Nursing Care of the Antepartum Family
Which finding is considered a presumptive (subjective) sign of pregnancy?
A. Positive pregnancy test
B. Chadwick sign
C. Amenorrhea
D. Ultrasound visualization of a fetus
Correct Answer: C
Rationale: Presumptive signs are subjective symptoms felt by the pregnant person (e.g., amenorrhea, nausea, fatigue).
Which finding is a probable (objective) sign of pregnancy?
A. Fetal heart tones heard by Doppler
B. Braxton Hicks contractions
C. Quickening
D. Ultrasound confirmation
Correct Answer: B
Rationale: Probable signs are objective but not diagnostic; Braxton Hicks contractions fall into this category.
Which finding is most consistent with true labor?
A. Contractions decrease with ambulation
B. Cervical dilation remains unchanged
C. Contractions become stronger and more regular
D. Discomfort is relieved by hydration
C.
Cephalic Presentation refers to which fetal position?
A. Buttocks entering the pelvis inlet first.
B. Shoulders entering the pelvis first.
C. Head entering the pelvis first.
D. Feet entering the pelvis first.
C.
Which value is demonstrated when a nurse advocates for equal access to healthcare services and opposes discrimination in patient care?
A. Autonomy
B. Integrity
C. Social Justice
D. Altruism
Correct Answer: C. Social Justice
Rationale:
Social justice refers to upholding moral, legal, and humanistic principles by ensuring fairness, equal treatment, and equal access to quality healthcare. Advocacy against discrimination aligns directly with this value.
Which statement correctly describes hCG during pregnancy?
A. Low levels indicate multiple gestation
B. It is secreted by the anterior pituitary
C. It is the earliest biochemical marker of pregnancy
D. It suppresses prolactin secretion
Correct Answer: C
Rationale: hCG is the earliest biochemical marker; low levels may indicate ectopic pregnancy.
A pregnant patient lies flat on her back during an exam and reports dizziness and nausea. What is the most likely cause?
A. Hypoglycemia
B. Increased cardiac output
C. Supine hypotensive syndrome
D. Dehydration
Correct Answer: C
Rationale: The gravid uterus compresses the inferior vena cava when supine, decreasing venous return.
Which pelvic type is considered most favorable for vaginal birth?
Gynecoid
A cervical canal that measures 1 cm in length would be documented as which effacement?
50%
Which statement best describes the primary purpose of the ANA Code of Ethics for Nurses?
A. It outlines hospital-specific policies for nursing practice
B. It defines the ethical ideals and duties of the nursing profession
C. It provides legal consequences for unethical behavior
D. It replaces the Nursing Bill of Rights
Correct Answer: B. It defines the ethical ideals and duties of the nursing profession
Rationale:
The ANA Code of Ethics is a concise statement of ethical ideals and obligations for all nurses, guiding professional conduct and decision-making across all practice settings.
The nurse expects which cardiovascular change during a normal pregnancy?
A. Decrease in blood volume
B. Sustained hypertension throughout pregnancy
C. Plasma volume increases more than RBCs
D. Decreased clotting factors
Correct Answer: C
Rationale: Plasma volume increases more than RBCs, causing physiologic anemia.
Which gastrointestinal complaint should the nurse anticipate in pregnancy due to smooth muscle relaxation and decreased peristalsis?
A. Diarrhea
B. Constipation
C. Increased appetite
D. Hyperactive bowel sounds
Correct Answer: B
Which assessment finding indicates placental separation during the third stage of labor?
A. Sudden drop in fetal heart rate
B. Uterus becomes boggyC. Umbilical cord lengthens
D. Cervix dilates to 10 cm
C. Rationale: Signs of placental separation include cord lengthening, globular uterus, uterine rise, and a gush of blood.
According to ACOG and AWHONN guidelines, how often should fetal heart rate be assessed in a high-risk patient during the second stage of labor?
Every five minutes
A nurse questions an order that may cause unnecessary harm to a patient. Which ethical principle is the nurse primarily upholding?
A. Beneficence
B. Fidelity
C. Nonmaleficence
D. Autonomy
C. Nonmaleficence
Rationale:
Nonmaleficence means “do no harm.” Questioning actions or orders that could cause patient harm reflects this ethical principle.
Oxytocin is secreted by the anterior pituitary gland.
A. True
B. False
B. It's created by the posterior pituitary gland
A pregnant patient with a prepregnancy BMI of 32 asks about recommended weight gain. What is the nurse’s best response?
A. “You should gain 25–35 lb.”
B. “You should gain 15–25 lb.”
C. “You should gain 11–20 lb.”
D. “Weight gain recommendations do not apply.”
Correct Answer: C
A laboring patient is using upright positions. Which outcome should the nurse anticipate?
A. Increased need for operative delivery
B. Increased supine hypotension
C. Shorter second stage of labor
D. Decreased pelvic dimensions
C.
A fetal heart rate tracing shows baseline variability of 3 bpm. How should the nurse interpret this finding?
A. Moderate variability
B. Marked variability
C. Minimal variability
D. Absent variability
C. Minimal variability is fluctuations less than 5 bpm.
A nurse knows the ethically correct action to take but feels unable to act due to institutional constraints and fear of retaliation. This situation best describes:
A. Moral agency
B. Moral resilience
C. Ethical uncertainty
D. Moral distress
D. Moral distress
Rationale:
Moral distress occurs when a nurse knows the right thing to do but is prevented from acting because of internal or external constraints, such as policies or power hierarchies.
Which nutritional counseling is most important to reduce the risk of congenital anomalies?
A. Increase calcium intake
B. Limit sodium intake
C. Ensure adequate folic acid intake
D. Avoid lactose-containing foods
Correct Answer: C
At a first prenatal visit, which finding requires priority follow-up by the nurse?
A. Ambivalence about the pregnancy in the first trimester
B. BMI of 27 with appropriate weight gain
C. History of isotretinoin use prior to conception
D. Mild nausea and vomiting
Correct Answer: C
Rationale: Isotretinoin is highly teratogenic and poses a serious fetal risk, requiring immediate evaluation.
Which maternal condition is most likely to cause late decelerations due to decreased uteroplacental perfusion?
A. Maternal hypotension
B. Umbilical cord compression
C. Fetal head compression
D. Rapid fetal descent
A.
A laboring patient has ruptured membranes, cervical dilation of 3 cm, and a low-lying presenting part. What is the priority nursing action?
A. Initiate intermittent auscultation
B. Prepare for internal fetal monitoring
C. Encourage ambulation
D. Obtain baseline vital signs
B. All criteria for internal fetal monitoring are met
A competent patient undergoing a C-section explicitly refuses general anesthesia. The physician orders it anyway due to impatience. What should the nurse identify as the primary ethical issue?
A. Violation of beneficence
B. Violation of patient autonomy
C. Lack of informed consent by the physician
D. Breakdown in team communication
Violation of patient autonomy
Rationale:
Autonomy is the patient’s right to make informed decisions about their own care. Administering anesthesia against the patient’s expressed wishes violates this core ethical principle, making it the priority concern.