Anatomy
When the placenta is delivered after birth, the physician notes its surface is rough and blood-tinged. The nurse knows this appearance is characteristic of which side of the placenta?
A.The Duncan side, which is the maternal side.
B.The Schultz side, which is the fetal side.
C.The Chorion side, which is the outermost membrane.
D.The Amnion side, which is the innermost membrane.
A.The Duncan side, which is the maternal side.
A pregnant patient in her first trimester is prescribed progesterone supplements. She asks why this is necessary. The nurse correctly explains that progesterone's primary role is to:
A.Decrease uterine contractility to create a stable environment for the fetus.
B.Stimulate the maturation of the ovarian follicle.
C.Increase the contractility of the uterus to prepare for labor.
D.Trigger the release of the egg from the follicle during ovulation.
A.Decrease uterine contractility to create a stable environment for the fetus.
A nurse is assessing a client who is 30 weeks pregnant. The client reports feeling dizzy and nauseous when she lies flat on her back. The nurse recognizes these symptoms are likely caused by which physiological phenomenon?
A.Supine hypotensive syndrome
B.Physiologic anemia of pregnancy
C.Increased cardiac output
D.Braxton Hicks contractions
A.Supine hypotensive syndrome
A public health nurse is screening clients at their first prenatal visit. Which client profile presents the highest number of risk factors for developing GDM?
A.A 22-year-old Caucasian woman with a twin pregnancy.
B.A 28-year-old Asian woman with a history of chronic hypertension.
C.A 19-year-old African American woman who is underweight.
D.A 30-year-old obese Latina woman whose mother has type 2 diabetes.
D.A 30-year-old obese Latina woman whose mother has type 2 diabetes.
A client at 30 weeks gestation presents with elevated blood pressure. Which set of readings, combined with proteinuria, would be sufficient to diagnose preeclampsia?
A.A blood pressure of 130/85 mmHg at 18 weeks gestation.
B.Two readings of 138/88 mmHg taken one hour apart.
C.A blood pressure of 142/92 mmHg and a second reading of 144/90 mmHg five hours later.
D.A single blood pressure reading of 160/110 mmHg without proteinuria.
C.A blood pressure of 142/92 mmHg and a second reading of 144/90 mmHg five hours later.
A nursing student is reviewing the process of conception. They correctly identify that fertilization most commonly occurs in which specific location?
A.The fundus of the uterus
B.The fimbriae of the fallopian tube
C.The fluid-filled follicle of the ovary
D.The ampulla of the fallopian tube
D.The ampulla of the fallopian tube
What is the essential role of human chorionic gonadotropin (hCG) in the first few weeks of pregnancy?
A.To decrease uterine contractility and prevent premature labor.
B.To stimulate changes in maternal metabolism for fetal nutrition.
C.To trigger the maturation and release of the ovum from the follicle.
D.To signal the corpus luteum to continue producing progesterone.
D.To signal the corpus luteum to continue producing progesterone.
A client who is 10 weeks pregnant reports amenorrhea, breast tenderness, and urinary frequency. How should these signs be classified?
A.Presumptive signs
B.Pathognomonic signs
C.Probable signs
D.Positive signs
A.Presumptive signs
A client newly diagnosed with gestational diabetes is receiving dietary counseling. Which meal selection demonstrates an understanding of the recommended diet?
A.A low-fat yogurt with a granola bar.
B.A bowl of pasta with white bread.
C.Grilled chicken breast with a side of steamed broccoli.
D.A large fruit smoothie with honey.
C.Grilled chicken breast with a side of steamed broccoli
During an hourly assessment of a client with severe preeclampsia, the nurse notes hyperreflexia and clonus. These findings indicate an increased risk for which life-threatening complication?
A.HELLP syndrome
B.Pulmonary edema
C.Eclamptic seizure
D.Placental abruption
C.Eclamptic seizure
A patient tracking her fertility using the basal body temperature (BBT) method calls the clinic and reports that her temperature has risen by 0.7 degrees and remained elevated for three days. The nurse interprets this finding as a strong indication that:
A.Fertilization has been confirmed and implantation is underway.
B.She is currently in her most fertile period and should have intercourse now.
C.Ovulation has occurred within the past few days.
D.She is about to ovulate in the next 24-48 hours.
C.Ovulation has occurred within the past few days.
A nurse is explaining gestational diabetes to a pregnant client. The nurse should mention that which placental hormone can interfere with maternal insulin action, contributing to this condition?
A.Oxytocin
B.Human Placental Lactogen (HPL)
C.Human Chorionic Gonadotropin (hCG)
D.Progesterone
B.Human Placental Lactogen (HPL)
A pregnant client at 34 weeks gestation has a blood test. The results show a 45% increase in plasma volume and a 25% increase in red blood cell (RBC) production. The nurse anticipates which expected finding in the client's complete blood count (CBC)?
A.A decrease in fibrinogen and clotting factors.
B.A significant decrease in white blood cell count.
C.Elevated hemoglobin and hematocrit levels.
D.Slightly lower hemoglobin and hematocrit levels.
D.Slightly lower hemoglobin and hematocrit levels.
