NUR2513 Exam 1 Test Bank
– Practice Questions and
Answers
1. While the vital signs of a pregnant client in her
third trimester are being assessed, the client
complains of feeling faint, dizzy, and agitated. Which
nursing intervention is appropriate?
a. Have the stand up and retake her blood pressure.
b. Have client the client sit down and hold her arm in a
dependent position.
c. Have the client turn to her left side and recheck her blood
pressure in 5 minutes.
d. Have the client lie supine for 5 minutes and recheck her
blood pressure on both arms.
Answer: c. Have the client turn to her left side and
recheck her blood pressure in 5 minutes.
Rationale: Blood pressure is affected by positions
during pregnancy. The supine position may cause
occlusion of the vena cava and descending aorta.
Turning the pregnant woman to a lateral recumbent
position alleviates pressure on the blood vessels and
quickly corrects supine hypotension. Pressures are
significantly higher when the patient is standing. This
would cause an increase in systolic and diastolic
pressures. The arm should be supported at the same
level of the heart. The supine position may cause
occlusion of the vena cava and descending aorta,
creating hypotension.
2. A pregnant client has come to the emergency
department with complaints of nasal congestion and
epistaxis. Which is the correct interpretation of these
symptoms by the health care provider?
a. Nasal stuffiness and nosebleeds are caused by a decrease
in progesterone.
b. These conditions are abnormal. Refer the client to an ear,
nose, and throat specialist.
1
,c. Estrogen relaxes the smooth muscles in the respiratory
tract, so congestion and epistaxis are within normal limits.
d. Estrogen causes increased blood supply to the mucous
membranes and can result in congestion and nosebleeds.
Answer: d. Estrogen causes increased blood supply to
the mucous membranes and can result in congestion
and nosebleeds.
Rationale: As capillaries become engorged, the upper
respiratory tract is affected by the subsequent edema
and hyperemia, which causes these conditions, seen
commonly during pregnancy. Progesterone is
responsible for the heightened awareness of the need
to breathe in pregnancy. Progesterone levels increase
during pregnancy. The client should be reassured that
these symptoms are within normal limits. No referral
is needed at this time. Relaxation of the smooth
muscles in the respiratory tract is affected by
progesterone.
3. Which suggestion is appropriate for the pregnant
client who is experiencing heartburn?
a. Drink plenty of fluids at bedtime.
b. Eat only three meals a day so the stomach is empty
between meals.
c. Drink coffee or orange juice immediately on arising in the
morning.
d. Use Tums or Alkamints to obtain relief, as directed by the
health care provider.
Answer: d. Use Tums or Alkamints to obtain relief, as
directed by the health care provider.
Rationale: Antacids high in calcium (e.g., Tums,
Alkamints) can provide temporary relief. Fluids
overstretch the stomach and may precipitate reflux
when lying down. Instruct the woman to eat five or six
small meals per day rather than three full meals.
Coffee and orange juice stimulate acid formation in
the stomach.
4. While providing education to a primiparous client
regarding the normal changes of pregnancy, what is
2
,important for the nurse to explain about Braxton
Hicks contractions?
a. These contractions may indicate preterm labor.
b. These are contractions that never cause any discomfort.
c. Braxton Hicks contractions only start during the third
trimester.
d. These occur throughout pregnancy, but you may not feel
them until the third trimester.
Answer: d. These occur throughout pregnancy, but
you may not feel them until the third trimester.
Rationale: Throughout pregnancy, the uterus
undergoes irregular contractions called Braxton Hicks
contractions. During the first two trimesters, the
contractions are infrequent and usually not felt by the
woman until the third trimester. Braxton Hicks
contractions do not indicate preterm labor. Braxton
Hicks contractions can cause some discomfort,
especially in the third trimester. Braxton Hicks
contractions occur throughout the whole pregnancy.
5. What is the reason for vascular volume increasing
by 40% to 60% during pregnancy?
1.
Prevents maternal and fetal dehydration
2.
3.
