Davis Advantage for Maternal-Newborn Success Full Test Bank Terms in this set (146) 1. Since 1995, there has been a significant decrease in the rate of infant death related to which of the following: a. Disorders associated with short gestatio

Davis Advantage for Maternal-Newborn Success Full Test Bank Terms in this set (146) 1. Since 1995, there has been a significant decrease in the rate of infant death related to which of the following: a. Disorders associated with short gestation and low birth weight b. Accidents c. Sudden infant death d. Newborns affected by complications of placenta, cord, and membranes ANS: c 2. Tobacco use during pregnancy is associated with adverse effects on the unborn infant, such as intrauterine growth restriction, preterm births, and respiratory problems. By race, which has the highest percentage of smokers? a. American Indian and Alaskan Natives b. Asian or Pacific Islanders c. Non-Hispanic blacks d. Non-Hispanic whites ANS: a 3. Which of the following women is at the highest risk for health disparity? a. A white, middle-class, 16-year-old woman b. An African American, middle-class, 25- year-old woman c. An African American, upper-middle-class, 19-year-old woman d. An Asian, low-income, 30-year-old woman ANS: d 4. A neonate born at 36 weeks gestation is classified as which of the following? a. Very premature b. Moderately premature c. Late premature d. Term ANS: c 5. The perinatal nurse explains to the student nurse that a goal of the Healthy People 2020 report is to: a. Increase proportion of infants who are breastfed to 93.1%. b. Increase proportion of infants who are breastfed to 90.7%. c. Increase proportion of infants who are breastfed to 85.6%. d. Increase proportion of infants who are breastfed to 83.9%. ANS: d 6. The perinatal nurse explains to the student nurse that is the leading cause of infant death in the United States. a. Sudden Infant Death Syndrome b. Respiratory distress of newborns c. Disorders related to short gestation and low birth weight d. Congenital malformations and chromosomal abnormalities ANS: d 7. Which of the following statements are true related to teen pregnancies? (Select all that apply.) a. Teen mothers are at higher risk for HIV. b. Teen mothers are at higher risk for hypertensive problems. c. The birth rate for teenaged women has increased in the past 15 years. d. Infants born to teen mothers are at higher risk for health problems. ANS: a, b, d An ethical dilemma unique to perinatal nursing is the: a. Innate conflict between maternal and fetal rights b. Intensive use of technology c. Shortage of health-care resources d. Risk of violation of the principle of veracity ANS: a The American Nurses Association Code of Ethics for Nurses directs nurses to provide patient care that is: a. Curative b. Utilitarian c. Negotiable d. Respectful ANS: d Evidence-based practice is the integration of the best: a. Randomized clinical trials, clinical expertise, and patients requests b. Research evidence, clinical expertise, and patients values c. Quantitative research, clinical expertise, and patients preferences d. Research findings, clinical experience, and patients preferences ANS: b Infants whose mothers were obese during pregnancy are at higher risk for which of the following? (Select all that apply.) a. Childhood diabetes b. Heart defects c. Hypospadias d. Respiratory distress ANS: a, b, c The color of a person's hair is an example of which of the following? a. Genome b. Sex-link inheritance c. Genotype d. Phenotype ANS: d Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risks to her unborn child from the potential effects of exposure to toxoplasmosis? a. I will avoid rare lamb. b. I will wear a mask when cleaning my cats litter box. c. I understand that exposure to toxoplasmosis can cause blindness in the baby. d. I will avoid rare beef. ANS: b 3. The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following? a. Ductus venosus b. Foramen ovale c. Ductus arteriosus d. Internal iliac artery ANS: c A woman at 40 weeks gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct? a. It indicates that there is a 25% increase in amniotic fluid. b. It indicates that there is a 25% reduction of amniotic fluid. c. It indicates that there is a 50% increase in amniotic fluid. d. It indicates that there is a 50% reduction of amniotic fluid. ANS: d 5. A diagnostic test commonly used to assess