Deck 4: Prenatal Care and Adaptations to Pregnancy

Question 1

An ultrasound confirms that a 16-year-old girl is pregnant. The nurse recognizes the need for prenatal care and counseling for adolescents because:

A) A pregnant adolescent is experiencing two major life transitions at the same time.
B) Adolescents who get pregnant are more likely to have other chronic health problems.
C) Adolescents are at greater risk for multifetal pregnancies.
D) At this age, a pregnant adolescent will accept the nurse's advice.

Answer 1

A pregnant adolescent is experiencing two major life transitions at the same time.

Question 2

A pregnant woman inquires about exercising during pregnancy. In planning the teaching for this woman, the nurse should include which of the following information?

A) Exercise elevates the mother's temperature and improves fetal circulation.
B) Exercise increases catecholamines, which can prevent preterm labor.
C) A regular schedule of moderate exercise during pregnancy is beneficial.
D) Pregnant women should limit water intake during exercise.

Answer 2

A regular schedule of moderate exercise during pregnancy is beneficial.

Question 3

At her initial prenatal visit a woman asks, "When can I hear the baby's heartbeat?" The nurse would respond that the fetal heartbeat can be auscultated with a specially adapted stethoscope or fetoscope at:

A) 4 weeks
B) 12 weeks
C) 16 weeks
D) 24 weeks

Answer 3

16 weeks

Question 4

A woman tells the nurse that she's quite sure that she is pregnant. The nurse recognizes which of the following to be a positive sign of pregnancy?

A) Amenorrhea
B) Uterine enlargement
C) HCG detected in the urine
D) Fetal heartbeat

Question 5

During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler device. When this instrument is used, fetal heart tones can be detected as early as:

A) 4 weeks
B) 8 weeks
C) 10 weeks
D) 14 weeks

Question 6

A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2-year-old son and had one previous spontaneous abortion. Using the TPAL system, the client's obstetrical history would be recorded as:

A) Gravida 2 para 20120
B) Gravida 3 para 10011
C) Gravida 3 para 10110
D) Gravida 2 para 11110

Question 7

The nurse encourages adequate intake of folic acid because it is thought to decrease the incidence of:

A) Structural heart defects
B) Craniofacial deformities
C) Limb deformities
D) Neural tube defects

Question 8

The nurse has explained physiological changes that occur during pregnancy. Which of the following statements indicate that the woman understands the information?

A) "Blood pressure goes up toward the end of pregnancy."
B) "My breathing will get deeper and a little faster."
C) "I'll notice a decreased pigmentation in my skin."
D) "There will be a curvature in the upper spine area."

Question 9

In a routine prenatal visit the nurse examines a client who is 37 weeks pregnant and notices that the fetal heart rate has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. The nurse should:

A) Ask if the client has taken a sedative
B) Notify the physician
C) Turn the client to her right side
D) Record rate as a normal finding

Question 10

A woman pregnant for the first time asks the nurse, "When will I begin to feel the baby move?" The nurse would answer :

A) "Mothers may notice the baby moving around the 4th to 5th month."
B) "Quickening varies with every woman."
C) "You'll feel something by the end of the first trimester."
D) "The baby will be big enough for you to feel in your 8th month."

Question 11

A woman asks the nurse about the frequency of prenatal visits. In an uncomplicated pregnancy, the nurse would tell her that appointments are scheduled:

A) Every 3 weeks until the 6th month, then every 2 weeks until delivery
B) Every 4 weeks until the 7th month, after which appointments will become more frequent
C) Monthly until the 8th month
D) Every 2 to 3 weeks for the entire pregnancy.

Question 12

After the examination is completed, the patient asks the nurse why Chadwick's sign occurs during pregnancy. The nurse would explain that it is caused by the:

A) Enlargement of the uterus
B) Progesterone action on the breasts
C) Increasing activity of the fetus
D) Vascular congestion in the pelvic area

Question 13

The client who is 28 weeks pregnant shows a 10-pound weight gain from 2 weeks ago. The nurse should initially:

A) Assess food intake
B) Weigh client again
C) Take the blood pressure
D) Notify the physician

Question 14

During the physical examination for the first prenatal visit, it is noted that Chadwick's sign is present. This refers to the:

A) Bluish or purplish discoloration of the vulva, vagina, and cervix
B) Presence of early fetal movements
C) Darkening of the areola and breast tenderness
D) Palpation of the fetal outline

Question 15

A woman's prepregnant weight is average for her height. The nurse would advise the woman that her recommended weight gain during pregnancy would be:

A) 10 to 20 pounds
B) 15 to 25 pounds
C) 25 to 35 pounds
D) 28 to 40 pounds

Question 16

A woman reports that her last normal menstrual period began on August 5, 2006. Using Nägele's rule, her expected date of delivery would be:

A) April 30, 2007
B) May 5, 2007
C) May 12, 2007
D) May 26, 2007

Question 17

The client who is 40 weeks pregnant complains of a sense of weakness and dizziness when she lies on her back. The nurse assesses this as an indication of:

A) Supine hypotension
B) Orthostatic hypotension
C) Gestational hypertension
D) Pseudoanemia

Question 18

A pregnant woman is experiencing nausea in the early morning. What recommendations would the nurse offer to alleviate this symptom?

A) Eat three well-balanced meals per day and limit snacks.
B) Drink a full glass of fluid at the beginning of each meal.
C) Have crackers handy at the bedside, and eat a few before getting out of bed.
D) Eat a bland diet and avoid concentrated sweets.

Question 19

When the nurse tells a pregnant woman that she needs 1,200 mg of calcium daily during pregnancy, the woman responds, "I don't like milk." What dietary adjustments could the nurse recommend?

A) Increase intake of organ meats
B) Eat more green leafy vegetables
C) Choose more fresh fruits, particularly citrus fruits
D) Include molasses and whole-grain breads in the diet

Question 20

The client remarks that she has heard that some foods will enhance the brain development of the fetus. The nurse replies that foods that are high in DHA are thought to enhance brain development. Such foods include:

A) Fried fish
B) Olive oil
C) Red meat
D) Leafy green vegetables

Question 21

The nurse reminds the prenatal patient that she should add ________ kcal to her daily intake to nourish the fetus.

Question 22

A woman who is 36 weeks pregnant tells the nurse she plans to fly to Hawaii, which is a 12-hour flight. The nurse would recommend that during the flight the patient should: Select all that apply.

A) Wear tight fitting clothing to promote venous return
B) Eat a large meal before boarding the flight
C) Request a seat with greater leg room
D) Drink at least 4 ounces of water every hour
E) Get up and walk around the plane frequently

Question 23

The patient confesses to eating crushed ice 10 or 12 times daily. The nurse assesses this behavior as ____________________.

Question 24

The nurse assesses the progress from the announcement stage of fatherhood to the acceptance stage when the patient reports that the father has: Select all that apply.

A) Begun fishing every afternoon
B) Revised his financial plan
C) Begun spending leisure time with his friends
D) Traded his sports car for a sedan
E) Helped select a crib

Question 25

The nurse cautions the patient that because of hormonal changes in late pregnancy, the pelvic joints relax, which can result in: Select all that apply.

A) Waddling gait
B) Joint instability
C) Urinary frequency
D) Back pain
E) Aching in cervical spine