The nurse caring for a newly pregnant woman would advise her that 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
B
(Prenatal care ideally should begin soon after the first missed menstrual period. Regular prenatal visits offer opportunities to ensure the health of the expectant mother and her infant.)
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 monogamou
A
(Testing for the antibody to HIV is strongly recommended for all pregnant women. A HIV test is recommended for all women, regardless of risk factors. Women who test positive for HIV can be treated, reducing the risk of transmission to the fetus.)
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
B. Urinary frequency
C. Fatigue
D. Vaginal bleeding
D
(Signs and symptoms that must be reported include severe vomiting, fever and chills, burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms may be signs of potential complications of the pregnancy. Nausea with occasiona
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 ex
C
(Typically running should be replaced with walking around the seventh month of pregnancy. The nurse should inform the woman that she may need to reduce her exercise level as the pregnancy progresses. Physical activity promotes a feeling of well-being in
The multiple marker test is used to assess the fetus for which condition?
A. Down syndrome
B. Congenital cardiac abnormality
C. Diaphragmatic hernia
D. Anencephaly
A
(The maternal serum level of alpha-fetoprotein is used to screen for Down syndrome, neural tube defects, and other chromosome anomalies. The multiple marker test would not detect diaphragmatic hernia, congenital cardiac abnormality, or anencephaly. Addi
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.
B
(An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy. Constipation, heart palpitations, and ankle and foot edema are normal discomforts of pregnancy that occur in the second and third trimesters.)
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 nur
D
(The statement "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" is accurate. A safe level of alcohol consumption during pregnancy has not yet been established
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.
B. Do pelvic rock exercises.
C. Use a softer
B
(Pelvic rock exercises may help stretch and strengthen the abdominal and lower back muscles and relieve low back pain. Kegel exercises increase the tone of the pelvic area, not the back. A softer mattress may not provide the support needed to maintain p
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
D
(Women who are HIV positive are discouraged from breastfeeding. Although hepatitis B antigen has not been shown to be transmitted through breast milk, as an added precaution infants born to HBsAg-positive women should receive the hepatitis B vaccine and
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.
D
(The statement "Hormonal changes during pregnancy commonly result in mood swings" is accurate and the most appropriate response by the nurse. The statement "Don't worry about it; you'll feel better in a month or so" dismisses the client's concerns and i
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 appoi
C
(The partner's main role in pregnancy is to nurture the pregnant woman and respond to her feelings of vulnerability. In older societies, the man enacted the ritual couvade. Changing cultural and professional attitudes have encouraged fathers' participat
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 femal
B
(Maternal physiologic changes such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses may affect sexuality and sexual expression. Libido may be depressed in the firs
Which behavior indicates that a woman is "seeking safe passage" for herself and her infant?
A. She keeps all prenatal appointments.
B. She drives her car slowly.
C. She "eats for two."
D. She wears only low-heeled shoes.
A
(The goal of prenatal care is to foster a safe birth for the infant and mother. Although eating properly, driving carefully, and using proper body mechanics all are healthy measures that a mother can take, obtaining prenatal care is the optimal method f
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"
B. What the baby will eat
C. Whether her mother will die
D. What color eyes the baby has
B
(By age 3 or 4, children like to be told the story of their own beginning and accept its comparison with the present pregnancy. They like to listen to the fetal heartbeat and feel the baby move. Sometimes they worry about how the baby is being fed and w
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 stateme
D
(The purpose of all cultural practices is to protect the mother and fetus during pregnancy. Although many cultures consider pregnancy normal, certain practices are expected of women of all cultures to ensure a good outcome. Cultural prescriptions tell w
What type of cultural concern is the most likely deterrent to many women seeking prenatal care?
