N321-Sherpath Exam 1 Questions With Complete Solutions
A change in which hormone during early pregnancy causes the
proliferation of the lactiferous ducts?
• Estrogen
Progesterone
Prolactin
Human placental lactogen Correct Answer The anatomy of
the breast undergoes several changes during pregnancy, and
these changes result from alterations in the hormonal levels. An
increase in the concentration of estrogen in early pregnancy is
responsible for the growth and proliferation of the lactiferous
ducts (milk ducts) in the breasts. During pregnancy, there is an
increase in the level of progesterone, and it stimulates the
growth of the mammary lobes. By the end of the first trimester,
there is an increase in the level of prolactin that stimulates the
differentiation of alveolar epithelial cells and the development of
lactocytes. During the second trimester, the level of the hormone
human placental lactogen increases and stimulates the
differentiation of alveolar epithelial cells into lactocytes.
A client with epilepsy presents with a positive pregnancy test,
which is later deemed to be a false-positive. Which explanation
by the nurse to the student nurse explains this result?
The test was taken too early.
The client is taking tranquilizers.
The client uses promethazine.
The client is undergoing diuretic therapy. Correct Answer
Interpreting the results of a pregnancy test requires some
judgment. Many factors, such as menstrual cycle, substance
abuse, and medications, interfere with the test results.
,Medications such as anticonvulsants and tranquilizers may give
false-positive results. Taking the test too early may return a
false-negative result.
Promethazine and diuretics affect the pregnancy test by causing
false-negative results.
After a nurse provides exercise tips to an 18-week pregnant
client, which statement by the client indicates the need for
further teaching?
"I should exercise regularly for 30 minutes at a time."
"I should decrease weight-bearing exercises."
"I should take my pulse every 15 minutes while exercising."
O "| should lie on my back for 10 minutes after exercising."
Correct Answer After the fourth month of pregnancy, the client
would not be encouraged to lie on her back. This position may
cause supine hypotension as a result of the fetus compressing the
main maternal vessels. Exercising regularly for 30 minutes at a
time improves muscles and increases stamina. Weight-bearing
exercises should be decreased to prevent joint injury. The client
would concentrate on non-weight-bearing activities to prevent
these complications. The client would take her pulse every 10 to
15 minutes to avoid the risk of cardiovascular complications.
arrange nursing interventions in order in which they would be
performed for client in labor whose electronic fetal monitor strip
shows the presence of variable decelerations
-assist in changing position
- notify primary HCP
-d/c oxytocin if infusing
-assist with amnioinfusion if prescribed
-assist with vaginal or speculum exam
,- assist with c/s or assisted vaginal delivery if needed Correct
Answer 1. D/C oxytocin infusion (may cause uterine
hypertonus)
2. help change position from side to side or knee to chest
position -reduce umbilical cord compression if this was the
cause of variable FHR decel
3. notify HCP if these do not help
4. assist with vag or speculum exam
5. amnioinfusion if prescribed
6. c/s or vaginal delivery w/ forcep or vacuum
At which interval during the first stage of labor would the nurse
assess the fetal heart rate
(FHR) tracing in a pregnant client with diabetes?
5 minutes
60 minutes
15 minutes
30 minutes Correct Answer Rationale
Diabetes is one of the risk factors in pregnancy. If any risk
factors are present, the FHR tracing would be evaluated more
frequently (every 15 minutes) in the first stage of labor and
every 5 minutes in the second stage. FHR is not evaluated every
60 minutes, either in low-risk or high-risk clients. In low-risk
clients, FHR is evaluated every 30 minutes during the first stage
of labor.
At which stage would the nurse expect the fetal head to be
engaged in the pelvic inlet for a multiparous client?
Before term at 2 weeks
Before the start of active labor
At the beginning of stage 1 of labor
, After labor is established` Correct Answer In a multiparous
client, the abdominal musculature is relaxed. The fetal head
often remains freely movable above the pelvic brim and may not
become engaged in the inlet until after labor is established. It
may not be engaged at the beginning of labor in a multiparous
client. In a nulliparous client, the uterus sinks downward and
forward about 2 weeks before term. The fetal head is engaged in
the pelvic inlet before the onset of active labor. The abdominal
muscles are firm in a nulliparous pregnancy and direct the
presenting part into the pelvis.
During which activity would the nurse observe early
decelerations in the fetal heart rate
(FHR) of a client in labor?
V 0 During uterine contractions
When external sound is applied
When the abdomen is palpated
During regular fetal movement Correct Answer Rationale
Compression of the fetal head during uterine contractions can
cause early decelerations. FHR accelerations occur in response
to applying external sounds. Palpation of the abdomen also
causes FHR accelerations but not decelerations. Spontaneous
and regular fetal movement indicates fetal well-being and results
in FHR accelerations.
Fetal bradycardia is common during which condition?
