Chapter 11 Nursing Care during pregnancy Test 1 Flashcards
The nurse caring for the newly pregnant woman would advise her that ideally prenatal care should begin:
A. Before the first missed menstrual period
B. After the first missed menstrual period.
C. After the second missed menstrual period.
D. After the third missed menstrual period.
B. Prenatal care ideally should begin soon after the first missed menstrual period. Regular prenatal visits offer opportunities to ensure the health o the expectant mother and her infant.
A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period(LMP) was February 14, 2010. Her expected date of birth (EDB) would be: A. September 17, 2010 B. November 7, 2010 C. November 21, 2010 D. December 17, 2010
C. Using Nägele’s rule, November 21, 2010, is the correct expected date of birth. The EDB is calculated by subtracting 3 months from the first day of the LMP and adding 7 days + 1 year to the day of the LMP. Therefore, with an LMP of February 14, 2010:
February 14, 2010 – 3 months = November 14, 2009 + 7 days = November 21, 2009 + 1 year = November 21, 2010
Prenatal testing for the human immunodeficiency virus (HIV) is recommended for:
a. All women, regardless of risk factors.
b. A woman who has had more than one sexual partner.
c. A woman who has had a sexually transmitted infection.
d. A woman who is monogamous with her partner.
A. Testing for the antibody to HIV is strongly recommended for all pregnant women. An HIV test is recommended for all women, regardless of risk factors. The incidence of perinatal transmission from an HIV-positive mother to her fetus ranges from 25% to 35%. Women who test positive for HIV can then be treated.
Which symptom is considered a first trimester warning sign and should be reported immediately by the pregnant woman to her health care provider? A. nausea with occasional vomiting B. fatigue C. urinary frequency D. vaginal bleeding
D. Signs and symptoms that must be reported include severe vomiting, fever and chills, burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms may be signs of potential complications of the pregnancy.
A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her:
a. “You don’t need to modify your exercising any time during your pregnancy.”
b. “Stop exercising because it will harm the fetus.”
c. “You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month.”
d. “Jogging is too hard on your joints; switch to walking now.”
C. Typically running should be replaced with walking around the seventh month of pregnancy. The nurse should inform the woman that she may need to reduce her exercise level as the pregnancy progresses. Physical activity promotes a feeling of well being in pregnant women. It improves circulation, promotes relaxation and rest, and counteracts boredom.
Which blood pressure finding during the second trimester indicates a risk for pregnany induced hypertension?
a. Baseline BP 120/80, current BP 126/85
b. Baseline BP 100/70, current BP 130/85
c. Baseline BP 140/85, current BP 130/80
d. Baseline BP 110/60, current BP 110/60
B. An increase in the systolic BP of 30 mm Hg or more over the baseline pressure or an increase in the diastolic BP of 15 mm Hg or more over the baseline pressure is a significant finding, regardless of the absolute values. A current BP of 130/85 indicates that such increases have occurred in both the diastolic and systolic pressures.
The multiple marker test is used to assess the fetus for which condition? A. Down syndrome B. Diaphragmatic hernia C. Congenital cardiac abnormality D. Anencephaly
A. The maternal serum level of alpha-fetoprotein is used to screen for Down syndrome, neural tube defects, and other chromosome anomalies. The multiple marker test would not detect diaphragmatic hernia, congenital cardiac abnormality, or anecephaly. Additional testing such as ultrasonography and aminocentesis would be required to diagnose them.
A woman who is 32 week’s pregnant is informed by the nurse that a danger sign of pregnancy could be:
A. constipation
B. alteration in the pattern of fetal movement
C. heart palpitations
D. edema in the ankles and feet at the end of the day
B. An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy. Constipation, heart palpitations, and ankle and foot edema are normal discomforts of pregnancy that occur in the second and third trimesters.
A woman who is 14 weeks’ pregnant tells the nurse that she alway had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse would tell her:
a. “Since you’re in your second trimester, there’s no problem with having one drink with dinner.”
b. “One drink every night is too much. One drink three times a week should be fine.”
c. “Since you’re in your second trimester, you can drink as much as you like.”
d. “Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy.”
D. “Because no one knows how much or how little alcohol it takes to cause fetal problems the best course is to abstain throughout your pregnancy” is an accurate statement. Complete abstinence is strongly advised.
A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild to moderate intensity. The nurse should recommend that she: A. do Kegel exercises B. do pelvic rock exercises C. use a softer mattress D. Stay in bed for 24 hours
B. Pelvic rock exercises may help stretch and strengthen the abdominal and lower back muscles and relieve low back pain. Stretching and other exercises to relieve back pain should be performed several times a day.
For what reason would breastfeeding be contraindicated? A. Hepatitis B B. everted nipples C. history of breast cancer 3 years ago D. HIV positive
D. Women who are HIV positive are discouraged from breastfeeding. Although hepatitis B antigen has not been shown to be transmitted through breast milk, as an added precaution infants born to HBsAg-positive women should receive the hepatitis B vaccine and immune globulin immediately after birth. Everted nipples are functional for breastfeeding. Newly diagnosed breast cancer would be a contraindication to breastfeeding.
