RNC-MNN QUESTIONS AND ANSWERS
While auscultating the heart sounds of a woman who is 18 weeks pregnant, the nurse
notes a splitting of the first heart sound as well as a systolic murmur. The nurses priority
action is:
a. Space immediately place the client on a Telemetry Monitor and assess for
dysrhythmias.
B. Place the client on her right side and reassess
C. Reassure the client that this is an expected finding - Answers -C. it is common for
pregnant women to experience changes in heart sounds beginning at 12 weeks and
persisting up to four weeks into the postpartum period. The most common changes
include a splitting of the first heart sound as well as a systolic murmur.
Which of the following is accurate concerning the increase in blood volume experienced
during pregnancy?
Maternal blood volume begins to increase at approximately 20 weeks of pregnancy
The average blood volume increase is approximately 1600 ml for a Singleton.
Red blood cells increased by approximately 50% and plasma by approximately 20%. -
Answers -B. The average blood volume increase is approximately 1600 ml for a
Singleton. Maternal blood volume begins to increase at approximately 6 weeks of
pregnancy. Red blood cells increased by approximately 20% and plasma by
approximately 50%.
The nurse is caring for a client who is 38 weeks pregnant. Which of the following would
assist the nurse and assessing heart sounds?
Anticipate the heart sounds will be shifted up and laterally and play stethoscope
accordingly
ask the client to Bear down while assessing heart sounds
place the stethoscope slightly to the right of usual landmarks while assessing -
Answers -a. during the third trimester the uterus places pressure on the diaphragm and
causes the heart to move up and laterally
which of the following is considered a normal adaptive change concerning the
cardiovascular status during pregnancy?
The muscles of The myocardium enlarge 10 - 15% during the first trimester
there is a decrease in cardiac output as the pregnancy advances
physiologic polycythemia occurs during pregnancy - Answers -a. The muscles of The
myocardium and large by 10 - 15% during the first trimester. There is an increase in
cardiac output due to the expanded blood volume a physiologic anemia occurs due to
the disproportionate increase in plasma volume
which of the following is true concerning acid-base balance during pregnancy?
The pH tends to be slightly lower.
The po2 tends to be slightly higher.
, The pco2 tends to be slightly higher - Answers -C. During pregnancy, there is a slight
increase in PH and CO2 with a corresponding decrease and po2. It is normal to be in a
state of compensated respiratory alkalosis.
Which of the following is accurate concerning pregestational diabetes?
It must be diagnosed before pregnancy.
Type 1 diabetes is only included in this category.
It encompasses both type 1 and type 2 diabetes. - Answers -C. Pregestational diabetes
encompasses both type 1 and type 2 and can be diagnosed before or during pregnancy
what is the ideal blood sugar in a pregnant woman with diabetes?
less than 90
less than 110
Less than 130 - Answers -B. The ideal blood sugar in a woman with diabetes is less
than 110
what effect does the rise in placental hormones have on pregnant diabetic patient?
It helps to allow for decreased diuresis
it leads to maternal hyperglycemia
it leads to increase insulin secretion - Answers -B. The rise and placental hormones
creates an insulin resistance that results in maternal hyperglycemia in the pregnant
diabetic patient
which of the following results will be concerning in a glucose tolerance test?
A fasting result of 91 mg / DL
a level of 171 1 hour after the test
a level of 145 3 hours after the test - Answers -C. Glucose levels of concern include a
fasting level greater than 95 mg / DL, a level greater than 180 mg / DL one hour after
the test, a level greater than 155 mg / DL 2 hours after the test, and a level greater than
140 mg / DL 3 hours after the test.
The nurse is caring for a woman who is 19 weeks pregnant with hypertension. Which of
the following orders for an anti-hypertensive should be questioned?
Nifedipine
Methyldopa
Metoprolol - Answers -C. Metoprolol is not used in pregnancy as it may lead to fetal
distress. Nifedipine and methyldopa are more commonly used.
Which of the following is accurate concerning the classification of gestational
hypertension?
Gestational hypertension occurs prior to 20 weeks and is resolved with delivery of the
infant.
The blood pressure must be greater than at least 2 x 4 to 6 hours apart during
a one week period.
