Fathers who smoke can contribute to decreased birth weight in their infants.
2. In addition to syphilis and gonorrhea, prenatal laboratory work usually includes tests for which of these infectious diseases?
-chlamdyia and human papillamavirus
3. Which of these terms would the nurse use when describing the fertilized ovum prior to implantation?
4. The nurse explains to the prenatal client that the implantation of the fertilized ovum begins on approximately what day after conception?
5th or 7th
5. Functions of the placenta include serving as:
an organ of oxygen exchange between the fetus and mother
6. Upon examination, a normal umbilical cord should contain:
two arteries and one vein
7. A father asks when his baby’s heart will start beating. The nurse should tell the father the primitive heart begins to beat at which of these times after conception?
8. A pregnant client expresses concern that she will develop varicose veins toward the end of her pregnancy. The nurse should recognize that varicose veins are result of:
compression of the abdominal veins by the progressively enlarging uterus
9. Normal physiologic changes of pregnancy include which of the following/-
Increased estrogen causes a loosening of connective tissue and an increase in vaginal secretions
10. At 34 weeks gestation, a normal prenatal client should have a hematocrit of:-
34% to 40%
11. At her first prenatal visit a client discusses how her breasts have changed since she became pregnant. What are the normal breast changes that occur during the first trimester?
-darkening of the areola, increased size, and enlarged Montgomery’s tubercles
12. A prenatal client expresses concern about the irregular brown spotted areas she has recently noticed on her forehead and around her eyes. What should the nurse tell the client about the name and nature of these changes?
They are called chloasma and are temporary
13. When a primigravida comes for her 20-week prenatal visit, which of these presumptive signs of pregnancy would the nurse expect the client to report?-
14. In addition to auscultation of fetal heartbeat and visualization of the fetus, which of these is a positive sign of pregnancy?
-palpitation of fetal movement
15. At her 36 weeks gestation prenatal visit, a client complains of backaches and an “unstable” sensation in the pelvis. The nurse should explain to the client that these are normal discomforts of pregnancy primarily due to:
posture changes as a result of the growing uterus
16. The obstetrician performed a vaginal examination on a client in her third trimester and gave a sudden push on the cervix. Later, the client asks the nurse what procedure was and why it was done. The MOST appropriate response from the nurse would be:
ballottement (fetal rebound)
17. Which of these terms describes the development task of pregnancy that occurs as the mother incorporates the growing fetus into her body image?
18. A client’s last menstrual period began on July 13. Using Naegal’s rule, the nurse calculates the client’s estimated date of delivery (EDD) as:
19. A client’s fundal height has increased 4 cm since her last prenatal exam 1 month ago. The nurse should recognize that this measurement indicates:
13. normal fetal growth
A client at 30 weeks gestation asks about her alloweable weight gain for the remainder of her pregnancy. The client’s pre-pregnancy weight is 100 lbs. and she currently weighs 125 lbs. A weight gain of how many pounds would be the most acceptable?
-1 lb. per week over the remainder of the pregnancy
21. A client of normal pre-pregnancy weight asks what her total weight gain during the pregnancy should be. The MOST appropriate answer from the nurse is:
-25 to 35 lbs.
22. A prenatal Pap smear is done on cervical secretions to diagnose which of these conditions?-
23. Assessment of fetal position is routinely performed during a client’s prenatal visits using:
24. During a physical examination, the fetal heart rate is considered to tachycardia. The nurse knows that a fetal heart rate that is tachycardic will display how beats per minute?
-170 – 180
25. A client asks why she must provide a urine specimen at each of her prenatal visits. The nurse should explain that it is necessary to:
-check for an excess of protein or sugar, which may indicate a complication of pregnancy
26. A nurse should instruct a prenatal client to repost any warning signs during pregnancy, such as:\
15. dizziness and visual disturbances
27. In addition to telling the client to report any warning signs, a nurse should provide anticipatory guidance for pregnant client that includes which of these topics?
