NURS 388 Final Exam ACTUAL QUESTIONS AND
CORRECT ANSWERS
What are modifiable risk factors in preconception? - CORRECT ANSWER - Alcohol,
smoking
- Diet (folic acid)
- Avoid over the counter medications
- Environmental hazards
What are psychological nursing care considerations for infertility? - CORRECT
ANSWER - Can be seen as a major life stressor
- Can affect one's self esteem
- In order to deal comfortably with a couple sexuality the RN needs to be comfortable with
their own sexuality to be nonjudgmental and skilled in communication techniques
- Be sensitive to couple sociocultural beliefs
What is the RN's role in prenatal screening and diagnosis? - CORRECT ANSWER -
Support women to undertake a pregnancy they might not have otherwise
- Reassurance if normal
- If abnormality detected increase parental options (further testing, referral, counselling re
planned birth or termination, preparation for special needs child), altered obstetric
management, facilitated neonatal management
What is pregnancy prenatal screening? - CORRECT ANSWER Identified higher than
average risk of having a baby with certain genetic conditions
1st trimester: 11-14 weeks - ultrasound (U/S) (fetal nuchal translucency - measures the
thickness of the folds on the back of the neck at 12 weeks), maternal serum screening
2nd trimester: 18-22 weeks U/S, Maternal serum alphas-fetoprotein (MSAFP) - about 75-
90% of neural tube defects are picked up with this testing
What is Trisomy 21, 18? - CORRECT ANSWER Edward's syndrome - usually a
combination of birth defects that are incompatible with life
,What are prenatal pregnancy diagnoses? - CORRECT ANSWER Ultrasound,
amniocentesis (testing the amniotic fluid) and chronic villus sampling (can be done earlier
than an amnio: a piece if the placenta is taken to analyze it for genetic makeup through the
cervix or abdominally) can detect physical deformities and genetic disorders
What happens when a mother who is RH- has a baby that is RH+ - CORRECT
ANSWER The first pregnancy will be no effect with different RH factor
The mother is more likely to have a miscarriage as the body can reject the baby
When the first baby is born the fetal cells may mix with the mothers and she creates
antibodies to this (next baby may be incompatible)
A shot is given at 21 weeks gestation and after birth
What are nursing responsibilities for when a genetic risk is identified? - CORRECT
ANSWER In preconception explore options without time pressures (help families
understand the risk present, help families to make decisions on management and surveillance,
support families to make informed choices, facilitate appropriate referrals)
Primary prevention of genetic and congenital anomalies to decrease perinatal morbidity,
mortality and enhance healthy families (to have the healthiest outcome possible for the infant,
need to look at the whole family)
Can not tell us if diseases are present unless they are genetic but can tell sex of baby and
genetic anomalies
What are risks of prenatal screening and diagnosis - CORRECT ANSWER - Parental
anxiety (in a false positive or true positive)
- Pregnancy complications
- Pregnancy loss
What is a family development assessment? - CORRECT ANSWER - Each family is
unique, influenced by past and present context plus future aspirations
- Disequilibrium occurs in transitional stages with family stress as members adapt, realign
and redefine relationships
- Shaped by predictable and unpredictable events, societal trends, family of origin
, What are presumptive signs of pregnancy? - CORRECT ANSWER Amenorrhea (an
abnormal absence of menstruation.)- often the first sign
Nausea- *morning sickness*
Breast tenderness/ enlargement
Deepening pigmentation
quickening- fetal movement felt by mother 16-20 wks
Sore breasts
What are probable signs of pregnancy? - CORRECT ANSWER Positive pregnancy test
(HCG testing)
Hagar sign
Compressibility and softening of the cervix (goodell sign)
Chadwick's sign - bluish colour to cervix
Ballottment in vaginal exam (tap and the baby moves)
What are positive signs of pregnancy? - CORRECT ANSWER Fetal heart sounds
Visualization of fetus ultrasound
Fetal movement palpated by hcp.
