Test Bank For Introduction to Maternity And Pediatric Nursing, 7th Edition by Gloria Leifer
Chapter 04: Prenatal Care and Adaptations to Pregnancy
MULTIPLE CHOICE
1. A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2-year-old son and had one previous spontaneous abortion. How would the nurse document the patient’s obstetric history using the TPALM system?
a.
Gravida 2, para 20120
b.
Gravida 3, para 10011
c.
Gravida 3, para 10110
d.
Gravida 2, para 11110
ANS: C
Refer to Box 4-1 in the textbook for the TPALM system of identifying gravida and para.
DIF: Cognitive Level: ApplicationREF: Page 48, Box 4-1
OBJ:1TOP: Definition of Terms
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
2. A woman calls her healthcare provider to schedule prenatal visits in an uncomplicated pregnancy. How frequently will the nurse assist the patient to schedule these appointments?
a.
Every 3 weeks until the 6th month, then every 2 weeks until delivery
b.
Every 4 weeks until the 7th month, after which appointments will become more frequent
c.
Monthly until the 8th month
d.
Every 2 to 3 weeks for the entire pregnancy
ANS: B
Monthly visits are scheduled up to 28 weeks, and then visits increase to every 2 to 3 weeks through 36 weeks. From 36 weeks until delivery, visits are weekly.
DIF: Cognitive Level: Application REF: Page 46 OBJ: 2 | 3
TOP: Prenatal Visits KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
3. During the physical examination for the first prenatal visit, it is noted that Chadwick’s sign is present. What is Chadwick’s sign?
a.
Bluish or purplish discoloration of the vulva, vagina, and cervix
b.
Presence of early fetal movements
c.
Darkening of the areola and breast tenderness
d.
Palpation of the fetal outline
ANS: A
Chadwick’s sign is the purplish or bluish discoloration of the cervix and vagina.
DIF: Cognitive Level: Knowledge REF: Page 49 OBJ: 7
TOP:Normal Physiological Changes in Pregnancy
KEY:Nursing Process Step: Data Collection
MSC:NCLEX: Physiological Integrity: Physiological Adaptation
4. After the examination is completed, the patient asks the nurse why Chadwick’s sign occurs during pregnancy. What would the nurse explain as the cause of Chadwick’s sign?
a.
Enlargement of the uterus
b.
Progesterone action on the breasts
c.
Increasing activity of the fetus
d.
Vascular congestion in the pelvic area
ANS: D
Chadwick’s sign is caused by increased vascular congestion in the cervical and vaginal area.
DIF: Cognitive Level: Comprehension REF: Page 49 OBJ: 6 | 7
TOP:Normal Physiological Changes in Pregnancy
KEY:Nursing Process Step: Implementation
MSC:NCLEX: Physiological Integrity: Physiological Adaptation
5. The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that the woman understands the information?
a.
“Blood pressure goes up toward the end of pregnancy.”
b.
“My breathing will get deeper and a little faster.”
c.
“I’ll notice a decreased pigmentation in my skin.”
d.
“There will be a curvature in the upper spine area.”
ANS: B
The pregnant woman breathes more deeply, and her respiratory rate may increase slightly.
DIF: Cognitive Level: Comprehension REF: Page 52 OBJ: 7 | 13
TOP:Normal Physiological Changes in Pregnancy
KEY:Nursing Process Step: Evaluation
MSC:NCLEX: Physiological Integrity: Physiological Adaptation
6. A woman reports that her last normal menstrual period began on August 5, 2013. What is this woman’s expected delivery date using Nägele’s rule?
a.
April 30, 2014
b.
May 5, 2014
c.
May 12, 2014
d.
May 26, 2014
ANS: C
To determine the expected date of delivery, count backward 3 months from the first day of the last menstrual period, then add 7 days and change the year if necessary.
DIF:Cognitive Level: AnalysisREF:Page 48, Box 4-2
OBJ:5TOP:Determining Estimated Date of Delivery
KEY:Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
7. During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler device. How early might fetal heart tones be detected with an electronic Doppler device?
a.
4 weeks
b.
8 weeks
c.
10 weeks
d.
14 weeks
ANS: C
The fetal heartbeat can be detected as early as 10 weeks of pregnancy using a Doppler device.
DIF: Cognitive Level: Knowledge REF: Page 50 OBJ: 3 | 7
TOP:Normal Physiological Changes in Pregnancy
KEY:Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
8. In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. What is the nurse’s first action?
a.
Ask if the patient has taken a sedative.
b.
Notify the physician.
c.
Turn the patient to her right side.
d.
Record the rate as a normal finding.
ANS: D
The FHR at term ranges from a low of 110 to 120 beats/min to a high of 150 to 160 beats/min. This should be recorded as normal. The FHR drops in the late stages of pregnancy.
DIF: Cognitive Level: Application REF: Page 50 OBJ: 3
TOP: Assessing Fetal Heart Tone KEY: Nursing Process Step: Data Collection
MSC:NCLEX: Physiological Integrity: Physiological Adaptation
9. A woman’s prepregnant weight is determined to be average for her height. What will the nurse advise the woman regarding recommended weight gain during pregnancy?
a.
10 to 20 pounds
b.
15 to 25 pounds
c.
25 to 35 pounds
d.
28 to 40 pounds
ANS: C
The recommended weight gain for a woman of normal weight before pregnancy is 25 to 35 pounds.
DIF: Cognitive Level: Knowledge REF: Page 57 OBJ: 8
TOP: Nutrition in Pregnancy KEY: Nursing Process Step: Implementation
MSC:NCLEX: Physiological Integrity: Physiological Adaptation
10. When the nurse tells a pregnant woman that she needs 1200 mg of calcium daily during pregnancy, the woman responds, “I don’t like milk.” What dietary adjustments could the nurse recommend?
a.
Increase intake of organ meats.
b.
Eat more green leafy vegetables.
c.
Choose more fresh fruits, particularly citrus fruits.
d.
Include molasses and whole-grain breads in the diet.
ANS: B
For women who do not like milk, other sources of calcium include enriched cereals, legumes, nuts, dried fruits, green leafy vegetables, and canned salmon and sardines that contain bones.
DIF: Cognitive Level: Application REF: Page 60 OBJ: 8 | 13
TOP: Nutrition for Pregnancy KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
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