OB NURS 306 - Test Bank Chapters 1 to 19 ( Awesome stuff) A+ Guide, West Coast University, Los Angeles. - $37.49   Add to cart

Looking for more study guides & notes to pass Nursing? Find more study material on our Nursing overview page 

Study guide

OB NURS 306 - Test Bank Chapters 1 to 19 ( Awesome stuff) A+ Guide, West Coast University, Los Angeles.

NURS 306 OB-Study Guide by chapters Ch1-to-Ch19 Chapter 1: Trends and Issues Multiple Choice 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 Feedback a. The rates of prematurity and low birth weight are increasing. b. The rates of accidents have increased. c. Correct. The rate of infant death related to SIDS has decreased from 87.1 to 47.2. The decrease in rate is partially attributed to placing infants on their backs when sleeping. d. The rates of newborns affected by complications of placenta, cord, and membranes have increased. 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 percentages of smokers? a. American Indian and Alaskan Natives b. Asian or Pacific Islanders c. Non-Hispanic blacks d. Non-Hispanic whites Feedback a. 36% of American Indian and Native American women are cigarette smokers. b. 4.3% of Asian or Pacific Islander women are cigarette smokers. c. 17.1% of non-Hispanic black women are cigarette smokers. d. 19.6% of non-Hispanic white women are cigarette smokers. 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 Feedback a. Although age is a risk factor, income contributes to disparity. b. Although African American women are at increased risk, income accounts for the largest disparity. c. Although age and race contribute to increased risk, income accounts for the largest disparity. d. Although age and race contribute to increased risk, income accounts for the largest disparity. 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 Feedback a. Very premature is less than 32 weeks’ gestation. b. Moderately premature is 32 to 33 completed weeks’ gestation. c. Correct. Late premature is 34 to 36 completed weeks’ gestation. d. Term is 37 to 42 weeks’ gestation. 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%. A goal of Healthy People 2020 is to increase the proportion of infants who are breastfed from 74% to 81.9%. 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 Multiple Response 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. Chapter 2: Ethics and Standards of Practice Issues Multiple Choice 1. An ethical dilemma unique to perinatal nursing is the:a. Innate conflict between maternal and fetal rights b. Intensive use of technologyc. Shortage of health-care resourcesd. Risk of violation of the principle of veracity Feedback a. A unique aspect of maternity nursing is that the nurse advocates for two individuals: the woman and the fetus. b. The use of technology is not unique to perinatal nursing. c. Currently, in the United States, decisions in perinatal nursing are not based on resources available. d. In perinatal nursing, the obligation to tell the truth is generally adhered to. 2. The American Nurses Association Code of Ethics for Nurses directs nurses to provide patient care that is:a. Curativeb. Utilitarianc. Negotiabled. Respectful Feedback a. Adaptation rather than cure is the goal of nursing. b. Nursing does not define the value of a person by his or her utility. c. The Code of Ethics outlines the nursing profession’s nonnegotiable ethical standard. d. Respect for the inherent dignity, worth, and uniqueness of every individual is part of the Code of Ethics. 3. Evidence-based practice is the integration of the best: a. Randomized clinical trials, clinical expertise, and patients’ requestsb. Research evidence, clinical expertise, and patients’ valuesc. Quantitative research, clinical expertise, and patients’ preferencesd. Research findings, clinical experience, and patients’ preferences Feedback a. Evidence-based practice is the use of evidence that may include research beyond randomized clinical trials. b. These elements are the accepted definition of evidence-based practice. c. Qualitative research, as well as quantitative research, contributes to evidence-based practice. d. Clinical expertise, as well as clinical experience, defines evidence-based practice. Multiple Response 4. 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 Chapter 3: Genetics, Conception, Fetal Development, and Reproductive Technology Multiple Choice 1. 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 Feedback a. Genome is an organism’s complete set of DNA. b. Sex-link inheritance refers to genes or traits that are located only on the X chromosome. c. Genotype refers to a person’s genetic makeup. d. Correct. Phenotype refers to how genes are outwardly expressed, such as eye color, hair color, and height. 2. 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 cat’s litter box.” c. “I understand that exposure to toxoplasmosis can cause blindness in the baby.” d. “I will avoid rare beef.” Feedback a. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb is ingested. b. Correct. Pregnant women and women who are attempting pregnancy should avoid contact with cat feces. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb is ingested. Wearing a mask will not decrease the risk through ingestion of the parasite. c. Exposure to toxoplasmosis can cause fetal death, mental retardation, and blindness. d. