NSG432 Final Exam Nursing Care of the
Childbearing Family Comprehensive Questions
(Frequently Tested) and Complete Solutions Graded
A+– GCU
A woman arrives at the clinic seeking confirmation that she is pregnant. The
following information is obtained: She is 24 years old with a body mass index
(BMI) of 17.5. She admits to having used cocaine ―several times‖ during the past
year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg,
her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The
family history is positive for diabetes mellitus and cancer. Her sister recently gave
birth to an infant with a neural tube defect (NTD). Which characteristics place the
woman in a high risk category?
a. Blood pressure, age, and BMI
b. Drug/alcohol use, age, and family history
c. Family history, blood pressure, and BMI
d. Family history, BMI, and drug/alcohol abuse
Family history, BMI, and drug/alcohol abuse
Her family history of NTD, low BMI, and substance abuse all are high risk factors
of pregnancy. The woman's BP is normal, and her age does not put her at risk. Her
BMI is low and may indicate poor nutritional status, which would be a high risk.
The woman's drug/alcohol use and family history put her in a high risk category,
but her age does not. The woman's family history puts her in a high risk category.
Her BMI is low and may indicate poor nutritional status, which would be high risk.
Her BP is normal.
,An accurate and appropriate response is, ―Your placenta changes as your
pregnancy progresses, and it is given a score that indicates the amount of calcium
deposits it has. The more calcium deposits, the higher the grade, or number, that is
assigned to the placenta. It also means that less blood and oxygen can be delivered
to your baby.‖ Although ―Your placenta isn't working properly, and your baby is
in danger‖ may be valid, it does not reflect therapeutic communication techniques
and is likely to alarm the patient. An ultrasound, not an amniocentesis, is the
method of assessment used to determine placental maturation. The response
―Don't worry about it. Everything is fine‖ is not appropriate and discredits the
patient's concerns.
A woman is undergoing a nipple-stimulated contraction stress test (CST). She is
having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a
baseline of approximately 120 beats/min without any decelerations. The
interpretation of this test is said to be a. negative.
b. positive.
c. satisfactory.
d. unsatisfactory.
negative.
Adequate uterine activity necessary for a CST consists of the presence of three
contractions in a 10-minute time frame. If no decelerations are observed in the
FHR pattern with the contractions, the findings are considered to be negative. A
positive CST indicates the presence of repetitive later FHR decelerations.
Satisfactory and unsatisfactory are not applicable terms.
When nurses help their expectant mothers assess the daily fetal movement counts,
they should be aware that
,a. alcohol or cigarette smoke can irritate the fetus into greater activity.
b. ―kick counts‖ should be taken every half hour and averaged every 6 hours, with
every other 6-hour stretch off.
c. the fetal alarm signal should go off when fetal movements stop entirely for 12
hours.
d. obese mothers familiar with their bodies can assess fetal movement as well as
average-size women.
the fetal alarm signal should go off when fetal movements stop entirely for 12
hours.
No movement in a 12-hour period is cause for investigation and possibly
intervention. Alcohol and cigarette smoke temporarily reduce fetal movement. The
mother should count fetal activity (―kick counts‖) two or three times daily for 60
minutes each time. Obese women have a harder time assessing fetal movement.
In comparing the abdominal and transvaginal methods of ultrasound examination,
nurses should explain to their patients that
a. both require the woman to have a full bladder.
b. the abdominal examination is more useful in the first trimester.
c. initially the transvaginal examination can be painful.
d. the transvaginal examination allows pelvic anatomy to be evaluated in greater
detail.
the transvaginal examination allows pelvic anatomy to be evaluated in greater
detail.
The transvaginal examination allows pelvic anatomy to be evaluated in greater
detail and allows intrauterine pregnancies to be diagnosed earlier. The abdominal
, examination requires a full bladder; the transvaginal examination requires an
empty bladder. The transvaginal examination is more useful in the first trimester;
the abdominal examination works better after the first trimester. Neither method
should be painful, although with the transvaginal examination the woman feels
pressure as the probe is moved.
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although
she has had irregular menstrual periods all her life. She has a history of smoking
approximately one pack of cigarettes a day, but she tells you that she is trying to
cut down. Her laboratory data are within normal limits. What diagnostic technique
could be used with this pregnant woman at this time? a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
d. Nonstress test (NST) Ultrasound examination
An ultrasound examination could be done to confirm the pregnancy and determine
the gestational age of the fetus. It is too early in the pregnancy to perform MSAFP
screening, amniocentesis, or NST. MSAFP screening is performed at 16 to 18
weeks of gestation, followed by amniocentesis if MSAFP levels are abnormal or if
fetal/maternal anomalies are detected. NST is performed to assess fetal well-being
in the third trimester.
The nurse sees a woman for the first time when she is 30 weeks pregnant. The
woman has smoked throughout the pregnancy, and fundal height measurements
now are suggestive of growth restriction in the fetus. In addition to ultrasound to
measure fetal size, what other tool would be useful in confirming the diagnosis? a.
Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
Childbearing Family Comprehensive Questions
(Frequently Tested) and Complete Solutions Graded
A+– GCU
A woman arrives at the clinic seeking confirmation that she is pregnant. The
following information is obtained: She is 24 years old with a body mass index
(BMI) of 17.5. She admits to having used cocaine ―several times‖ during the past
year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg,
her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The
family history is positive for diabetes mellitus and cancer. Her sister recently gave
birth to an infant with a neural tube defect (NTD). Which characteristics place the
woman in a high risk category?
a. Blood pressure, age, and BMI
b. Drug/alcohol use, age, and family history
c. Family history, blood pressure, and BMI
d. Family history, BMI, and drug/alcohol abuse
Family history, BMI, and drug/alcohol abuse
Her family history of NTD, low BMI, and substance abuse all are high risk factors
of pregnancy. The woman's BP is normal, and her age does not put her at risk. Her
BMI is low and may indicate poor nutritional status, which would be a high risk.
The woman's drug/alcohol use and family history put her in a high risk category,
but her age does not. The woman's family history puts her in a high risk category.
Her BMI is low and may indicate poor nutritional status, which would be high risk.
Her BP is normal.
,An accurate and appropriate response is, ―Your placenta changes as your
pregnancy progresses, and it is given a score that indicates the amount of calcium
deposits it has. The more calcium deposits, the higher the grade, or number, that is
assigned to the placenta. It also means that less blood and oxygen can be delivered
to your baby.‖ Although ―Your placenta isn't working properly, and your baby is
in danger‖ may be valid, it does not reflect therapeutic communication techniques
and is likely to alarm the patient. An ultrasound, not an amniocentesis, is the
method of assessment used to determine placental maturation. The response
―Don't worry about it. Everything is fine‖ is not appropriate and discredits the
patient's concerns.
A woman is undergoing a nipple-stimulated contraction stress test (CST). She is
having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a
baseline of approximately 120 beats/min without any decelerations. The
interpretation of this test is said to be a. negative.
b. positive.
c. satisfactory.
d. unsatisfactory.
negative.
Adequate uterine activity necessary for a CST consists of the presence of three
contractions in a 10-minute time frame. If no decelerations are observed in the
FHR pattern with the contractions, the findings are considered to be negative. A
positive CST indicates the presence of repetitive later FHR decelerations.
Satisfactory and unsatisfactory are not applicable terms.
When nurses help their expectant mothers assess the daily fetal movement counts,
they should be aware that
,a. alcohol or cigarette smoke can irritate the fetus into greater activity.
b. ―kick counts‖ should be taken every half hour and averaged every 6 hours, with
every other 6-hour stretch off.
c. the fetal alarm signal should go off when fetal movements stop entirely for 12
hours.
d. obese mothers familiar with their bodies can assess fetal movement as well as
average-size women.
the fetal alarm signal should go off when fetal movements stop entirely for 12
hours.
No movement in a 12-hour period is cause for investigation and possibly
intervention. Alcohol and cigarette smoke temporarily reduce fetal movement. The
mother should count fetal activity (―kick counts‖) two or three times daily for 60
minutes each time. Obese women have a harder time assessing fetal movement.
In comparing the abdominal and transvaginal methods of ultrasound examination,
nurses should explain to their patients that
a. both require the woman to have a full bladder.
b. the abdominal examination is more useful in the first trimester.
c. initially the transvaginal examination can be painful.
d. the transvaginal examination allows pelvic anatomy to be evaluated in greater
detail.
the transvaginal examination allows pelvic anatomy to be evaluated in greater
detail.
The transvaginal examination allows pelvic anatomy to be evaluated in greater
detail and allows intrauterine pregnancies to be diagnosed earlier. The abdominal
, examination requires a full bladder; the transvaginal examination requires an
empty bladder. The transvaginal examination is more useful in the first trimester;
the abdominal examination works better after the first trimester. Neither method
should be painful, although with the transvaginal examination the woman feels
pressure as the probe is moved.
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although
she has had irregular menstrual periods all her life. She has a history of smoking
approximately one pack of cigarettes a day, but she tells you that she is trying to
cut down. Her laboratory data are within normal limits. What diagnostic technique
could be used with this pregnant woman at this time? a. Ultrasound examination
b. Maternal serum alpha-fetoprotein (MSAFP) screening
c. Amniocentesis
d. Nonstress test (NST) Ultrasound examination
An ultrasound examination could be done to confirm the pregnancy and determine
the gestational age of the fetus. It is too early in the pregnancy to perform MSAFP
screening, amniocentesis, or NST. MSAFP screening is performed at 16 to 18
weeks of gestation, followed by amniocentesis if MSAFP levels are abnormal or if
fetal/maternal anomalies are detected. NST is performed to assess fetal well-being
in the third trimester.
The nurse sees a woman for the first time when she is 30 weeks pregnant. The
woman has smoked throughout the pregnancy, and fundal height measurements
now are suggestive of growth restriction in the fetus. In addition to ultrasound to
measure fetal size, what other tool would be useful in confirming the diagnosis? a.
Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
