NURS 4403 Chapter 08: Nursing Care of the Family During Pregnancy
MULTIPLE CHOICE
1. The nurse caring for a newly pregnant woman would advise her t
... [Show More] hat ideally prenatal care should begin:
a. Before the first missed menstrual period.
b. After the first missed menstrual period.
c. After the second missed menstrual period.
d. After the third missed menstrual period.
2. Prenatal testing for human immunodeficiency virus (HIV) is recommended for:
a. All women, regardless of risk factors.
b. A woman who has had more than one sexual partner.
c. A woman who has had a sexually transmitted infection.
d. A woman who is monogamous with her partner.
3. Which symptom is considered a first-trimester warning sign and should be reported immediately by the pregnant woman to her health care provider?
a. Nausea with occasional vomiting c. Urinary frequency
b. Fatigue d. Vaginal bleeding
4. A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should inform her:
a. “You don’t need to modify your exercising any time during your pregnancy.”
b. “Stop exercising because it will harm the fetus.”
c. “You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month.”
d. “Jogging is too hard on your joints; switch to walking now.”
5. The multiple marker test is used to assess the fetus for which condition?
a. Down syndrome c. Congenital cardiac abnormality
b. Diaphragmatic hernia d. Anencephaly
6. A woman who is 32 weeks’ pregnant is informed by the nurse that a danger sign of pregnancy could be:
a. Constipation.
b. Alteration in the pattern of fetal movement.
c. Heart palpitations.
d. Edema in the ankles and feet at the end of the day.
7. A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse would tell her:
a. “Since you’re in your second trimester, there’s no problem with having one drink with dinner.”
b. “One drink every night is too much. One drink three times a week should be fine.”
c. “Since you’re in your second trimester, you can drink as much as you like.”
d. “Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy.”
8. A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild-to-moderate intensity. The nurse would recommend that she:
a. Do Kegel exercises. c. Use a softer mattress.
b. Do pelvic rock exercises. d. Stay in bed for 24 hours.
9. For what reason would breastfeeding be contraindicated?
a. Hepatitis B
b. Everted nipples
c. History of breast cancer 3 years ago
d. Human immunodeficiency virus (HIV) positive
10. A woman is 3 months pregnant. At her prenatal visit, she tells the nurse that she doesn’t know what is happening; one minute she’s happy that she is pregnant, and the next minute she cries for no reason. Which response by the nurse is most appropriate?
a. “Don’t worry about it; you’ll feel better in a month or so.”
b. “Have you talked to your husband about how you feel?”
c. “Perhaps you really don’t want to be pregnant.”
d. “Hormonal changes during pregnancy commonly result in mood swings.”
11. The nurse should be aware that the partner’s main role in pregnancy is to:
a. Provide financial support.
b. Protect the pregnant woman from “old wives’ tales.”
c. Support and nurture the pregnant woman.
d. Make sure the pregnant woman keeps prenatal appointments.
12. During the first trimester, a woman can expect which of the following changes in her sexual desire?
a. An increase, because of enlarging breasts
b. A decrease, because of nausea and fatigue
c. No change
d. An increase, because of increased levels of female hormones
13. Which behavior indicates that a woman is “seeking safe passage” for herself and her infant?
a. She keeps all prenatal appointments. c. She drives her car slowly.
b. She “eats for two.” d. She wears only low-heeled shoes.
14. A 3-year-old girl’s mother is 6 months pregnant. What concern is this child likely to verbalize?
a. How the baby will “get out” c. Whether her mother will die
b. What the baby will eat d. What color eyes the baby has
15. In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose?
a. To promote family unity
b. To ward off the “evil eye”
c. To appease the gods of fertility
d. To protect the mother and fetus during pregnancy
16. What type of cultural concern is the most likely deterrent to many women seeking prenatal care?
a. Religion c. Ignorance
b. Modesty d. Belief that physicians are evil
17. Which statement about pregnancy is accurate?
a. A normal pregnancy lasts about 10 lunar months.
b. A trimester is one third of a year.
c. The prenatal period extends from fertilization to conception.
d. The estimated date of confinement (EDC) is how long the mother will have to be bedridden after birth.
