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Unit Test 01: Foundations of Childbearing and Antenatal Care

Nov 10, 202439 min read7686 words

Directions: Read each question thoroughly and carefully. Then, applying Dr. RPS techniques and strategies of critical thinking, choose the best answer.

It takes a minimum of 1 hour to finish this 50-item test. It is followed by a mandatory 15- to 30-minute break. Evaluate your performance by checking your answers.

  1. A client who has just learned she is pregnant tells the nurse that she smokes two packs of cigarettes a day. During counseling, the nurse encourages her to stop smoking because studies show that newborns of mothers who smoke are often:
    1. Born with congenital facial malformations
    2. Excessively large for gestational age
    3. Small for gestational age
    4. Postmature with meconium aspiration syndrome
  1. Of the following conditions, the one recognized as a known teratogen is:
    1. Coronary heart disease
    2. Smoking
    3. Scarlet Fever
    4. German Measles
  1. A primigravida, Mrs. Jose, tests positive for hepatitis B virus (HBV). The nurse determines that Mrs. Jose understands about this infection when she says:
    1. “I am glad I won’t transfer my virus to my baby.”
    2. “I understand that my baby will stay in the nursery for about a month.”
    3. “So my baby will receive eye prophylaxis to prevent blindness.”
    4. “I am so glad that I can breastfeed my baby after he has been vaccinated with immune serum globulin.”
  1. In the rural health unit (RHU), the nurse is interviewing primigravid Carla for health history information. What should be considered by the nurse to elicit accurate responses to questions that refer to sexually transmitted diseases? Select all that apply.
    1. Establish a therapeutic relationship between the nurse and the pregnant client.
    2. Provide privacy
    3. Use open-ended questions.
    4. Omit highly personal areas of questioning.
  1. In planning the care of a pregnant client with herpes simplex virus (HSV) infection, the clinic nurse would include which of the following measures in the nursing care plan under the teaching component?
    1. Sitz bath
    2. Daily administration of acyclovir (Zovirax) to effect a cure
    3. Total abstinence from sexual intercourse
    4. Preparation for a C-section if vaginal lesions are present at the time of labor
  1. In early pregnancy, a serology test for syphilis is given to pregnant women. The nurse explains to the client that the reason for this test is given because:
    1. The hormonal changes of pregnancy cause an exacerbation of latent syphilis.
    2. Syphilis may be passed to the fetus after 4 months of pregnancy.
    3. The law requires the serology test for all pregnant women.
    4. Syphilis may be passed to the infant during delivery and cause congenital syphilis.
  1. Which of the following interventions, if selected by the nurse, is appropriate for a pregnant client with acquired immunodeficiency syndrome (AIDS) with the nursing diagnosis of high risk for infection?
    1. Offer spiritual support if desired
    2. Enforce total bed rest
    3. Provide information on safe sex practices
    4. Administer ferrous sulfate
  1. The nurse is interviewing Jane, an adolescent who is pregnant, during her initial RHY visit. She is beginning week 24 of her first pregnancy. Which of the following statements made by Jane indicates an immediately need for further assessment?
    1. “I don’t like my figure. I could hardly fit into my clothes.”
    2. “I don’t like my eyes anymore. I look like I have been crying.”
    3. “This dark line in the middle of my abdomen is disgusting.”
    4. “I don’t feel comfortable when I am flat in bed; I feel burning in the middle of my chest.”
  1. As part of the prenatal teaching, the nurse instructs the client to immediately report any blurring or dimness of vision. The best rationale for this instruction is that the symptom is:
    1. Indicative of renal failure
    2. A forerunner to preeclampsia
    3. A sign of avitaminosis A
    4. Indicative of liver failure
  1. Primigravid 16-year-old Susie comes to the prenatal clinic for her monthly check-up. She has gained 20 lbs. from her 30–36 weeks; her face and hands indicate edema. She is diagnosed as having severe PIH and referred to the high-risk prenatal clinic. The client’s weight increase is most likely due to:
    1. Hypertension
    2. Overeating
    3. Fluid retention
    4. Obesity
  1. Primigravid Belen, 30 weeks pregnant, is admitted for management of severe preeclampsia. Belen’s treatment includes intravenous magnesium sulfate. Which of the following assessment findings would alert the nurse to suspect hypermagnesemia?
