Deck 15: Antepartum Nursing Assessment

Question 1

During the initial prenatal visit, the nurse assesses the history of the father of the child for:

A) Stability of living conditions.
B) ABO and Rh type.
C) Significant health problems.
D) Nutritional history.
E) Previous or present use of tobacco.

Answer 1

ABO and Rh type.
Significant health problems.
Previous or present use of tobacco.

Question 2

The nurse is explaining clinical pelvimetry to a patient. The nurse explains that the anteroposterior diameters consist of the:

A) Diagonal conjugate.
B) Transverse diameter.
C) Conjugata vera.
D) Obstetric conjugate.
E) Oblique diameter.

Answer 2

Diagonal conjugate.
Conjugata vera.
Obstetric conjugate.

Question 3

While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts with "Why are you asking me all these questions? What difference does it make?" Which statement would best answer the patient's questions? "We ask these questions:

A) "To detect anything that happened in your past that might affect the pregnancy."
B) "To see whether you can have prenatal visits less often than most patients do."
C) "To make sure that our paperwork and records are complete and up to date."
D) "To look for any health problems in the past that might affect your parenting."

Answer 3

"To detect anything that happened in your past that might affect the pregnancy."

Question 4

The nurse is assessing a newly pregnant patient. Which finding does the nurse note as a normal psychosocial adjustment in this patient's first trimester?

A) An unlisted telephone number
B) Reluctance to tell the partner of the pregnancy
C) Parental disapproval of the woman's partner
D) Ambivalence about the pregnancy

Question 5

The prenatal clinic nurse is designing a new prenatal intake information form for pregnant patients. Which is best to include on this form?

A) Where was the father of the baby born?
B) Do genetic diseases run in the family of the baby's father?
C) What is the name of the baby's father?
D) Are you married to the father of the baby?

Question 6

The nurse is seeing prenatal patients in the clinic. Which patient is exhibiting expected findings?

A) Primip at 12 weeks with fetal heart tones heard by Doppler fetoscope
B) Multip at 22 weeks who reports no fetal movement felt yet
C) Primip at 26 weeks with fundal height of 30 cm
D) Multip at 12 weeks reports bright red vaginal bleeding.

Question 7

The nurse is explaining to a new prenatal patient that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the patient states, "The certified nurse-midwife will perform this examination because:

A) "It will help us know how big a baby I can deliver vaginally."
B) "Doing this exam is a part of prenatal care at this clinic."
C) "My sister had both of her babies by cesarean."
D) "I am pregnant with my first child."

Question 8

The nurse receives a phone call from a patient who claims she is pregnant. The patient reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10. What would the patient's estimated date of delivery (EDD) be?

A) Nov. 13
B) Jan. 17
C) Jan. 10
D) Dec. 3

Question 9

The nurse is assessing a primiparous patient who indicates that her religion is Judaism. This information is important for the nurse to assess because:

A) Religious and cultural background can impact what a patient eats during pregnancy.
B) It provides a baseline from which to ask questions about the patient's religious and cultural background.
C) Knowing the patient's beliefs and behaviors regarding pregnancy is important.
D) Patients sometimes encounter problems in their pregnancies based on what religion they practice.

Question 10

The patient has delivered her first child at 37 weeks. The nurse would describe this to the patient as what type of delivery?

A) Preterm
B) Postterm
C) Term
D) Near term

Question 11

What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing?

A) Measurement of the diagonal conjugate
B) Hepatitis B screening (HBsAg)
C) Fundal height measurement
D) Complete blood count

Question 12

During a patient's initial prenatal visit, the nurse must assess and document the patient's current medical history, including:

A) Body mass index.
B) Infections before the last menstrual period.
C) Homeopathic or herbal medication use.
D) ABO type and Rh factor.
E) History of previous pregnancies.

Question 13

The nurse working in an outpatient obstetric clinic assesses four primigravida patients. Which patient findings would the nurse tell the physician about?

A) 17 weeks' gestation and denies feeling fetal movement.
B) 24 weeks' gestation and fundal height is at the umbilicus.
C) 27 weeks' gestation and complains of excess salivation.
D) 34 weeks' gestation and complains of hemorrhoidal pain.

Question 14

A nurse is performing an assessment on four patients at 22 weeks' gestation. The nurse reports to the obstetrician that which patient might be carrying twins?

A) The patient who states that she feels "huge"
B) The patient with a weight gain of 15 pounds
C) The patient whose fundal height is 27 cm
D) The patient whose heart rate is 90

Question 15

The nurse in the OB-GYN clinic is working with a patient who is seeking her initial prenatal visit. The nurse will use the acronym TPAL to document the patient's number of:

A) Term infants born.
B) Children living in the home.
C) Pregnancies ending in abortion.
D) Preterm infants born.
E) Pregnancies that occurred.

Question 16

The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings?

A) Document the findings on the prenatal chart.
B) Have the physician see the patient today.
C) Instruct the patient to avoid direct sunlight.
D) Analyze previous thyroid hormone lab results.

Question 17

A woman gave birth last week to a fetus at 18 weeks' gestation after her first pregnancy. She is in the clinic for follow-up, and notices that her chart states she has had one abortion. The patient is upset over the use of this word. How can the nurse best explain this terminology to the patient?

A) "Abortion is the medical term for all pregnancies that end before 20 weeks."
B) "Abortion is the word we use when someone has miscarried."
C) "Abortion is how we label babies born in the second trimester."
D) "Abortion is what we call all babies who are born dead."