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb is ingested. 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 Feedback a. The ductus venosus connects the umbilical vein to the inferior vena cava. b. The foramen ovale is the opening between the right and left atria. c. Correct. d. The internal iliac artery connects the external iliac artery to the umbilical artery. 4. 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. Feedback a. Oligohydramnios is a decrease, not an increase in amniotic fluid. b. Oligohydramnios is a 50% reduction in amniotic fluid. c. Oligohydramnios is a decrease, not an increase in amniotic fluid. d. Correct. Oligohydramnios refers to a decreased amount of amniotic fluid of less than 500 mL at term or 50% reduction of normal amounts. 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 Feedback a. Endometrial biopsy provides information on the response of the uterus to hormonal signals. b. Ovarian reserve testing is used to assess ovulatory functioning. c. Correct. Hysterosalpingogram provides information on the endocervical canal, uterine cavity, and fallopian tubes. d. STIs can cause adhesions within the fallopian tubes, but screening cannot confirm that adhesions are present. KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate 6. 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 Feedback a. The patient should refrain from coming in direct contact with cat feces. Cats often harbor toxoplasmosis, a teratogenic illness. b. No pathology has been associated with the feces of pet dogs. c. No pathology has been associated with the feces of pet hamsters. d. No pathology has been associated with the feces of pet birds. 7. 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 Feedback a. Clomiphene Citrate will not reduce a client’s symptoms of endometriosis. b. Clomiphene Citrate will not increase a client’s progesterone levels. c. Clomiphene Citrate stimulates release of FSH and LH. d. Clomiphene Citrate will not reduce the acidity of vaginal secretions. 8. 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 Feedback a. Amblyopia rarely results from a genetic predisposition. b. A subdural hematoma does not result from a genetic defect. c. Sickle cell anemia is an autosomal recessive illness. This client needs to be seen by a genetic counselor. d. Glomerular nephritis does not result from a genetic defect. 9. 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 Feedback a. The maturation of the graafian follicle occurs during the follicular phase. b. There is no such thing as the multiplication of the fimbriae. c. Human chorionic gonadotropin is secreted by the fertilized ovum during the early weeks of a pregnancy. d. The proliferation of the endometrium occurs during the secretory phase of the menstrual cycle. 10. 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. Feedback a. This is correct. The foramen ovale is a duct between the atria. In fetal circulation, there is a right to left shunt through the duct. b. Blood returns to the placenta via the umbilical arteries. c. Most of the blood bypasses the pulmonary system. The blood that does enter the pulmonary system returns to the left atrium. d. There is no duct between the umbilical arteries. 11. 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 Feedback a. The menstrual phase is the time of vaginal bleeding, approximately days 1 to 6. b. The proliferative phase ends the menses through ovulation, approximately days 7 to 14. c. The secretory phases occurs from the time of ovulation to the period just prior to menses, or approximately days 15 to 26. d. The ischemic phase occurs from the end of the secretory phase to the onset of menstruation, approximately days 27 to 28. 12. 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 . 13. 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 Feedback a. Amniotic fluid allows for symmetrical fetal growth. b. Amniotic fluid cushions the fetus from mechanical injury. c. Amniotic fluid does not promote muscle tone. d. Amniotic fluid prevents adherence of the amnion to the fetus. 14. 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 to12 weeks c. 5 to 10 weeks d. 6 to 15 weeks 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 Feedback a. The average fetal weight at 16 weeks is 200 grams. b. Lanugo is present on the head. c. Brown fat begins to develop at 20 weeks. d. This is the correct answer. 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 nurse’s best response is: a. It is best if someone other than you change the cat’s 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 cat’s litter pan and also to avoid consuming uncooked meat. Feedback a. The nurse should also explain that the patient should not eat uncooked meat as it is a potential source for toxoplasmosis. b. Raw vegetables are not a source for toxoplasmosis. c. This is not an accurate way to diagnose if the woman has had toxoplasmosis. d. Women need to be aware that Toxoplasma gondii, a single-celled parasite, is responsible for the infection toxoplasmosis. The majority of individuals who become infected with toxoplasmosis are asymptomatic, although when present, symptoms are described as “flu like” and include glandular pain and enlargement and myalgia. Severe toxoplasmosis infection may cause damage to the fetal brain, eyes, or other organs. Toxoplasmosis is usually acquired by consuming raw or poorly cooked meat that has been contaminated with T. gondii. Toxoplasmosis may also be acquired through close contact with feces from an infected animal (usually cats) or soil that has been contaminated with T. gondii. 