Question 1

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

Accepted Answer

Folic acid can reduce the incidence of neural tube defects such as spina bifida and anencephaly.

Question 2

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

Accepted Answer

The pregnant adolescent must cope with two of life's most stress-laden transitions simultaneously: adolescence and parenthood.

Question 3

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

Accepted Answer

Quickening, fetal movement felt by the mother, is first perceived at 16 to 20 weeks of gestation.

Question 4

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

Accepted Answer

The marked weight gain may be an indication of gestational hypertension. The blood pressure should be assessed before notifying the physician.

Question 5

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

Accepted Answer

Foods rich in DHA are red meat, flounder, halibut, and soybean and canola oil. Frying fish negatively alters the DHA.

Question 6

A woman reports that her last normal menstrual period began on August 5, 2010. Using Nägele's rule, her expected date of delivery would be _____, 2011.

Accepted Answer

To determine the expected date of delivery, count backward 3 months from the first day of the last menstrual period, then add 7 days.

Question 7

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:

Accepted Answer

Chadwick's sign is caused by increased vascular congestion in the cervical and vaginal area.

Question 8

In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. The nurse should:

Accepted Answer

The FHR at term ranges from a low of 110 to 120 beats/min to a high of 150 to 160 beats/min. This should be recorded as normal. The FHR drops in the late stages of pregnancy.

Question 9

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 _____ weeks.

Accepted Answer

The fetal heartbeat can be detected as early as 10 weeks of pregnancy using a Doppler device.

Question 10

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

Accepted Answer

The nurse can recommend eating dry toast or crackers before getting out of bed in the morning to alleviate nausea during pregnancy.

Question 11

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 patient's obstetric history would be recorded as:

Accepted Answer

Refer to Box 4-1 in the textbook for the TPAL system of identifying gravida and para.

Question 12

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

Accepted Answer

In general, moderate exercise several times a week, from the 8th week through delivery, is advised during pregnancy.

Question 13

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 _____ pounds.

Accepted Answer

The recommended weight gain for a woman of normal weight before pregnancy is 25 to 35 pounds.

Question 14

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

Accepted Answer

Chadwick's sign is the purplish or bluish discoloration of the cervix and vagina.

Question 15

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?

Accepted Answer

For women who do not like milk, other sources of calcium include enriched cereals, legumes, nuts, dried fruits, green leafy vegetables, and canned salmon and sardines that contain bones.

Question 16

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

Accepted Answer

Monthly visits are scheduled up to 28 weeks, and then visits increase to every 2 to 3 weeks through 36 weeks. From 36 weeks until delivery, visits are weekly.

Question 17

A woman tells the nurse that she is quite sure she is pregnant. The nurse recognizes which as a positive sign of pregnancy?

Accepted Answer

Positive indications are caused only by the developing fetus and include fetal heart activity, visualization by ultrasound, or fetal movements felt by the examiner.

Question 18

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 _____ weeks.

Accepted Answer

The fetal heartbeat can be heard with a fetoscope between the 18th and 20th week of pregnancy.

Question 19

The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that the woman understands the information?

Accepted Answer

The pregnant woman breathes more deeply, and her respiratory rate may increase slightly.

Question 20

The patient 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:

Accepted Answer

When in the supine position, the weight of the uterus compresses the vena cava and aorta, causing hypotension. Placing a pillow under the right hip will reduce the symptoms.

Quiz 4: Prenatal Care and Adaptations to Pregnancy