What are maternal adaptations to pregnancy? - CORRECT ANSWER - Accepting the
pregnancy
- Identify with mothers role
- Reorder personal relationships
- Undergo changes
- Build a relationship with the fetus
- Prepare for the birth
What are prenatal adaptations to pregnancy? - CORRECT ANSWER Can be the
husband
CORRECT ANSWERS
What are modifiable risk factors in preconception? - CORRECT ANSWER - Alcohol,
smoking
- Diet (folic acid)
- Avoid over the counter medications
- Environmental hazards
What are psychological nursing care considerations for infertility? - CORRECT
ANSWER - Can be seen as a major life stressor
- Can affect one's self esteem
- In order to deal comfortably with a couple sexuality the RN needs to be comfortable with
their own sexuality to be nonjudgmental and skilled in communication techniques
- Be sensitive to couple sociocultural beliefs
What is the RN's role in prenatal screening and diagnosis? - CORRECT ANSWER -
Support women to undertake a pregnancy they might not have otherwise
- Reassurance if normal
- If abnormality detected increase parental options (further testing, referral, counselling re
planned birth or termination, preparation for special needs child), altered obstetric
management, facilitated neonatal management
What is pregnancy prenatal screening? - CORRECT ANSWER Identified higher than
average risk of having a baby with certain genetic conditions
1st trimester: 11-14 weeks - ultrasound (U/S) (fetal nuchal translucency - measures the
thickness of the folds on the back of the neck at 12 weeks), maternal serum screening
2nd trimester: 18-22 weeks U/S, Maternal serum alphas-fetoprotein (MSAFP) - about 75-
90% of neural tube defects are picked up with this testing
What is Trisomy 21, 18? - CORRECT ANSWER Edward's syndrome - usually a
combination of birth defects that are incompatible with life
,What are prenatal pregnancy diagnoses? - CORRECT ANSWER Ultrasound,
amniocentesis (testing the amniotic fluid) and chronic villus sampling (can be done earlier
than an amnio: a piece if the placenta is taken to analyze it for genetic makeup through the
cervix or abdominally) can detect physical deformities and genetic disorders
What happens when a mother who is RH- has a baby that is RH+ - CORRECT
ANSWER The first pregnancy will be no effect with different RH factor
The mother is more likely to have a miscarriage as the body can reject the baby
When the first baby is born the fetal cells may mix with the mothers and she creates
antibodies to this (next baby may be incompatible)
A shot is given at 21 weeks gestation and after birth
What are nursing responsibilities for when a genetic risk is identified? - CORRECT
ANSWER In preconception explore options without time pressures (help families
understand the risk present, help families to make decisions on management and surveillance,
support families to make informed choices, facilitate appropriate referrals)
Primary prevention of genetic and congenital anomalies to decrease perinatal morbidity,
mortality and enhance healthy families (to have the healthiest outcome possible for the infant,
need to look at the whole family)
Can not tell us if diseases are present unless they are genetic but can tell sex of baby and
genetic anomalies
What are risks of prenatal screening and diagnosis - CORRECT ANSWER - Parental
anxiety (in a false positive or true positive)
- Pregnancy complications
- Pregnancy loss
What is a family development assessment? - CORRECT ANSWER - Each family is
unique, influenced by past and present context plus future aspirations
- Disequilibrium occurs in transitional stages with family stress as members adapt, realign
and redefine relationships
- Shaped by predictable and unpredictable events, societal trends, family of origin
, What are presumptive signs of pregnancy? - CORRECT ANSWER Amenorrhea (an
abnormal absence of menstruation.)- often the first sign
Nausea- *morning sickness*
Breast tenderness/ enlargement
Deepening pigmentation
quickening- fetal movement felt by mother 16-20 wks
Sore breasts
What are probable signs of pregnancy? - CORRECT ANSWER Positive pregnancy test
(HCG testing)
Hagar sign
Compressibility and softening of the cervix (goodell sign)
Chadwick's sign - bluish colour to cervix
Ballottment in vaginal exam (tap and the baby moves)
What are positive signs of pregnancy? - CORRECT ANSWER Fetal heart sounds
Visualization of fetus ultrasound
Fetal movement palpated by hcp.
What are maternal adaptations to pregnancy? - CORRECT ANSWER - Accepting the
pregnancy
- Identify with mothers role
- Reorder personal relationships
- Undergo changes
- Build a relationship with the fetus
- Prepare for the birth
What are prenatal adaptations to pregnancy? - CORRECT ANSWER Can be the
husband
