mp
, lOMoAR cPSD| 61157369
mp
Maternal OB Testbank - mp mp mp
Test bank questions and answers with rationales
mp mp mp mp mp mp mp
Anatomy and Physiology of Pregnancy
mp mp mp mp mpmpmp
Perry: Maternal Child Nursing Care, 7th Edition
mp mp mp mp mp mp mpmp
MULTIPLE CHOICE mp mpmp
1. A woman‘s obstetric history indicates that she is pregnant for the fourth time and all of her chi
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp
ldren from previous pregnancies are living. One was born at 39 weeks of gestation, twins were
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp
born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is h
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
er gravidity and parity using the GTPAL system?
mp mp mp mp mp mp mp mpmp
a. 3-1-1-1-3 mpmp
b. 4-1-2-0-4 mpmp
c. 3-0-3-0-3 mpmp
d. 4-2-1-0-3 mpmp
ANS: B mp mpmp
The correct calculation of this woman‘s gravidity and parity is 4-1-2-0-
mp mp mp mp mp mp mp mp mp mp
4. The numbers reflect the woman‘s gravidity and parity information. Using the GPTAL system, her i
mp mp mp mpmp mp mp mp mp mp mp mp mp mp mp mp
nformation is calculated as: mp mpmp mp mpmp
G: The first number reflects the total number of times the woman has been pregnant; she is pregn
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
ant for the fourth time. mp mp mp mp mpmp
T: This number indicates the number of pregnancies carried to term, not the number of deliveries
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
at term; only one of her pregnancies has resulted in a fetus at term.
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp
P: This is the number of pregnancies that resulted in a preterm birth; the woman has had two preg
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
nancies in which she delivered preterm. mp mp mp mp mp mpmp
A: This number signifies whether the woman has had any abortions or miscarriages before the per
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
iod of viability; she has not. mp mp mp mp mp mpmp
L: This number signifies the number of children born who are currently living; the woman has fou
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
r children. mp mpmp
mp
2. A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs an
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
d symptoms of pregnancy likely will have
mp mp mp mp mp mp mpmp
a. amenorrhea. mpmp
b. positive pregnancy test. mp mp mpmp
c. Chadwick‘s sign. mp mpmp
d. Hegar‘s sign. mp mpmp
ANS: A mp mpmp
Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are felt by the wom
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
an. A positive pregnancy test, the presence of Chadwick‘s sign, and the presence of Hegar‘s sign are a
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp
ll probable signs of pregnancy.
mp
mp mp mp mp mpmp
3. The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of p
mp mp mp mp mp mp mp mp mp mp mp mp mp mp
regnancy. The woman demonstrates understanding of the nurse‘s instructions if she states tha
mp mp mp mp mp mp mp mp mp mp mp mp
t a positive sign of pregnancy is
mp mp mp mp mp mp mpmp
a. a positive pregnancy test. mp mp mp mpmp
b. fetal movement palpated by the nurse-midwife. mp mp mp mp mp mpmp
c. Braxton Hicks contractions. mp mp mpmp
d. quickening. mpmp
ANS: B mp mpmp
Positive signs of pregnancy are attributed to the presence of a fetus, such as hearing the fetal heartbeat
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp
or palpating fetal movement. A positive pregnancy test and Braxton Hicks contractions are probable s
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
igns of pregnancy. Quickening is a presumptive sign of pregnancy.
mp
mp mp mp mp mp mp mp mp mp mpmp
, lOMoAR cPSD| 61157369
mp
4. A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which le
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
vel? mpmp
a. Not palpable above the symphysis at this time mp mp mp mp mp mp mp mpmp
b. Slightly above the symphysis pubis mp mp mp mp mpmp
c. At the level of the umbilicus mp mp mp mp mp mpmp
d. Slightly above the umbilicus mp mp mp mpmp
ANS: B mp mpmp
In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the symphysis
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
pubis sometime between the 12th and 14th weeks of pregnancy. As the uterus grows, it may be palpate
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
d above the symphysis pubis sometime between the 12th and 14th weeks of pregnancy. The uterus rise
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
s gradually to the level of the umbilicus at 22 to 24 weeks of gestation.
