ATI Maternal Newborn OB The Ultimate Study Companion and Exam Preparation Manual: In-Depth Concept Review, Complete Test Bank, Realistic Practice Questions, and Final Knowledge Assessment

A pregnant woman at 32 weeks’ gestation reports feeling dizzy and lightheaded whenever she lies flat on her back. Which instruction should the nurse provide? A. Remain flat on her back until the symptoms disappear. B. Rest in a side-lying position, preferably on her left side. C. Limit fluid intake before going to bed. D. Assume that the symptoms indicate fetal distress. Correct Answer: B. Rest in a side-lying position, preferably on her left side. Rationale: The enlarged uterus can compress the inferior vena cava when the pregnant woman lies supine. This decreases venous return, cardiac output, and potentially uteroplacental blood flow, causing dizziness and hypotension. Side-lying positioning, particularly on the left side, helps relieve this compression. This condition is commonly called supine hypotensive syndrome. Question 2 Which fetal structure allows blood to flow from the pulmonary artery directly into the descending aorta during fetal life? A. Foramen ovale B. Ductus venosus C. Umbilical vein D. Ductus arteriosus Correct Answer: D. Ductus arteriosus Rationale: The ductus arteriosus connects the pulmonary artery to the descending aorta and allows most blood from the right ventricle to bypass the fetal lungs, which are not yet functioning for gas exchange. The foramen ovale connects the right and left atria, while the ductus venosus allows blood to bypass much of the fetal liver. Question 3 A woman at 33 weeks’ gestation reports urinary frequency, urgency, and burning during urination. What should the nurse do first? A. Explain that these symptoms are normal during pregnancy. B. Encourage the woman to reduce her fluid intake. C. Obtain a clean-catch urine specimen for urinalysis and culture. D. Perform Leopold maneuvers to determine fetal position. Correct Answer: C. Obtain a clean-catch urine specimen for urinalysis and culture. Rationale: Urinary frequency can occur normally during pregnancy, but burning, urgency, and frequency suggest a possible urinary tract infection. The infection should be evaluated promptly because untreated UTIs can progress to pyelonephritis and are associated with adverse pregnancy outcomes, including preterm birth. Fluid restriction is inappropriate. Question 4 During prenatal counseling, a pregnant woman states that she plans to wear a mask while cleaning her cat’s litter box. Which response by the nurse is most appropriate? A. “A mask will completely protect you from toxoplasmosis.” B. “Toxoplasmosis is primarily transmitted by inhaling cat hair.” C. “You can safely clean the litter box after the first trimester.” D. “It is best to have someone else clean the litter box while you are pregnant.” Correct Answer: D. “It is best to have someone else clean the litter box while you are pregnant.” Rationale: Toxoplasmosis can be acquired through contact with contaminated cat feces and subsequent ingestion of the parasite. A mask does not eliminate the risk of hand-to-mouth transmission. Pregnant women should avoid cleaning litter boxes whenever possible. If exposure cannot be avoided, gloves and thorough handwashing are recommended. The risk is present throughout pregnancy. Question 5 A woman at 40 weeks’ gestation is diagnosed with oligohydramnios. Which interpretation of this condition is correct? A. The amniotic fluid volume is abnormally low. B. The amniotic fluid volume is approximately 25% above normal. C. The fetus is producing an excessive amount of urine. D. The amniotic fluid contains an excessive amount of fetal protein. Correct Answer: A. The amniotic fluid volume is abnormally low. Rationale: Oligohydramnios refers to an abnormally decreased amount of amniotic fluid. It can occur with placental insufficiency, ruptured membranes, fetal renal abnormalities, or post-term pregnancy. Increased amniotic fluid is called polyhydramnios. Question 6 A pregnant woman asks the nurse about the function of amniotic fluid. Which explanation is most accurate? A. It supplies the fetus with its primary source of oxygen and nutrients. B. It prevents all maternal infections from reaching the fetus. C. It cushions the fetus and allows movement that supports normal growth and development. D. It keeps the fetal lungs completely collapsed until birth. Correct Answer: C. It cushions the fetus and allows movement that supports normal growth and development. Rationale: Amniotic fluid protects the fetus from mechanical injury, helps maintain a stable environment, and permits fetal movement. Movement supports normal musculoskeletal development and contributes to lung development. Oxygen and nutrients are supplied primarily through placental circulation. Question 7 Which physiologic change is most closely associated with the secretory phase of the menstrual cycle? A. Shedding of the functional endometrial layer B. Development of a thick, vascular, nutrient-rich endometrium C. Maturation of the dominant ovarian follicle D. Secretion of human chorionic gonadotropin by the pituitary gland Correct Answer: B. Development of a thick, vascular, nutrient-rich endometrium Rationale: During the secretory phase, progesterone produced by the corpus luteum stimulates the endometrium to become thick, vascular, and rich in nutrients in preparation for possible implantation. Menstrual shedding occurs during menstruation, while follicular maturation primarily occurs during the follicular phase. Human chorionic gonadotropin is produced by trophoblastic tissue after implantation. Question 8 A woman who may be pregnant reports exposure to a medication known to be teratogenic. During which period is the embryo generally most vulnerable to major structural abnormalities? A. Approximately 2–8 weeks after conception B. Conception through the first week C. Approximately 16–24 weeks D. Approximately 28–40 weeks Correct Answer: A. Approximately 2–8 weeks after conception Rationale: The embryonic period, approximately 2–8 weeks after conception, is when major organs and body structures are forming. Exposure to teratogens during this period can result in significant structural abnormalities. Very early exposure may produce an all-or-none effect, while later exposure is more likely to affect growth, neurologic development, or organ function. Question 9 Which finding would the nurse expect in a fetus at approximately 16 weeks’ gestation? A. The fetus weighs approximately 1,500 grams. B. The lungs are fully mature and producing adequate surfactant. C. Substantial brown fat completely covers the fetal body. D. Tooth development has begun, and skeletal structures are becoming more distinct. Correct Answer: D. Tooth development has begun, and skeletal structures are becoming more distinct. Rationale: Around 16 weeks, fetal bones are undergoing increasing ossification, facial features are becoming more recognizable, and tooth development has begun. The fetus weighs considerably less than 1,500 grams, and adequate surfactant production and substantial brown-fat accumulation occur later in pregnancy. Question 10 A couple is being evaluated for infertility, and the male partner has a low sperm count. Which factor could contribute to decreased sperm production? A. Moderate aerobic exercise B. Sleeping in a lateral position C. Frequent exposure of the testes to excessive heat D. Adequate dietary protein intake Correct Answer: C. Frequent exposure of the testes to excessive heat Rationale: Normal sperm production requires the testes to remain slightly cooler than core body temperature. Frequent exposure to excessive heat, such as prolonged hottub use, can negatively affect sperm production and quality. Moderate exercise, normal sleeping positions, and adequate protein intake do not generally impair spermatogenesis.