Gestational hypertension includes mild-to-moderate proteinuria - Answers -B. And just
a tional hypertension, the blood pressure must be greater than at least 2 x 4 to
While auscultating the heart sounds of a woman who is 18 weeks pregnant, the nurse
notes a splitting of the first heart sound as well as a systolic murmur. The nurses priority
action is:
a. Space immediately place the client on a Telemetry Monitor and assess for
dysrhythmias.
B. Place the client on her right side and reassess
C. Reassure the client that this is an expected finding - Answers -C. it is common for
pregnant women to experience changes in heart sounds beginning at 12 weeks and
persisting up to four weeks into the postpartum period. The most common changes
include a splitting of the first heart sound as well as a systolic murmur.
Which of the following is accurate concerning the increase in blood volume experienced
during pregnancy?
Maternal blood volume begins to increase at approximately 20 weeks of pregnancy
The average blood volume increase is approximately 1600 ml for a Singleton.
Red blood cells increased by approximately 50% and plasma by approximately 20%. -
Answers -B. The average blood volume increase is approximately 1600 ml for a
Singleton. Maternal blood volume begins to increase at approximately 6 weeks of
pregnancy. Red blood cells increased by approximately 20% and plasma by
approximately 50%.
The nurse is caring for a client who is 38 weeks pregnant. Which of the following would
assist the nurse and assessing heart sounds?
Anticipate the heart sounds will be shifted up and laterally and play stethoscope
accordingly
ask the client to Bear down while assessing heart sounds
place the stethoscope slightly to the right of usual landmarks while assessing -
Answers -a. during the third trimester the uterus places pressure on the diaphragm and
causes the heart to move up and laterally
which of the following is considered a normal adaptive change concerning the
cardiovascular status during pregnancy?
The muscles of The myocardium enlarge 10 - 15% during the first trimester
there is a decrease in cardiac output as the pregnancy advances
physiologic polycythemia occurs during pregnancy - Answers -a. The muscles of The
myocardium and large by 10 - 15% during the first trimester. There is an increase in
cardiac output due to the expanded blood volume a physiologic anemia occurs due to
the disproportionate increase in plasma volume
which of the following is true concerning acid-base balance during pregnancy?
The pH tends to be slightly lower.
The po2 tends to be slightly higher.
, The pco2 tends to be slightly higher - Answers -C. During pregnancy, there is a slight
increase in PH and CO2 with a corresponding decrease and po2. It is normal to be in a
state of compensated respiratory alkalosis.
Which of the following is accurate concerning pregestational diabetes?
It must be diagnosed before pregnancy.
Type 1 diabetes is only included in this category.
It encompasses both type 1 and type 2 diabetes. - Answers -C. Pregestational diabetes
encompasses both type 1 and type 2 and can be diagnosed before or during pregnancy
what is the ideal blood sugar in a pregnant woman with diabetes?
less than 90
less than 110
Less than 130 - Answers -B. The ideal blood sugar in a woman with diabetes is less
than 110
what effect does the rise in placental hormones have on pregnant diabetic patient?
It helps to allow for decreased diuresis
it leads to maternal hyperglycemia
it leads to increase insulin secretion - Answers -B. The rise and placental hormones
creates an insulin resistance that results in maternal hyperglycemia in the pregnant
diabetic patient
which of the following results will be concerning in a glucose tolerance test?
A fasting result of 91 mg / DL
a level of 171 1 hour after the test
a level of 145 3 hours after the test - Answers -C. Glucose levels of concern include a
fasting level greater than 95 mg / DL, a level greater than 180 mg / DL one hour after
the test, a level greater than 155 mg / DL 2 hours after the test, and a level greater than
140 mg / DL 3 hours after the test.
The nurse is caring for a woman who is 19 weeks pregnant with hypertension. Which of
the following orders for an anti-hypertensive should be questioned?
Nifedipine
Methyldopa
Metoprolol - Answers -C. Metoprolol is not used in pregnancy as it may lead to fetal
distress. Nifedipine and methyldopa are more commonly used.
Which of the following is accurate concerning the classification of gestational
hypertension?
Gestational hypertension occurs prior to 20 weeks and is resolved with delivery of the
infant.
The blood pressure must be greater than at least 2 x 4 to 6 hours apart during
a one week period.
Gestational hypertension includes mild-to-moderate proteinuria - Answers -B. And just
a tional hypertension, the blood pressure must be greater than at least 2 x 4 to
