Question 1

When assessing a woman who is in her third trimester of pregnancy, the nurse looks for the classic symptoms associated with preeclampsia. What symptoms is the nurse looking for that would indicate preeclampsia?

Accepted Answer

A)   Edema, headaches, and seizures
B)   Decreased blood pressure and edema
C)   Elevated blood pressure and proteinuria
D)   Elevated liver enzymes and high platelet counts C

Question 2

The nurse is palpating the abdomen of a woman who is 35 weeks' pregnant and notices that the fetal head is facing downward toward the pelvis. What does this describe?

Accepted Answer

A)   Fetal lie
B)   Fetal variety
C)   Fetal attitude
D)   Fetal presentation D

Question 3

A patient who is 20 weeks' pregnant tells the nurse that she feels more shortness of breath as her pregnancy progresses. The nurse recognizes which statement to be true?

Accepted Answer

A)   High levels of estrogen cause shortness of breath.
B)   Feelings of shortness of breath are abnormal during pregnancy.
C)   Hormones of pregnancy cause an increased respiratory effort.
D)   The patient should get more exercise in an attempt to increase her respiratory reserve. C

Question 4

During auscultation of fetal heart tones (FHTs), the nurse determines that the heart rate is 136 beats per minute. How should the nurse proceed?

Accepted Answer

A)   Document the results, which are within normal range.
B)   Have the patient change positions and count the FHTs again.
C)   Immediately notify the physician for possible fetal distress.
D)   Take the maternal pulse to verify these findings as the uterine souffle.

Question 5

A woman in her second trimester of pregnancy complains of heartburn and indigestion. When discussing this with the woman, the nurse considers which explanation for these problems?

Accepted Answer

A)   Tone and motility of the gastrointestinal tract increase during the second trimester.
B)   Sluggish emptying of the gallbladder, from the effects of progesterone, often causes heartburn.
C)   Lower blood pressure at this time decreases blood flow to the stomach and gastrointestinal tract.
D)   Enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.

Question 6

During a group prenatal teaching session, the nurse teaches Kegel exercises. Which statements would be appropriate for this teaching session? (Select all that apply.)

Accepted Answer

A)   "Kegel exercises should be performed twice a day."
B)   "Kegel exercises should be performed 50 to 100 times a day."
C)   "Kegel exercises help keep your uterus strong during the pregnancy."
D)   "To perform Kegel exercises, rapidly perform alternating squeeze-release exercises up to the count of eight."
E)   "To perform Kegel exercises, slowly squeeze to a peak at the count of eight, and then slowly release to a count of eight."

Question 7

When the nurse is assessing the deep tendon reflexes (DTRs) on a woman who is 32 weeks' pregnant, which of these would be considered a normal finding?

Accepted Answer

A)   Absent DTRs
B)   2+
C)   4+
D)   Brisk reflexes with clonus

Question 8

Which best describes the average length of pregnancy?

Accepted Answer

A)   38 weeks
B)   9 lunar months
C)   280 days from the last day of the last menstrual period
D)   280 days from the first day of the last menstrual period

Question 9

During the examination of a woman in her second trimester of pregnancy, the nurse notices the presence of a small amount of yellow drainage from the nipples. How does the nurse interpret this finding?

Accepted Answer

A)   An indication that the woman's milk is coming in.
B)   A sign of possible breast cancer in a pregnant woman.
C)   Most likely colostrum and considered a normal finding at this stage of the pregnancy.
D)   Too early in the pregnancy for lactation to begin and refers the woman to a specialist.

Question 10

A 25-year-old woman is in the clinic for her first prenatal visit. The nurse will prepare to obtain which laboratory screening test at this time?

Accepted Answer

A)   Urine toxicology
B)   Alpha-fetoprotein
C)   Complete blood cell count
D)   Carrier screening for cystic fibrosis

Question 11

The nurse auscultates a functional systolic murmur, grade ii/iv, on a woman in week 30 of her pregnancy. The remainder of her physical assessment is within normal limits. How should the nurse proceed?