    1. Decreased deep tendon reflexes
    2. Cool skin temperature
    3. Rapid pulse rate
    4. Tingling in the toes
  1. Whenever magnesium sulfate is used to prevent convulsions in the preeclamptic clients, its antidote should always be available. This antidote is:
    1. Acetylcysteine
    2. Calcium gluconate
    3. Propranolol
    4. Ipecac Syrup
  1. Primigravid Dina, 32 weeks pregnant, is admitted to the maternity unit with severe preeclampsia. While her vital signs are being checked by the nurse, she goes into convulsions. Which nursing action would be contraindicated in caring for Dina during an episode of convulsive eclampsia?
    1. Not leaving the client
    2. Firmly restraining the client to prevent self-injury
    3. Keeping air passages clear of secretions
    4. Having the siderails up and padded
  1. When a woman who is confirmed to be at 12 weeks gestation has sudden vaginal bleeding and uterine cramps, she would be suspected to be experiencing:
    1. Hydatidiform mole
    2. Abortion
    3. Placenta previa
    4. Abruptio placenta
  1. The factors that play a significant role in the causation of spontaneous abortion include:
    1. Smoking, paternal factors, young age
    2. Accidents, early pregnancy coitus, high parity
    3. Infection, defective ovum, diabetes mellitus, incompetent cervix
    4. Competent cervix, high parity, and heart defects
  1. Mrs. Max, at 10 weeks gestation, complains to the physician of slight vaginal bleeding and mild cramps. On examination, her physician determines that her cervix is closed. The client is exhibiting signs of:
    1. An inevitable abortion
    2. An incomplete abortion
    3. A threatened abortion
    4. A missed abortion
  1. A competent maternity care provider should be able to identify early signs of abortion in order to be able to save a product of conception. Which of the following represents an incomplete abortion? Select all that apply.
    1. Profuse vaginal bleeding
    2. Passage of the fetus, placenta, and embryonic sac
    3. Mild abdominal pain
    4. Severe uterine cramps
  1. At 16 weeks of gestation, a pregnant client is admitted to the maternity unit to have a McDonald procedure (cerclage) done. When asked about the purpose of this procedure, the nurse answers correctly by explaining that this procedure is to:
    1. Reinforce an incompetent cervix permanently
    2. Evaluate the cephalopelvic disproportion
    3. Dilate the cervix
    4. Reinforce an incompetent cervix temporarily
  1. Jane, an unmarried by sexually active 24-year-old woman, tells the nurse that she missed one menstrual cycle and that her next cycle resulted in a slight amount of blood flow. Considering the history of her menstrual cycle, the nurse suspects she may have a tubal pregnancy. What is the most appropriate initial intervention?
    1. Make her the priority patient to be seen by the physician.
    2. Ask her if she has a history of tubal pregnancy.
    3. Position her on the examination table and palpate her abdomen for the presence of a unilateral pelvic pain over a mass.
    4. Take her vital signs to determine any abnormal findings.
  1. Which of the following is the most common factor related to the development of tubal pregnancy?
    1. Primigravidity
    2. Pelvic inflammatory disease (PID)
    3. Multiple pregnancy
    4. Uterine tumor
  1. Mrs. Hilario, amenorrheic for two months, is diagnosed with a ruptured ectopic pregnancy. Which of the following are signs and symptoms of ectopic pregnancy? Select all that apply.
    1. Cullen’s sign
    2. Kehr’s sign
    3. Sudden bradycardia
    4. Profuse external bleeding
  1. In the care of a client with a ruptured ectopic pregnancy, which of the following activities should be implemented?
    1. Monitoring vital signs
    2. Performing an abdominal scrub in preparation for CS
    3. Repositioning to the left
    4. All of the above
  1. The physician ordered preparation of a client with suspected ruptured tubal pregnancy for culdocentesis. Which of these preparations are appropriate? Select all that apply.
