Question 1

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:

Accepted Answer

FHTs can be heard with the use of the Doppler device between 9 and 12 weeks.The other responses are incorrect.

Question 2

The nurse is palpating the uterus of a woman who is 8 weeks pregnant.Which finding would be considered to be most consistent with this stage of pregnancy?

Accepted Answer

The 8-week pregnant uterus is approximately the size of an avocado, 7 to 8 cm across the fundus.The 6-week pregnant uterus is slightly enlarged and softened.The 10-week pregnant uterus is approximately the size of a grapefruit and may reach the pelvic brim.The 12-week pregnant uterus will fill the pelvis.At 12 weeks, the uterus size is measured from the abdomen.

Question 3

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

Accepted Answer

Normally during pregnancy, the DTRs are 1+ to 2+ and bilaterally equal.Brisk or greater than 2+ DTRs and the presence of clonus are abnormal and may be associated with an elevated blood pressure and cerebral edema in a woman with pre-eclampsia.

Question 4

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's response should be:

Accepted Answer

The nausea, vomiting, and fatigue of pregnancy improve by week 12.Quickening, when the mother recognizes fetal movement, occurs at approximately 18 to 20 weeks.

Question 5

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

Accepted Answer

Because of the increase in blood volume, a functional systolic murmur, grade II/IV or less, can be heard in 95% of pregnant women.The other actions are not appropriate.

Question 6

A woman in her second trimester of pregnancy complains of heartburn and indigestion.When discussing this with the woman, the nurse considers which explanation for these problems?

Accepted Answer

Stomach displacement from the enlarging uterus plus altered esophageal sphincter and gastric tone as a result of progesterone predispose the woman to heartburn.The tone and motility of the gastrointestinal tract are decreased, not increased, during pregnancy.Emptying of the gallbladder may become more sluggish during pregnancy but is not related to indigestion.Rather, some women are predisposed to gallstone formation.A lower blood pressure may occur during the second semester, but it does not affect digestion.

Question 7

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

Accepted Answer

During the second trimester, colostrum, the precursor of milk, may be expressed from the nipples.Colostrum is yellow and contains more minerals and protein but less sugar and fat compared with mature milk.The other options are incorrect.

Question 8

When examining the face of a woman who is 28 weeks pregnant, the nurse notices the presence of a butterfly-shaped increase in pigmentation on the face.The proper term for this finding in the documentation is:

Accepted Answer

Chloasma is a butterfly-shaped increase in pigmentation on the face.It is known as the mask of pregnancy, but when documenting, the nurse should use the correct medical term, chloasma.Striae is the term for stretch marks.The term linea nigra refers to a hyperpigmented line that begins at the sternal notch and extends down the abdomen through the umbilicus to the pubis.

Question 9

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

Accepted Answer

Fetal presentation describes the part of the fetus that is entering the pelvis first.Fetal lie is orientation of the fetal spine to the maternal spine.Fetal attitude is the position of fetal parts in relation to each other, and fetal variety is the location of the fetal back to the maternal pelvis.

Question 10

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

Accepted Answer

The thyroid may be palpable during pregnancy.It should feel full, but smooth.Significant diffuse enlargement occurs with hyperthyroidism, thyroiditis, and hypothyroidism.Pale mucous membranes may indicate anemia.Bilateral lower extremity edema is common in pregnancy, but edema with pain in only one leg occurs with deep vein thrombosis.

Question 11

When performing an examination of a woman who is 34 weeks pregnant, the nurse notices a midline linear protrusion in the abdomen over the area of the rectus abdominis muscles as the woman raises her head and shoulders off of the bed.Which response by the nurse is correct?

Accepted Answer

The separation of the abdominal muscles is called diastasis recti and frequently occurs during pregnancy.The rectus abdominis muscles will return together after pregnancy with abdominal exercise.This condition is not a true hernia.

Question 12

When assessing an adolescent female who is in her third trimester of pregnancy, the nurse assesses for the classic symptoms associated with pre-eclampsia, which include:

Accepted Answer

The classic symptoms of pre-eclampsia are hypertension and proteinuria.Headaches may occur with worsening symptoms, and seizures may occur if preeclampsia is left untreated and leads to eclampsia.Pregnant adolescents are also at risk for pre-eclampsia, a multisystem disease specific to pregnancy characterized by new-onset hypertension, proteinuria, or both, usually after 20 weeks' gestation.A serious variant of pre-eclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count), is an ominous picture.Edema is a common occurrence in pregnancy.

Question 13

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 pre-pregnancy systolic blood pressure.The nurse should:

Accepted Answer

During the seventh week of pregnancy, blood pressure begins to drop as a result of falling peripheral vascular resistance.Early in the first trimester, blood pressure values are similar to those of pre-pregnancy measurements.In this case, the woman's blood pressure is higher than it should be.

Question 14

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

Accepted Answer

Progesterone and estrogen cause an increase in respiratory effort during pregnancy by increasing tidal volume.Increased tidal volume causes a slight drop in partial pressure of arterial carbon dioxide (PaCO₂), causing the woman to have dyspnea occasionally.The other options are not correct.

Question 15

A woman who is 28 weeks pregnant has bilateral edema in her lower legs after working 8 hours a day as a cashier at a local grocery store.She is worried about her legs.What is the nurse's best response?

Accepted Answer

Edema of the lower extremities occurs because of the enlarging fetus, which impairs venous return.Prolonged standing worsens the edema.Typically, the bilateral, dependent edema experienced with pregnancy is not the result of a cardiac pathological condition.

Question 16

A female patient has nausea, breast tenderness, fatigue, and amenorrhea.Her last menstrual period was 6 weeks ago.The nurse interprets that this patient is experiencing __________ signs of pregnancy.

Accepted Answer

Presumptive signs of pregnancy are those that the woman experiences and include amenorrhea, breast tenderness, fatigue, nausea, and increased urinary frequency.Probable signs are those that are detected by the examiner, such as an enlarged uterus or changes in the cervix.Positive signs of pregnancy are those that document direct evidence of the fetus, such as fetal heart tones (FHTs) or positive cardiac activity on ultrasonography.

Question 17

Which of these statements best describes the action of the hormone progesterone during pregnancy?

Accepted Answer

Progesterone prevents the sloughing of the endometrial wall and maintains the endometrium around the fetus.Progesterone increases the alveoli in the breast and keeps the uterus in a quiescent state.The other options are not correct.

Question 18

The nurse is palpating the fundus of a pregnant woman.Which statement about palpation of the fundus is true?

Accepted Answer

After 20 weeks' gestation, the number of centimetres should approximate the number of weeks of gestation.In addition, at 20 weeks' gestation, the examiner may be able to feel fetal movement, and the head can be balloted.

Question 19

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

Accepted Answer

Blood flow through the blood vessels, specifically the internal mammary artery, can often be heard over the second, third, and fourth intercostal spaces.This finding is called a mammary soufflé, but it may be mistaken for a cardiac murmur.The other options are incorrect.

Question 20

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

Accepted Answer

Measure the blood pressure after the patient has been sitting quietly and before the physical examination, when the patient is most relaxed.The other options are not correct.

Quiz 30: The Pregnant Woman