17. A couple who has sought infertility counseling has been told that the man’s 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. Feedback a. Spermatogenesis occurs in the testes. High temperatures harm the development of the sperm. b. When the vas deferens is ligated, a man has had a vasectomy and is sterile. The sterility is not due to impaired spermatogenesis, but rather to the inability of the sperm to migrate to the woman’s reproductive track. c. The enlarged prostrate has no effect on spermatogenesis. d. The flagella are the “tails” of the sperm. They are normally divided into the middle segment and an end segment. 18. 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. Feedback a. Couples who “schedule” intercourse often complain that their sexual relationship is unsatisfying. b. Years of marriage are not directly related to a couple’s sexual relationship. c. The fact that the couple lives with one set of parents is unlikely related to their sexual relationship. d. Although it can be very difficult to be around couples who have become pregnant or have healthy babies, this factor is not usually related to a couple’s sexual relationship. True/False 19. 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 The highest oxygen concentration (PO2 = 30–35 mm Hg) is found in the blood returning from the placenta via the umbilical vein; the lowest oxygen concentration occurs in blood shunted to the placenta where reoxygenation takes place. The blood with the highest oxygen content is delivered to the fetal heart, head, neck, and upper limbs, and the blood with the lowest oxygen content is shunted toward the placenta. Fill-in-the-Blank 20. After birth, the perinatal nurse explains to the new mother that __________ is the hormone responsible for stimulating milk production. ANS: prolactin Following birth and delivery of the placenta, there is an abrupt decrease in estrogen. This event triggers an increased secretion of prolactin (the hormone that stimulates milk production) by the anterior pituitary gland. The posterior pituitary and hypothalamus play a role in the production and secretion of oxytocin, a hormone that causes release of milk from the alveoli. 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. 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 __________. 23. The perinatal nurse explains to the student nurse that the growing embryo is called a __________ beginning at 8 weeks of gestational age. 24. The perinatal nurse defines a __________ as any substance that adversely affects the growth and development of the embryo/fetus. 25. __________ __________ __________ is when sperm and oocytes are mixed outside the woman’s body and then placed into the fallopian tube via laparoscopy. Multiple Response 26. 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 Feedback a. Chorionic villus sampling is done to assess for genetic disorders of the fetus. b. Endometrial biopsy is performed about 1 week following ovulation to detect the endometrium’s response to progesterone. c. Hysterosalpingogram is used to determine if fallopian tubes are patent. d. Serum FSH levels are used to assess ovarian function. 27. 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. , b, d Feedback a. Infertile couples often feel anger toward couples who have babies. b. Infertile couples often express feelings of personal failure. c. Infertile couples undergoing infertility testing and treatment often express an aversion to sex. d. Guilt is often expressed by the couple. 28. 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 29. 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 30. 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. 31. 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 Chapter 4: Physiological Aspects of Antepartum Care Multiple Choice 1. 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 fetusd. Improve calcium uptake in pregnant women Feedback a. Folic acid is not related to bone density. b. Correct. The use of folic acid has decreased the incidence of neural tube defects by 50%. c. The use of folic acid is not associated with a reduction in Down syndrome. d. Folic acid is not related to calcium uptake in women. 2. 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 Feedback a. Physiological and anatomical changes of pregnancy are presumptive signs of pregnancy. b. All subjective signs of pregnancy are the probable signs of pregnancy. c. All those physiological changes perceived by the woman herself are presumptive signs of pregnancy. d. Correct. Positive signs of pregnancy are the objective signs of pregnancy that can only be attributed to the fetus, such as fetal heart tones. 3. 