N405 Quiz 1

A pregnant client reports a significant increase in saliva and asks the nurse for management strategies. Which recommendation is most appropriate?

Using oral lozenges.

A nurse is teaching a prenatal class about gastrointestinal changes. Which statement should the nurse include regarding gastric acidity?

Acidity increases during the third trimester.

A client at 32 weeks gestation reports intense skin itching (pruritus). The nurse understands this is likely related to which physiologic change?

Retained bile salts.

A client presents for her first prenatal visit. She has a 3-year-old born at 38 weeks, a 1-year-old born at 34 weeks, and had a miscarriage at 12 weeks. She is currently pregnant. What is her GTPAL?

G4, T1, P1, A1, L2

A woman gave birth to twins at 35 weeks gestation. How does this affect the 'P' and 'L' in the GTPAL system?

P is 1, L is 2.

Using Naegele's rule, calculate the Estimated Date of Confinement (EDC) for a client whose last menstrual period began on October 15, 2025.

July 22, 2026

A nurse notes a bluish-purple discoloration of the cervix during a pelvic exam. Which sign of pregnancy should the nurse document?

Chadwick Sign

Which of the following is considered a positive sign of pregnancy?

Auscultation of fetal heart tones.

The nurse identifies the softening and compression of the lower uterine segment as which of the following?

Hegar Sign

During a Non Stress Test (NST), the nurse observes 2 fetal heart rate (FHR) accelerations within a 20-minute period. How should the nurse document this result?

Reactive

Recurrent variable decelerations lasting 1 minute or longer during an NST are associated with which risk?

Increased C-section risk.

A nurse sees a 'Variable Deceleration' on the monitor. What is the primary cause of this finding?

Umbilical Cord Compression

What is the primary purpose of a transvaginal ultrasound during the first trimester?

Confirming cardiac function.

At which week of gestation is a transabdominal ultrasound usually performed to screen for congenital malformations?

18-20 weeks

Which study is used to examine the flow of blood in blood vessels to assess fetal well-being?

Doppler Flow Studies

The nurse is teaching a client about the umbilical cord. Which information should be included?

It contains one vein and two arteries.

What is the primary function of Wharton's Jelly in the umbilical cord?

Protection of vessels.

In fetal circulation, which shunt allows blood to bypass the fetal liver?

Ductus Venosus

Which structure in the fetal heart directs highly oxygenated blood from the right atrium directly into the left atrium?

Foramen Ovale

A nurse is explaining fetal circulation to a student. Which side of the fetal heart has the greatest pressure?

Right Side

What is the significance of closed fetal circulation?

Incompatible blood types.

A client is diagnosed with oligohydramnios. The nurse should assess the newborn for which potential complication?

Failure of kidney development.

Which condition is most commonly associated with polyhydramnios?

Poorly controlled maternal diabetes mellitus.

What is considered the 'key function' of the placenta during pregnancy?

Respiration (oxygenation)

The nurse notes that the side of the placenta facing the baby is which of the following?

Smooth

Which placental hormone is primarily responsible for maintaining the pregnancy and relaxing smooth muscle?

Progesterone

An Rh-negative client at 28 weeks gestation requires which intervention to prevent maternal-fetal blood incompatibility?

Rho(D) Immune Globulin

A client's rubella titer indicates she is not immune. What is the nurse's priority action?

Immunize Postpartum

If a mother tests positive for Hepatitis B surface antigen, what should be administered to the infant after birth?

Immune globulin and vaccine.

When is a vaginal-rectal culture for Group B Strep (GBS) typically performed?

Late in pregnancy.

A client has a high glucose challenge test result. What is the next recommended step?

3 hour glucose tolerance test.

At 3 weeks gestation, what is the status of the fetal nervous system?

Neural tube begins to close.

During which week of fetal development do the heart tubes fuse and begin to contract?

3 weeks

At 4 weeks gestation, which respiratory milestone occurs?

Tracheal development begins.

A student nurse asks when upper extremity (UE) limb buds first appear. What is the correct answer?

4 weeks and they resemble flippers.

At 6 weeks gestation, where is blood formation primarily occurring?

Liver

At what week of development is the separation of the heart into four chambers complete?

6 weeks

During the 6th week of gestation, where are most of the intestines located?

Umbilical Cord

When does the development of the pituitary gland and cranial nerves begin?

6 weeks

At 8 weeks gestation, what change occurs in the fetal nervous system regarding the spinal cord?

It stops at the end of the vertebral column.

At which week is a heartbeat first detectable with an ultrasound?

8 weeks

What is the status of the fetal intestines at 10 weeks gestation?

Contained within the abdominal cavity.

At 10 weeks gestation, where is blood being produced?

Spleen and lymphatic tissue.

A client at 12 weeks gestation is excited to hear the baby's heart. Which device should the nurse use?

Doppler

At 12 weeks, what major renal milestone is reached?

Kidneys begin producing urine.

Which integumentary feature begins to develop at the end of 12 weeks?

Downy Lanugo (fine, soft, unpigmented hair)

When does implantation usually occur after conception?

6-10 days

Where is the best place for implantation to occur in the uterus?

Upper Uterus

A nurse is explaining urinary changes to a pregnant client. Which statement is correct regarding the kidneys?

GFR increases by 50%.

