Chapter 14: Nursing Care of the Family During Pregnancy
MULTIPLE CHOICE
1. Ideally, when should prenatal care begin?
a. Before the first missed menstrual period
b. After the first missed menstrual period
c. After the second missed menstrual period
d. After the third missed menstrual period
ANS: B
Prenatal care should begin soon after the first missed menstrual period. This offers the
greatest opportunities to ensure the health of the expectant mother and her infant. Prenatal
care before missing the first menstrual period is too early. It is unlikely the woman is even
aware of the pregnancy. Ideally, prenatal visits should begin soon after the first period is
missed. Beginning prenatal care after the third missed menstrual period is too late. The
woman will have completed the first trimester by that time.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
2. A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was
February 14, 2019. What is the client’s expected date of birth (EDB)?
a. September 17, 2019 NURSINGTB.COM
b. November 7, 2019
c. November 21, 2019
d. December 17, 2019
ANS: C
Using the Nägele’s rule, the EDB is calculated by subtracting 3 months from the month of
the LMP and adding 7 days + 1 year to the day of the LMP. Therefore, with an LMP of
February 14, 2019, her due date is November 21, 2019. September 17, 2019 is too short a
period to complete a normal pregnancy. Using the Nägele’s rule, an EDB of November 7,
2019, is 2 weeks early. December 17, 2019 is almost a month past the correct EDB.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. Which women should undergo prenatal testing for the human immunodeficiency virus
(HIV)?
a. All women, regardless of risk factors
b. Women who have had more than one sexual partner
c. Women who have had a sexually transmitted infection (STI)
d. Woman who are monogamous with one partner
ANS: A
, An HIV test is recommended for all women, regardless of risk factors. The incidence of
perinatal transmission from an HIV-positive mother to her fetus ranges from 25% to 35%.
Women who test positive for HIV can then be treated.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
4. Which sign or symptom is considered a first-trimester warning sign and should be
immediately reported by the pregnant woman to her health care provider?
a. Nausea with occasional vomiting
b. Fatigue
c. Urinary frequency
d. Vaginal bleeding
ANS: D
Signs and symptoms that must be reported include severe vomiting, fever and chills,
burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms
may be signs of complications of the pregnancy. Nausea with occasional vomiting is a
normal first-trimester complaint. Although it may be worrisome or annoying to the mother,
it is not usually an indication of a problem with the pregnancy. Fatigue is common during
the first trimester. Because of physiologic changes that happen during pregnancy, clients
should be taught that urinary frequency is normal.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
NURSINGTB.COM
5. A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been
experiencing occasional backaches of mild-to-moderate intensity. Which intervention
should the nurse recommend?
a. Kegel exercises
b. Pelvic rock exercises
c. Softer mattress
d. Bed rest for 24 hours
ANS: B
Pelvic rock exercises may help stretch and strengthen the abdominal and lower back
muscles and relieve low back pain. Stretching and other exercises to relieve back pain
should be performed several times a day. Kegel exercises increase the tone of the pelvic
area, not the back. A softer mattress may not provide the support needed to maintain proper
alignment of the spine and may contribute to back pain.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
6. A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she does not
know what is happening; one minute she is happy that she is pregnant and the next minute
she cries for no reason. Which response by the nurse is most appropriate?
a. “Don’t worry about it; you’ll feel better in a month or so.”
, b. “Have you talked to your husband about how you feel?”
c. “Perhaps you really don’t want to be pregnant.”
d. “Hormone changes during pregnancy commonly result in mood swings.”
ANS: D
Explaining that hormone changes can result in mood swings is an accurate statement and the
most appropriate response by the nurse. Telling the woman not to worry dismisses her
concerns and is not the most appropriate response. Although the woman should be
encouraged to share her feelings, asking if she has spoken to her husband about them is not
the most appropriate response and does not provide her with a rationale for the psychosocial
dynamics of her pregnancy. Suggesting that the woman does not want to be pregnant is
completely inappropriate and deleterious to the psychologic well-being of the woman.
Hormonal and metabolic adaptations often cause mood swings in pregnancy. The woman’s
responses are normal. She should be reassured about her feelings.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Diagnosis MSC: Client Needs: Psychosocial Integrity
7. During the first trimester, which of the following changes regarding her sexual drive should
a client be taught to expect?
a. Increased sexual drive, because of enlarging breasts
b. Decreased sexual drive, because of nausea and fatigue
c. No change in her sexual drive
d. Increased sexual drive, because of increased levels of female hormones
ANS: B
A pregnant woman usually experiences a decrease, not an increase, in libido during the first
NUicRcShanINgesGT
trimester. Maternal physiolog B.C
, such aO
s breast enlargement, nausea, fatigue,
abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic
responses, may affect sexuality and sexual expression. Libido may be depressed in the first
trimester but often increases during the second and third trimesters. During pregnancy, the
breasts may become enlarged and tender, which tends to interfere with coitus, thereby
decreasing the desire to engage in sexual activity.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Diagnosis
MSC: Client Needs: Health Promotion and Maintenance
8. A 3-year-old girl’s mother is 6 months pregnant. What concern is this child most likely to
verbalize?
a. How the baby will get out?
b. How will the baby eat?
c. Will you die having the baby?
d. What color eyes will the baby have?