mp
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp
5. During a patient‘s physical examination, the nurse notes that the lower uterine segment is soft
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
on palpation. The nurse would document this finding as
mp mp mp mp mp mp mp mp mp mpmp
a. Hegar‘s sign. mp mpmp
b. McDonald‘s sign. mp mpmp
c. Chadwick‘s sign. mp mpmp
d. Goodell‘s sign. mp mpmp
ANS: A mp mpmp
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occ
mp mp mp mp mp mp mp mp mp mp mp mp mp mp
urs; this is called Hegar’s sign. McDonald‘s sign is not a sign of pregnancy. McDonald's rule is a met
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp
hod used to estimate the gestational age of a fetus by measuring the distance from the top of the uterus
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
to the pubic bone. This measurement is typically done during prenatal exams. Chadwick‘s sign is the b
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
lue-
violet coloring of the cervix caused by increased vascularity; this occurs around the fourth week of ge
mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp mp mp
station. Softening of the cervical tip is called Goodell‘s sign, which may be observed around the sixth
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp m
week of pregnancy.
p
mp
mp mp mpmp
6. Cardiovascular system changes occur during pregnancy. Which finding would be considered mp mp mp mp mp mp mp mp mp mp mp
normal for a woman in her second trimester? mp mp mp mp mp mp mp mpmp
a. Less audible heart sounds (S1, S2) mp mp mp mp mp mpmp
b. Increased pulse rate mp mp mpmp
c. Increased blood pressure mp mp mpmp
d. Decreased red blood cell (RBC) production mp mp mp mp mp mpmp
ANS: B mp mpmp
Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp m
term. Splitting of S1 and S2 is more audible. In the first trimester, blood pressure usually remains the
p mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp
same as at the prepregnancy level, but it gradually decreases up to about
mp mp mp mp mp mp mp mp mp mp mp mp mpmpmp
20 weeks of gestation. During the second trimester, both the systolic and the diastolic pressures
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp m
decrease by about 5 to 10 mm Hg. Production of RBCs accelerates during pregnancy.
p
mp
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mpmp
7. Numerous changes in the integumentary system occur during pregnancy. Which change persis
mp mp mp mp mp mp mp mp mp mp mp
ts after birth? mp mp mpmp
a. Epulis mpmp
b. Chloasma mpmp
c. Telangiectasia mpmp
d. Striae gravidarum mp mpmp
ANS: D mp mpmp
Striae gravidarum, or stretch marks, reflect separation within the underlying connective tissue of the s
mp mp mp mp mp mp mp mp mp mp mp mp mp mp
kin. They usually fade after birth, although they never disappear completely. An epulis is a red, raised
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp
nodule on the gums that bleeds easily. Chloasma, or mask of pregnancy, is a blotchy, brown hyperpig
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp
mentation of the skin over the cheeks, nose, and forehead, especially in dark-
mp mp mp mp mp mp mp mp mp mp mpmp mp
complexioned pregnant women. Chloasma usually fades after the birth. Telangiectasia, or vascular spi
mp mp mp mp mp mp mp mp mp mp mp mp
ders, are tiny, star-shaped or branch-like, slightly raised, pulsating end-
mp mp mp mp mp mp mp mpmp mp
arterioles usually found on the neck, thorax, face, and arms. They occur as a result of elevated levels o
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp
f circulating estrogen. These usually disappear after birth.
mp
mp mp mp mp mp mp mp mpmp
, lOMoAR cPSD| 61157369
mp
8. The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can
mp mp mp mp mp mp mp mp mp mp mp mp mp mp
expect to experience what change? mp mp mp mp mpmp
a. Her center of gravity will shift backward. mp mp mp mp mp mp mpmp
b. She will have increased lordosis. mp mp mp mp mpmp
c. She will have increased abdominal muscle tone. mp mp mp mp mp mp mpmp
d. She will notice decreased mobility of her pelvic joints. mp mp mp mp mp mp mp mp mpmp
ANS: B mp mpmp
An increase in the normal lumbosacral curve (lordosis) develops, and a compensatory curvature in the
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
cervicodorsal region develops to help the woman maintain her balance. The center of gravity shifts for
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp
ward. She will have decreased muscle tone. She will notice increased mobility of her pelvic joints.
mp
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp
9. A 31-year- mp
old woman believes that she may be pregnant. She took an OTC pregnancy test 1 week ago af
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp
ter missing her period; the test was positive. During her assessment interview, the nurse enqui
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
res about the woman‘s last menstrual period and asks whether she is taking any medications.
