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To reassure and educate pregnant clients about changes in their breasts, nurses should be aware that:
a) The mammary glands do not develop until 2 weeks before labor.
b) Lactation is inhibited until the estrogen level declines after birth.
c) The visibility of blood vessels that form an intertwining blue network indicates full function of Montgomery’s tubercles and possibly infection of the tubercles.
d) Colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.
To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that:
a) Palpitations are twice as likely to occur in twin gestations.
b) A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear.
c) All of the above changes likely will occur.
d) Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.
Some pregnant clients may complain of changes in their voice and impaired hearing. The nurse can tell these clients that these are common reactions to:
a) Displacement of the diaphragm, resulting in thoracic breathing.
b) A decreased estrogen level.
c) Increased blood volume.d) Congestion and swelling, which occur because the upper respiratory tract has become more vascular.
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
The nurse providing care to the pregnant woman should know that all are normal gastrointestinal changes in pregnancy except:
b) Decreased peristalsis.
A woman’s obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?
To reassure and educate pregnant clients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:
a) Increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty.
b) Increased urinary output makes pregnant women less susceptible to urinary infection.
c) Using diuretics during pregnancy can help keep kidney function regular.
d) Renal (kidney) function is more efficient when the woman assumes a supine position.
During a client’s physical examination the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:
a) Chadwick’s sign
b) McDonald’s sign
c) Goodell’s sign
d) Hegar’s sign
Which statement about a condition of pregnancy is accurate?
a) Hyperthyroidism often develops (temporarily) because hormone production increases.
b) Insufficient salivation (ptyalism) is caused by increases in estrogen.
c) Acid indigestion (pyrosis) begins early but declines throughout pregnancy.d) Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.
A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that:
a) The woman has been using cocaine intranasally.
b) This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.
c) This is an abnormal cardiovascular change, and the nosebleeds are an ominous sign.
d) The woman is a victim of domestic violence and is being hit in the face by her partner.
A 31-year-old woman believes that she may be pregnant. She took an OTC pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview the nurse inquires about the woman’s last menstrual period and asks whether she is taking any medications. The woman states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. She also has a history of irregular periods. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which reveals that she is not pregnant. What is the most likely cause of the false-positive pregnancy test result?
a) She has a fibroid tumor.
b) She took the pregnancy test too early.
c) She takes anticonvulsants.
d) She has been under considerable stress and has a hormone imbalance.
A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have:
a) Hegar’s sign
c) Chadwick’s sign.
d) Positive pregnancy test
A woman is in for a routine prenatal checkup. You are assessing her urine for proteinuria. You know that which findings are considered normal? Choose all that apply.
a) 300 mg/24 hours
b) Dipstick assessment of +2
c) 300 mg/24 hours
d) Dipstick assessment of trace to +1
The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a positive sign of pregnancy is:
b) A positive pregnancy test.
c) Fetal movement palpated by the nurse-midwife.
d) Braxton Hicks contractions.
Which time-based description of a stage of development in pregnancy is accurate?
a) Preterm—pregnancy from 20 to 28 weeks
b) Term—pregnancy from the beginning of week 38 of gestation to the end of week 42
c) Viability—22 to 37 weeks since the last menstrual period (LMP) (assuming a fetal weight greater than 500 g)
d) Postdate—pregnancy that extends beyond 38 weeks
To reassure and educate pregnant clients about changes in the uterus, nurses should be aware that:
a) Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise.
b) The uterine souffle is the movement of the fetus.
c) Lightening occurs near the end of the second trimester as the uterus rises into a different position.
d) The woman’s increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softening.
A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lb) since conception. How would the nurse interpret this?
a) This weight gain indicates that the woman’s infant is at risk for intrauterine growth restriction (IUGR).
b) This weight gain indicates possible gestational hypertension
c) The woman’s weight gain is appropriate for this stage of pregnancy.
d) This weight gain cannot be evaluated until the woman has been observed for several more weeks.
Which meal would provide the most absorbable iron?
a) Red beans and rice, cornbread, mixed greens, and decaffeinated tea
b) Oatmeal, whole wheat toast, jelly, and low-fat milk
c) Toasted cheese sandwich, celery sticks, tomato slices, and a grape drink
d) Black bean and tomato soup, wheat crackers, cooked spinach, ambrosia (orange sections, coconut, and pecans), and prunes
A pregnant woman’s diet history indicates that she likes the following list of foods. The nurse would encourage this woman to consume more of which food to increase her calcium intake?
a) Canned sardines
b) Fresh apricots
c) Canned clamsd) Spaghetti with meat sauce
A pregnant woman’s diet consists almost entirely of whole grain breads and cereals, legumes, beans, calcium fortified soy and juice, fruits, and vegetables. The nurse would be most concerned about this woman’s intake of:
b) Vitamin B12.
c) Folic acid.
Which vitamins or minerals can lead to congenital malformations of the fetus if taken in excess by the mother?
a) Vitamin D
b) Folic acid
d) Vitamin A
A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman:
a) Reduce the amount of fiber she consumes.
b) Eat five small meals daily.
c) Substitute other calcium sources for milk in her diet.
d) Lie down after each meal.
Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:
a) Down syndrome.
b) Diabetes mellitus.
c) Spina bifida.
d) Intrauterine growth restriction.
To prevent gastrointestinal upset, clients should be instructed to take iron supplements:
a) At bedtime.
b) On a full stomach.
c) With milk.
d) After eating a meal.
When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:
a) Constipation is common with iron supplements.
b) Iron absorption is inhibited by a diet rich in vitamin C.
c) Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.
d) Iron supplements are permissible for children in small doses.
Which statement made by a lactating woman would lead the nurse to believe that the woman might have lactose intolerance?
a) “Sometimes I notice that I have bad breath after I drink a cup of milk.”
b) “Drinking milk usually makes me break out in hives.”
c) “If I drink more than a cup of milk, I usually have abdominal cramps and bloating.”
d) “I always have heartburn after I drink milk.”
Three servings of milk, yogurt, or cheese plus two servings of meat, poultry, or fish will adequately supply the recommended amount of protein for the pregnant woman. Many clients are concerned about the increased levels of mercury in fish and may be afraid to include this source of nutrients in their diet. Sound advice by the nurse to assist the client in determining which fish is safe to consume would include:
a) Avoid shark, swordfish, and King mackerel.
b) Salmon and shrimp contain high levels of mercury.
c) Fish caught in local waterways are the safest.
d) Canned white tuna is a preferred choice
A pregnant woman experiencing nausea and vomiting should:
a) Increase her intake of high-fat foods to keep the stomach full and coated.
b) Eat small, frequent meals (every 2 to 3 hours).
c) Limit fluid intake throughout the day.
d) Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.
To help a woman reduce the severity of nausea caused by morning sickness, the nurse might suggest that she:
a) Brush her teeth immediately after eating.
b) Try a tart food or drink such as lemonade or salty foods such as potato chips.
c) Never snack before bedtime.
d) Drink plenty of fluids early in the day.
While taking a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. This represents a nutritional problem known as:
Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. The nurse or midwife should refer a client to a registered dietitian for in-depth nutritional counseling when the following exist(s)? Choose all that apply.
a) Ethnic or cultural food patterns
b) Preexisting or gestational illness such as diabetes
d) Vegetarian diets
A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She can expect the following advice:
a) “Lose weight so that you can gain more during pregnancy.”
b) “You may take any medications you have been taking regularly.”
c) “Discontinue all contraception now.”
d) “Make sure that you include adequate folic acid in your diet and or take prenatal vitamins with folic acidi or take a folic acid supplement.”
Pregnant adolescents are at high risk for _____ because of lower body mass indices (BMIs) and “fad” dieting.
a) Low-birth-weight babies
c) High-birth-weight babies
After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so you can assess her understanding of the instructions given. Which statement indicates that she understands the role of protein in her pregnancy?
a) “Protein will help my baby grow.”
b) “Eating protein will make my baby have strong teeth after he is born.”
c) “Eating protein will prevent me from becoming anemic.”
d) “Eating protein will prevent me from being diabetic.”
With regard to protein in the diet of pregnant women, nurses should be aware that:
a) Many women need to increase their protein intake during pregnancy.
b) Many protein-rich foods are also good sources of calcium, iron, and B vitamins.
c) As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet.
d) High-protein supplements can be used without risk by women on macrobiotic diets.
Which minerals and vitamins usually are recommended to supplement a pregnant woman’s diet?
a) Iron and folate
b) Water-soluble vitamins C and B6
c) Calcium and zinc
d) Fat-soluble vitamins A and D
A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 16.0. The nurse knows that this woman’s total recommended weight gain during pregnancy should be at least:
a) 16 kg (35 lb).
b) 10 kg (22 lb).
c) 20 kg (44 lb).
d) 12.5 kg (27.5 lb).
Which of the following is true about autosomal recessive inheritance.
a) Brown eyes are an example of an autosomal recessive trait.
b) Hemophilia is inherited as an autosomal recessive gene inherited from both parents.
c) If both parents have the recessive gene then all of their offspring will have the condition.
d) When the characteristic is autosomal recessive trait, it requires a recessive gene received from both parents for it to be expressed.
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time?
a) Ultrasound examination
b) Nonstress test (NST)
c) Maternal serum alpha-fetoprotein screening (MSAFP)
A pregnant client comes for a prenatal visit at 20 weeks gestation. where would you expect to find the fundus.
a) 24 cm
b) half between the umbilicus and the symphysis
c) at the umbilicus
d) 22 cm
A woman with a last menstrual period of July 4, 2012 - using Nagele rule when is she due.
a) April 11, 2013
b) May 11, 2013
c) April 25, 2013
d) April 18, 2013
Which of the following is correct with respect to anemia in pregnancy?
a) A serum ferritin level below 20 mcg/L confirms an anemia is caused by iron deficiency.
b) Normal hematocrit values in pregnancy are above 30%.
c) Iron rich foods as well as iron supplements are better absorbed with vitamin C.
d) Other than fatigue there are no particular risks associated with anemia in pregnancy.
Iron rich foods as well as iron supplements are better absorbed with vitamin C.
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