-avoiding environmental hazards
28. Which of the following factors place at woman at risk of nutritional inadequacy during her pregnancy?-
29. A pregnant client tells the nurse that she is having leg cramps. Which of these suggestions should the nurse offer?
-pull toes toward the knee flexing the calf muscles
30. A pregnant client tells that nurse “I don’t know what’s the matter with me. I am happy about my pregnancy but seem to cry a lot.” Which of these responses should the nurse make?
normal hormonal changes contribute to these mood swings
31. A client’s last menstrual period began on June 16. Using Naegele’s rule, the nurse calculates the client’s estimated date of delivery (EDD) as:
32. Which of the following is NOT considered a general high-risk factor in a pregnant client?
-being a 17-year-old female
33. A pregnant client has a nonstress test (NST) that is “nonreactive.” The nurse should recognize that this means:
the fetus is asleep or is having problems
A high-risk client in labor is having electronic fetal monitoring (EFM). Which of these interpretations should the nurse recognize as normal, requiring no intervention?
a baseline rate of 180 bpm
35. A 17-year-old primigravida client is admitted to the hospital at 15 weeks gestation with a diagnosis of hyperemesis gravidum. The nurse should recognize that this condition can have which of these consequences?
dehydration and disruption in cardiac function
36. The nurse is explaining fetus viability to a client considering terminating her pregnancy. The nurse explains that a fetus us usually considered viable and can survive with medical interventions at how many weeks?
37. A new client is admitted with vaginal bleeding and cramping at 12 weeks gestation. A vaginal examination reveals her cervix is partially dilated. The client appears to be experiencing which type of spontaneous abortion?
38. What is the treatment of choice for a newly pregnant woman whose pregnancy history includes habitual abortions as the result of an incompetent cervix?
surgical treatment with cerclage at 16weeks following by cesarean delivery at term
39. A client states that she may have appendicitis because she started having pains in her side last week, and it is becoming progressively more severe. During the nursing assessment, the client tells the nurse she missed her period a month ago and has experienced nausea and breast tenderness. The nurse should report this information to the health care provider immediately , because the client may have developed which of these complications?
40. A client is admitted at 18 weeks gestation with a probable diagnosis of hydatidiform mole. Her signs and symptoms include high-serum human chorionic gonadotropin (HCG) levels, pregnancy-induced hypertension (PIH), uterine enlargement greater than expected for the estimatedgestational period, and vaginal bleeding. For the client’s nursing diagnosis of Fear related to the possible development of choriocarcinoma, which of these nursing interventions is appropriate?
allow the client to express her feelings, and refer her to support sources
41. A client has painless vaginal bleeding at 35 weeks gestation and is scheduled for an ultrasound to confirm a diagnosis of placenta previa. In addition to monitoring the client’s vital signs and fetal heart rate, nursing management of this client would include?
bed rest with bathroom privileges if no bleeding occurs
42. Which of these obstetrical problems may precipitate a client developing disseminated intravascular coagulation (DIC)?
pregnancy-induced hypertension (PIH), hydatiform mole, abruption placenta, or placenta previa
43. A client a with mild preeclampsia is ordered to stay in bed rest at home, lying on either side. Why is client teaching essential to improve her compliance with this plan of care?
the client may feel guilty for having others care for her
44. A 35-year-old gravid V para IV is admitted at 36 weeks gestation with a diagnosis of severe preeclampsia. She is started on magnesium sulfate IV. Which of these signs would indicate to the nurse that the client has developed magnesium sulfate toxicity?
respirations are 10 per minute
45. When a client undergoing treatment for severe preeclampsia complains of epigastric pain, the nurse should notify her health care provider immediately because the client is:
moving into eclampsia
46. When a client is being treated with magnesium sulfate for preeclampsia, which of these drugs must be kept in a syringe at the client’s bedside ready for administration if signs of magnesium toxicity are noted?
47. When a pregnant woman with phenylketonuria (PKU) has a poorly regulated phenylalaine level, it causes an increase in the incidence of which condition in the fetus or neonate?
intrauterine growth retardation ( IUGR)
48. To prevent fetal infection, a cesarean birth is required for the pregnant client who is infected with which of these organisms at the time of delivery?
49. In which of these situations can Rh incompatibility develop?
the mother is Rh negative, and the fetus is Rh positive
50. A pregnant client is admitted at 36 weeks gestation with documented uterine contractions, ruptured membranes, and a 5cm cervical dilation. The nurse should anticipate the health care provider wil:
make no attempt to stop the labor
51. A client in scheduled for amniocentesis. What should the nurse do to prepare the client for the procedure?
ask the client to void. Assess fetal heart rate. Monitor maternal vital signs.