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. Feedback a. This is a normal occurrence in pregnancy and does not indicate pathology. The probable cause of the problem is supine hypotension. b. This is a normal finding that does not warrant immediate notification to her care provider. c. Correct. Teaching the woman to avoid lying on her back because of occlusion of the vena cava with the gravid uterus causes supine hypotension syndrome. d. Antenatal testing is not indicated with supine hypotension. 4. 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 Feedback a. Iron-deficiency anemia is treated with iron supplementation. Iron-deficiency anemia is defined as hemoglobin of less than 11 g/dL and hematocrit less than 33%. b. Maternal iron stores that are insufficient to meet the demands for iron in fetal development result in iron-deficiency anemia. c. Hypercoagulation that occurs during pregnancy is to decrease the risk of postpartum hemorrhage. These changes taking place are not related to blood volume expansion. d. Correct. Physiological anemia of pregnancy, also referred to as pseudo-anemia of pregnancy, is due to hemodilution. The increase in plasma volume is relatively larger than the increase in RBCs that results in decreased hemoglobin and hematocrit values. 5. 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 Feedback a. Intimate partner violence is underreported by women, necessitating universal screening. b. Correct. AWHONN advocates for universal screening for domestic violence for all pregnant women. Homicide is the most likely cause of death for pregnant or recently pregnant women, and a significant portion of those homicides are committed by their intimate partners. One in six pregnant women reported physical or sexual abuse during pregnancy, seriously impacting maternal and fetal health and infant birth weight. c. IPV crosses all ethnic, racial, religious, and socioeconomic levels. d. IPV crosses all ethnic, racial, religious, and socioeconomic levels. 6. 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 Leopold’s maneuver to assess fetal position and station. Feedback a. Correct. Dysuria, frequency, and urgency with urination are signs and symptoms of a urinary tract infection, necessitating further assessment and testing. b. These are abnormal urinary symptoms in the third trimester. c. Pregnant women need to increase their fluid intake during pregnancy, and dysuria and urgency are abnormal. d. Assessment of fetal position and station is not an appropriate response to reported signs and symptoms of a urinary tract infection. 7. 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 gestation d. Suggest woman discuss this with her care provider at her next appointment Feedback a. Although this is a normal response, providing reassurance is not enough. Further intervention is indicated. b. Although shy to discuss this, she wants to maintain a sexual relationship with her partner. Suggesting alternative positions for sexual intercourse and alternative sexual activity to sexual intercourse provides the woman with information to maintain sexual relations. c. She wants to maintain a sexual relationship with her partner, and there are no contraindications to intercourse during a healthy pregnancy. d. The patient is seeking out information and to defer her to her care provider at her next appointment is inappropriate. Additionally, she may not be comfortable discussing this with anyone else. 8. 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 nurse’s 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.” Feedback a. This sleep pattern is a normal finding. b. Sleeping for several hours in the morning and afternoon would contribute to further sleep disturbances at night. c. This sleep pattern is a normal finding. d. Pregnancy sleep patterns are characterized by reduced sleep efficiency, fewer hours of night sleep, frequent awakenings, and difficulty going to sleep. Nurses can advise patients that afternoon napping may help alleviate the fatigue associated with the sleep alterations. 9. 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 Feedback a. The progesterone-induced prolonged emptying time of bile from the gallbladder, combined with elevated blood cholesterol levels, may predispose the pregnant woman to gallstone formation (cholelithiasis). Pain in the epigastric region following ingestion of a high-fat meal constitutes the major symptom of these conditions. The pain is self-limiting and usually resolves within 2 hours. b. The symptoms described are not associated with influenza. c. The symptoms described are not associated with urinary tract infection. d. Prolonged emptying time of bile from the gallbladder, combined with elevated blood cholesterol levels, make cholelithiasis a more probable diagnosis than indigestion. 10. The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks’ gestation. Tamara’s 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 Feedback a. The values are low normal for adults but represent normal findings for pregnant women. b. During pregnancy the woman’s hematocrit values may appear low due to the increase in total plasma volume (on average, 50%). Because the plasma volume is greater than the increase in erythrocytes (30%), the hematocrit decreases by about 7%. This alteration is termed “physiologic anemia of pregnancy,” or “pseudo-anemia.” The hemodilution effect is most apparent at 32 to 34 weeks. The mean acceptable hemoglobin level in pregnancy is 11 to 12 g/dL of blood. c. The values are not increased; they are low normal for adults but represent normal findings for pregnant women. d. The values are not increased; they are low normal for adults but represent normal findings for pregnant women. 