ANTEPARTUM
1. An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? Select all that apply.
1. Amenorrhea.
2. Breast tenderness.
3. Quickening.
4. Frequent urination.
5. Uterine growth.
1. 1, 2, 3, and 4 are correct.
1. Amenorrhea is a presumptive sign of
pregnancy.
2. Breast tenderness is a presumptive sign
of pregnancy.
3. Quickening is a presumptive sign of
pregnancy.
4. Frequent urination is a presumptive sign
of pregnancy.
5. Uterine growth is a probable sign of pregnancy.
16. A client makes the following statement after finding out that her pregnancy test is positive, “This is not a good time. I am in college and the baby will be due during final exams!” Which of the following responses by the nurse would be most appropriate at this time?
1. “I’m absolutely positive that everything will turn out all right.”
2. “I suggest that you e-mail your professors to set up an alternate plan.”
3. “It sounds like you’re feeling a little overwhelmed right now.”
4. “You and the baby’s father will find a way to get through the pregnancy.”
3. This is the best comment. It acknowl- edges the concerns that the client is having
23. The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the physician? Select all that apply.
1. 17 weeks’ gestation; denies feeling fetal movement.
2. 24 weeks’ gestation; fundal height at the umbilicus. 3. 27 weeks’ gestation; salivates excessively.
4. 34 weeks’ gestation; experiences uterine cramping.
5. 37 weeks’ gestation; complains of hemorrhoidal pain.
23. 2 and 4 are correct.
1. It is common for primigravid women not
to feel fetal movement until 19 to 20
weeks’ gestation.
2. The fundal height at 24 weeks should be 4 cm above the umbilicus. The fundal height at the level of the umbilicus is expected at 20 weeks’ gestation.
3. Excessive salivation, called ptyalism, is an expected finding in pregnancy.
4. The woman may be going into preterm labor.
5. Hemorrhoids are commonly seen in pregnant women.
30. A client who was seen in the prenatal clinic at 20 weeks’ gestation weighed 128 lb at that time. Approximately how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks’ gestation?
1. 129 to 130 lb.
2. 131 to 132 lb. 3. 133 to 134 lb. 4. 135 to 136 lb.
2. The woman would be expected to weigh 131 to 132 lb. At this stage of pregnancy, the woman is expected to gain about 0.8 to 1 lb a week.
36. A nurse midwife has advised a 39-week gestation gravid to take evening primrose oil 2,500 mg daily as a complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions?
1. Relieve back strain.
2. Improve development of colostrum.
3. Ripen the cervix.
4. Reduce the incidence of hemorrhoids.
3. Evening primrose converts to a prostaglandin substance in the body. Prostaglandins are responsible for readying the cervix for dilation.
3. When analyzing the need for health teaching of a prenatal multigravida, the nurse should ask which of the following questions?
1. “What are the ages of your children?”
2. “What is your marital status?”
3. “Do you ever drink alcohol?”
4. “Do you have any allergies?”
2. 2 and 5 are correct.
1. Glucose levels should be within normal
limits.
2. Fibrinogen levels will be elevated slightly in a 40-week-pregnant woman because coagulation factors like fibrinogen increase to help prevent excessive blood loss during delivery.
3. Hematocrit levels are usually slightly lower.
4. Bilirubin levels should be within normal
limits.
5. A 40-week-pregnant woman’s white blood cell count will be elevated above normal as a means of protecting her body from infection.
17. The nurse notes each of the following findings in a 10-week gestation client. Which of the findings would enable the nurse to tell the client that she is positively pregnant? 1. Fetal heart rate via Doppler.
2. Positive pregnancy test.
3. Positive Chadwick’s sign.
4. Montgomery gland enlargements.
17.
1. Hearing a fetal heart rate is a positive sign of pregnancy.
24. The following four changes occur during pregnancy. Which of them usually increases the father’s interest and involvement in the pregnancy?
1. Learning the results of the pregnancy test.
2. Attending childbirth education classes.
3. Hearing the fetal heartbeat.
4. Meeting the obstetrician or midwife.
3. Hearing the fetal heartbeat often increases fathers’ interests in their partners’ pregnancies
31. An 18-week gestation client telephones the obstetrician’s office stating, “I’m really scared. I think I have breast cancer. My breasts are filled with tumors.” The nurse should base the response on which of the following?
1. Breast cancer is often triggered by pregnancy.
2. Nodular breast tissue is normal during pregnancy.
3. The woman is exhibiting signs of a psychotic break.
4. Anxiety attacks are especially common in the second trimester.
2. Nodular breast tissue is normal in pregnancy
37. A 38-week gestation client, Bishop score 1, is advised by her nurse midwife to take evening primrose daily. The office nurse advises the client to report which of the following side effects that has been attributed to the oil?
1. Diarrhea.
2. Pedal edema.
3. Blurred vision.
4. Tinnitus.
1. Evening primrose has been shown to cause skin rash in some women.
4. A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time?
1. “We expect you to gain about 1 lb per week, so your weight is a little low at this
time.”
2. “Most women gain no weight during the first trimester, so I would suggest you eat
fewer desserts for the next few weeks.”
3. “You entered the pregnancy well underweight, so we should check your diet to
make sure you are getting the nutrients you need.”
4. “Your weight gain is exactly what we would expect it to be at this time.”