problems of the fallopian tubes is: a. Endometrial biopsy b. Ovarian reserve testing c. Hysterosalpingogram d. Screening for sexually transmitted infections ANS: c The nurse is interviewing a gravid woman during the first prenatal visit. The woman confides to the nurse that she lives with a number of pets. The nurse should advise the woman to be especially careful to refrain from coming in contact with the stool of which of the pets? a. Cat b. Dog c. Hamster d. Bird ANS: a A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication? a. Decrease the symptoms of endometriosis b. Increase serum progesterone levels c. Stimulate release of FSH and LH d. Reduce the acidity of vaginal secretions ANS: c The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of _. a. Unilateral amblyopia b. Subdural hematoma c. Sickle cell anemia d. Glomerular nephritis ANS: c A nurse is teaching a woman about her menstrual cycle. The nurse states that __________ is the most important change that happens during the secretory phase of the menstrual cycle. a. Maturation of the graafian follicle b. Multiplication of the fimbriae c. Secretion of human chorionic gonadotropin d. Proliferation of the endometrium ANS: d An ultrasound of a fetus heart shows that normal fetal circulation is occurring. Which of the following statements is consistent with the finding? a. A right-to-left shunt is seen between the atria. b. Blood is returning to the placenta via the umbilical vein. c. Blood is returning to the right atrium from the pulmonary system. d. A right-to-left shunt is seen between the umbilical arteries. ANS: a The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the: a. Menstrual phase b. Proliferative phase c. Secretory phase d. Ischemic phase ANS: c A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 weeks gestation is approximately: a. 500 mL b. 750 mL c. 800 mL d. 1000 mL ANS: c Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also: a. Facilitates asymmetrical growth of the fetal limbs b. Cushions the fetus from mechanical injury c. Promotes development of muscle tone d. Promotes adherence of fetal lung tissue ANS: b During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from: a. 2 to 8 weeks b. 4 to 12 weeks c. 5 to 10 weeks d. 6 to 15 weeks ANS: a 15. A major fetal development characteristic at 16 weeks gestation is: a. The average fetal weight is 450 grams b. Lanugo covers entire body c. Brown fat begins to develop d. Teeth begin to form ANS: d 16. Karen, a 26-year-old woman, has come for preconception counseling and asks about caring for her cat as she has heard that she should not touch the cat during pregnancy. The clinic nurses best response is: a. It is best if someone other than you changes the cats litter pan during pregnancy so that you have no risk of toxoplasmosis during pregnancy. b. It is important to have someone else change the litter pan during pregnancy and also avoid consuming raw vegetables. c. Have you had any flu-like symptoms since you got your cat? If so, you may have already had toxoplasmosis, and there is nothing to worry about. d. Toxoplasmosis is a concern during pregnancy, so it is important to have someone else change the cats litter pan and also to avoid consuming uncooked meat. ANS: d A couple who has sought infertility counseling has been told that the mans sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur? a. The testes are overheated. b. The vas deferens is ligated. c. The prostate gland is enlarged. d. The flagella are segmented. ANS: a A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? a. The couple has established a set schedule for their sexual encounters. b. The couple has been married for more than 8 years. c. The couple lives with one set of parents. d. The couple has close friends who gave birth within the last year. ANS: a The perinatal nurse explains to the student nurse that in the fetal circulation, the lowest level of oxygen concentration is found in the umbilical arteries. ANS: True 20. After birth, the perinatal nurse explains to the new mother that is the hormone responsible for stimulating milk production. ANS: prolactin 21. During prenatal class, the childbirth educator describes the two membranes that envelop the fetus. The contains the amniotic fluid, and the is the thick, outer membrane. ANS: amnion; chorion 22. The perinatal nurse is teaching nursing students about fetal circulation