Maternal hyperthyroidism
Fetal anemia
Viral infection
Tocolytic treatment using terbutaline Correct Answer
Rationale
A change in which hormone during early pregnancy causes the
proliferation of the lactiferous ducts?
• Estrogen
Progesterone
Prolactin
Human placental lactogen Correct Answer The anatomy of
the breast undergoes several changes during pregnancy, and
these changes result from alterations in the hormonal levels. An
increase in the concentration of estrogen in early pregnancy is
responsible for the growth and proliferation of the lactiferous
ducts (milk ducts) in the breasts. During pregnancy, there is an
increase in the level of progesterone, and it stimulates the
growth of the mammary lobes. By the end of the first trimester,
there is an increase in the level of prolactin that stimulates the
differentiation of alveolar epithelial cells and the development of
lactocytes. During the second trimester, the level of the hormone
human placental lactogen increases and stimulates the
differentiation of alveolar epithelial cells into lactocytes.
A client with epilepsy presents with a positive pregnancy test,
which is later deemed to be a false-positive. Which explanation
by the nurse to the student nurse explains this result?
The test was taken too early.
The client is taking tranquilizers.
The client uses promethazine.
The client is undergoing diuretic therapy. Correct Answer
Interpreting the results of a pregnancy test requires some
judgment. Many factors, such as menstrual cycle, substance
abuse, and medications, interfere with the test results.
,Medications such as anticonvulsants and tranquilizers may give
false-positive results. Taking the test too early may return a
false-negative result.
Promethazine and diuretics affect the pregnancy test by causing
false-negative results.
After a nurse provides exercise tips to an 18-week pregnant
client, which statement by the client indicates the need for
further teaching?
"I should exercise regularly for 30 minutes at a time."
"I should decrease weight-bearing exercises."
"I should take my pulse every 15 minutes while exercising."
O "| should lie on my back for 10 minutes after exercising."
Correct Answer After the fourth month of pregnancy, the client
would not be encouraged to lie on her back. This position may
cause supine hypotension as a result of the fetus compressing the
main maternal vessels. Exercising regularly for 30 minutes at a
time improves muscles and increases stamina. Weight-bearing
exercises should be decreased to prevent joint injury. The client
would concentrate on non-weight-bearing activities to prevent
these complications. The client would take her pulse every 10 to
15 minutes to avoid the risk of cardiovascular complications.
arrange nursing interventions in order in which they would be
performed for client in labor whose electronic fetal monitor strip
shows the presence of variable decelerations
-assist in changing position
- notify primary HCP
-d/c oxytocin if infusing
-assist with amnioinfusion if prescribed
-assist with vaginal or speculum exam
,- assist with c/s or assisted vaginal delivery if needed Correct
Answer 1. D/C oxytocin infusion (may cause uterine
hypertonus)
2. help change position from side to side or knee to chest
position -reduce umbilical cord compression if this was the
cause of variable FHR decel
3. notify HCP if these do not help
4. assist with vag or speculum exam
5. amnioinfusion if prescribed
6. c/s or vaginal delivery w/ forcep or vacuum
At which interval during the first stage of labor would the nurse
assess the fetal heart rate
(FHR) tracing in a pregnant client with diabetes?
5 minutes
60 minutes
15 minutes
30 minutes Correct Answer Rationale
Diabetes is one of the risk factors in pregnancy. If any risk
factors are present, the FHR tracing would be evaluated more
frequently (every 15 minutes) in the first stage of labor and
every 5 minutes in the second stage. FHR is not evaluated every
60 minutes, either in low-risk or high-risk clients. In low-risk
clients, FHR is evaluated every 30 minutes during the first stage
of labor.
At which stage would the nurse expect the fetal head to be
engaged in the pelvic inlet for a multiparous client?
Before term at 2 weeks
Before the start of active labor
At the beginning of stage 1 of labor
, After labor is established` Correct Answer In a multiparous
client, the abdominal musculature is relaxed. The fetal head
often remains freely movable above the pelvic brim and may not
become engaged in the inlet until after labor is established. It
may not be engaged at the beginning of labor in a multiparous
client. In a nulliparous client, the uterus sinks downward and
forward about 2 weeks before term. The fetal head is engaged in
the pelvic inlet before the onset of active labor. The abdominal
muscles are firm in a nulliparous pregnancy and direct the
presenting part into the pelvis.
During which activity would the nurse observe early
decelerations in the fetal heart rate
(FHR) of a client in labor?
V 0 During uterine contractions
When external sound is applied
When the abdomen is palpated
During regular fetal movement Correct Answer Rationale
Compression of the fetal head during uterine contractions can
cause early decelerations. FHR accelerations occur in response
to applying external sounds. Palpation of the abdomen also
causes FHR accelerations but not decelerations. Spontaneous
and regular fetal movement indicates fetal well-being and results
in FHR accelerations.
Fetal bradycardia is common during which condition?
Maternal hyperthyroidism
Fetal anemia
Viral infection
Tocolytic treatment using terbutaline Correct Answer
Rationale
