While assisting the physician with a physical examination, the nurse notes which sign or symptom as
most definitive of a diagnosis of pregnancy? - Answers Auscultation of fetal heart sounds
Which nursing assessment finding indicates the need for further testing before a diagnosis of pregnancy
can be confirmed? - Answers Amenorrhea
The nurse caring for a woman who is beginning the second trimester of pregnancy recognizes the need
for further assessment when the woman reports which change in her body? - Answers Nasal congestion
The nurse caring for a woman who is in the third trimester of pregnancy suspects a urinary tract
infection on the basis of which reported symptom? - Answers Burning on urination
A pregnant woman tells the nurse how clumsy she feels. Which teaching will the nurse provide? -
Answers Wearing low-heeled shoes and using good body mechanics
When talking with the nurse, a pregnant patient points out her darkened areolas, the linea nigra on her
abdomen, and the brown patches on her forehead and nose and says, "I'm never going to be able to
wear a bikini again." Which is the nurse's best response? - Answers "These changes normally go away
after you have the baby."
The nurse reviews a pregnant patient's laboratory values and notes a reduced red blood cell count and
hemoglobin level. Which symptom reported by the patient results from these findings? - Answers
Fatigue
After assessing the cardiovascular system of a pregnant woman, the nurse recognizes the need to report
which finding to the provider? - Answers Blood pressure of 152/94 mm Hg
Which symptom reported to the nurse by the patient needs to be brought to the attention of the health-
care provider? - Answers Vaginal itching
The nurse reviews the patient's laboratory findings and suspects anemia when noting which result? -
Answers Red blood cell count 4.1
Which finding does the nurse recognize as a normal result of pregnancy? - Answers Reduced platelet
count
The nurse reviews the patient's laboratory values and sees the following:
Hemoglobin 12.2 g/dL
Hematocrit 42.8%
Serum blood urea nitrogen (BUN) 18 mg/dL
,Serum creatinine 0.68 mg/dL
Alanine transaminase (ALT) 8 units/L
Aspartate aminotransferase (AST) 12 units/L
Alkaline phosphatase (ALP) 108 ImU/mL
Lactate dehydrogenase (LDH) 635 units/L
Which conclusion does the nurse draw on the basis of these findings? - Answers The patient is
dehydrated.
During the woman's first prenatal visit, she makes many statements about the recommendations she
has received from her friends about maintaining her health and the health of the growing fetus.
According to Reva Rubin, which maternal task is this woman demonstrating? - Answers Seeking safe
passage for herself and her fetus
The nurse learns that a pregnant patient lost her mother when she was a teenager and recognizes that
the absence of a mother figure will cause this patient to have difficulty with which of Reva Rubin's four
maternal tasks? - Answers Securing acceptance for herself as a mother and for her fetus
Upon examining a woman in the late second trimester of pregnancy, the nurse notes circular bruises
around each wrist and circular bruises above the umbilicus. What should the nurse suspect? - Answers
Physical abuse from the father of the baby
A pregnant woman is telling the nurse about her other children's reaction to news of the pregnancy but
says she is waiting to tell her toddler until she's further along. Which is the nurse's best response? -
Answers "That's a wise decision because toddlers have no concept of time."
When the nurse cares for a pregnant adolescent, which psychosocial assessment takes priority before
teaching self-care? - Answers Developmental level
The emergency department nurse admits an adolescent who is complaining of abdominal pain and
denies pregnancy. Assessment findings include a distended, pregnant-appearing abdomen and fetal
heart tones. How does the nurse interpret these contradictory findings? - Answers Denial of pregnancy
until late in gestation is not uncommon in adolescence.
The nurses is caring for a pregnant Indian woman. Which observations does the nurse attribute to the
woman's cultural beliefs? (Select all that apply.) - Answers -The woman believes it is her husband's
responsibility to satisfy her food cravings.
-The woman continues to carry heavy loads.
-The woman does not believe doctors are necessary during pregnancy.
,The nurse working with a culturally diverse obstetric patient population recognizes which common
cultural practices? (Select all that apply.) - Answers -Hispanic and Indian women tend to remain
physically active.
-Japanese women do not freely discuss problems with morning sickness.
-Hispanic women rely on older women in the family for advice.
-Indian women expect others to satisfy food cravings.
At a prenatal visit, a primigravida asks the nurse how she will know her labor has started. The nurse
knows that what indicates the beginning of true labor?
a. Contractions that are relieved by walking.
b. Discomfort in the abdomen and groin.
c. A decrease in vaginal discharge.
d. Regular contractions becoming more frequent and intense. - Answers Answer: d. Regular contractions
becoming more frequent and intense.
Rationale: In true labor, contractions gradually develop a regular pattern and become more frequent,
longer, and more intense.
The nurse is caring for a woman in the first stage of labor. What will the nurse remind the patient about
contractions during this stage of labor?
a. They get the infant positioned for delivery.
b. They push the infant into the vagina.
, c. They dilate and efface the cervix.
d. They get the mother prepared for true labor. - Answers Answer: c. They dilate and efface the cervix.
Rationale: The first stage of labor describes the time from the onset of labor until full dilation of the
cervix.
What is the function of contractions during the second stage of labor?
a. Align the infant into the proper position for delivery.
b. Dilate and efface the cervix.
c. Push the infant out of the mothers body.
d. Separate the placenta from the uterine wall. - Answers Answer: c. Push the infant out of the mothers
body.
Rationale: The contractions push the infant out of the mothers body as the second stage of labor ends
with the birth of the infant.
What marks the end of the third stage of labor?
a. Full cervical dilation.
b. Expulsion of the placenta and membranes.
c. Birth of the infant.