and explains that fetal blood flows through the superior vena cava into the right via the __________. ANS: atrium; foramen ovale The perinatal nurse explains to the student nurse that the growing embryo is called a __________ beginning at 8 weeks of gestational age. ANS: fetus The perinatal nurse defines a as any substance that adversely affects the growth and development of the embryo/fetus. ANS: teratogen __________ __________ __________ is when sperm and oocytes are mixed outside the womans body and then placed into the fallopian tube via laparoscopy. ANS: Gamete intrafallopian transfer A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.) a. Chorionic villus sampling b. Endometrial biopsy c. Hysterosalpingogram d. Serum FSH analysis ANS. b, c, d A couple who has been attempting to become pregnant for 5 years is seeking assistance from an infertility clinic. The nurse assesses the clients emotional responses to their infertility. Which of the following responses would the nurse expect to find? (Select all that apply.) a. Anger at others who have babies. b. Feelings of failure because they cannot make a baby. c. Sexual excitement because they want to conceive a baby. d. Guilt on the part of one partner because he or she is unable to give the other a baby. ANS: a, b, d Which of the following places a couple at higher risk for conceiving a child with a genetic abnormality? (Select all that apply.) a. Maternal age over 35 years b. Partner who has a genetic disorder c. Maternal type 1 diabetes d. Paternal heart disease ANS: a, b The ovarian cycle includes which of the following phases? (Select all that apply.) a. Follicular phase b. Secretory phase c. Ovulatory phase d. Luteal phase e. Menstrual phase ANS: a, c, d A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have a potential effect on sperm maturity? (Select all that apply.) a. The man rides a bike to and from work each day. b. The man takes a calcium channel blocker for the treatment of hypertension. c. The man drinks 6 cups of coffee a day. d. The man was treated for prostatitis 12 months ago and has been symptom free since treatment. ANS: a, b The clinic nurse recognizes that pregnant women who are in particular need of support are those who (select all that apply): a. Are experiencing a second pregnancy b. Are awaiting genetic testing results c. Are experiencing a first pregnancy d. Are trying to conceal this pregnancy as long as possible ANS: b, d Folic acid supplementation during pregnancy is to: a. Improve the bone density of pregnant women b. Decrease the incidence of neural tube defects in the fetus c. Decrease the incidence of Down syndrome in the fetus d. Improve calcium uptake in pregnant women ANS: b The positive signs of pregnancy are: a. All physiological and anatomical changes of pregnancy b. All subjective signs of pregnancy c. All those physiological changes perceived by the woman herself d. The objective signs of pregnancy that can only be attributed to the fetus ANS: d During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to: a. Order an EKG. b. Report this abnormal finding immediately to her care provider. c. Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension. d. Order a nonstress test to assess fetal well- being. ANS: c Blood volume expansion during pregnancy leads to: a. Iron-deficiency anemia b. Maternal iron stores being insufficient to meet the demands for iron in fetal development c. Plasma fibrin increase of 40% and fibrinogen increase of 50% d. Physiological anemia of pregnancy ANS: d Intimate partner violence (IPV) against women consists of actual or threatened physical or sexual violence and psychological and emotional abuse. Screening for IPV during pregnancy is recommended for: a. Pregnant women with a history of domestic violence b. All pregnant women c. All low-income pregnant women d. Pregnant adolescents ANS: b A woman presents to the prenatal clinic at 30 weeks gestation reporting dysuria, frequency, and urgency with urination. Appropriate nursing actions include: a. Obtain clean-catch urine to assess for a possible urinary tract infection. b. Reassure the woman that the signs are normal urinary changes in the third trimester. c. Teach the woman to decrease fluid intake to manage these symptoms. d. Perform a Leopolds maneuver to assess fetal position and station. ANS: a At the end of her 32-week prenatal visit, a woman