Ch 26 - Test 1

Question 1

Where does implantation of the fertilized ovum usually occur?
a. Lower uterine wall
b. Side of the uterus
c. Fundus of the uterus
d. Body of the uterus

Answer 1

ANS: C

Question 2

A patient has been diagnosed with a tubal pregnancy. What is the typical outcome of a tubal pregnancy?
a. The patient will carry the pregnancy to term and have a cesarean delivery.
b. The patient will have to remain in bed for the remainder of the pregnancy.
c. The patient will spontaneously abort this ectopic pregnancy.
d. The patient will require surgery to remove the zygote.

Answer 2

ANS: D

Question 3

How long does the embryonic stage of pregnancy typically last?
a. 3 weeks
b. 4 weeks
c. 6 weeks
d. 8 weeks

Answer 3

ANS: D

Question 4

Why is the nurse concerned about a patient in her first trimester of pregnancy being exposed to German measles?
a. The disease is capable of causing a spontaneous abortion.
b. The disease is capable of causing birth defects.
c. The disease is capable of causing high fever and convulsions.
d. The disease is capable of interfering with placental implantation.

Answer 4

ANS: B

Question 5

Which hormone is secreted by the placenta?
a. Follicle-stimulating hormone (FSH)
b. Alpha-fetoprotein (AFP)
c. Human chorionic gonadotropin (HCG)
d. Luteinizing hormone (LH)

Answer 5

ANS: C
The placenta functions as an endocrine gland, secreting estrogen, progesterone, and HCG.

Question 6

What protects the fetus from most bacterial infections?
a. The yolk sac
b. The placental barrier
c. The cotyledons
d. The chorionic villa

Answer 6

ANS: B
The placental barrier protects the embryo/fetus from most bacteria, but not from viruses or drugs. The cotyledons are sections that make up the placenta. The chorionic villa are tiny vascular projections on the chorionic surface that help form the placenta.

Question 7

What period of the maternity cycle does the intrapartal period cover?
a. Beginning of pregnancy to midterm
b. Conception to third trimester
c. Onset of labor to delivery of the baby
d. Onset of labor to delivery of the placenta

Answer 7

ANS: D
The intrapartal period of the maternity cycle covers the onset of labor to delivery of the placenta. The antepartal period begins at conception and continues until the onset of labor. The postpartal period begins after the delivery of the placenta and continues for approximately 6 weeks, until the reproductive organs return to their prepregnancy state.

Question 8

A woman who has just discovered she is pregnant states that the first day of her last menstrual period was July 10. What will be her expected date of birth (EDB)?
a. April 10
b. April 17
c. May 10
d. October 17

Answer 8

ANS: B
To determine the EDB (estimated date of birth), the woman should count from the first day of her last menstrual period. Count back 3 months and forward 7 days.

Question 9

Which is a positive sign of pregnancy?
a. Positive pregnancy test
b. Positive Chadwick sign
c. Ultrasonic tracing of the fetus
d. Positive Goodell sign

Answer 9

ANS: C
A positive sign of pregnancy is an ultrasonic tracing of the fetus. A positive pregnancy test, positive Chadwick sign, and positive Goodell sign are all probable signs of pregnancy.

Question 10

What is the cause of frequent urination in early pregnancy?
a. Increased fluid intake
b. The fetus’s kidneys functioning
c. Retention of fluid
d. Increased circulating volume

Answer 10

ANS: D
Early in pregnancy, the increase in circulating volume and the enlarging uterus placing pressure on the bladder cause urinary frequency.

Question 11

A woman asks the nurse about the safety of sexual intercourse during her pregnancy. Which response by the nurse is the most correct?
a. “Sexual activity should be avoided after the first trimester.”
b. “Sexual activity should be ceased in the case of vaginal bleeding.”
c. “Sexual activity should be avoided in the second trimester.”
d. “Sexual activity should be limited to activity that does not include intercourse.”

Answer 11

ANS: B
Sexual intercourse can be enjoyed throughout pregnancy unless it is contraindicated by other conditions. In the case of vaginal bleeding, sexual activity should cease until the cause of the bleeding is determined by the health care provider.

Question 12

A woman tells the nurse that this is her third pregnancy. She has had twin girls at full term and one miscarriage. How does the nurse record the information?
a. G2, T2, L3
b. G4, T3, A1, L1
c. G3, T3, A2, L1
d. G3, T1, A1, L2

Answer 12

ANS: D
Standard obstetrical terminology is: G = gravida, T = term birth, P = preterm birth, A = abortion, L = living children.

Question 13

During which gestational week can a primigravida expect to first feel fetal movement?
a. 8
b. 10
c. 16
d. 20

Answer 13

ANS: C
At about 16 to 18 weeks, the sensation of the first movement is felt.

Question 14

At what week of fetal development can the nurse expect to first hear fetal heart tones with an amplified stethoscope?
a. 10
b. 12
c. 14
d. 16

Answer 14

ANS: D
During week 16, the fetal heart can be heard with an amplified stethoscope.

Question 15

The nurse assures an anxious primigravida that during fetal development from week 34 and beyond, maternal antibodies are transferred to the baby. How long will these antibodies provide the baby with immunity?
a. 1 month
b. 3 months
c. 4 months
d. 6 months

Answer 15

ANS: D
The maternal antibodies that are transferred to the baby provide immunity for 6 months.

Question 16

Early in the first trimester, a woman complains of morning sickness. What does the nurse suggest to aid with the discomfort?
a. Eating something with a high-fat content
b. Eating dry crackers before getting up
c. Eating three well-balanced meals
d. Getting rest and taking antiemetics

Answer 16

ANS: B
A remedy for morning sickness is to eat a few dry crackers before getting up.

