Chapter 10

Question 1

The nurse caring for the newly pregnant woman would advise her that ideally prenatal care should begin at what time?
a.
Prenatal care should begin before the first missed menstrual period.
b.
Prenatal care should begin after the first missed menstrual period.
c.
Prenatal care should begin after the second missed menstrual period.
d.
Prenatal care should begin after the third missed menstrual period.

Answer 1

B

Question 2

A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period (LMP) was February 14, 2012. What would be her expected date of birth (EDB)?
a.
May 21, 2012
b.
November 7, 2013
c.
November 21, 2012
d.
May 2, 2013

Answer 2

C

Question 3

Prenatal testing for the human immunodeficiency virus (HIV) is recommended for which of the following?
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

Answer 3

A

Question 4

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

Answer 4

D

Question 5

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. How should the nurse respond?
a.
“You don’t need to modify your exercising at 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 later in your pregnancy.”
d.
“Jogging is too hard on your joints; switch to walking now.”

Answer 5

C

Question 6

Which blood pressure (BP) finding during the second trimester indicates a risk for pregnancy-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

Answer 6

B

Question 7

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

Answer 7

A

Question 8

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be which of the following?
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

Answer 8

B

Question 9

A woman who is 14 weeks pregnant tells the nurse that she always 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. What is the nurse’s best response?
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.
“It is best to abstain from alcohol as the effects of alcohol on the fetus are inconclusive.”

Answer 9

D

Question 10

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. What should the nurse recommend to the woman?
a.
Do Kegel exercises.
b.
Do pelvic rock exercises.
c.
Use a softer mattress.
d.
Stay in bed for 24 hours.

Answer 10

B

Question 11

For which of the following reasons would breastfeeding be contraindicated?
a.
A woman has hepatitis B.
b.
A woman has everted nipples.
c.
A woman has a history of breast cancer 3 years ago.
d.
A woman is human immunodeficiency virus (HIV) positive.

Answer 11

D

Question 12

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.”

Answer 12

D

Question 13

The nurse should be aware that the partner’s main role in pregnancy is to do which of the following?
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.

Answer 13

C

Question 14

During the first trimester, a pregnant woman can expect which of the following changes in her sexual desire?
a.
Her sexual desire is increased, related to enlarging breasts.
b.
Her sexual desire is decreased, related to nausea and fatigue.
c.
There is no change in sexual desire.
d.
Her sexual desire is increased, related to increased levels of female hormones.

Answer 14

B

Question 15

Which behaviour 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.

Answer 15

A

Question 16

A 3-year-old girl’s mother is 6 months pregnant. What concern is this child likely to express?
a.
How the baby will “get out”
b.
What the baby will eat
c.
Whether her mother will die
d.
What colour eyes the baby has

Answer 16

B

Question 17

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

Answer 17

D

Question 18

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

Answer 18

B

Question 19

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 is on bed rest.

Answer 19

A

Question 20

Which of the following should the nurse know to assist in understanding and guiding a woman through her acceptance of pregnancy?
a.
Nonacceptance of the pregnancy very often equates to rejection of the child.
b.
Mood swings most likely are the result of a changed lifestyle as well as profound hormonal changes.
c.
Ambivalent feelings usually are seen only in emotionally immature or very young mothers.
d.
Conflicts such as not wanting to be pregnant or childrearing and career-related decisions will resolve themselves naturally after birth.

Answer 20

B

Question 21

With regard to a woman’s reordering of personal relationships during pregnancy, the nurse should be aware of which of the following?
a.
Because of the special motherhood bond, a woman’s relationship with her mother is even more important than with the father of the child.
b.
Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other.
c.
Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child be accepted by the father.
d.
The woman’s sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier.

Answer 21

C

Question 22

What represents a typical progression through the phases of a woman’s establishing a relationship with the fetus?
a.
Accepts the fetus as distinct from herself—accepts the biological fact of pregnancy—has a feeling of caring and responsibility
b.
Fantasizes about the child’s gender and personality—views the child as part of herself—becomes introspective
c.
Views the child as part of herself—has feelings of well-being—accepts the biological fact of pregnancy
d.
“I am pregnant.”— “I am going to have a baby.”—“I am going to be a mother.”

Answer 22

D

Question 23

What should the nurse know with regard to the father’s acceptance of the pregnancy and preparation for childbirth?
a.
For most men, pregnancy is a time of fantasy and intense learning.
b.
The father’s attachment to the fetus cannot be as strong as that of the mother.
c.
During the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home.
d.
Typically, men remain ambivalent about fatherhood right up to the birth of their child.