reports discomfort with intercourse and tells you shyly that she wants to maintain a sexual relationship with her partner. The best response is to: a. Reassure woman/couple of normalcy of response b. Suggest alternative positions for sexual intercourse and alternative sexual activity to sexual intercourse c. Recommend cessation of intercourse until after delivery due to advanced gestationd. Suggest woman discuss this with her care provider at her next appointment ANS: b The clinic nurse talks to a 30-year-old woman at 34 weeks gestation who complains of having difficulty sleeping. Jayne has noticed that getting back to sleep after she has been up at night is difficult. The nurses best response is: a. This is abnormal; it is important that you describe this problem to the doctor. b. This is normal, and many women have this same problem during pregnancy; try napping for several hours each morning and afternoon. c. This is abnormal; tell the doctor about this problem because diagnostic testing may be necessary. d. This is normal in pregnancy, particularly during the third trimester when you also feel fetal movement at night; try napping once a day. ANS: d A 26-year-old woman at 29 weeks gestation experienced epigastric pain following the consumption of a large meal of fried fish and onion rings. The pain resolved a few hours later. The most likely diagnosis for this symptom is: a. Cholelithiasis b. Influenza c. Urinary tract infection d. Indigestion ANS: a The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks gestation. Tamaras hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as: a. Normal adult values b. Normal pregnancy values for the third trimester c. Increased adult values d. Increased values for 33 weeks gestation ANS: b The clinic nurse is aware that the pregnant womans blood volume increases by: a. 20% to 25% b. 30% to 35% c. 40% to 45% d. 50% to 55% ANS: c The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurses hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the: a. First maneuver b. Second maneuver c. Third maneuver d. Fourth maneuver a. First maneuver The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as: a. Positive signs of pregnancy b. Presumptive signs of pregnancy c. Probable signs of pregnancy d. Possible signs of pregnancy ANS: b Lina is an 18-year-old woman at 20 weeks gestation. This is her first pregnancy. Lina is complaining of fatigue and listlessness. Her vital signs are within a normal range: BP = 118/60, pulse = 70, and respiratory rate 16 breaths per minute. Linas fundal height is at the umbilicus, and she states that she is beginning to feel fetal movements. Her weight gain is 25 pounds over the prepregnant weight (110 lb), and her height is 5 feet 4 inches. The perinatal nurses best approach to care at this visit is to: a. Ask Lina to keep a 3-day food diary to bring in to her next visit in 1 week. b. Explain to Lina that weight gain is not a concern in pregnancy, and she should not worry. c. Teach Lina about the expected normal weight gain during pregnancy (approximately 20 pounds by 20 weeks gestation). d. Explain to Lina the possible concerns related to excessive weight gain in pregnancy, including the risk of gestational diabetes. ANS: a 15. A woman presents to a prenatal clinic appointment at 10 weeks gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy? a. Occipital headache b. Urinary frequency c. Diarrhea d. Leg cramps ans: B The nurse is providing prenatal teaching to a group of diverse pregnant women. One woman, who indicates she smokes two to three cigarettes a day, asks about its impact on her pregnancy. The nurse explains that the most significant risk to the fetus is: a. Respiratory distress at birth b. Severe neonatal anemia c. Low neonatal birth weight d. Neonatal hyperbilirubinemia ANS: C While performing Leopolds maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following? a. The fetal position is right occiput posterior. b. The fetal attitude is flexed. c. The fetal presentation is scapular. d. The fetal lie is vertical. ANS: c A nurse is reviewing diet with a pregnant woman in her second trimester. Which of the following foods should the nurse advise the patient to avoid consuming during her pregnancy? a. Brie cheese b. Bartlett pears c. Sweet potatoes d. Grilled lamb ANS: a The nurse is working in a prenatal clinic caring for a patient at 14 weeks gestation, G2 