52. According to Mrs. Barbara Mafnas possible pre-term complications to the fetus include:
low birth weight baby, weaken immune system, and increased risk for Sudden Infant Death Syndrome (SIDS)
53. According to Mrs. Barbara Mafnas post-term complications to the fetus include:
increased body weight, increased risk of cesarean section, placental insufficiency, decreased Fetal Kick Count (FKC), and meconium leakage
54. According to Mrs. Barbara Mafnas a positive Group-B Strep (+GBS) will require:
intravenous (IV) antibiotics (ABx) before and after delivery
55. According to Mrs. Barbara Mafnas the benefits of Lamaze are:
less labor and delivery complications
shorter labor and deliver
56. According to Mrs. Barbara Mafnas the possible causes of a pregnant client less than 37 weeks having 4 contractions in 1 hour may be caused by:
urinary tract infections or dehydration
57. According to Mrs. Barbara Mafnas a baby born jaundice is due to a breakdown of or immature red blood cells (RBC) leading to yellowing of the skin. Possible complications of a baby being born jaundice include:
seizures and mental retardation
58. According to Mrs. Barbara Mafnas Lamaze teaches and encourages the following breathing techniques during delivery:
focus on a fixed item and breath through mouth mimicking the sounds of “hee… hee…hee…hooo…”
59. The following are signs and symptoms of abortion:
vaginal bleeding: scant to profuse
abdominal cramping: slight to severe
contractions: intermittent, steady, mild or severe
60. A patient who is a mother of a 5-year-old son and is now pregnant again should be classified as:
gravid 2, para 1
61. One of the earliest presumptive signs of pregnancy is:
missed menstrual period
62. A couple planning their first pregnancy asks the nurse about the accuracy of home pregnancy tests. The nurse replies “home pregnancy tests are widely used today.” However, it is most important that prospective parents.
wait at least 9-10 days after the first missed period
63. For better accuracy the suspected pregnant client should be given the following instructions by the nurse:
tell her to withhold fluid intake during the night and bring the first voided specimen in the morning to the clinic
64. Which of the following are the most common reasons for why a pregnant client does not seek
underlying mental illness issues
substance abuse problems
unaware of pregnancy
denial of pregnancy
65. A client is receiving magnesium sulfate for HELLP syndrome (aka Hemolytic Anemia-Elevated Liver Enzymes-Low Platelet Count). The nursing interventions for this client should include which of the following
monitor respirations (must at least be 12)
monitor deep tendon reflexes
monitor hemoglobin level
monitor urine output (at least 30 cc/hr)
66. A client with diabetes gives birth to a 9-lb, 10-oz neonate at 38 weeks. The neonates glucose serum will be assessed immediately after birth
67. The nurse is assisting in monitoring a client who is receiving oxytocin (pitocin) to induce labor. The nurse should be alert that it may adversely affect the maternal client’s status by possibly leading to hypertension, tachycardia, and fluid overload.
68. The nurse is collecting data on a client in labor. The nurse notes that the fetal heart rate is 110 beats/minute and classified as a “bradaycardic fetal heart rate.”
69. The nurse is assisting in the labor and delivery room. The physician makes an incision in the client’s perineum to enlarge to vaginal opening and facilitate delivery. The nurse documents in the client’s chart that this procedure is termed “episiotomy.”
70. A primigravida client experiences spontaneous rupture of the membranes. It is the nurse’s responsibility to immediately check fetal heart rate to detect changes associated with prolapsed or compression of the umbilical cord.
71. According to Mrs. Barbara Mafnas ann OB-GYN Clinic must meet the “gold standards” established by the American College of Obstetrics and Gynecology (ACOG) to receive accreditation.
72. According to Mrs. Barbara Mafnas a Fetal Kick Count (FKC) is performed at 28 weeks and 15 minutes after the client eats her evening meal. A normal FKC must be equal to or greater than 10 kicks per hour.
73. According to Mrs. Barbara Mafnas the first OB appointment will consist of a (1) pap smear (2) breast exam (3) Sexually Transmitted Disease (STD) (4) urinalysis
74. According to Mrs. Barbara Mafnas the following OB appointments will include (1) blood pressure (BP) measurement (2) urinalysis (3) client’s weight
75. According to Mrs. Barbara Mafnas recent research indicates that a pregnant client who smokes cigarettes causes increased risk of a sexually transmitted disease (STD) to the fetus