A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she doesn’t know what is happening; one minute she’s happy that she is pregnant, and the next minute she cries for no reason. Which response by the nurse is most appropriate?
a. “Don’t worry about it; you’ll feel better in a month or so.”
b. “Have you talked to your husband about how you feel?”
c. “Perhaps you really don’t want to be pregnant.”
d. “Hormonal changes during pregnancy commonly result in mood swings.”
D.“Hormonal changes during pregnancy commonly result in mood swings” is an accurate statement and the most appropriate response by the nurse. “Don’t worry about it; you’ll feel better in a month or so” dismisses the client’s concerns and is not the most appropriate response. Although women should be encouraged to share their feelings, “Have you talked to your husband about how you feel” is not the most appropriate response and does not provide the client with a rationale for the psychosocial dynamics of her pregnancy. “Perhaps you really don’t want to be pregnant” is completely inappropriate and deleterious to the psychologic well-being of the woman. Hormonal and metabolic adaptations often cause mood swings in pregnancy. The woman’s responses are normal. She should be reassured about her feelings.
The nurse should be aware that the partner’s main role in pregnancy is to:
A. provide financial support
B. protect the pregnant woman from “old wives” tales
C. support and nurture the pregnant woman
D. make sure the pregnant woman keeps prenatal appointments
C. The partner’s main role in pregnancy is to nurture the pregnant woman and respond to her feelings of vulnerability. In older societies the man enacted the ritual couvade. Changing cultural and professional attitudes have encouraged fathers’ participation in the birth experience over the past 30 years.
During the first trimester a woman can expect which of the following changes in her sexual desire?
A. an increase, because of enlarging breasts
B. a decrease, because of nausea and fatigue
C. no change
D. an increase, because of increased levels of female hormones
B. Maternal physiologic changes such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses may affect sexuality and sexual expression. Libido may be depressed in the first trimester but often increases during the second and third trimesters. During pregnancy the breasts may become enlarged and tender; this tends to interfere with coitus, thereby decreasing the desire to engage in sexual activity. Libido may be depressed in the first trimester but often increases during the second and third trimesters. Maternal physiologic changes such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses may affect sexuality and sexual expression.
Which behavior indicates that a woman is "seeking safe passage" for herself and her infant? A. she keeps all prenatal appointments B. she eats for two C. she drives her car slowly D. she wears only low heeled shoes.
A. The goal of prenatal care is to foster a safe birth for the infant and mother. Although eating properly, driving carefully, and using proper body mechanics are all healthy measures that a mother can take, obtaining prenatal care is the optimal method for providing safety for both herself and her baby.
A 3 year old girl's mother is 6 months pregnant. What concern is this child likely to verbalize? A. How the baby will get out B. what will the baby eat C. whether her mother will die D. what color eyes the baby has
B. By age 3 or 4, children like to be told the story of their own beginning and accept its comparison with the present pregnancy. They like to listen to the fetal heartbeat and feel the baby move. Sometimes they worry about how the baby is being fed and what it wears. School-age children take a more clinical interest in their mother’s pregnancy and may want to know, “How did the baby get in there?” and “How will it get out?” Whether her mother will die does not tend to be the focus of a child’s questions about the impending birth of a sibling. The baby’s eye color does not tend to be the focus of children’s questions about the impending birth of a sibling.
In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose?
a. To promote family unity
b. To ward off the “evil eye”
c. To appease the gods of fertility
d. To protect the mother and fetus during pregnancy
D. The purpose of all cultural practices is to protect the mother and fetus during pregnancy. Although many consider pregnancy normal, certain practices are expected of women of all cultures to ensure a good outcome. Cultural prescriptions tell women what to do, and cultural proscriptions establish taboos. The purposes of these practices are to prevent maternal illness resulting from a pregnancy-induced imbalanced state and to protect the vulnerable fetus.
What type of cultural concern is the most likely deterrent to many women seeking prenatal care? A. religion B. modesty C. ignorance D. belief that physicians are evil
B. A concern for modesty is a deterrent to many women seekng prenatal care. For some women exposing body parts, especially to a man, is considered a major violation of their modesty. Many cultural variations are found in prenatal care. Even if the prenatal care described is familiar to a woman, some practices may conflict with the beliefs and practices of a subculture group to which she belongs.
Which statement about pregnancy is accurate?
a. A normal pregnancy lasts about 10 lunar months.
b. A trimester is one third of a year.
c. The prenatal period extends from fertilization to conception.
d. The estimated date of confinement (EDC) is how long the mother will have to be bedridden after birth.
A. A lunar month lasts 28 days, or 4 weeks. Pregnancy spans 9 calendar months but 10 lunar months. A trimester is one third of a normal pregnancy, or about 13 to 14 weeks. The prenatal period covers the full course of pregnancy (prenatal means before birth). The EDC is now called the EDB, or estimated date of birth. It has nothing to do with the duration of bed rest.