11. The clinic nurse is aware that the pregnant woman’s blood volume increases by: a. 20% to 25% b. 30% to 35% c. 40% to 45% d. 50% to 55% Feedback a. An increase in maternal blood volume begins during the first trimester and peaks at term. The increase approaches 40% to 45%, not 20% to 25%. b. An increase in maternal blood volume begins during the first trimester and peaks at term. The increase approaches 40% to 45, not 30% to 35%. c. An increase in maternal blood volume begins during the first trimester and peaks at term. The increase approaches 40% to 45% and is primarily due to an increase in plasma and erythrocyte volume. Additional erythrocytes, needed because of the extra oxygen requirements of the maternal and placental tissue, ensure an adequate supply of oxygen to the fetus. The elevation in erythrocyte volume remains constant during pregnancy. d. An increase in maternal blood volume begins during the first trimester and peaks at term. The increase approaches 40% to 45%, not as high as 50% to 55%. 12. The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurse’s 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 Feedback a. Leopold maneuvers are a four-part clinical assessment method used to determine the lie, presentation, and position of the fetus. The first maneuver determines which fetal body part (e.g., head or buttocks) occupies the uterine fundus. The examiner faces the patient’s head and places the hands on the abdomen, using the palmar surface of the hands to gently palpate the fundal region of the uterus. The buttocks feel soft, broad, and poorly defined and move with the trunk. The fetal head feels firm and round and moves independently of the trunk. b. Leopold maneuvers are a four-part clinical assessment method used to determine the lie, presentation, and position of the fetus. The first maneuver is described in this scenario. c. Leopold maneuvers are a four-part clinical assessment method used to determine the lie, presentation, and position of the fetus. The first maneuver is described in this scenario. d. Leopold maneuvers are a four-part clinical assessment method used to determine the lie, presentation, and position of the fetus. The first maneuver is described in this scenario. 13. 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 Feedback a. Positive signs include fetal heartbeat, visualization of the fetus, and fetal movements palpated by the examiner. b. Presumptive signs of pregnancy include amenorrhea, nausea and vomiting, frequent urination, breast tenderness, perception of fetal movement, skin changes, and fatigue. Probable signs of pregnancy include abdominal enlargement, Piskacek sign, Hegar sign, Goodell sign, Braxton Hicks sign, positive pregnancy test, and ballottement. Positive signs include fetal heartbeat, visualization of the fetus, and fetal movements palpated by the examiner. c. Probable signs of pregnancy include abdominal enlargement, Piskacek sign, Hegar sign, Goodell sign, Braxton Hicks sign, positive pregnancy test, and ballottement. d. Possible signs of pregnancy may vary widely. 14. 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. Lina’s 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 nurse’s 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. Feedback a. Nutrition and weight management play an essential role in the development of a healthy pregnancy. Not only does the patient need to have an understanding of the essential nutritional elements, she must also be able to assess and modify her diet for the developing fetus and her own nutritional maintenance. To facilitate this process, it is the nurse’s responsibility to provide education and counseling concerning dietary intake, weight management, and potentially harmful nutritional practices. To facilitate this process, it is the nurse’s responsibility to gather more information on the woman’s dietary practices through a food diary. b. Nutrition and weight management play an essential role in the development of a healthy pregnancy. To facilitate this process, it is the nurse’s responsibility to provide education and counseling concerning dietary intake, weight management, and potentially harmful nutritional practices. c. Nutrition and weight management play an essential role in the development of a healthy pregnancy. Not only does the patient need to have an understanding of the essential nutritional elements, she must also be able to assess and modify her diet for the developing fetus and her own nutritional maintenance. To facilitate this process, it is the nurse’s responsibility to provide education and counseling concerning dietary intake, weight management, and potentially harmful nutritional practices, not just inform the patient of expected normal weight gain. d. Nutrition and weight management play an essential role in the development of a healthy pregnancy. Not only does the patient need to have an understanding of the essential nutritional elements, she must also be able to assess and modify her diet for the developing fetus and her own nutritional maintenance. To facilitate this process, it is the nurse’s responsibility to provide education and counseling concerning dietary intake, weight management, and potentially harmful nutritional practices. 