A. Religion
B. Modesty
C. Ignorance
D. Belief that physicians are evil
B
(A concern for modesty is a deterrent to many women seeking prenatal care. For some women, exposing body parts, especially to a man, is considered a major violation of their modesty. Many cultural variations are found in prenatal care. Even if the prena
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
A
(A lunar month lasts 28 days, or 4 weeks. Pregnancy spans 9 calendar months but 10 lunar months. A trimester is one third of a normal pregnancy, or about 13 to 14 weeks. The prenatal period covers the full course of pregnancy (prenatal means before birt
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 fi
B
(Mood swings are natural and are likely to affect every woman to some degree. A woman may dislike being pregnant, refuse to accept it, and still love and accept the child. Ambivalent feelings about pregnancy are normal for mature or immature women, youn
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 th
C
(Love and support help a woman feel better about her pregnancy. The most important person to the pregnant woman is usually the father. Nurses can facilitate communication between partners about sexual matters if, as is common, they are nervous about exp
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
D
(The woman first centers on herself as pregnant, then on the baby as an entity separate from herself, and then on her responsibilities as a mother. The expressions, "I am pregnant," "I am going to have a baby," and "I am going to be a mother" sum up the
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 t
A
(A father typically goes through three phases of development to reach acceptance of fatherhood: the announcement phase, the moratorium phase, and the focusing phase. The father-child attachment can be as strong as the mother-child relationship and can a
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 condi
C
(Besides these potential problems, nurses need to be alert to the woman's attitude toward health care. The initial interview needs to be planned, purposeful, and focused on specific content. A lot of ground must be covered. Nurses must be sensitive to s
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 em
B
(An empty bladder facilitates the examination; this is also an opportunity to get a urine sample easily for a number of tests. All women should be assessed for a history of physical abuse, particularly because the likelihood of abuse increases during pr
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 fi
C
(The woman lies on her back during the abdominal examination, possibly compressing the vena cava and aorta, which can cause a decrease in blood pressure and a feeling of faintness. The interview portion of follow-up examinations is less extensive than i
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. B
A
(The main danger from taking baths is falling in the tub. The perineum should be wiped from front to back. Bubble baths and bath oils should be avoided because they may irritate the urethra. Soap, alcohol, ointments, and tinctures should not be used to
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
B
(The pinch test is used to determine whether the nipple is everted or inverted. Nipples must be everted to allow breastfeeding.)
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 an
C
(The second trimester is best for dental treatment because that is when the woman will be able to sit most comfortably in the dental chair. Dental care such as brushing with fluoride toothpaste is especially important during pregnancy because nausea dur
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
D
(Periodic walking helps prevent thrombophlebitis. Pregnant women should avoid sitting or standing for long periods and crossing the legs at the knees. Pregnant women must wear lap belts and shoulder restraints. The most common injury to the fetus comes
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 met
A
(Both prescription and OTC drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus. This is especially true for new medications and combinations of drugs. The greatest danger of drug-caused developmental defects ex
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 shoul
B
(Twin pregnancies often end in prematurity. Serious efforts should be made to bring the pregnancy to term. A woman with a multifetal pregnancy often develops anemia, suffers more or worse backache, and needs to gain more weight. Counseling is needed to
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.
B. Sister of the pregnant woman.
C. Couple's teenage daughter.
D. Expectant father.
D
(An expectant father's experiencing pregnancy-like symptoms is called the couvade syndrome.)
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. Gr
C
(Gestational age cohorts comprise the groups, with approximately 8 to 12 women in each group. This group remains intact throughout the pregnancy. Individual follow-up visits are scheduled as needed. Group sessions begin at 12 to 16 weeks of gestation an
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
D
(Blood pressure is affected by maternal position during pregnancy. The supine position may cause occlusion of the vena cava and descending aorta. Turning the pregnant woman to a lateral recumbent position alleviates pressure on the blood vessels and qui
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.
A, B, C
(Vaginal bleeding, rupture of membranes, and severe headaches all are signs of potential complications in pregnancy. Clients should be advised to report these signs to the health care provider. Decreased libido and urinary frequency are common dis
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
A, B, E
(Immunization with live or attenuated live viruses is contraindicated during pregnancy because of potential teratogenicity. Vaccines consisting of killed viruses may be used. Immunizations that may be administered during pregnancy include tetanus,
During the first trimester the pregnant woman would be most motivated to learn about:
A. Fetal development.
B. Impact of a new baby on family members.
C. Measures to reduce nausea and fatigue so she can feel better.
D. Location of childbirth preparation a
C
(Fetal development concerns are more apparent in the second trimester when the woman is feeling fetal movement. Impact of a new baby on the family would be appropriate topics for the second trimester when the fetus becomes "real" as its movements are fe
An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" The nurse's BEST respons
C
(Although this statement is appropriate, it does not answer the father's question. Mood swings are a normal finding in the first trimester; the woman does not need counseling. This is the most appropriate response since it gives an explanation and a tim
If exhibited by an expectant father, what would be a warning sign of ineffective adaptation to his partner's first pregnancy?