Answer 23

A

Question 24

What should the nurse be aware of for the initial visit with a patient who is beginning prenatal care?
a.
The first interview is a relaxed, get-acquainted affair to gather general impressions.
b.
Avoid assessing any handicap conditions until the second prenatal visit.
c.
Be alert to the appearance of potential parenting problems such as depression or lack of family support.
d.
Nurses should not ask about illegal drug use; that is left to physicians.

Answer 24

C

Question 25

With regard to the initial physical examination of a woman beginning prenatal care, the nurse should be aware of which of the following?
a.
Only women who show physical signs or meet the sociological profile should be assessed for physical abuse.
b.
The woman should empty her bladder before the pelvic examination is performed.
c.
The distribution, amount, and quality of body hair are of no particular importance.
d.
The size of the uterus is discounted in the initial examination because it is just going to get bigger soon.

Answer 25

B

Question 26

Which should the nurse be aware of to care for women receiving prenatal care?
a.
The interview portions become more intensive as the visits become more frequent over the course of the pregnancy.
b.
Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester.
c.
During the abdominal examination the nurse should be alert for supine hypotension.
d.
For pregnant women a systolic blood pressure (BP) of 130 and a diastolic BP of 80 is sufficient to be considered hypertensive.

Answer 26

C

Question 27

What should the nurse teach the mother to properly promote personal hygiene?
a.
Tub bathing is permitted even in late pregnancy unless membranes have ruptured.
b.
The perineum should be wiped from back to front.
c.
Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath.
d.
Expectant mothers should use specially treated soap to cleanse the nipples.

Answer 27

A

Question 28

What is the purpose of the pinch test?
a.
To check the sensitivity of the nipples
b.
To determine whether the nipple is everted or inverted
c.
To calculate the adipose buildup in the abdomen
d.
To see whether the fetus has become inactive

Answer 28

B

Question 29

Which of the following should the nurse be aware of with regard to dental care during pregnancy?
a.
Dental care need not be a priority because the woman is getting a lot of calcium anyway.
b.
Dental surgery, in particular, is contraindicated because of psychological stress.
c.
The woman will be most comfortable with dental treatment in the second trimester.
d.
Dental care interferes with the need to practice conscious relaxation.

Answer 29

C

Question 30

With regard to work and travel during pregnancy, the nurse should be aware of which of the following?
a.
Women should sit for as long as possible and cross their legs at the knees from time to time for exercise.
b.
Women should avoid seat belts and shoulder restraints in the car because they press on the fetus.
c.
Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times.
d.
While working or travelling in a car or on a plane, women should arrange to walk around at least every hour or so.

Answer 30

D

Question 31

With regard to medications, herbs, immunizations, and other substances normally encountered, the nurse should be aware of which of the following?
a.
Both prescription and over-the-counter (OTC) drugs that otherwise are harmless can become hazardous by metabolic deficiencies of the fetus.
b.
The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester.
c.
Killed-virus vaccines (e.g., tetanus) should not be given during pregnancy, but live-virus vaccines (e.g., measles) are permissible.
d.
No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.

Answer 31

A

Question 32

Which statement about multifetal pregnancy is accurate?
a.
The expectant mother rarely develops anemia because the fetuses have a greater supply of iron.
b.
Twin pregnancies come to term with the same frequency as single pregnancies.
c.
Counsel the mother to increase her nutritional intake and gain more weight.
d.
Backache and varicose veins often are less pronounced.

Answer 32

C

Question 33

What is the name of the phenomenon of the expectant father experiencing pregnancy-like symptoms such as nausea?
a.
Hyperemesis
b.
Couvade
c.
Identification syndrome
d.
Psychological bingeing

Answer 33

B

Question 34

An innovative new approach to prenatal care known as centring pregnancy was recently implemented in one community in British Columbia. Which statement would accurately apply to the centring model of care?
a.
Group sessions begin with the first prenatal visit.
b.
At each visit, blood pressure, weight, and urine dipsticks are obtained by the nurse.
c.
Eight to 12 women are placed in gestational-age cohort groups.
d.
Outcomes are similar to those of traditional prenatal care.

Answer 34

C

Question 35

Which sign or symptom should the nurse teach the pregnant woman to report immediately to her health care provider?
a.
Vaginal mucous discharge
b.
Decreased libido
c.
Urinary frequency
d.
Heartburn accompanied by severe headache

Answer 35

D

Question 36

Which immunization is safe to administer to a pregnant woman?
a.
Tetanus
b.
Mumps
c.
Chickenpox
d.
Rubella

Answer 36

A