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 Feedback a. Headaches may be benign or, especially if noted after 20 weeks’ gestation, may be a symptom of pregnancy-induced hypertension (PIH). b. Urinary frequency is a common complaint of women during their first trimester. c. Diarrhea is rarely seen in pregnancy. Constipation is a common complaint. d. Leg cramps are commonly seen during the second and third trimesters. 16. 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 Feedback a. Respiratory distress is not the most significant risk to the fetus unless the fetus is also premature. b. Severe neonatal anemia is not associated with pregnancies complicated by cigarette smoking. c. Low neonatal birth weight is the most common complication seen in pregnancies complicated by cigarette smoking. d. Neonatal hyperbilirubinemia is not associated with pregnancies complicated by cigarette smoking. 17. While performing Leopold’s 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. Feedback a. This is a shoulder presentation. b. It is not possible to determine whether the attitude is flexed or not when doing Leopold’s maneuvers. c. This is a shoulder presentation. d. The lie is transverse or horizontal. 18. 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 Feedback a. Soft cheese may harbor Listeria. The patient should avoid consuming uncooked soft cheese. b. A pear is an excellent food for a pregnant woman to consume. c. Sweet potatoes are an excellent food for a pregnant woman to consume. d. Grilled lamb is an excellent food for a pregnant woman to consume, although it should be well cooked. 19. 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 Feedback a. A body mass index of 23 is normal. b. A blood pressure of 100/60 is normal. c. A hematocrit of 29% indicates that the patient is anemic. The nurse should highlight the finding for the nurse-midwife. d. A pulse rate of 76 bpm is a normal rate. 20. 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. Feedback a. The patient is experiencing a normal pregnancy. b. Quickening is not felt until 16 to 20 weeks’ gestation. c. There is no apparent need for a nutritionist to see this patient. d. There is no indication in the scenario that this patient is at high risk for a miscarriage. 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 Feedback a. At 36 weeks’ gestation, the fundus should be felt at the xiphoid process. b. At 36 weeks’ gestation, the fundus should be felt at the xiphoid process. c. At 20 weeks’ gestation, the fundus should be felt at the umbilicus. d. At 12 weeks’ gestation, the fundus should be felt directly above the symphysis pubis. 22. 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. Leopold’s 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 Feedback a. This baby is in the breech position. This is not a sign of IUGR. b. This weight gain is slightly above normal. This is not a sign of IUGR. c. The fundal height at 26 weeks should be approximately 26 cm. The fundal height, therefore, is below expected. This patient may be experiencing intrauterine growth restriction. d. A low AFP level is seen in patients whose babies have spina bifida and other central nervous system defects. 23. A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2007. Using Naegele’s rule, which of the following would the nurse determine to be the patient’s estimated date of delivery (EDC)? a. January 9, 2008 b. April 13, 2008 c. April 20, 2008 d. September 6, 2008 Feedback a. The EDC is calculated as April 13, 2008. b. The EDC is calculated as April 13, 2008. Naegele’s rule: subtract 3 months and add 7 days to the first day of the last normal menstrual period. c. The EDC is calculated as April 13, 2008. d. The EDC is calculated as April 13, 2008. 24. 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 Feedback a. Diplopia is sometimes seen in patients with pregnancy-induced hypertension (PIH). b. Epistaxis is commonly seen in pregnant patients. The bleeding is related to the increased vascularity of the mucous membranes. Unless the blood loss is significant, it is a normal finding. c. Bradycardia is often seen immediately after delivery but not during the third trimester. d. Oliguria is seen in patients with PIH. 25. 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 Feedback a. Nausea is usually not seen in the third trimester. b. Dysuria is not a normal finding at any time during a pregnancy. The possibility of a urinary traction infection (UTI) should be considered. c. Urinary frequency recurs at the end of the third trimester. As the uterus enlarges, it again compresses the bladder causing urinary frequency. d. Diarrhea is not a normal finding at any time during a pregnancy. 26. 