Why is mild proteinuria common during pregnancy?

Increased GFR and volume.

A pregnant client reports frequent nighttime urination. The nurse explains this nocturia is caused by what?

Release of retained sodium and water at night.

Which position most effectively increases renal blood flow and GFR during pregnancy?

Left Side Lying

A client is concerned about increased thirst and appetite. The nurse should explain that this is related to:

Normal GI Adaptation

Which lab finding is expected during pregnancy due to hemodilution (increased plasma volume)?

Decreased Albumin

Which trimester is associated with a 'decreased' risk for gastric ulcers?

Entire Pregnancy

A woman has one child born at 39 weeks and is currently 10 weeks pregnant. What is her Gravida and Para?

G2, P1

A client's LMP was December 20, 2025. What is the EDC?

September 27, 2026

Which of the following is a presumptive sign of pregnancy?

Amenorrhea

A nurse is performing ballottement. This is categorized as which type of pregnancy sign?

Probable

What is the criteria for a reactive NST?

2 accelerations in 20 minutes.

A nurse is monitoring an NST and notices the test is nonreactive after 20 minutes. What is the next action?

Continue for 20 more minutes.

A first trimester ultrasound shows the presence of a 'yolk sac'. When does this typically become visible?

Early in 6th week.

What is the primary function of the umbilical arteries?

Return deoxygenated blood to placenta.

Which shunt allows blood to move from the pulmonary artery into the descending aorta?

Ductus Arteriosus

What happens to the fetal lungs and liver during pregnancy?

They do not function until birth.

A client with oligohydramnios is at risk for which pulmonary issue in the fetus?

Poor fetal lung development.

How does the placenta remove waste products from the fetus?

Simple Diffusion

A CBC is performed during the first prenatal visit. What finding would require a follow-up?

WBC over 15,000

A client's VDRL test is positive. What is the priority intervention?

Treat with antibiotics.

At 3 weeks gestation, which germ layer forms the muscle, bone, and cartilage?

Mesoderm

At 4 weeks gestation, what is the appearance of the embryo's cranial and caudal ends?

Neural tube is closed at each end.

By week 6, which part of the eye is beginning to develop?

Eyelid

At 8 weeks gestation, how do the male and female external genitalia appear?

Quite Similar

At 10 weeks gestation, what is the position of the fetal ears?

Top of ear slightly below eye level.

A client asks when her baby will have permanent tooth buds. The nurse knows this occurs at:

10 weeks

Which reflex is present at 12 weeks gestation?

Sucking

Why might a woman experience bleeding during implantation?

Uterus being imbedded.

A client is concerned about protein in her urine. The nurse should explain that which level is common during pregnancy?

Mild Proteinuria

What happens to the bladder capacity by the end of pregnancy?

It doubles.

The nurse identifies the 'Chadwick sign' during a pelvic examination. Which category of pregnancy signs does this belong to?

Presumptive Sign

A client at 16 weeks gestation reports feeling the baby move. How should the nurse document this finding?

Presumptive Sign: Quickening

The nurse notes softening and compression of the lower uterine segment (isthmus) during an exam. How should this be documented?

Hegar Sign

During an NST, the nurse notes variable decelerations that occur more than $3$ times in $20$ minutes. What is the priority nursing action?

Monitor for an extended period.

What is the primary physiological cause of variable decelerations during fetal monitoring?

Umbilical cord compression.

A client is scheduled for a second-trimester ultrasound at $19$ weeks. The nurse explains that the primary purpose of this scan is to evaluate which of the following?

Detect congenital malformations.

A provider orders a 'Doppler Flow Study' for a high-risk client. The nurse understands this test is used to assess which of the following?

Placental Function

Which shunt directs oxygenated blood from the right atrium directly into the left atrium?

Foramen OvaleWhat is the function of the 'Ductus Arteriosus'?

What is the function of the 'Ductus Arteriosus'?

Shunts blood to the aorta.

A client is diagnosed with 'Oligohydramnios'. The nurse knows this condition is associated with which fetal complication?

Failure of fetal kidney development.

Which of the following is a characteristic of 'Polyhydramnios'?

Fluid volume exceeding 2000ml.

Why does poorly controlled maternal diabetes often lead to Polyhydramnios?

Increased fetal urine excretion.

A prenatal CBC shows a White Blood Cell (WBC) count of $18,000/mm^3$. What is the nurse's priority action?

Notify the provider for follow-up.

At which gestational week is Rho(D) immune globulin (RhoGAM) typically administered to an Rh-negative client?

28 weeks

When is the vaginal-rectal culture for Group B Streptococcus (GBS) usually performed?

Late in the third trimester, typically 35-37 weeks.

During week $3$ of development, what critical structure begins to close to form the neural tube?

Neural Plate

At which week of gestation does the embryonic heart typically begin to beat?

Week 4

A client at 8 weeks gestation asks if the baby's fingers are formed. What is the nurse's best response?

Fingers are distinct by now.

Fetal kidneys begin producing urine and excreting it into the amniotic fluid during which week?

Week 12

The nurse explains that the risk of urinary stasis and infection increases during pregnancy due to which anatomical change?

Dilation of the renal pelvis.

A client is 8 weeks pregnant. Which GI-related finding should the nurse anticipate?

Slowed gastric emptying that leads to heartburn and nausea.