18. In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that:
a. Nonacceptance of the pregnancy very often equates to rejection of the child.
b. Mood swings most likely are the result of worries about finances and a changed lifestyle as well as profound hormonal changes.
c. Ambivalent feelings during pregnancy usually are seen only in emotionally immature or very young mothers.
d. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth.
19. With regard to a woman’s reordering of personal relationships during pregnancy, the maternity nurse should understand that:
a. Because of the special motherhood bond, a woman’s relationship with her mother is even more important than with the father of the child.
b. Nurses need not get involved in any sexual issues the couple has during pregnancy,
particularly if they have trouble communicating them to each other.
c. Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father.
d. The woman’s sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier.
20. What represents a typical progression through the phases of a woman’s establishing a relationship with the fetus?
a. Accepts the fetus as distinct from herself—accepts the biologic fact of pregnancy— has a feeling of caring and responsibility
b. Fantasizes about the child’s gender and personality—views the child as part of herself—becomes introspective
c. Views the child as part of herself—has feelings of well-being—accepts the biologic fact of pregnancy
d. “I am pregnant.”—“I am going to have a baby.”—“I am going to be a mother.”
21. As relates to the father’s acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that:
a. The father goes through three phases of acceptance of his own.
b. The father’s attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth.
c. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home.
d. Typically men remain ambivalent about fatherhood right up to the birth of their child.
22. With regard to the initial visit with a client who is beginning prenatal care, nurses should be aware that:
a. The first interview is a relaxed, get-acquainted affair in which nurses gather some general impressions.
b. If nurses observe handicapping conditions, they should be sensitive and not inquire about them because the client will do that in her own time.
c. Nurses should be alert to the appearance of potential parenting problems, such as depression or lack of family support.
d. Because of legal complications, nurses should not ask about illegal drug use; that is left to physicians.
23. With regard to the initial physical examination of a woman beginning prenatal care, maternity nurses should be cognizant of:
a. Only women who show physical signs or meet the sociologic profile should be assessed for physical abuse.
b. The woman should empty her bladder before the pelvic examination is performed.
c. The distribution, amount, and quality of body hair are of no particular importance.
d. The size of the uterus is discounted in the initial examination.
24. With regard to follow-up visits for women receiving prenatal care, nurses should be aware that:
a. The interview portions become more intensive as the visits become more frequent over the course of the pregnancy.
b. Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester.
c. During the abdominal examination, the nurse should be alert for supine hypotension.
d. For pregnant women, a systolic blood pressure (BP) of 130 and a diastolic BP of 80 is sufficient to be considered hypertensive.
25. While teaching the expectant mother about personal hygiene during pregnancy, maternity nurses should be aware that:
a. Tub bathing is permitted even in late pregnancy unless membranes have ruptured.
b. The perineum should be wiped from back to front.
c. Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath.
d. Expectant mothers should use specially treated soap to cleanse the nipples.
26. The nurse should have knowledge of the purpose of the pinch test. It is used to:
a. Check the sensitivity of the nipples.
b. Determine whether the nipple is everted or inverted.
c. Calculate the adipose buildup in the abdomen.
d. See whether the fetus has become inactive.
27. To provide the patient with accurate information about dental care during pregnancy, maternity nurses should be aware that:
a. Dental care can be dropped from the priority list because the woman has enough to worry about and is getting a lot of calcium anyway.
b. Dental surgery, in particular, is contraindicated because of the psychologic stress it engenders.
c. If dental treatment is necessary, the woman will be most comfortable with it in the second trimester.
d. Dental care interferes with the expectant mother’s need to practice conscious relaxation.
28. When discussing work and travel during pregnancy with a pregnant patient, nurses should instruct them that:
a. Women should sit for as long as possible and cross their legs at the knees from time to time for exercise.
b. Women should avoid seat belts and shoulder restraints in the car because they press on the fetus.
c. Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times.
d. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.