Question 18

The nurse is seeing a patient who asks about the accuracy of Nagele's rule. The nurse explains that accuracy can be compromised when:

A) There is a history of regular menses every 28 days.
B) Amenorrhea is present and ovulation occurs with breastfeeding.
C) Oral contraception was discontinued, but no regular menstruation was established.
D) There has been one or months of amenorrhea.
E) There is an accurate date for the last menstrual period.

Question 19

The primigravida at 22 weeks' gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the patient why she needs to be seen by a physician today?

A) "Your baby is growing too much and getting too big."
B) "Your uterus might have an abnormal shape."
C) "The position of your baby can't be felt."
D) "Your baby might not be growing enough."

Question 20

The clinic nurse is compiling data for a yearly report. Which patient would be classified as a primigravida?

A) A patient at 18 weeks' gestation who had a spontaneous loss at 12 weeks
B) A patient at 13 weeks' gestation who had an ectopic pregnancy at 8 weeks
C) A patient at 14 weeks' gestation who has a 3-year-old daughter at home
D) A patient at 15 weeks' gestation who has never been pregnant before

Question 21

The nurse in the prenatal clinic is seeing a pregnant 16-year-old for the first time. What comment by the young woman is the most critical for the nurse to address first?

A) "My favorite lunch is burger and fries."
B) "I've been dating my new boyfriend for 2 weeks."
C) "On weekends, we go out and drink a few beers."
D) "I dropped out of school about 3 months ago."

Question 22

The nurse at the prenatal clinic has four calls to return. Which phone call should the nurse return first?

A) Primip at 32 weeks, reports headache and blurred vision.
B) Multip at 18 weeks, reports no fetal movement this pregnancy.
C) Primip at 16 weeks, reports increased urinary frequency.
D) Multip at 40 weeks, reports sudden gush of fluid and contractions.

Question 23

A woman comes into the prenatal clinic accompanied by her boyfriend. When asked by the nurse why she is there, the patient looks down, and the boyfriend states, "She says she is pregnant. She constantly complains of feeling tired, and her vomiting is disgusting." What is a priority for the nurse to do at this point?

A) Ask the woman what time of the day her fatigue is more common.
B) Recommend that the woman have a pregnancy test done as soon as possible.
C) Continue the interview of the woman in private.
D) Give the woman suggestions on ways to decrease the vomiting.

Question 24

The nurse is providing health teaching to a group of women of childbearing age. One woman states that she is a smoker, and asks about the effect on her fetus. The nurse tells her that which fetal complication can occur when the mother smokes?

A) Genetic changes in the fetal reproductive system
B) Extensive central nervous system damage
C) Addiction to the nicotine inhaled from the cigarette
D) Fetal intrauterine growth restriction

Question 25

A pregnant patient calls the clinic nurse to say she is worried about symptoms she is experiencing. The nurse advises the patient to come immediately to the clinic because of reported:

A) Vaginal bleeding.
B) Abdominal pain.
C) Constipation.
D) Epigastric pain.
E) null

Question 26

A pregnant patient has a hemoglobin of 10 g/dl and a Hct of 30%. The clinic nurse recognizes the fetus is at risk for:

A) Macrosomia.
B) Respiratory distress syndrome.
C) Low birth weight.
D) Prematurity.
E) Prenatal mortality.

Question 27

The nurse is providing guidance for a woman in her second trimester of pregnancy and telling her about some of the signs and symptoms that she might experience. Which statement by the patient indicates that further teaching is necessary?

A) "During the third trimester, I might have frequent urination."
B) "During the third trimester, I might have heartburn."
C) "During the third trimester, I might have back pain."
D) "During the third trimester, I might have a persistent headache."

Question 28

A nurse examining a prenatal patient recognizes that a lag in progression of measurements of fundal height from month to month and week to week could signal:

A) Twin pregnancy.
B) Intrauterine growth restriction.
C) Polyhydramnios.
D) Breech position.

Question 29

A pregnant patient at 30 weeks' gestation has had a steady rise in blood pressure. She is now 20 mmHg above her systolic baseline. The nurse advises her to immediately report:

A) Dizziness.
B) Even a small amount of dependent edema.
C) Spots before her eyes.
D) Persistent nausea and vomiting.
E) Vaginal spotting.

Question 30

Which third-trimester woman would you suspect might be having difficulty with psychological adjustments to her pregnancy?

A) A woman who says, "Either a boy or a girl will be fine with me."
B) A woman who puts her feet up and listens to some music for 15 minutes when she is feeling too stressed
C) A woman who was a smoker but who has quit at least for the duration of her pregnancy
D) A woman who has not investigated the kind of clothing or feeding methods the baby will need

Question 31

When doing a prenatal assessment of parenting, which comment by a woman would the nurse recognize as needing further investigation?

A) "I have so much to learn about taking care of a baby. I've bought a couple of books already."
B) "When will I be able to feel my baby move?"
C) "I work and have an active social life; I don't see how a baby will change it all that much."
D) "We've already told our parents we're expecting, and our friends and the people at work, too."

Question 32

The nurse seeing a patient at 28 weeks' gestation explains that a 1-hour glucose screen must be done, and that normal results are:

A) 135 mg/dl.
B) 120 mg/dl.
C) 155 mg/dl.
D) 130 mg/dl.
E) 140 mg/dl.