Chapter 04: Prenatal Care and Adaptations to Pregnancy

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. Using the TPAL system, the patient's obstetric history would be recorded as:

c. gravida 3 para 10110.

2. A woman asks the nurse about the frequency of prenatal visits. In an uncomplicated pregnancy, the nurse would tell her that appointments are scheduled:

b. every 4 weeks until the 7th month, after which appointments will become more frequent.

3. During the physical examination for the first prenatal visit, it is noted that Chadwick's sign is present. This refers to the:

a. bluish or purplish discoloration of the vulva, vagina, and cervix.

4. After the examination is completed, the patient asks the nurse why Chadwick's sign occurs during pregnancy. The nurse would explain that it is caused by the:

d. vascular congestion in the pelvic area.

5. The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that the woman understands the information?

b. "My breathing will get deeper and a little faster."

6. A woman reports that her last normal menstrual period began on August 5, 2010. Using Nägele's rule, her expected date of delivery would be _____, 2011.

c. May 12

7. During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler device. When this instrument is used, fetal heart tones can be detected as early as _____ weeks.

c. 10

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. The nurse should:

d. record rate as a normal finding.

9. A woman's prepregnant weight is average for her height. The nurse would advise the woman that her recommended weight gain during pregnancy would be _____ pounds.

c. 25 to 35

10. When the nurse tells a pregnant woman that she needs 1,200 mg of calcium daily during pregnancy, the woman responds, "I don't like milk." What dietary adjustments could the nurse recommend?

b. Eat more green leafy vegetables.

11. A pregnant woman is experiencing nausea in the early morning. What recommendations would the nurse offer to alleviate this symptom?

c. Have crackers handy at the bedside, and eat a few before getting out of bed.

12. The patient who is 28 weeks pregnant shows a 10-pound weight gain from 2 weeks ago. The nurse should initially:

c. take the blood pressure.

13. The patient remarks that she has heard some foods will enhance brain development of the fetus. The nurse replies that foods high in docosahexaenoic acid (DHA) are thought to enhance brain development. Such foods include:

c. red meat.

14. The nurse encourages adequate intake of folic acid because it is thought to decrease the incidence of:

d. neural tube defects.

15. A woman tells the nurse that she is quite sure she is pregnant. The nurse recognizes which as a positive sign of pregnancy?

d. Fetal heartbeat

17. A woman pregnant for the first time asks the nurse, "When will I begin to feel the baby move?" The nurse would answer:

a. "You may notice the baby moving around the 4th to 5th month."

18. The patient who is 40 weeks pregnant complains of a sense of weakness and dizziness when she lies on her back. The nurse assesses this as an indication of:

a. supine hypotension.

19. A pregnant woman inquires about exercising during pregnancy. In planning the teaching for this woman, the nurse should include what information?

c. A regular schedule of moderate exercise during pregnancy is beneficial.

20. An ultrasound confirms that a 16-year-old girl is pregnant. The nurse recognizes the need for prenatal care and counseling for adolescents because:

a. a pregnant adolescent is experiencing two major life transitions at the same time.

24. A woman who is 36 weeks pregnant tells the nurse she plans to fly to Hawaii, which is a 12-hour flight. What would the nurse recommend that the patient do during the flight? Select all that apply.

c. Request a seat with greater leg room.

d. Drink at least 4 ounces of water every hour.

e. Get up and walk around the plane frequently

25. The nurse cautions the patient that, because of hormonal changes in late pregnancy, the pelvic joints relax. What does this result in? Select all that apply.

a. Waddling gait

b. Joint instability

Which sign indicates the flexing of the body of the uterus against the cervix?

4 McDonald's sign

Which condition increases the risk of yeast infection in a postpartum patient?

c. The presence of higher levels of glycogen in the patient's vaginal secretions

The nurse is caring for a patient in the second trimester of pregnancy who reports a burning sensation in the chest, burping, and a sour taste in the mouth. Which instruction would the nurse provide to alleviate these symptoms?

d. "Sit up for 30 minutes after meals."

Which statement made by a pregnant patient to the nurse indicates a risk for aortocaval compression?

b. "I sleep flat on my back every night."

The nurse is caring for a patient at 30 weeks of gestation who is irritated as a result of leakage from the nipples and breast lumps. Which instructions does the nurse reinforce while providing intervention to relieve the patient?

d. Instruct the patient to clean the nipples with water.

The nurse is caring for a patient in the third trimester of pregnancy. Laboratory results show an 8% increase in white blood cell count and a hematocrit of 35%. On assessment the pulse rate has increased by 10-15 beats/minute and the blood pressure is 150/100 mm Hg. Which finding would the nurse report to the health care provider?

a. Blood pressure of 150/100 mm Hg

Which condition in the fetus is associated with excessive maternal intake of vitamin A?

b. Cardiac defects