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
The woman states that she takes medicine for epilepsy. She has been under considerable stres
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
s lately at work and has not been sleeping well. She also has a history of irregular periods. He
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp
r physical examination does not indicate that she is pregnant. She has an ultrasound scan that
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp
reveals she is not pregnant. What is the most likely cause of the false-
mp mp mp mp mp mp mp mp mp mp mp mp mp mp
positive pregnancy test result? mp mp mp mpmp
a. She took the pregnancy test too early. mp mp mp mp mp mp mpmp
b. She takes anticonvulsants. mp mp mpmp
c. She has a fibroid tumor. mp mp mp mp mpmp
d. She has been under considerable stress and has a hormone imbalance. mp mp mp mp mp mp mp mp mp mp mpmp
ANS: B mp mpmp
Anticonvulsants may cause false-positive pregnancy test results. OTC pregnancy tests use enzyme- mp mp mp mp mp mp mp mp mp mp mpmp
linked immunosorbent assay technology, which can yield positive results 4 days after implantation. I
mp mp mp mp mp mp mp mp mp mp mp mpmp mp
mplantation occurs 6 to 10 days after conception. If the woman were pregnant, she would be into her t
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp mp
hird week at this point (having missed her period 1 week ago). Fibroid tumors do not produce hormon
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp
es and have no bearing on hCG pregnancy tests. Although stress may interrupt normal hormone cycle
mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp mp
s (menstrual cycles), it does not affect human chorionic gonadotropin levels or produce positive pregn
mp mp mp mp mp mp mp mp mp mp mp mp mp mp
ancy test results.
mp
mp mp mpmp
10. A woman is in her seventh month of pregnancy. She has been reporting nasal congestion and
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp
occasional epistaxis. The nurse suspects that mp mp mp mp mp mpmp
a. This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mpmp
b. This is an abnormal cardiovascular change, and the nosebleeds are an ominous sign. mp mp mp mp mp mp mp mp mp mp mp mp mpmp
c. The woman is a victim of domestic violence and is being hit in the face by her partner.
mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mpmp
d. The woman has been using cocaine intranasally. mp mp mp mp mp mp mpmp
ANS: A mp mpmp
Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract. This may res
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp
ult in edema in the nose, larynx, trachea, and bronchi. This congestion may cause nasal stuffiness and
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp
epistaxis. Cardiovascular changes in pregnancy may cause edema in lower extremities.
mp mp mp mp mp mp mp mp mp mp mp
Determining that the woman is a victim of domestic violence and was hit in the face cannot be made o
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp mp
n the basis of the sparse facts provided. If the woman had been hit in the face, she most likely would h
mp mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp mp mp mp mp mp mp
ave additional physical findings. Determination of the use of cocaine by the woman cannot be made o
mp mp mp mp mp mp mp mpmp mp mp mp mp mp mp mp mp
n the basis of the sparse facts provided.
mp
mp mp mp mp mp mp mp mpmp
11. The nurse caring for the pregnant patient must understand that the hormone essential for mai
mp mp mp mp mp mp mp mp mp mp mp mp mp mp
ntaining pregnancy is mp mp mpmp
a. estrogen. mpmp
b. human chorionic gonadotropin (hCG). mp mp mp mpmp
c. oxytocin. mpmp
d. progesterone. mpmp
ANS: D mp mpmp
Progesterone is essential for maintaining pregnancy; it does so by relaxing smooth muscles. This
mp mp mp mp mp mp mp mp mp mp mp mp mpmp mp