Eliminates metabolic wastes of the mother
4.
5.
Provides adequate perfusion of the placenta
6.
7.
Compensates for decreased renal plasma flow
8.
Answer: 3. Provides adequate perfusion of the
placenta.
Rationale: The primary function of increased vascular
volume is to transport oxygen and nutrients to the
fetus via the placenta. Preventing maternal and fetal
dehydration is not the primary reason for the increase
in volume. Assisting with pulling metabolic wastes
from the fetus for maternal excretion is one purpose
3
, of the increased vascular volume. Renal plasma flow
increases during pregnancy.
6. Physiologic anemia often occurs during pregnancy
because of:
a. inadequate intake of iron.
b. the fetus establishing iron stores.
c. dilution of hemoglobin concentration.
d. decreased production of erythrocytes.
Answer: c. dilution of hemoglobin concentration.
Rationale: When blood volume expansion is more
pronounced and occurs earlier than the increase in
red blood cells, the woman will have physiologic
anemia, which is the result of dilution of hemoglobin
concentration rather than inadequate hemoglobin.
Inadequate intake of iron may lead to true anemia. If
the woman does not take an adequate amount of iron,
true anemia may occur when the fetus pulls stored
iron from the maternal system. There is increased
production of erythrocytes during pregnancy.
7. A client is currently pregnant; she has a 5-year-old
son and a 3-year-old daughter. She had one other
pregnancy that terminated at 8 weeks. Which are her
gravida and para?
a. 3,2
b. 4,3
c. 4,2
d. 3,3
Answer: c. 4,2.
Rationale: She has had four pregnancies, including
the current one (gravida 4). She had two pregnancies
that terminated after 20 weeks (para 2). The
pregnancy that terminated at 8 weeks is classified as
an abortion. Because she is currently pregnant, she is
classified as a gravida 4. Gravida 4 is correct, but she
is para 2; the pregnancy that was terminated at 8
weeks is classified as an abortion. Because she is
currently pregnant, she would be classified as a
gravida 4, not 3.
4
– Practice Questions and
Answers
1. While the vital signs of a pregnant client in her
third trimester are being assessed, the client
complains of feeling faint, dizzy, and agitated. Which
nursing intervention is appropriate?
a. Have the stand up and retake her blood pressure.
b. Have client the client sit down and hold her arm in a
dependent position.
c. Have the client turn to her left side and recheck her blood
pressure in 5 minutes.
d. Have the client lie supine for 5 minutes and recheck her
blood pressure on both arms.
Answer: c. Have the client turn to her left side and
recheck her blood pressure in 5 minutes.
Rationale: Blood pressure is affected by positions
during pregnancy. The supine position may cause
occlusion of the vena cava and descending aorta.
Turning the pregnant woman to a lateral recumbent
position alleviates pressure on the blood vessels and
quickly corrects supine hypotension. Pressures are
significantly higher when the patient is standing. This
would cause an increase in systolic and diastolic
pressures. The arm should be supported at the same
level of the heart. The supine position may cause
occlusion of the vena cava and descending aorta,
creating hypotension.
2. A pregnant client has come to the emergency
department with complaints of nasal congestion and
epistaxis. Which is the correct interpretation of these
symptoms by the health care provider?
a. Nasal stuffiness and nosebleeds are caused by a decrease
in progesterone.
b. These conditions are abnormal. Refer the client to an ear,
nose, and throat specialist.
1
,c. Estrogen relaxes the smooth muscles in the respiratory
tract, so congestion and epistaxis are within normal limits.
d. Estrogen causes increased blood supply to the mucous
membranes and can result in congestion and nosebleeds.
Answer: d. Estrogen causes increased blood supply to
the mucous membranes and can result in congestion
and nosebleeds.
Rationale: As capillaries become engorged, the upper
respiratory tract is affected by the subsequent edema
and hyperemia, which causes these conditions, seen
commonly during pregnancy. Progesterone is
responsible for the heightened awareness of the need
to breathe in pregnancy. Progesterone levels increase
during pregnancy. The client should be reassured that
these symptoms are within normal limits. No referral
is needed at this time. Relaxation of the smooth
muscles in the respiratory tract is affected by
progesterone.
