A pregnant woman reports to the nurse that the first day of her last menstrual period was January 22. Using Nagele’s rule, which of the following dates would be the most accurate estimated date of delivery?
September 16
September 22
October 29
October 17
Which of the following best describes an abnormality in structure or function that occurs during fetal development?
Congenital defect
Genetic defect
Embryonic defect
Chromosomal defect
During which week would pregnancy begin to pose health concerns for the fetus?
36 weeks
38 weeks
40 weeks
42 weeks
Which of the following changes is experienced by the urinary system during pregnancy?
Increased urinary output secondary to total body water increase
Decreased bladder capacity
Decreased glomerular filtration rate (GFR) resulting from estrogen and progesterone surge
Increased renal excretion of acidic drugs
During a routine clinic visit, a pregnant woman expresses concern about reflux she is experiencing. Which statement should be made by the nurse when addressing the woman’s concern?
“Frequent heartburn may be a sign of fetal distress and an ultrasound should be performed immediately.”
“Frequent heartburn is caused by high levels of hormones during pregnancy.”
“Frequent heartburn is a result of gastrointestinal system changes that occur during pregnancy.”
“Frequent heartburn during pregnancy requires immediate consultation with a gastroenterologist.”
The client who is taking prescribed _____ would require preconception management to minimize the potential for drug-related birth defects
antiemitics
antiepiletics
iron
non-narcotic analgesics
A nurse is caring for a pregnant woman who has a pre-pregnancy body mass index (BMI) of 27. Which of the following instructions should the nurse provide the woman regarding weight gain during pregnancy?
“You should gain 11 to 20 pounds during your pregnancy.”
“You should gain 15 to 25 pounds during your pregnancy.”
“You should gain 25 to 35 pounds during your pregnancy.”
“You should gain 28 to 40 pounds during your pregnancy.”
A nurse is caring for a woman who is in labor. The nurse anticipates that the labor will progress through which of the following sequences?
Dilation stage, pressure stage, placental stage, recovery stage
Dilation stage, pushing stage, pain stage, recovery stage
Dilation stage, pushing stage, placental stage, recovery stage
Dilation stage, pushing stage, placental stage, refractory stage
A nurse is caring for a woman who is in labor and the fetus descends to the lower birth canal. The woman is in which of the following stages of labor?
First
Second
Third
Fourth
A nurse is caring for a woman during the fourth stage of labor. Which of the following best describes an action the nurse would take during this stage?
Providing constant reinforcement and education about the labor process and assisting the woman with pushing
Explaining unusual interventions such as the use of a fetal heart monitor
Assisting with labor discomfort by modeling breathing
Teaching the new mother positioning of the infant to assist with breastfeeding
Which of the following statements about race and culture in the United States is correct?
The United States ranks 22nd in the world for infant mortality rate
Ethnic minority populations have higher rates of low-birth-weight infants
Black infants are more likely to have cleft palates than Native American infants
Whites have more fraternal twin pregnancies than non-Whites
During the second prenatal visit, the pregnant woman informs the nurse that she has stopped smoking. This finding is based on an assessment of which functional health pattern?
Cognitive-perceptual pattern
Self-perception–self-concept pattern
Health perception–health management pattern
Values-beliefs pattern
A pregnant woman who is at the end of 20 weeks of gestation is at a prenatal visit. Which of the following changes in weight from pre-pregnancy would require the nurse to take additional action?
6 pound increase
11 pound increase
14 pound increase
20 pound increase
During a prenatal visit, a nurse discovers that a Black woman has been occasionally craving and eating clay. Which of the following actions should be taken by the nurse?
Tell the client that many pregnant women crave such nonfood substances, and it is not a problem
Ignore the comment because pica is acceptable in some rural Black cultures
Encourage the client to eat it with plenty of water because of the risk of constipation
Stress the importance of an appropriate diet and avoiding pica in a culturally sensitive way
A nurse is assessing the nutritional-metabolic patterns of a pregnant woman. Which of the following findings would be of concern to the nurse?
The woman drinks about 1 gallon of water a day
The woman works out at the gym daily
The woman does not like vegetables
The woman usually eats three meals a day in addition to two snacks a day
A woman who is 23 weeks pregnant is concerned because her baby is moving less than it was a few weeks ago. Which of the following statements would be the most appropriate response by the nurse?
“Your infant is in distress. We should call an ambulance.”
“You need to be more active; take a dance class once a week.”
“At this point in your pregnancy, the baby moves less frequently because of lack of space in the uterus.”
“You probably counted incorrectly.”
Which of the following mothers would be most likely to bond appropriately with their infant?
A mother who feels unloved will bond appropriately because now the baby will love her
A mother who feels great about herself will show love toward the infant and bond appropriately.
A mother who feels empty by the birth of her child will bond appropriately once she holds the baby
A mother who feels ugly will bond appropriately with her child because her child will bring self-esteem.
During the first prenatal visit, the pregnant woman informs the nurse that she cannot wait to start wearing maternity clothes. This finding is based on an assessment of which functional health pattern?
Cognitive–perceptual pattern
Values–beliefs pattern
A nurse is caring for a client who is 30 weeks pregnant at a prenatal visit. Which of the following statements made by the client would be of concern to the nurse and warrant further explanation and close follow-up?
“I have been feeling more tired lately.”
“My husband complains every time I ask him to do something for me.”
“Sometimes, the smell of food makes me nauseous.”
“I need to get up two times a night to go to the bathroom.”
A woman who is 30 weeks pregnant tells the nurse that she and her husband are having sexual difficulties. Which of the following actions should the nurse take?