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 Feedback a. The etiology of developmental dysplasia of the hip is unrelated to the mother’s nutritional status. b. Achondroplasia is an inherited defect. Its etiology is unrelated to the mother’s nutritional status. c. The incidence of spina bifida is much higher in women with poor folic acid intakes. It is a priority that this patient receives nutrition counseling. d. Most forms of muscular dystrophy are inherited. Their etiologies are unrelated to the mother’s nutritional status. 27. 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 patient’s daily vitamin C needs? a. Strawberries b. Asparagus c. Iceberg lettuce d. Cucumber Feedback a. Strawberries are an excellent source of vitamin C. b. Although asparagus has some vitamin C, it is not an excellent source. c. Iceberg lettuce is a poor source of vitamin C. d. Cucumber is a poor source of vitamin C. 28. 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 Feedback a. A fetal heart rate is a positive sign of pregnancy. b. A positive pregnancy test is a probable sign of pregnancy. It is not a positive sign because the hormone tested for—human chorionic gonadatropin (hCG)—may be being produced by, for example, a hydatidiform mole. c. A positive ultrasound is a positive sign of pregnancy. d. Amenorrhea is a presumptive sign of pregnancy. 29. 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. ½ cup vanilla yogurt c. ½ cup cottage cheese d.1-ounce cream cheese Feedback a. 1 cup of any milk (e.g., whole milk, skim milk, buttermilk, chocolate milk) is equal to 1 serving size from the dairy group. b. 1 cup of yogurt is equal to 1 serving size from the dairy group. c. 1 ½ cup of cottage cheese is equal to 1 serving size from the dairy group. d. Cream cheese is not included in the dairy group. It is a fat product. 30. 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 Feedback a. At 12 weeks’ gestation, the fundus should be felt at the level of the symphysis pubis. b. The fundus at the level of the umbilicus indicates 20 weeks’ gestation. In this question, the fact that this patient is a multigravida is not relevant. Uterine growth should be consistent for both primigravidas and multigravidas. c. At 28 weeks’ gestation, the fundus should be felt 8 cm above the level of the umbilicus. d. At 36 weeks’ gestation, the fundus should be felt at the xiphoid process. 31. 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 Feedback a. A weight change of approximately 4 pounds in 4 weeks is normal in the second and third trimesters of pregnancy. b. This pulse rate change is within normal limits. c. A blood pressure elevation to 140/90 is a sign of mild preeclampsia. d. This respiratory rate change is within normal limits. 32. 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? Feedback a. Intimate partner violence is a difficult subject to discuss, and the nurse may fear insulting or psychologically hurting the patient more. A nonthreatening approach is to ask patients directly whether they feel safe going home and whether they have been hurt physically, emotionally, or sexually by a past or present partner. b. Intimate partner violence is a difficult subject to discuss, and the nurse may fear insulting or psychologically hurting the patient more. A nonthreatening approach is to ask patients directly whether they feel safe going home rather than asking if they have any abuse, as women may define abuse differently than care providers. c. Intimate partner violence is a difficult subject to discuss, and the nurse may fear insulting or psychologically hurting the patient more. A nonthreatening approach is to ask patients directly whether they feel safe going home and whether they have been hurt physically, emotionally, or sexually by a past or present partner. d. Intimate partner violence is a difficult subject to discuss, and the nurse may fear insulting or psychologically hurting the patient more. A nonthreatening approach is to ask patients directly whether they feel safe going home rather than asking if they have any abuse, as women may define abuse differently than care providers. Multiple Response 33. 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 Sweating is a warning sign that often precedes syncope. Syncope (a trandient loss of consciousness and postural tone with spontaneous recovery) during pregnancy is frequently attributed to orthostatic hypotension or inferior vena cava compression by the gravid uterus. Nausea and yawning are warning signs that often precede syncope. Lightheadedness, sweating, nausea, yawning, and feelings of warmth are warning signs that often precede syncope. Chills are not a warning sign that often precede syncope. 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 35. 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 36. 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 Heartburn is a common discomfort throughout pregnancy. Because the appendix is pushed upward and posterior by the gravid uterus, the typical location of pain is not a reliable indicator for a ruptured appendix during pregnancy. The pain should gradually subside, but if it persists or is accompanied by fever, a change in bowel habits, or decreased fetal movement, the patient should promptly contact her medical provider. 37. The clinic nurse talks with Suzy, a pregnant woman at 9 weeks’ gestation who has just learned of her pregnancy. Suzy’s 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 38. 