,"I just cannot stop crunching on ice! What's wrong with me?" The nurse recognizes that:

A)she is experiencing a common food intolerance.
B)the woman is experiencing pica,or craving for nonfood items,which is sometimes associated with anemia.
C)she may be experiencing gastrointestinal changes associated with pregnancy.
D)she probably craved ice before her pregnancy,and this is nothing new.

Question 32

A woman in week 25 of her pregnancy has come to the clinic with a complaint of 3 weeks of bouts of severe vomiting.The nurse notes that she is showing signs of dehydration.Her blood pressure is lower than usual,and she is extremely fatigued.The nurse recognizes that this patient is experiencing:

A)pre-eclampsia.
B)polyhydramnios.
C)proteinuria.
D)hyperemesis.

Question 33

A patient's pregnancy test is positive,and she wants to know when the baby is due.The first day of her last menstrual period was June 14,and that period ended June 20.What is her expected date of delivery,using Nägele's rule?

A)March 7
B)March 14
C)March 21
D)March 27

Question 34

A patient,who is 24 weeks pregnant,asks about wearing a seatbelt while driving.The nurse should reply:

A)"Seatbelts should not be worn during pregnancy."
B)"Place the lap belt below the uterus,and use the shoulder strap at the same time."
C)"Place the lap belt below the uterus,but omit the shoulder strap during pregnancy."
D)"Place the lap belt at your waist above the uterus,and use the shoulder strap at the same time."