Question 1

A woman is having a triple-screen test during her second trimester of pregnancy.The nurse teaches the patient that this test includes which of the following? (Select all that apply.)

Accepted Answer

The triple screen includes maternal serum alpha-fetoprotein,unconjugated estriol,and free beta-human chorionic gonadotropin.The inhibin A is included in the quadruple screen.Nuchal translucency testing is offered in the first trimester as part of the combined screen.

Question 2

A woman in the OB clinic complains of multiple,fluid-filled blisters in her genital area that make walking extremely painful.What information should the nurse provide this patient? (Select all that apply.)

Accepted Answer

The patient's symptoms are suggestive of herpes simplex virus (HSV)infection.HSV can cause serious consequences,including increased risk of pregnancy loss (60%)and severe neurological consequences in the infants who do survive.There is no cure,but several medications are available for treatment.Unfortunately,the safety of these medications during pregnancy and lactation has not been firmly established.Gonorrhea can cause neonatal eye problems (ophthalmia neonatorum).Antiretroviral medications are used for HIV infections.Blood cultures for bacterial infection are not warranted,as HSV is a viral infection.

Question 3

A student nurse asks the OB clinic nurse why a pregnancy test is needed if a woman has missed several menstrual periods in a row.The nurse explains that amenorrhea can be caused by several conditions other than pregnancy,including which of the following? (Select all that apply.)

Accepted Answer

Amenorrhea is a presumptive sign of pregnancy,meaning that the same signs can be caused by conditions other than pregnancy.Amenorrhea can be caused by chronic illness;endocrine,metabolic,or psychological factors;or infection.

Question 4

A pregnant woman's last normal menstrual period started on June 8,2013.Calculate her expected date of birth (EDB)using Naegle's rule.Her EDB is what date?

Accepted Answer

The answer of A pregnant woman's last normal menstrual period...

Question 5

The nurse explains to a newly diagnosed pregnant woman at 10 weeks' gestation that her rubella titer indicates that she is not immune.Which of the following should the nurse teach the patient? (Select all that apply.)

Accepted Answer

Rubella (German measles)is one of the most commonly recognized viral infections known to cause congenital problems.If a woman contracts rubella during the first 12 weeks of pregnancy,the fetus has a 90% chance of being adversely affected.A maternity patient who is not immune to rubella should be offered the rubella immunization following childbirth,ideally prior to hospital discharge.She should also be taught to avoid becoming pregnant for at least 4 weeks after the immunization.The patient should report signs or symptoms of rubella during pregnancy to her health-care provider,but she does not need to seek medical care immediately.Avoiding contact with all children is unreasonable.There is no reason to be retested in 3 months,because she cannot receive the vaccination until after she has given birth.

Question 6

The nurse recognizes that a pregnant adolescent must successfully complete developmental tasks to be an effective mother.Which tasks does the nurse understand this to include? (Select all that apply.)

Accepted Answer

For a teenager to successfully adapt and fulfill the role of being a mother,she must achieve four major developmental tasks: gain acceptance of pregnancy,set goals,view self as a mother,and grow up.Maintaining freedom is antithetical to growing up and accepting the responsibility of motherhood.

Question 7

A nurse is caring for a woman who is positive for hepatitis B. What other screening tests does the nurse facilitate for this patient? (Select all that apply.)

Accepted Answer

Women who are positive for hepatitis B should have screening for hepatitis C.Their household contacts and intimate contacts should also be screened for hepatitis B.There is no correlation between hepatitis B and either cytomegalovirus or parvovirus.

Question 8

A nurse assesses the pregnant woman for recreational drug use as part of the first prenatal visit.What harmful effects of recreational drugs does the nurse teach the woman about? (Select all that apply.)

Accepted Answer

Approximately 3% of pregnant women use nonprescription drugs such as cocaine,Ecstasy,marijuana,methamphetamines,and heroin.Ecstasy can cause congenital abnormalities such as cleft palate.Marijuana can cause intrauterine growth restriction.Methamphetamines can cause spontaneous abortion.Cocaine can cause placental abruption (not previa).Heroin can lead to spontaneous abortion,intrauterine growth restriction,preterm labor/birth,or stillbirth.

Question 9

A pregnant woman in the perinatal clinic is a commercial sex worker and states that she frequently has unprotected sexual intercourse.The nurse should educate this woman about which complications of sexually transmitted diseases (STDs)? (Select all that apply.)

Accepted Answer

STDs (sometimes referred to as sexually transmitted infections-STIs)predispose to a number of complications,including ectopic pregnancy,spontaneous abortion,preterm labor,and increased neonatal morbidity.All pregnant women should be screened for STDs.STDs are not associated with frequent multi-fetal pregnancy or gestational hypertension.

Question 10

A pregnant woman's last normal menstrual period started on July 27,2013.Calculate her expected date of birth (EDB)using Naegle's rule.Her EDB is what date?

Accepted Answer

The answer of A pregnant woman's last normal menstrual period...

Question 11

A nurse is educating a woman who is 38 years old and experiencing her first pregnancy.When planning care for this woman,what information does the nurse take into consideration? (Select all that apply.)