Question 17

What does the increase in circulating blood volume during pregnancy cause in the mother?
a. Shortness of breath
b. Frontal headaches
c. Decreased white blood cell count
d. Decreased hemoglobin

Answer 17

ANS: D
Maternal circulating volume increases 30% to 40%, causing a virtual decrease in hemoglobin.

Question 18

A woman entering the 22nd week of pregnancy complains that she has become unsightly because of chloasma. What should the nurse recommend to reduce the appearance of the chloasma?
a. Use heavy makeup.
b. Take extra doses of vitamin A.
c. Avoid exposure to the sun.
d. Reduce caffeine intake.

Answer 18

ANS: C
At week 22, skin pigment changes called chloasma are found. Avoiding exposure to the sun will reduce the pigmentation.

Question 19

During the final weeks of pregnancy, urinary frequency may return due to the enlarged uterus, compressing the bladder against the pelvic bones. What does the nurse suggest to aid in relieving the urinary frequency?
a. Decrease fluid intake.
b. Use the knee-chest position.
c. Sleep on her side.
d. Avoid fluid intake in evening.

Answer 19

ANS: C
The patient should decrease pressure on the bladder at night by sleeping on her side. Fluids should not be decreased unless directed by a health care provider.

Question 20

A pregnant teenager presents with the following complaints. Which complaint could be an indicator of a serious complication?
a. Painful hemorrhoids
b. Linea nigra
c. Visual disturbances
d. Low back pain

Answer 20

ANS: C
Visual disturbances may be an indicator of increased blood pressure and retained fluids. These are indicators of eclampsia. Hemorrhoids, linea nigra, and back pain are common discomforts of pregnancy.

Question 21

During the last trimester of pregnancy, the nurse recommends that the woman wear low-heeled shoes. What is the nurse trying to prevent with this recommendation?
a. Lower back pain
b. Leg cramps
c. Leg swelling
d. Joint pain

Answer 21

ANS: A
A remedy for backache is to wear low-heeled shoes.

Question 22

The newly diagnosed primigravida who is 6 weeks pregnant states, “I don’t feel like I have a real baby inside me.” To reassure the mother, the nurse provides reassurance that which of the following is functioning in the 6-week-old embryo?
a. Brain
b. Lungs
c. Hands
d. Heart

Answer 22

ANS: D
At 6 weeks, the fetus has a pumping heart.

Question 23

Smoking by the mother can have what effect in the fetus?
a. Hearing deficits
b. Neuromuscular deformities
c. Cerebral palsy
d. Low birth weight

Answer 23

ANS: D
Smoking has been proven to cause slow intrauterine growth and low birth weight.

Question 24

When can the sex of the fetus be confirmed?
a. Conception
b. 2 weeks
c. 6 weeks
d. 9 weeks

Answer 24

ANS: D
At 9 weeks the genitalia are well defined.

Question 25

The health care provider decides to send the mother for a test to determine the fetal lung maturity. What is the name of this fetal well-being test? a. Biophysical profile b. Alpha-fetoprotein c. Amniocentesis d. Ultrasound

Answer 25

ANS: C Amniocentesis helps determine the maturity of the fetal lungs.

Question 26

When the young primigravida asks about how to adjust her diet for her pregnancy, what should the nurse suggest the mother add to her diet? a. Leafy green vegetables and fruit b. Beef and poultry c. Foods high in sodium and potassium d. Bread and grains

Answer 26

ANS: A A pregnant woman should eat foods containing roughage, such as raw fruits, vegetables, and cereals with bran.

Question 27

Which of the following discomforts of a pregnant woman should be reported to the health care provider at the first occurrence? a. Leg cramps b. Pelvic discomfort c. Vaginal bleeding d. Urinary frequency

Answer 27

ANS: C Vaginal bleeding at any time during pregnancy should be reported to the health care provider. Leg cramps, pelvic discomfort, and urinary frequency are common discomforts of pregnancy and not a cause for immediate concern.

Question 28

What do the arteries in the umbilical cord carry? a. Nutrients to the fetus from the placenta b. Oxygenated blood to perfuse the placenta c. Antibodies from the fetus to the mother d. Deoxygenated blood back to the placenta

Answer 28

ANS: D The arteries of the umbilical cord are unique in that they carry deoxygenated blood back to the placenta.

Question 29

What should a nurse instruct the patient to do before assessing fundal height? a. Press her lower back against the examination table. b. Empty her bladder. c. Take a deep breath and hold it. d. Bear down.

Answer 29

ANS: B The bladder should be emptied before the measurement of the fundal height.

Question 30

mult resp The nurse concludes that the prenatal patient has no need for further instruction when she correctly states that amniocentesis can determine which of the baby’s characteristics? (Select all that apply.) a. Sex b. Maturity c. Approximate weight d. Health e. Genetic defects

Answer 30

ANS: A, B, D, E The amniocentesis can reveal the sex, maturity, health, and some genetic defects.

Question 31

Which of the following demonstrate culturally competent care of the pregnant patient? (Select all that apply.) a. Discuss beliefs with the patient and incorporate them in the plan of care. b. Prohibit visits from anyone other than immediate family members. c. Require the patient’s participation in every aspect of the health care system. d. Maintain the patient’s modesty at all times. e. Strive to maintain a harmonious environment for the patient.

Answer 31

ANS: A, D, E The nurse should discuss the patient’s cultural beliefs and incorporate as many as possible into the plan of care. Modesty is important in almost all cultures, and the nurse should take measures to ensure the patient’s modesty. Absence of a stressful environment is important for a positive outcome for both mother and baby, and the nurse should strive to alleviate stress and maintain a harmonious environment. Many cultures will foster relationships, and visits from extended family members may be important. The patient may not participate in all aspects of the health care system due to cultural issues.