3. Which suggestion is appropriate for the pregnant
client who is experiencing heartburn?
a. Drink plenty of fluids at bedtime.
b. Eat only three meals a day so the stomach is empty
between meals.
c. Drink coffee or orange juice immediately on arising in the
morning.
d. Use Tums or Alkamints to obtain relief, as directed by the
health care provider.
Answer: d. Use Tums or Alkamints to obtain relief, as
directed by the health care provider.
Rationale: Antacids high in calcium (e.g., Tums,
Alkamints) can provide temporary relief. Fluids
overstretch the stomach and may precipitate reflux
when lying down. Instruct the woman to eat five or six
small meals per day rather than three full meals.
Coffee and orange juice stimulate acid formation in
the stomach.
4. While providing education to a primiparous client
regarding the normal changes of pregnancy, what is
2
,important for the nurse to explain about Braxton
Hicks contractions?
a. These contractions may indicate preterm labor.
b. These are contractions that never cause any discomfort.
c. Braxton Hicks contractions only start during the third
trimester.
d. These occur throughout pregnancy, but you may not feel
them until the third trimester.
Answer: d. These occur throughout pregnancy, but
you may not feel them until the third trimester.
Rationale: Throughout pregnancy, the uterus
undergoes irregular contractions called Braxton Hicks
contractions. During the first two trimesters, the
contractions are infrequent and usually not felt by the
woman until the third trimester. Braxton Hicks
contractions do not indicate preterm labor. Braxton
Hicks contractions can cause some discomfort,
especially in the third trimester. Braxton Hicks
contractions occur throughout the whole pregnancy.
5. What is the reason for vascular volume increasing
by 40% to 60% during pregnancy?
1.
Prevents maternal and fetal dehydration
2.
3.
Eliminates metabolic wastes of the mother
4.
5.
Provides adequate perfusion of the placenta
6.
7.
Compensates for decreased renal plasma flow
8.
Answer: 3. Provides adequate perfusion of the
placenta.
Rationale: The primary function of increased vascular
volume is to transport oxygen and nutrients to the
fetus via the placenta. Preventing maternal and fetal
dehydration is not the primary reason for the increase
in volume. Assisting with pulling metabolic wastes
from the fetus for maternal excretion is one purpose
3
, of the increased vascular volume. Renal plasma flow
increases during pregnancy.
6. Physiologic anemia often occurs during pregnancy
because of:
a. inadequate intake of iron.
b. the fetus establishing iron stores.
c. dilution of hemoglobin concentration.
d. decreased production of erythrocytes.
Answer: c. dilution of hemoglobin concentration.
Rationale: When blood volume expansion is more
pronounced and occurs earlier than the increase in
red blood cells, the woman will have physiologic
anemia, which is the result of dilution of hemoglobin
concentration rather than inadequate hemoglobin.
Inadequate intake of iron may lead to true anemia. If
the woman does not take an adequate amount of iron,
true anemia may occur when the fetus pulls stored
iron from the maternal system. There is increased
production of erythrocytes during pregnancy.
7. A client is currently pregnant; she has a 5-year-old
son and a 3-year-old daughter. She had one other
pregnancy that terminated at 8 weeks. Which are her
gravida and para?
a. 3,2
b. 4,3
c. 4,2
d. 3,3
Answer: c. 4,2.
Rationale: She has had four pregnancies, including
the current one (gravida 4). She had two pregnancies
that terminated after 20 weeks (para 2). The
pregnancy that terminated at 8 weeks is classified as
an abortion. Because she is currently pregnant, she is
classified as a gravida 4. Gravida 4 is correct, but she
is para 2; the pregnancy that was terminated at 8
weeks is classified as an abortion. Because she is
currently pregnant, she would be classified as a
gravida 4, not 3.
4