    1. Check if there is informed consent.
    2. Assess feelings and concerns about the procedure.
    3. Position the client on a dorsal recumbent.
    4. Prepare sterile gloves, a vaginal speculum, lubricant, and a flood lamp.
  1. Rho (D) immune globulin (RhoGAM) is ordered for a client before she is discharged after an ectopic pregnancy. The nurse understands that the rationale for RhoGAM administration is to prevent which of the following?
    1. Development of a future Rh-positive fetus
    2. An antibody response to Rh-negative blood
    3. A future pregnancy resulting in abortion
    4. Development of Rh-positive antibodies
  1. A client, amenorrheic for 3 months, comes to the hospital with complaints of vaginal discharge and is diagnosed to have hydatidiform mole. Which of the following signs is not consistent with the diagnosis?
    1. Bright red vaginal bleeding
    2. Fundal height palpated at the level of the navel
    3. BP of 140/90
    4. Cullen’s sign
  1. When asked about the cause of H-mole, your answer will reflect an understanding that the exact cause of H-mole is:
    1. Low-protein diet
    2. History of abortion
    3. Unknown
    4. Low socioeconomic status
  1. Forty-year-old Mrs. David receives a diagnosis of H-mole, which was treated by thorough evacuation with dilatation and curettage. Which of the following discharge health instructions is inappropriate?
    1. Avoid pregnancy for 6 months.
    2. Report for regular follow-up checkups.
    3. Take highly nutritious foods, particularly those rich in iron.
    4. Do not fail to take her contraceptive method.
  1. A client who is ordered for diagnostic pelvic ultrasound asks what preparations she will take. Appropriate preparations for this procedure include:
    1. Explanation of the procedure
    2. Informed consent
    3. Void
    4. NPO 6 hours prior
  1. Pelvic ultrasound can detect which of the following?
    1. Fetal sex, number, and lung maturity
    2. Congenital defects in structure, fetal gender, H-mole
    3. Fetal DM, multiple pregnancies, fetal age of gestation
    4. Fetal congenital defects, placental previa, fetal lung maturity
  1. The nurse is conducting a clinic visit with a prenatal client with heart disease. The nurse carefully evaluates vital signs, weight gain, and fluid and nutritional status to detect complications caused by:
    1. Hypertrophy and increased contractility
    2. The increase in circulating volume
    3. Fetal cardiomegaly
    4. Rh incompatibility
  1. Mrs. Diaz, a G₂P₁ with class II cardiac disease, is now in the thirty-fourth week of gestation. She is scheduled for a nonstress test (NST). The nurse, after explaining the procedure, evaluates that Mrs. Diaz understands the teaching when she says:
    1. “I hope my baby doesn’t get distressed after this procedure.”
    2. “If my baby’s heart reacts normally during the test, he should do okay during delivery.”
    3. “I hate receiving injections, but now I understand why it’s necessary.”
    4. “I understand now why I need to be confined for 1 to 2 days.”
  1. After a nonstress test is completed, the nurse looks at the test results on the monitor strip. The RN observes that the fetal heart accelerates to 15 BPM with each fetal movement. The accelerations lasted 20 seconds and occurred three times during the 20-minute test. The nurse is correct in interpreting the test as:
    1. Reactive test
    2. Nonreactive test
    3. Positive test
    4. Negative Test
  1. Mrs. Cortez, a primigravid client at 20 weeks gestation and with a history of heart disease, has been instructed on home management. Which of the following statements, if made by Mrs. Cortez, indicates that she needs further teaching?
    1. “I need to observe some restrictions on people who visit me.”
    2. “I should avoid stressful situations.”
    3. “My weight gain is not important.”
    4. “I should report early signs of infection.”
  1. You are planning a home visit evaluate the condition of Beth, who is 12 weeks pregnant and has a history of cardiac disease that was being treated with digitalis therapy before this pregnancy. Which of the following would you anticipate happening with Beth’s drug therapy regimen?
    1. Need for a change in medication
    2. Continuation of the same dosage
    3. Switching to a more potent brand
    4. Addition of a diuretic and an antibiotic to the regimen
  1. Multigravid Divine is in the first stage of labor, the active phase. Considering that Divine has a complicating heart disease due to rheumatic fever, which of the following interventions will you include in the care plan?