A. Views pregnancy with pride as a confirmation of his virility
B. Consistently changes the subject when the topic of the fetus/n
B
(This is an expected view for an expectant father. Persistent refusal to talk about the fetus-newborn may be a sign of a problem and should be assessed further. This is an expected feeling for an expectant father. This is an expected finding with expect
What laboratory results would be a cause for concern if exhibited by a woman at her first prenatal visit during the second month of her pregnancy?
A. Hematocrit 38%, hemoglobin 13 g/dL
B. White blood cell count 6000/mm3
C. Platelets 300,000/mm3
D. Rubella
D
(This is a normal laboratory value in the pregnant woman. This is a normal laboratory value in the pregnant woman. This is a normal laboratory value in the pregnant woman. A rubella titer of less than 1:10 indicates a lack of immunity to rubella, a vira
A maternal serum alpha-fetoprotein (MSAFP) test is performed at 16 to 18 weeks of gestation. An elevated level has been associated with:
A. Down syndrome.
B. Sickle cell anemia.
C. Cardiac defects.
D. Open neural tube defects such as spina bifida.
D
(Low levels of MSAFP are associated with Down syndrome. Sickle cell anemia is not detected by the MSAFP. Cardiac defects would not be detected with the MSAFP. A triple marker test determines the levels of MSAFP along with serum levels of estriol and hum
An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. The nurse should tell the couple that:
A. Intercourse should be avoided if any spotting from the vagina occurs afterward.
B. Intercourse is safe until th
D
(Some spotting can normally occur as a result of the increased fragility and vascularity of the cervix and vagina during pregnancy. Intercourse can continue as long as the pregnancy is progressing normally. Safer-sex practices are always recommended; ru
A pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to:
A. Assess the woman's blood pressure and pulse.
B. Have
D
(Vital signs can be assessed next. Breathing into a paper bag is the solution for dizziness related to respiratory alkalosis associated with hyperventilation. Raising her legs will not solve the problem since pressure will still remain on the major abdo
A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she:
A. Wiggles and points her toes during the cramp.
B. Applies cold compresses to the affected leg.
C. Extends her leg and dorsiflexes her foot dur
C
(Pointing toes can aggravate rather than relieve the cramp. Application of heat is recommended. Extending the leg and dorsiflexing the foot is the appropriate relief for a leg cramp. Bearing weight on the affected leg can help to relieve the leg cramp,
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 ex
C
(The nurse should inform the woman that she may need to reduce her exercise level as the pregnancy progresses. Physical activity promotes a feeling of well-being in pregnant women. It improves circulation, promotes relaxation and rest, and counteracts b
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.
B
(Constipation is a normal discomfort of pregnancy that occurs in the second and third trimesters. An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy. Heart palpitations are a normal change related to pregnancy. This is
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 nur
D
(Regardless of which trimester the woman has reached, no amount of alcohol during pregnancy has been deemed safe for the fetus. Neither one drink per night nor three drinks per week is a safe recommendation. Although the first trimester is a crucial per
With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that:
A. Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of
A
(This is especially true for new medications and combinations of drugs. The greatest danger of drug-caused developmental defects exists in the interval from fertilization through the first trimester, when a woman may not realize that she is pregnant. Li
The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that:
A. She will have to give birth at home.
B. She must see an obstetrician as well as the midwife during pregnancy.
C. She will not be able to have epidural analgesia
D
(Most nurse-midwife births are managed in hospitals or birth centers; a few may be managed in the home. Nurse-midwives may practice with physicians or independently with an arrangement for physician backup. They must refer clients to physicians for comp
Which statements about multifetal pregnancy are most appropriate? (Select all that apply.)
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
A, C, D
(A woman with a multifetal pregnancy often develops anemia due to the increased demands of two fetuses. This should be monitored closely throughout her pregnancy. Twin pregnancies often end in prematurity. Serious efforts should be made to bring t