Tell the woman she should not be sexually active at this point in her pregnancy because it may harm the fetus
Ask her to elaborate on the difficulties
Tell her that they should modify their positions during intercourse and that will take care of the problem
Tell her men like the way pregnant women look.
During a prenatal visit, a pregnant woman informs the nurse that she and her husband have chosen godparents for the baby. This finding is based on an assessment of which functional health pattern?
A pregnant woman is having a TORCH screening done at today’s prenatal visit. She states she is anxious to get the results back because she recently had unprotected sex with someone she just met and is afraid she might have HIV. Which of the following statements would be the best response by the nurse?
“You will know your HIV status in about 1 week when the results come back.”
“You will require additional testing for HIV as it is not tested for with the TORCH screen.”
“You will need to be tested for HIV after you deliver because pregnancy can produce false HIV results.”
“You need to be exposed for at least 6 months before being tested for HIV in order for the results to be accurate.”
A nurse makes a home visit to monitor the blood pressure of a pregnant woman who is single. Which finding would be of most concern to the nurse?
The bedroom is located on the second floor
She has a pet cat
There is an area rug in the living room.
She has a 1-year-old child
A client who is 36 weeks of gestation is at her prenatal visit. The nurse tells the client that she will be screened for group B Streptococcus during today’s visit. Which of the following statements would be made by the nurse when providing client education about this screening test?
“Screening for group B Streptococcus is necessary as this infection can cause complications with pregnancy and to the unborn infant.”
“This screening will help us to determine if your unborn infant will be susceptible to respiratory distress when he or she is born.”
“Screening for group B Streptococcus will help us identify if you have been exposed to this or any other infections during your pregnancy.”
“This screening is necessary to determine if there is any Rh blood group incompatibility between you and your unborn child.”
A woman is Rh negative and the father of her baby is Rh negative. The woman states that her friend told her that she would need a “shot” to keep her baby alive. Which of the following statements would be the best response by the nurse?
“Yes, you will need an injection of RhoGAM at 28 weeks of gestation and within 72 h after birth.”
“Because the father of the baby is also Rh negative, your baby will not inherit Rh positive blood cells and you will not need the injection.”
“Yes, you will need the injection because this is your first pregnancy. You will not need it with subsequent pregnancies.”
“No, you will not need the injection because you are White. Rh incompatibility affects only Black women.”
A woman who just found out she is pregnant starts crying. She tells the nurse that over the last 3 days she was not feeling herself, so she took some Tylenol. She states if she knew she was pregnant, she never would have taken the medication. Which of the following actions should be taken by the nurse?
Tell the client that there is a high probability that her baby will have a birth defect
Tell the client not to worry because research indicates that in recommended doses Tylenol is safe
Tell the client not to worry because she did not know she was pregnant, but in the future, she should use herbal products instead of over-the-counter medication.
Tell the client that there is a high probability of a stillbirth
A nurse is discussing the harmful effects that chemical agents can have on an unborn child with a woman who is pregnant. Which of the following statements made by the woman indicates a need for further teaching?
“It is safe to eat up to 12 ounces of cooked fish weekly.”
“I should avoid using caffeine during pregnancy.”
“Consumption of one drink per day will not cause any harm to my unborn baby.”
“Use of nicotine during pregnancy may cause my child to be born prematurely.”
During a prenatal visit, pregnant parents ask the nurse what they can do to prepare their 4-year-old child for the birth of the new baby. Which of the following actions would be most appropriate for the nurse to suggest?
Discourage any negative comments the child makes about the baby or the pregnancy
Do not make any plans regarding the baby in front of the 4-year-old child.
Provide him with very detailed information about the pregnancy and the birth
Ask the 4-year-old boy to help decorate the new baby’s room
A Mexican American woman comes to the office for a visit. She is found to be 30 weeks pregnant. Which of the following conclusions can the nurse draw from this finding?
The woman does not value prenatal care.
Client education may require a different approach because of dissimilar cultural beliefs
This culture does not believe in traditional medicine
Signs of pregnancy were not recognized by the woman
At 1 minute of age, an infant has a heart rate of 95, a strong cry, some flexion of extremities, a cry reflex, and is completely pink. Which of the following is a correct assessment of the infant’s Apgar score?
4
6
8
10
A woman usually eats an 1800-calorie diet. She is now in the second trimester of her pregnancy. Which of the following best describes the caloric nutritional needs for this woman during the second and third trimester?
1800 calories
2100 calories
2400 calories
2700 calories
Which properties must the sperm possess for conception to occur? (Select all that apply.)
High motility
Uniform size
Ability to secrete enzymes that dissolve the membrane surrounding the egg
Life span of at least 3 h
A nurse is assessing a woman for positive signs of pregnancy. Which of the following assessment findings would the nurse discover? (Select all that apply.)
Positive test for HCG in the maternal urine
Detection of fetal heart tones
Enlargement of the uterus
Palpation of fetal body parts
Which of the following statements is correct regarding Zika virus disease? (Select all that apply.)
Zika virus is transmitted primarily from a nocturnal mosquito bite
Up to 80% of people infected have no symptoms
The virus can cause microcephaly in the developing fetus
Women who may become pregnant should receive a preventive vaccine
Which of the following statements is correct regarding neonatal abstinence syndrome (NAS)? (Select all that apply.)
It results from exposure of the fetus in utero to illicit substances
Cocaine does cause this syndrome but opioids do not cause it
Infants with NAS have prolonged hospital stays for serious medical complications.
This problem is limited to lower socioeconomic levels, primarily in the inner cities.