4. Is correct
The weight gain is within normal for the first trimester
18. The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor?
1. “My first child has cerebral palsy.”
2. “My first child has hypertension.” 3. “My first child has asthma.”
4. “My first child has cystic fibrosis.”
4. Cystic fibrosis is an autosomal recessive genetic disease, so the client with a family history of cystic fibrosis should be referred to a genetic counselor
26. A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit?
1. Nausea.
2. Dyspnea.
3. Urinary frequency. 4. Leg cramping.
4. Leg cramping is often a complaint of clients in the second trimester.
32. A woman states that she frequently awakens with “painful leg cramps” during the night. Which of the following assessments should the nurse make?
1. Dietary evaluation.
2. Goodell’s sign.
3. Hegar’s sign.
4. Posture evaluation.
1. A dietary evaluation is indicated since painful leg cramps can be caused by consuming too little calcium or too much phosphorus.
38. A 37-week gravid client states that she noticed a “white liquid” leaking from her breasts during a recent shower. Which of the following nursing responses is appropriate at this time?
1. Advise the woman that she may have a galactocele.
2. Encourage the woman to pump her breasts to stimulate an adequate milk supply.
3. Assess the liquid because a breast discharge is diagnostic of a mammary infection.
4. Reassure the mother that this is normal in the third trimester.
4. It is normal for colostrum to be expressed late in pregnancy.
7. A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? Select all that apply.
1. Pap smear.
2. Mammogram.
3. Glucose challenge test. 4. Biophysical profile.
5. Complete blood count.
7. 1 and 5 are correct.
1. The client will have a Pap smear done.
2. A mammogram will not be performed.
3. A glucose challenge test will likely be per-
formed at the end of the second trimester.
4. A biophysical profile may be done, but not
until the third trimester.
5. A complete blood count will be performed.
21. A woman, 6 weeks pregnant, is having a vaginal examination. Which of the following would the practitioner expect to find?
1. Thin cervical muscle.
2. An enlarged ovary.
3. Thick cervical mucus. 4. Pale pink vaginal wall.
2. The practitioner would expect to palpate an enlarged ovary
27. The glucose challenge screening test is performed at or after 24 weeks’ gestation to assess for the maternal physiological response to which of the following pregnancy hormones?
1. Estrogen.
2. Progesterone.
3. Human placental lactogen.
4. Human chorionic gonadotropin.
3. Human placental lactogen is an insulin antagonist.
34. A woman in her third trimester advises the nurse that she wishes to breastfeed her baby, “but I don’t think my nipples are right.” Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time?
1. Advise the client that it is unlikely that she will be able to breastfeed.
2. Refer the client to a lactation consultant for advice.
3. Call the labor room and notify them that a client with inverted nipples will be
admitted.
4. Teach the woman exercises to evert her nipples.
2. The client should be referred to a lactation consultant.
39. A 36-week gestation gravid client is complaining of dyspnea when lying flat. Which of the following is the likely clinical reason for this complaint?
1. Maternal hypertension.
2. Fundal height.
3. Hydramnios.
4. Congestive heart failure.
2. The fundal height is the likely cause of the woman’s dyspnea.
15. When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of?
1. Ambivalence.
2. Depression.
3. Anxiety. 4. Ecstasy.
15. 1. It is common for women to be ambiva- lent about their pregnancy during the first trimester.
22. A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the preprocedure teaching?
1. Fast for 12 hours before the test.
2. Bring a urine specimen to the laboratory on the day of the test.
3. Be prepared to have 4 blood specimens taken on the day of the test. 4. The test should take one hour to complete.
4. The test does take about 1 hour to complete
28. A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse’s best response?
1. “Because the organ systems in the baby are developing right now, it is risky to
take medicine.”
2. “You can take any of the over-the-counter medications because they are all safe in
pregnancy.”
3. “The physician will prescribe a category ‘X’ medication for you.”
4. “You can take acetaminophen because it is a category ‘B’ medicine.”
4. Category “B” medications have been shown to be safe to take throughout pregnancy.
35. Which of the following vital sign changes should the nurse highlight for a pregnant woman’s obstetrician?
1. Prepregnancy blood pressure (BP) 100/60 and third trimester BP 140/90.
2. Prepregnancy respiratory rate (RR) 16 rpm and third trimester RR 22 rpm.
3. Prepregnancy heart rate (HR) 76 bpm and third trimester HR 88 bpm. 4. Prepregnancy temperature (T) 98.6oF and third trimester T 99.2oF.
1. The blood pressure should not ele- vate during pregnancy. This change should be reported to the health care practitioner.
40. The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of the pregnancy. Which of the following comments by the client indicates that teaching was successful? Select all that apply.
1. “During the third trimester I may experience frequent urination.”
2. “During the third trimester I may experience heartburn.”
3. “During the third trimester I may experience nagging backaches.”
4. “During the third trimester I may experience persistent headache.”
5. “During the third trimester I may experience blurred vision.”
40. 1, 2, and 3 are correct.
1. Frequency is seen once lightening, or
the descent of the fetus into the pelvis,
has occurred.
2. Heartburn is a common complaint of
pregnant women.
3. Backaches are common complaints of
pregnant women.
4. Persistent headache should not be seen in pregnant women.
5. Pregnant women should not complain of blurred vision.