29. With regard to medications, herbs, shots, and other substances normally encountered by pregnant women, the maternity nurse should be aware that:
a. Both prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus.
b. The greatest danger of drug-caused developmental deficits in the fetus is seen in the
final trimester.
c. Killed-virus vaccines (e.g., tetanus) should not be given during pregnancy, but live- virus vaccines (e.g., measles) are permissible.
d. No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus.
30. Which statement about multifetal pregnancy is inaccurate?
a. The expectant mother often develops anemia because the fetuses have a greater demand for iron.
b. Twin pregnancies come to term with the same frequency as single pregnancies.
c. The mother should be counseled to increase her nutritional intake and gain more weight.
d. Backache and varicose veins often are more pronounced.
31. The phenomenon of someone other than the mother-to-be experiencing pregnancy-like symptoms such as nausea and weight gain applies to the:
a. Mother of the pregnant woman. c. Sister of the pregnant woman.
b. Couple’s teenage daughter. d. Expectant father.
32. In response to requests by the U.S. Public Health Service for new models of prenatal care, an innovative new approach to prenatal care known as centering pregnancy was developed. Which statement would accurately apply to the centering model of care?
a. Group sessions begin with the first prenatal visit.
b. At each visit, blood pressure, weight, and urine dipsticks are obtained by the nurse.
c. Eight to 12 women are placed in gestational-age cohort groups.
d. Outcomes are similar to those of traditional prenatal care.
33. While you are assessing the vital signs of a pregnant woman in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate?
a. Have the patient stand up and retake her blood pressure.
b. Have the patient sit down and hold her arm in a dependent position.
c. Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms.
d. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.
MULTIPLE RESPONSE
34. Signs and symptoms that a woman should report immediately to her health care provider include (Select all that apply):
a. Vaginal bleeding.
b. Rupture of membranes.
c. Heartburn accompanied by severe headache.
d. Decreased libido.
e. Urinary frequency.
35. A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview, you discover that she has not had any immunizations. Which immunizations should she receive at this point in her pregnancy (Select all that apply)?
a. Tetanus
b. Diphtheria
c. Chickenpox
d. Rubella
e. Hepatitis B
MATCHING
All pregnant women should be instructed to recognize and report potential complications for each trimester of pregnancy. Match the sign or symptom with a possible cause.
a. Severe vomiting in early pregnancy d. Decreased fetal movement
b. Epigastric pain in late pregnancy e. Glycosuria
c. Severe backache and flank pain
36. Fetal jeopardy or intrauterine fetal death
37. Kidney infection or stones
38. Gestational diabetes
39. Hyperemesis gravidarum
40. Hypertension, preeclampsia
36. ANS: D PTS: 1 DIF: Cognitive Level: Comprehension REF: 198 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
NOT: It is essential for the nurse to plan education needed by the pregnant woman to recognize and report these potential complications a timely manner. A trusting relationship contributes to a positive outcome for the pregnancy.
37. ANS: C PTS: 1 DIF: Cognitive Level: Comprehension REF: 198 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
NOT: It is essential for the nurse to plan education needed by the pregnant woman to recognize and report these potential complications a timely manner. A trusting relationship contributes to a positive outcome for the pregnancy.
38. ANS: E PTS: 1 DIF: Cognitive Level: Comprehension REF: 198 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
NOT: It is essential for the nurse to plan education needed by the pregnant woman to recognize and report these potential complications a timely manner. A trusting relationship contributes to a positive outcome for the pregnancy.
39. ANS: A PTS: 1 DIF: Cognitive Level: Comprehension REF: 198 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
NOT: It is essential for the nurse to plan education needed by the pregnant woman to recognize and report these potential complications a timely manner. A trusting relationship contributes to a positive outcome for the pregnancy.
40. ANS: B PTS: 1 DIF: Cognitive Level: Comprehension REF: 198 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
NOT: It is essential for the nurse to plan education needed by the pregnant woman to recognize and report these potential complications a timely manner. A trusting relationship contributes to a positive outcome for the pregnancy.
COMPLETION
41. A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period (LMP) was September 10, 2013. Her expected date of birth (EDB) would be? [Show Less]