,Chapter 04: Prenatal Care and Adaptations to Pregnancy
Keenan-Lindsay: Leifer’s Introduction to Maternity and Pediatric
Nursing in 9th Edition
MULTIPLE CHOICE
1. A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She
has a 2-year-old son born at 34 weeks’ gestation and had one previous spontaneous
abortion. How would the nurse document the patient’s obstetric history using the GTPAL
system?
a. 2-1-0-0-1
b. 3-1-0-1-1
c. 3-0-1-1-1
d. 2-0-1-1-1
ANS: C
Refer to Box 4.1 in the textbook for the GTPAL system for identifying obstetric history.
DIF: Cognitive Level: Application REF: 58 OBJ: 1
TOP: Definition of Terms KEY: Nursing Process Step: Implementation
2. A woman calls her health care provider to schedule prenatal visits in an uncomplicated
pregnancy. How frequently will the nurse assist the patient to schedule these appointments?
a. Every 3 weeks until the 6th month, then every 2 weeks until birth
b. Every 4 weeks until the 7th month, after which appointments will become more
frequent
c. Monthly until the 8th month
d. Every 2 to 3 weeks for the entire pregnancy
ANS: B
Monthly visits are scheduled up to 28 weeks, and then visits increase to every 2 to 3 weeks
through 36 weeks. From 36 weeks until birth, visits are weekly.
DIF: Cognitive Level: Application REF: 60 OBJ: 2 | 3
TOP: Prenatal Visits KEY: Nursing Process Step: Implementation
3. During the physical examination for the first prenatal visit, it is noted that Chadwick sign is
,present. What is Chadwick sign?
a. Bluish or purplish discoloration of the vulva, vagina, and cervix
b. Presence of early fetal movements
c. Darkening of the areola and breast tenderness
d. Palpation of the fetal outline
ANS: A
Chadwick sign is the purplish or bluish discoloration of the cervix, vulva and vagina.
DIF: Cognitive Level: Knowledge REF: 63 OBJ: 7
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Data Collection
, 4. After an initial physical examination is completed, the woman asks a nurse why Chadwick
sign occurs during pregnancy. What would the nurse explain as the cause of Chadwick sign?
a. Enlargement of the uterus
b. Progesterone action on the breasts
c. Increasing activity of the fetus
d. Vascular congestion in the pelvic area
ANS: D
Chadwick sign is caused by increased vascular congestion in the cervical and vaginal area.
DIF: Cognitive Level: Comprehension REF: 63 OBJ: 6|7
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Implementation
5. A nurse has explained physiological changes that occur during pregnancy. Which statement
indicates that a woman understands the information?
a. ―Blood pressure goes up toward the end of pregnancy.‖
b. ―My breathing will get deeper and a little faster.‖
c. ―I’ll notice a decreased pigmentation in my skin.‖
d. ―There will be a curvature in my upper spine area.‖
ANS: B
The pregnant woman breathes more deeply, and her respiratory rate may increase slightly.
DIF: Cognitive Level: Comprehension REF: 66 OBJ: 7 | 11
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Implementation
6. A woman reports that her last normal menstrual period began on August 5, 2020. What is
this woman’s expected date of birth using Nägele’s rule?
a. April 30, 2021
b. May 5, 2021
c. May 12, 2021
d. May 26, 2021
ANS: C
To determine the expected date of birth, count forward 7 days from the first day of the last
menstrual period, add 9 months and change the year if necessary.
DIF: Cognitive Level: Analysis REF: 59 OBJ: 5
TOP: Determining Estimated Date of Birth
KEY: Nursing Process Step: Data Collection
7. During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an
electronic Doppler device. How early might fetal heart tones be detected with an electronic
Doppler device?
a. 4 weeks
b. 8 weeks
c. 10 weeks
Keenan-Lindsay: Leifer’s Introduction to Maternity and Pediatric
Nursing in 9th Edition
MULTIPLE CHOICE
1. A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She
has a 2-year-old son born at 34 weeks’ gestation and had one previous spontaneous
abortion. How would the nurse document the patient’s obstetric history using the GTPAL
system?
a. 2-1-0-0-1
b. 3-1-0-1-1
c. 3-0-1-1-1
d. 2-0-1-1-1
ANS: C
Refer to Box 4.1 in the textbook for the GTPAL system for identifying obstetric history.
DIF: Cognitive Level: Application REF: 58 OBJ: 1
TOP: Definition of Terms KEY: Nursing Process Step: Implementation
2. A woman calls her health care provider to schedule prenatal visits in an uncomplicated
pregnancy. How frequently will the nurse assist the patient to schedule these appointments?
a. Every 3 weeks until the 6th month, then every 2 weeks until birth
b. Every 4 weeks until the 7th month, after which appointments will become more
frequent
c. Monthly until the 8th month
d. Every 2 to 3 weeks for the entire pregnancy
ANS: B
Monthly visits are scheduled up to 28 weeks, and then visits increase to every 2 to 3 weeks
through 36 weeks. From 36 weeks until birth, visits are weekly.
DIF: Cognitive Level: Application REF: 60 OBJ: 2 | 3
TOP: Prenatal Visits KEY: Nursing Process Step: Implementation
3. During the physical examination for the first prenatal visit, it is noted that Chadwick sign is
,present. What is Chadwick sign?
a. Bluish or purplish discoloration of the vulva, vagina, and cervix
b. Presence of early fetal movements
c. Darkening of the areola and breast tenderness
d. Palpation of the fetal outline
ANS: A
Chadwick sign is the purplish or bluish discoloration of the cervix, vulva and vagina.
DIF: Cognitive Level: Knowledge REF: 63 OBJ: 7
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Data Collection
, 4. After an initial physical examination is completed, the woman asks a nurse why Chadwick
sign occurs during pregnancy. What would the nurse explain as the cause of Chadwick sign?
a. Enlargement of the uterus
b. Progesterone action on the breasts
c. Increasing activity of the fetus
d. Vascular congestion in the pelvic area
ANS: D
Chadwick sign is caused by increased vascular congestion in the cervical and vaginal area.
DIF: Cognitive Level: Comprehension REF: 63 OBJ: 6|7
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Implementation
5. A nurse has explained physiological changes that occur during pregnancy. Which statement
indicates that a woman understands the information?
a. ―Blood pressure goes up toward the end of pregnancy.‖
b. ―My breathing will get deeper and a little faster.‖
c. ―I’ll notice a decreased pigmentation in my skin.‖
d. ―There will be a curvature in my upper spine area.‖
ANS: B
The pregnant woman breathes more deeply, and her respiratory rate may increase slightly.
DIF: Cognitive Level: Comprehension REF: 66 OBJ: 7 | 11
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Implementation
6. A woman reports that her last normal menstrual period began on August 5, 2020. What is
this woman’s expected date of birth using Nägele’s rule?
a. April 30, 2021
b. May 5, 2021
c. May 12, 2021
d. May 26, 2021
ANS: C
To determine the expected date of birth, count forward 7 days from the first day of the last
menstrual period, add 9 months and change the year if necessary.
DIF: Cognitive Level: Analysis REF: 59 OBJ: 5
TOP: Determining Estimated Date of Birth
KEY: Nursing Process Step: Data Collection
7. During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an
electronic Doppler device. How early might fetal heart tones be detected with an electronic
Doppler device?
a. 4 weeks
b. 8 weeks
c. 10 weeks
