Maternal & Child Practice Exam 4

Maternal & Child Practice Exam 4 What event occurring in the second trimester helps the expectant mother to accept the pregnancy? A Quickening B Lightening C Pseudocyesis D Ballotment Rationale: Quickening is the first fetal movement felt by the mother makes the woman realize that she is truly pregnant. In early pregnancy, the fetus is moving but too weak to be felt by the mother. In the 18th-20th week of gestation, the fetal movements become stronger thus the mother already feels the movements. The nursing intervention to relieve "morning sickness" in a pregnant woman is by giving A Low sodium diet B Intravenous infusion C Antacid D Dry carbohydrate food like crackers Rationale: Morning sickness maybe caused by hypoglycemia early in the morning thus giving carbohydrate food will help. In the Batholonew's rule of 4, when the level of the fundus is midway between the umbilicus and xyphoid process the estimated age of gestation (AOG) is: A 6th month B 5th month C 8th month D 7th month Rationale: In Bartholomew's Rule of 4, the landmarks used are the symphysis pubis, umbilicus and xyphoid process. At the level of the umbilicus, the AOG is approximately 5 months and at the level of the xyphoid process 9 months. Thus, midway between these two landmarks would be considered as 7 months AOG. Which of the following findings in a woman would be consistent with a pregnancy of two months duration? A Increased respiratory rate and ballottement B Weight gain of 6-10 lbs. and presence of striae gravidarum C Fullness of the breast and urinary frequency D Braxton Hicks contractions and quickening Rationale: Fullness of the breast is due to the increased amount of progesterone in pregnancy. The urinary frequency is caused by the compression of the urinary bladder by the gravid uterus which is still within the pelvic cavity during the first trimester. If the LMP is Jan. 30, the expected date of delivery (EDD) is A Nov. 8 B Nov. 7 C Oct. 7 D Oct. 24 Rationale: Based on the last menstrual period, the expected date of delivery is Nov. 7. The formula for the Naegele's Rule is subtract 3 from the month and add 7 to the day. In Leopold's maneuver step # 3 you palpated a hard round movable mass at the supra pubic area. The correct interpretation is that the mass palpated is: A The buttocks because the presentation is breech. B The mass is the fetal back. C The mass palpated is the head. D The mass palpated is the fetal small part Rationale: When the mass palpated is hard round and movable, it is the fetal head. A pregnant mother is admitted to the hospital with the chief complaint of profuse vaginal bleeding, AOG 36 wks, not in labor. The nurse must always consider which of the following precautions: A Internal exam must be done following routine procedure B An emergency delivery set for vaginal delivery must be made ready before examining the patient C The preferred manner of delivering the baby is vaginal D The internal exam is done only at the delivery under strict asepsis with a double set-up Rationale: Painless vaginal bleeding during the third trimester maybe a sign of placenta praevia. If internal examination is done in this kind of condition, this can lead to even more bleeding and may require immediate delivery of the baby by cesarean section. If the bleeding is due to soft tissue injury in the birth canal, immediate vaginal delivery may still be possible so the set up for vaginal delivery will be used. A double set-up means there is a set up for cesarean section and a set-up for vaginal delivery to accommodate immediately the necessary type of delivery needed. In both cases, strict asepsis must be observed. The hormone responsible for a positive pregnancy test is: A Human Chorionic Gonadotropin B Estrogen C Progesterone D Follicle Stimulating hormone Rationale: Human chorionic gonadotropin (HCG) is the hormone secreted by the chorionic villi which is the precursor of the placenta. In the early stage of pregnancy, while the placenta is not yet fully developed, the major hormone that sustains the pregnancy is HCG. Which of the following causes of infertility in the female is primarily psychological in origin? A Vaginismus B Impotence C Endometriosis D Dyspareunia Rationale: Vaginismus is primarily psychological in origin. Endometriosis is a condition that is caused by organic abnormalities. Dyspareunia is usually caused by infection, endometriosis or hormonal changes in menopause although may sometimes be psychological in origin. The diet that is appropriate in normal pregnancy should be high in A Fats and minerals B Protein, minerals and vitamins C Proteins, carbohydrates and fats D Carbohydrates and vitamins Rationale: In normal pregnancy there is a higher demand for protein (body building foods), vitamins (esp. vitamin A, B, C, folic acid) and minerals (esp. iron, calcium, phosphorous, zinc, iodine, magnesium) because of the need of the growing fetus. Which of the following statements is TRUE of conception? A Conception is possible during menstruation in a long menstrual cycle B To avoid conception, intercourse must be avoided 5 days before and 3 days after menstruation C Generally, fertilization is possible 4 days after ovulation D Within 2-4 hours after intercourse conception is possible in a fertile woman Rationale: The sperms when deposited near the cervical os will be able to reach the fallopian tubes within 4 hours. If the woman has just ovulated (within 24hours after the rupture of the graafian follicle), fertilization is possible. Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy? A Small for gestational age (SGA) baby B Large for gestational age (LGA) fetus C Erythroblastosis fetalis D Hemorrhage Rationale: Anemia is a condition where there is a reduced amount of hemoglobin. Hemoglobin is needed to supply the fetus with adequate oxygen. Oxygen is needed for normal growth and development of the fetus. The hormone responsible for the maturation of the graafian follicle is: A Follicle stimulating hormone B Progesterone C Estrogen D Luteinizing hormone Rationale: The hormone that stimulates the maturation if the of the graafian follicle is the Follicle Stimulating Hormone which is released by the anterior pituitary gland. Which of the following is TRUE in Rh incompatibility? A Every pregnancy of an Rh(-) mother will result to erythroblastosis fetalis B The condition can occur if the mother is Rh(+) and the fetus is Rh(-) C On the first pregnancy of the Rh(-) mother, the fetus will not be affected D RhoGam is given only during the first pregnancy to prevent incompatibility Rationale: On the first pregnancy, the mother still has no contact with Rh(+) blood thus it has not antibodies against Rh(+). After the first pregnancy, even if terminated into an abortion, there is already the possibility of mixing of maternal and fetal blood so this can trigger the maternal blood to produce antibodies against Rh(+) blood. The fetus takes it's blood type usually form the father. Which of the following signs and symptoms will most likely make the nurse suspect that the patient is having hydatidiform mole? A Absence of fetal heart beat B Enlargement of the uterus C Slight bleeding D Passage of clear vesicular mass per vagina Rationale: Hydatidiform mole (H-mole) is characterized by the degeneration of the chorionic villi wherein the villi becomes vesicle-like. These vesicle-like substances when expelled per vagina and is a definite sign that the woman has H-mole. .................