P1001. Which of the following findings should the nurse highlight for the nurse midwife? a. Body mass index of 23 b. Blood pressure of 100/60 c. Hematocrit of 29% d. Pulse rate of 76 bpm ANS: c A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct? a. The woman is experiencing a normal pregnancy. b. The woman may be having difficulty accepting this pregnancy. c. The woman must see a nutritionist as soon as possible. d. The woman will likely miscarry the conceptus. ANS: a 21. A patient at 37 weeks gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated? a. At the xiphoid process b. At a point between the umbilicus and the xiphoid c. At the umbilicus d. At a level directly above the symphysis pubis ANS: a A nurse is performing an assessment on a pregnant woman during a prenatal visit. Which of the following findings would lead the nurse to report to the obstetrician that the patient may be experiencing intrauterine growth restriction (IUGR)? a. Leopolds maneuvers: Hard round object in the fundus, flat object on left of uterus, small parts on right of uterus, soft round object above the symphysis b. Weight gain: 6-pound increase over 4- week period c. Fundal height measurement: 22 cm at 26 weeks gestation d. Alpha-fetoprotein assessment: level is one-half normal, accompanied by complaints of severe nausea and vomiting ANS: c A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2007. Using Naegeles rule, which of the following would the nurse determine to be the patients estimated date of delivery: a. January 9, 2008 b. April 13, 2008 c. April 20, 2008 d. September 6, 2008 ANS: b Which of the following findings, seen in pregnant women in the third trimester, would the nurse consider to be within normal limits? a. Diplopia b. Epistaxis c. Bradycardia d. Oliguria ANS: b A primigravida patient is 39 weeks pregnant. Which of the following symptoms would the nurse expect the patient to exhibit? a. Nausea b. Dysuria c. Urinary frequency d. Intermittent diarrhea ANS: c The nurse has taken a health history on four multigravida patients at their first prenatal visits. It is high priority that the patient whose first child was diagnosed with which of the following diseases receives nutrition counseling? a. Development dysplasia of the hip b. Achondroplastic dwarfism c. Spina bifida d. Muscular dystrophy ANS: c A nurse working in a prenatal clinic is caring for a woman who asks advice on foods that are high in vitamin C because I hate oranges. The nurse states that 1 cup of which of the following raw foods will meet the patients daily vitamin C needs? a. Strawberries b. Asparagus c. Iceberg lettuce d. Cucumber ANS: a The nurse notes each of the following findings in a woman at 10 weeks gestation. Which of the findings would enable the nurse to tell the woman that she is probably pregnant? a. Fetal heart rate via Doppler b. Positive pregnancy test c. Positive ultrasound assessment d. Absence of menstrual period ANS: b A nurse who is discussing serving sizes of foods with a new prenatal patient would state that which of the following is equal to 1 (one) serving from the dairy food group? a. 1 cup low-fat milk b. cup vanilla yogurt c. cup cottage cheese d. 1 ounce cream cheese ANS: a The nurse who is assessing a G2 P1 palpates the fundal height at the location noted on the picture below. The nurse concludes that the fetus is equal to which of the following gestational ages? a. 12 weeks b. 20 weeks c. 28 weeks d. 36 weeks ANS: b A patient at 28 weeks gestation was last seen in the prenatal clinic at 24 weeks gestation. Which of the following changes should the nurse bring to the attention of the Certified Nurse Midwife? a. Weight change from 128 pounds to 132 pounds b. Pulse change from 88 bpm to 92 bpm c. Blood pressure change from 110/70 to 140/90 d. Respiratory change from 16 rpm to 20 rpm ANS: c The clinic nurse includes screening for domestic violence in the first prenatal visit for all patients. An appropriate question would be: a. This is something that we ask everyone. Do you feel safe in your current living environment and relationships? b. This is something we ask everyone. Do you have any abuse in your life right now? c. Is your partner threatening or harming you in any way right now? d. I need to ask you, do you feel safe from abuse right now? ANS: a An 18-year-old woman at 23 weeks gestation tells the nurse that she has fainted two