Accepted Answer

Older women who are pregnant have unique potential problems.These include a higher likelihood of chronic illness that impacts the pregnancy;obstetrical complications such as vaginal bleeding,preeclampsia,multiple gestation,gestational diabetes,preterm labor,dysfunctional labor,and cesarean birth;and increased incidence of Down syndrome,for which genetic screening should be offered.

Question 12

The nurse is explaining to students in the perinatal clinic that some adolescents are at higher risk of teen pregnancy than others.Which teens does the nurse include in these high-risk groups? (Select all that apply.)

Accepted Answer

Teens who lack the support,security,and love of a family home are more likely to engage in high-risk behaviors,including sex at an early age.Incarcerated teens are the most vulnerable group.Teens from middle-class,two-parent homes;teens who are able to obtain reliable information and who do not receive the message that sex is a taboo subject;and teens with religious affiliations have lower rates of teen pregnancy.

Question 13

A nurse is running for public office and plans to fund a comprehensive program to prevent teen pregnancy.When asked how to justify the cost of such a venture,what information could the nurse provide? (Select all that apply.)

Accepted Answer

Teen pregnancy has enormous social and personal repercussions,including high rates of teen mothers on welfare,high rates of teen mothers having a second child within 2 years,low rates of teen mothers gaining education beyond high school,and high rates of teen pregnancy in the United States.Teen mothers are not overwhelming the health-care system.

Question 14

A nurse is teaching a group of middle school girls about the complications associated with teen pregnancy.What topics should the nurse include? (Select all that apply.)

Accepted Answer

Pregnant teens face an increased risk for many problems,including anemia,hypertensive problems,preeclampsia,and preterm birth.They are not at higher risk for developing gestational diabetes.

Question 15

The nurse provides increased support to a woman during her first prenatal visit for her current pregnancy.The patient's first pregnancy ended in a miscarriage.The nurse understands that the reasons the patient may be ambivalent about this baby include which of the following? (Select all that apply.)

Accepted Answer

Ambivalence is a normal response to pregnancy that is in part related to the anticipated role changes that will occur.The loss of a previous pregnancy brings many emotions to a subsequent pregnancy.This patient should be counseled for her previous loss,unresolved grief and mourning,potential role changes,and new responsibilities as a parent if she carries this pregnancy to term.

Question 16

The nurse schedules a patient for her first prenatal appointment with the certified nurse-midwife (CNM)in the clinic.About what topics does the nurse help the patient formulate questions to ask the CNM? (Select all that apply.)

Accepted Answer

A woman's journey through the pregnancy experience can have long-term effects on her self-perception and self-concept.Therefore,it is especially important that the patient choose a care provider with whom she can openly relate and who shares the same philosophical views on the management of pregnancy.Although in unusual circumstances a patient may give permission for the CNM to provide her information to a patient with a similar situation,routinely sharing personal information with other patients would be a violation of confidentiality principles and laws.

Question 17

The perinatal nurse explains to a group of nursing students that there are positive signs of pregnancy.Which of the following does the nurse include in this explanation? (Select all that apply.)

Accepted Answer

Positive signs of pregnancy are those attributable only to the presence of a fetus and include fetal heartbeat,fetal movement palpated by an examiner,and the visualization of a fetus.A positive pregnancy test and intermittent uterine contractions are presumptive signs of pregnancy and may be caused by other conditions.A positive pregnancy test can be caused by certain medications,premature menopause,choriocarcinoma,or blood in the urine.Intermittent uterine contractions (Braxton Hicks contractions)can be caused by uterine leiomyomas or other tumors.

Question 18

The nurse advocates for smoking cessation during pregnancy and teaches pregnant women about the effects of tobacco exposure.Which of the following are potential harmful effects of prenatal tobacco use that the nurse should plan to include in the teaching? (Select all that apply.)

Accepted Answer

Effects of tobacco use during pregnancy are well documented and predispose to premature rupture of the membranes,preterm labor,placental abruption,placenta previa,and infants who are small for gestational age.These effects continue well into childhood and are associated with upper respiratory problems,such as infections,asthma,and wheezing.Exposure to tobacco products is not associated with congenital diabetes or gestational hypertension.

Question 19

The student nurse in the perinatal clinic asks why it is so important to screen women for intimate partner violence during the first prenatal visit.What information does the registered nurse provide the student? (Select all that apply.)

Accepted Answer

Intimate partner violence (IPV)is the most common form of violence women are exposed to worldwide.In the United States,approximately 25% of women (or one in four)have been the victim of intimate partner violence,including over 324,000 pregnant women.IPV is more common than preeclampsia or gestational diabetes,both of which are significant problems in pregnant women.Many women cope with this violence by turning to substance abuse,both prescription and nonprescription.Shockingly,IPV may occur for the first time during pregnancy.

Question 20

A woman comes for her first prenatal appointment at 31 weeks' gestation with her first pregnancy.Which of the following are appropriate statements by the nurse? (Select all that apply.)

Accepted Answer

Assessment of the patient and gathering data are important components of the first prenatal visit.However,the nurse needs to use professional communication skills in order to elicit information from the patient about personal details of her life and potentially embarrassing information.Questions that show openness and acceptance are best.Stating that you can't believe this is the patient's first prenatal visit and the comment "now that you are finally here" are judgmental and will not help to establish a trusting relationship.

Quiz 9: The Prenatal Assessment