ANS: B
MULTIPLE CHOICE
1. Ideally, when should prenatal care begin?
a. Before the first missed menstrual period
b. After the first missed menstrual period
c. After the second missed menstrual period
d. After the third missed menstrual period
ANS: B
Prenatal care should begin soon after the first missed menstrual period. This offers the
greatest opportunities to ensure the health of the expectant mother and her infant. Prenatal
care before missing the first menstrual period is too early. It is unlikely the woman is even
aware of the pregnancy. Ideally, prenatal visits should begin soon after the first period is
missed. Beginning prenatal care after the third missed menstrual period is too late. The
woman will have completed the first trimester by that time.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
2. A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was
February 14, 2019. What is the client’s expected date of birth (EDB)?
a. September 17, 2019 NURSINGTB.COM
b. November 7, 2019
c. November 21, 2019
d. December 17, 2019
ANS: C
Using the Nägele’s rule, the EDB is calculated by subtracting 3 months from the month of
the LMP and adding 7 days + 1 year to the day of the LMP. Therefore, with an LMP of
February 14, 2019, her due date is November 21, 2019. September 17, 2019 is too short a
period to complete a normal pregnancy. Using the Nägele’s rule, an EDB of November 7,
2019, is 2 weeks early. December 17, 2019 is almost a month past the correct EDB.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. Which women should undergo prenatal testing for the human immunodeficiency virus
(HIV)?
a. All women, regardless of risk factors
b. Women who have had more than one sexual partner
c. Women who have had a sexually transmitted infection (STI)
d. Woman who are monogamous with one partner
ANS: A
, An HIV test is recommended for all women, regardless of risk factors. The incidence of
perinatal transmission from an HIV-positive mother to her fetus ranges from 25% to 35%.
Women who test positive for HIV can then be treated.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
4. Which sign or symptom is considered a first-trimester warning sign and should be
immediately reported by the pregnant woman to her health care provider?
a. Nausea with occasional vomiting
b. Fatigue
c. Urinary frequency
d. Vaginal bleeding
ANS: D
Signs and symptoms that must be reported include severe vomiting, fever and chills,
burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms
may be signs of complications of the pregnancy. Nausea with occasional vomiting is a
normal first-trimester complaint. Although it may be worrisome or annoying to the mother,
it is not usually an indication of a problem with the pregnancy. Fatigue is common during
the first trimester. Because of physiologic changes that happen during pregnancy, clients
should be taught that urinary frequency is normal.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
NURSINGTB.COM
5. A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been
experiencing occasional backaches of mild-to-moderate intensity. Which intervention
should the nurse recommend?
a. Kegel exercises
b. Pelvic rock exercises
c. Softer mattress
d. Bed rest for 24 hours
ANS: B
Pelvic rock exercises may help stretch and strengthen the abdominal and lower back
muscles and relieve low back pain. Stretching and other exercises to relieve back pain
should be performed several times a day. Kegel exercises increase the tone of the pelvic
area, not the back. A softer mattress may not provide the support needed to maintain proper
alignment of the spine and may contribute to back pain.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
6. A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she does not
know what is happening; one minute she is happy that she is pregnant and the next minute
she cries for no reason. Which response by the nurse is most appropriate?
a. “Don’t worry about it; you’ll feel better in a month or so.”
, b. “Have you talked to your husband about how you feel?”
c. “Perhaps you really don’t want to be pregnant.”
d. “Hormone changes during pregnancy commonly result in mood swings.”
ANS: D
Explaining that hormone changes can result in mood swings is an accurate statement and the
most appropriate response by the nurse. Telling the woman not to worry dismisses her
concerns and is not the most appropriate response. Although the woman should be
encouraged to share her feelings, asking if she has spoken to her husband about them is not
the most appropriate response and does not provide her with a rationale for the psychosocial
dynamics of her pregnancy. Suggesting that the woman does not want to be pregnant is
completely inappropriate and deleterious to the psychologic well-being of the woman.
Hormonal and metabolic adaptations often cause mood swings in pregnancy. The woman’s
responses are normal. She should be reassured about her feelings.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Diagnosis MSC: Client Needs: Psychosocial Integrity
7. During the first trimester, which of the following changes regarding her sexual drive should
a client be taught to expect?
a. Increased sexual drive, because of enlarging breasts
b. Decreased sexual drive, because of nausea and fatigue
c. No change in her sexual drive
d. Increased sexual drive, because of increased levels of female hormones
ANS: B
A pregnant woman usually experiences a decrease, not an increase, in libido during the first
NUicRcShanINgesGT
trimester. Maternal physiolog B.C
, such aO
s breast enlargement, nausea, fatigue,
abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic
responses, may affect sexuality and sexual expression. Libido may be depressed in the first
trimester but often increases during the second and third trimesters. During pregnancy, the
breasts may become enlarged and tender, which tends to interfere with coitus, thereby
decreasing the desire to engage in sexual activity.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Diagnosis
MSC: Client Needs: Health Promotion and Maintenance
8. A 3-year-old girl’s mother is 6 months pregnant. What concern is this child most likely to
verbalize?
a. How the baby will get out?
b. How will the baby eat?
c. Will you die having the baby?
d. What color eyes will the baby have?
ANS: B