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 39. 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 40. 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 d. An increased airway resistance 41. 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 42. 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 43. 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 44. 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 45. 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 labor 46. 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 47. 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 48. Presumptive signs of pregnancy include (select all that apply): a. Nausea b. Fatigue c. Ballottement d. Amenorrhea . 49. 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 50. 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 51. 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 52. Jorgina is a 24-year-old pregnant woman at 26 weeks’ gestation. This is Jorgina’s 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 Jorgina’s 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 53. The clinic nurse is assessing the complete blood count results for Kim-Ly, a 23-year-old pregnant woman. Kim-Ly’s hemoglobin is 9.8 g/dL. This laboratory finding places Kim-Ly’s pregnancy at risk for (select all that apply): a. Preterm birth b. Placental abruption c. Intrauterine growth restriction d. Thrombocytopenia 54. 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 Teera’s diet with her as she may be deficient in (select all that apply): a. Iron b. Magnesium c. Zinc d. Vitamin B12 55. During the initial antenatal visit, the clinic nurse asks questions about the woman’s 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 56. 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 Short Answer 57. Lesions at the gum line that bleed easily 58. Anterior convexity of the lumbar spine Refer To: Glossary 59. Increased saliva production Refer To: Glossary 60. Reflux of the stomach contents into the esophagus Refer To: Glossary 61. Severe itching due to stasis of bile in the liver Refer To: Glossary 62. Nosebleeds Refer To: Glossary True/False 63. 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. 64. Cecilia, a pregnant woman at 30 weeks’ gestation, has her vital signs assessed during a routine prenatal visit. Cecilia’s blood pressure has remained at 110/70 for the last few visits, and her pulse rate has increased from 70 to 80 beats per minute. These findings would be considered normal at this time in pregnancy. 65. The clinic nurse knows that every time a woman of childbearing age comes in to the office for a health maintenance visit, she should be counseled about the benefits of daily folic acid supplementation. 66. The perinatal nurse recommends strengthening exercises during pregnancy, as this can improve posture and increase energy levels. 67. The perinatal nurse explains to the new nurse that ptyalize is a condition more acute than the normal nausea and vomiting of pregnancy and is often associated with dehydration, hypokalemia, and weight loss. Fill-in-the-Blank 68. The clinic nurse explains to the new nurse that during pregnancy, the maternal metabolism is altered to support the pregnancy by the hormones __________ and __________, which are produced by the anterior __________ gland. 69. During the prenatal class, the perinatal nurse describes factors that may initiate the process of labor. One of these factors is the production of __________, which are found in the uterine __________ and are released from the __________ at term as it softens and dilates. 70. The perinatal nurse describes common complaints of pregnancy to the prenatal class attendees. Nasal __________, medically termed “__________ of pregnancy,” is caused by increased levels of estrogen and progesterone. Nasal stuffiness and congestion (rhinitis of pregnancy) are common complaints during pregnancy. The nurse should educate the patient about these normal changes and offer reassurance. Increasing oral fluid intake helps to keep the mucus thin and easier to mobilize. 71. The clinic nurse promotes a diet rich in vitamin __________ during the third trimester to prevent the possibility of __________ rupture of the membranes. 72. The clinic nurse monitors the blood pressure and assesses a woman’s urine at each prenatal visit to assess for signs or symptoms of __________. A previous history or the presence of a __________ are also risk factors. 73. The clinic nurse is aware of the importance of chlamydia screening during pregnancy. Chlamydia transmission to the infant at __________ may result in __________. 74. The prenatal nurse describes the need for __________ and __________ screening at the first antenatal visit. If the pregnant woman is not immune, she will be counseled to avoid contact with young children who have a rash and could be infectious. 75. The prenatal nurse cautions a pregnant woman about Caesar salad consumption during pr

Preview 4 out of 201  pages

avatar-seller
dennys

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 450,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

$ 37.49
  • (0)
  Add to cart