times. The nurse teaches about the warning signs that often precede syncope so that she can sit or lie down to prevent personal injury. Warning signs include (select all that apply): a. Sweating b. Nausea c. Chills d. Yawning ANS: a, b, d 34. The perinatal nurse teaches the student nurse about the physiological changes in pregnancy that most often contribute to the increased incidence of urinary tract infections. These changes include (select all that apply): a. Relaxation of the smooth muscle of the urinary sphincter b. Relaxation of the smooth muscle of the bladder c. Inadequate emptying of the bladder d. Increased incidence of bacteriuria ANS: a, b, c, d The clinic nurse discusses normal bladder function in pregnancy with a 22- year-old pregnant woman who is now in her 29th gestational week. The nurse explains that at this time in pregnancy, it is normal to experience (select all that apply): a. Urinary frequency b. Urinary urgency c. Nocturia d. Incontinence ANS: a, b, c A 32-year-old woman now at 32 weeks gestation is complaining of right-sided sharp abdominal pain. The patient is examined by the clinic nurse and given information about abdominal discomfort in pregnancy. She is also instructed to seek immediate attention if she (select all that apply): a. Has heartburn b. Has chills or a fever c. Feels decreased fetal movements d. Has increased abdominal pain ANS: b, c, d The clinic nurse talks with Suzy, a pregnant woman at 9 weeks gestation who has just learned of her pregnancy. Suzys nausea and vomiting are most likely caused by (select all that apply): a. Increased levels of estrogen b. Increased levels of progesterone c. An altered carbohydrate metabolism d. Increased levels of human chorionic gonadotropin ANS: c, d The clinic nurse encourages all pregnant women to increase their water intake to at least 8 to 10 glasses per day in order to (select all that apply): a. Decrease the risk of constipation b. Decrease the risk of bile stasis c. Decrease their feelings of fatigue d. Decrease the risk of urinary tract infections ANS: a, b, c, d The perinatal nurse examines the thyroid gland as part of the physical examination of Savannah, a pregnant woman who is now at 16 weeks gestation. The perinatal nurse informs Savannah that during pregnancy (select all that apply): a. Increased size of the thyroid gland is normal b. Increased function of the thyroid gland is normal c. Decreased function of the thyroid gland is normal d. The thyroid gland will return to its normal size and function during the postpartal period ANS: a, b, d The clinic nurse describes the respiratory system changes common to pregnancy to the new nurse. These changes include (select all that apply): a. An increased tidal volume b. A decreased airway resistance c. An increased chest circumference ANS: a, b, c Davis Advantage for Maternal-Newborn Success Full Test Bank The clinic nurse teaches the new nurse about pregnancy-induced blood clotting changes. The nurse explains that a pregnant woman is at risk for venous thrombosis due to (select all that apply): a. Increased fibrinogen volume b. Increased blood factor V c. Increased blood factor X d. Venous stasis ANS: a, c, d The clinic nurse describes possible interventions for the pregnant woman who is experiencing pain and numbness in her wrists. The nurse suggests (select all that apply) :a. Elevating the arms and wrists at night b. Reassessment during the postpartum period c. The use of cock splints to prevent wrist flexion d. Massaging the hands and wrists with alcohol ANS: a, b, c The clinic nurse advocates for smoking cessation during pregnancy. Potential harmful effects of prenatal tobacco use include (select all that apply): a. Preterm birth b. Gestational hypertension c. Gestational diabetes d. Low birth weight ANS: a, d Asking the pregnant woman about her use of recreational drugs is an essential component of the prenatal history. Harmful fetal effects that may occur from recreational drugs include (select all that apply): a. Miscarriage/spontaneous abortion b. Low birth weight c. Macrosomia d. Post-term labor/birth ANS: a, b The clinic nurse schedules Tracy for her first prenatal appointment with the certified nurse-midwife (CNM) in the clinic. Tracy has appropriate questions for her potential health-care provider that include (select all that apply): a. Complementary and alternative methods used during labor