A nursing student is explaining the pathophysiology of gestational diabetes (GDM). Which statement accurately describes the role of human placental lactogen (hPL)?
A.hPL decreases maternal insulin production, leading to hyperglycemia.
B.hPL enhances the mother's sensitivity to insulin, preventing high blood sugar.
C.hPL directly converts maternal fat into glucose for the fetus.
D.hPL increases maternal insulin resistance to ensure more glucose is available for the fetus.
D.hPL increases maternal insulin resistance to ensure more glucose is available for the fetus.
A nurse is preparing a room for a client being admitted with severe preeclampsia. Which intervention is a priority for patient safety?
A.Preparing for immediate delivery via C-section.
B.Padding the side rails of the bed.
C.Encouraging frequent ambulation to prevent clots.
D.Placing the client on a high-protein diet.
B.Padding the side rails of the bed.
A patient's last menstrual period (LMP) began on April 20th. Using Naegle's rule, the nurse calculates the estimated due date (EDD) as which of the following?
A.July 27th
B.January 27th
C.February 20th
D.January 13th
B.January 27th
Which statement best contrasts the roles of estrogen and progesterone in maintaining a pregnancy?
A.Progesterone maintains the uterine lining and decreases contractions, while high levels of estrogen can increase contractility.
B.Progesterone is produced by the anterior pituitary, while estrogen is produced by the corpus luteum.
C.Both estrogen and progesterone work together to stimulate FSH and LH production during pregnancy.
D.Estrogen causes uterine relaxation while progesterone causes uterine contractility.
A.Progesterone maintains the uterine lining and decreases contractions, while high levels of estrogen can increase contractility.
A client presents for her first prenatal visit. She has a 4-year-old son born at 39 weeks and experienced a fetal loss at 18 weeks. She is currently 8 weeks pregnant. How would the nurse correctly document her obstetric history using the Gravida/Para system?
A.G2 P2
B.G3 P2
C.G3 P1
D.G2 P1
C.G3 P1
A fetus of a mother with poorly controlled GDM is at risk for respiratory distress syndrome after birth. What is the underlying cause of this risk?
A.Polyhydramnios restricts the fetus's ability to practice breathing movements.
B.Maternal hyperglycemia is directly toxic to fetal lung cells.
C.High levels of fetal insulin inhibit surfactant production.
D.Fetal macrosomia physically compresses the developing lungs.
C.High levels of fetal insulin inhibit surfactant production.
A nursing student asks why a fetus is at risk for complications like IUGR and oligohydramnios when the mother has preeclampsia. Which statement is the most accurate explanation?
A.The fetus develops its own vasospastic response in utero, which restricts its own growth.
B.Fetal exposure to the mother's high blood pressure directly damages the fetal kidneys and brain.
C.Maternal vasospasm leads to decreased placental perfusion, causing fetal hypoxia and malnutrition.
D.High levels of protein in the maternal urine draw essential nutrients away from the fetus.
C.Maternal vasospasm leads to decreased placental perfusion, causing fetal hypoxia and malnutrition.
A patient calls the clinic concerned. She says she had unprotected intercourse 10 days ago and her home urine pregnancy test was negative this morning. What is the nurse's most appropriate advice?
A.Tell her to wait until her next menstrual cycle to test again.
B.Advise her that she is definitely not pregnant since the test was negative.
C.Suggest she get a blood test, as it might already be positive.
D.Explain that home pregnancy tests are highly unreliable and she should ignore the result.
C.Suggest she get a blood test, as it might already be positive.
A patient is diagnosed with a pituitary adenoma affecting the anterior lobe. The nurse anticipates that this could disrupt the secretion of which pair of hormones essential for ovulation?
A.Oxytocin and ADH
B.FSH and LH
C.hCG and HPL
D.Estrogen and Progesterone
B.FSH and LH
A nurse reviews a client's history: she is currently pregnant, had one spontaneous abortion at 12 weeks, and has a living child who was born at 36 weeks. What is her correct TPAL status?
A.T: 0, P: 1, A: 1, L: 1
B.T: 1, P: 1, A: 1, L: 2
C.T: 0, P: 1, A: 0, L: 1
D.T: 1, P: 0, A: 1, L: 1
A.T: 0, P: 1, A: 1, L: 1
While GDM is often associated with large babies (macrosomia), it can sometimes lead to Intrauterine Growth Restriction (IUGR). What is the cause of IUGR in this context?
A.Fetal CNS defects associated with GDM prevent normal growth.
B.The mother's strict diet control provides inadequate calories for fetal growth.
C.The fetus produces too little insulin to utilize the available glucose for growth.
D.Decreased uteroplacental perfusion due to premature placental aging.
D.Decreased uteroplacental perfusion due to premature placental aging.
A nurse is caring for a client with preeclampsia. Which of the following findings would classify the condition as 'preeclampsia with severe features'?
A.A urine dipstick showing 2+ proteinuria.
B.Mild pitting edema in the lower extremities.
C.A platelet count of 95,000/mm3.
D.A blood pressure of 150/98 mmHg.
C.A platelet count of 95,000/mm3.