Accepted Answer

A)   Consider this finding abnormal, and refer her for additional consultation.
B)   Ask the woman to run briefly in place and then assess for an increase in intensity of the murmur.
C)   Know that this finding is normal and is a result of the increase in blood volume during pregnancy.
D)   Ask the woman to restrict her activities and return to the clinic in 1 week for re-evaluation.

Question 12

When auscultating the anterior thorax of a pregnant woman, the nurse notices the presence of a murmur over the second, third, and fourth intercostal spaces. The murmur is continuous but can be obliterated by pressure with the stethoscope or finger on the thorax just lateral to the murmur. How does the nurse interpret these findings?

Accepted Answer

A)   Murmur of aortic stenosis
B)   Most likely a mammary souffle
C)   Associated with aortic insufficiency
D)   Indication of a patent ductus arteriosus

Question 13

The nurse should know that what is the best time to assess a woman's blood pressure during an initial prenatal examination?

Accepted Answer

A)   At the end of the examination when she will be the most relaxed
B)   At the beginning of the interview as a nonthreatening method of gaining rapport
C)   During the middle of the physical examination when she is the most comfortable
D)   Before beginning the pelvic examination because her blood pressure will be higher after the pelvic examination

Question 14

Which of these statements best describes the action of the hormone progesterone during pregnancy?

Accepted Answer

A)   Progesterone produces the hormone human chorionic gonadotropin.
B)   Duct formation in the breast is stimulated by progesterone.
C)   Progesterone promotes sloughing of the endometrial wall.
D)   Progesterone maintains the endometrium around the fetus.

Question 15

During a woman's 34th week of pregnancy, she is told that she has preeclampsia. The nurse knows which statement concerning preeclampsia is true?

Accepted Answer

A)   Preeclampsia has little effect on the fetus.
B)   Edema is one of the main indications of preeclampsia.
C)   Eclampsia only occurs before delivery of the baby.
D)   Untreated preeclampsia may contribute to restriction of fetal growth.

Question 16

During a health history interview, a 38-year-old woman shares that she is thinking about having another baby. The nurse knows which statement to be true regarding pregnancy after 35 years of age?

Accepted Answer

A)   Fertility does not start to decline until age 40 years.
B)   Occurrence of Down syndrome is significantly more frequent after the age of 35 years.
C)   Genetic counseling and prenatal screening are not routine until after age 40 years.
D)   Women older than 35 years who are pregnant have the same rate of pregnancy-related complications as those who are younger than 35 years.

Question 17

A patient is being seen at the clinic for her 10-week prenatal visit. She asks when she will be able to hear the baby's heartbeat. How should the nurse reply?

Accepted Answer

A)   "The baby's heartbeat is not usually heard until the second trimester."
B)   "The baby's heartbeat may be heard anywhere from the ninth to the twelfth week."
C)   "It is often difficult to hear the heartbeat at this point, but we can try."
D)   "It is normal to hear the heartbeat at 6 weeks. We may be able to hear it today."

Question 18

A patient's pregnancy test is positive, and she wants to know when the baby is due. The first day of her last menstrual period was June 14, and that period ended June 20. Using the Nägele rule, what is her expected date of delivery?

Accepted Answer

A)   March 7
B)   March 14
C)   March 21
D)   March 27

Question 19

Which finding is considered normal and expected when the nurse is performing a physical examination on a pregnant woman?

Accepted Answer

A)   Palpable, full thyroid
B)   Edema in one lower leg
C)   Pale mucous membranes of the mouth
D)   Significant diffuse enlargement of the thyroid

Question 20

A woman who is 28 weeks' pregnant has bilateral edema in her lower legs after working 8 hours a day as a cashier at a local grocery store. She is worried about her legs. What is the nurse's best response?

Accepted Answer

A)   "You will be at risk for development of varicose veins when your legs are edematous."
B)   "I would like to listen to your heart sounds. Edema can indicate a problem with your heart."
C)   "Edema is usually the result of too much salt and fluids in your diet. You may need to cut down on salty foods."
D)   "As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with prolonged standing."

Exam 31: The Pregnant Woman