and birth b. An opportunity to meet other providers in the practice c. Beliefs and practices concerning an episiotomy and an epidural anesthetic d. Whether the nurse-midwife will be continually available for support during ANS: a, b, c Davis Advantage for Maternal-Newborn Success Full Test Bank The clinic nurse explains to Margaret, a newly diagnosed pregnant woman at 10 weeks gestation, that her rubella titer indicates that she is not immune. Margaret should be advised to (select all that apply): a. Avoid contact with all children b. Be retested in 3 months c. Receive the rubella vaccine postpartum d. Report signs or symptoms of fever, runny nose, and generalized red rash to the health- care provider ANS: c, d An overweight or obese pre-pregnancy weight increases the risk for which poor maternal outcomes? (Select all that apply.) a. Preeclampsia b. Hemorrhage c. Difficult delivery d. Vaginal infections ANS: a, b, c Presumptive signs of pregnancy include (select all that apply): a. Nausea b. Fatigue c. Ballottement d. Amenorrhea ANS: a, b, d Physiologic changes that occur in the renal system during pregnancy predispose the pregnant woman to urinary tract infections (UTIs). Symptoms of a UTI include (select all that apply): a. Dysuria b. Hematuria c. Urgency d. Delayed urination ANS: a, b, c Urinary tract infection (UTI) prevention measures during pregnancy include counseling the pregnant woman to (select all that apply): a. Delay urination until bladder is full b. Limit hydration c. Wipe from front to back d. Urinate after intercourse ANS: a, c, d Interventions for low back pain during pregnancy should include (select all that apply): a. Utilizing proper body mechanics b. Applying ice or heat to affected area c. Avoiding pelvic rock and pelvic tilt d. Using additional pillows for support during sleep ANS: a, b, d Jorgina is a 24-year-old pregnant woman at 26 weeks gestation. This is Jorginas third pregnancy, and her obstetrical history includes one full-term birth, one preterm birth, and two living children. Today Jorgina arrives at the clinic with complaints of fatigue, insomnia, and backache. She reports that she is a nurse on an oncology unit and is worried about continuing with working her 12-hour shifts. The perinatal nurse identifies concerns in Jorginas history and work environment including (select all that apply): a. Risk of preterm birth b. Presence of chemotherapeutic agents c. Requirement for heavy lifting d. History of diabetes ANS: a, b, c The clinic nurse is assessing the complete blood count results for Kim-Ly, a 23-year-old pregnant woman. Kim-Lys hemoglobin is 9.8 g/dL. This laboratory finding places Kim-Lys pregnancy at risk for (select all that apply): a. Preterm birth b. Placental abruption c. Intrauterine growth restriction d. Thrombocytopenia ANS: a, c Teera is a 22-year-old woman who is experiencing her third pregnancy. Her obstetrical history includes one first- trimester elective abortion and one first- trimester spontaneous abortion. Teera is a semi-vegetarian who drinks milk and eats yogurt and fish as part of her daily intake. The perinatal nurse discusses Teeras diet with her as she may be deficient in (select all that apply): a. Iron b. Magnesium c. Zinc d. Vitamin B12 ANS: a, c During the initial antenatal visit, the clinic nurse asks questions about the womans nutritional intake. Specific questions should include information pertaining to (select all that apply): a. Preferred foods b. The presence of cravings c. Use of herbal supplements d. Aversions to certain foods and odors ANS: a, b, c, d The perinatal nurse talks to the prenatal class attendees about guidelines for exercise in pregnancy. Recommended guidelines include (select all that apply): a. Stopping if the woman is tired b. Bouncing and slowly arching the back c. Increasing fluid intake throughout the physical activity d. Maintaining the ability to walk and talk during exercise ANS: a, c, d The clinic nurse speaks with the student nurse prior to the physical examination of a pregnant woman who is 32 weeks gestation. The clinic nurse explains that the heart sounds heard in pregnancy are usually S1 and S3 with a possible murmur related to increased cardiac output. ANS: True Sally is in her third trimester and has begun to sing and talk to the fetus. Sally is probably exhibiting signs of: a. Mental illness b. Delusions c. Attachment d. Crisis ANS: c