    1. Encourage ambulation to improve labor contractions.
    2. Anticipate and prepare for operative obstetrics.
    3. Reinforce instructions on correct, strong pushing.
    4. Give continuous oxygen through the nasal cannula.
  1. Mrs. Andres, a G₄P₃, is admitted to the prenatal clinic at eight and one-half months of gestation with a diagnosis of placenta previa, incomplete. The chief complaint is painless vaginal bleeding. Which action should the nurse perform initially?
    1. Anticipate and set up for emergency LCCS
    2. Elevate the foot of the bed, check for cervical dilatation, and check vital signs.
    3. Assess the amount and character of the bleeding.
    4. Check the FHT, anticipate, and set up for oxygen therapy.
  1. A client asks you how she developed placenta previa when she has been submitting herself to regular prenatal checkups. You will base your response on an understanding of the etiology of placenta previa, which includes:
    1. Advancing age, nulliparity, and previous low cervical CS
    2. Young age, tumor in the lower uterine segment, and previous low cervical CS
    3. Multiparity, multifetal pregnancy, and scarring or tumor in the upper third of the uterus
    4. Low age and parity; previous CS scar
  1. The assessment findings in placenta previa include? Select all that apply.
    1. Hard board-like abdomen
    2. Flaccid uterus
    3. Painless vaginal bleeding
    4. Signs of anaphylactic shock
  1. In taking care of patients with placenta previa, the health personnel should do the following except:
    1. Internal vaginal examination
    2. Inform relatives to prepare blood for a possible transfusion
    3. Notify pediatrician/nursery nurse of the possible admission of a preterm baby
    4. Prepare a double-set-up delivery when labor is imminent
  1. The nurse assessing Mrs. Jose, 33 weeks pregnant, with vaginal bleeding is aware that an abruptio placenta is accompanied by which of the following assessment findings?
    1. Abdomen soft upon palpation
    2. No complaint of abdominal pain
    3. Lack of uterine irritability
    4. Uterine tenderness upon palpation
  1. Which of the following findings best indicates abruptio placenta and not placenta previa
    1. The amount of external bleeding
    2. The presence of a flaccid uterus
    3. The absence of pain
    4. Strong, tetanic contractions
  1. The nurse realizes that the abdominal pain associated with abruptio placenta may be initially caused by:
    1. Hemorrhagic shock
    2. Inflammatory reactions
    3. Concealed hemorrhage
    4. Blood in the uterine muscle
  1. The complications of abruptio placenta do not include:
    1. Hemorrhage
    2. Disseminated intravascular coagulation
    3. Couvelaire uterus
    4. Postmaturity
  1. A diabetic pregnant client is unsure of the date of her last menstrual period (LMP); she says that she missed three menses, but her fundus palpated slightly below the level of the umbilicus. Means other than Naegele’s rule will be used to determine the estimated date of delivery. The nurse would expect that physician to estimate the date by:
    1. Hearing the first audible fetal heart tone with a fetoscope
    2. Serial estriols
    3. Ultrasonography
    4. The nonstress test
  1. A pregnant client, 28 weeks pregnant, has Type I diabetes mellitus. On assessment, which sign are you likely to identify?
    1. Fundus midway between the symphysis pubis and the navel
    2. FHR on auscultation
    3. Low serial estriol levels
    4. Anorexia and oliguria
  1. The nurse understands that a diabetic mother’s metabolism is significant altered during pregnancy as a result of:
    1. Renal insufficiency in pregnancy
    2. Increased effect of insulin during pregnancy
    3. Decrease in serum glucose during pregnancy
    4. Effect of pregnancy hormones on carbohydrate and lipid metabolism
  1. The nurse prepares a teaching plan for a newly diagnosed diabetic pregnant client. Which of the following should not be included in the teaching plan?
    1. Effects of diabetes on pregnancy and the fetus
    2. Nutritional requirements for pregnancy and diabetic control
    3. To avoid exercise due to its negative effects on insulin production
    4. To be aware of any infections and report signs of infection immediately to the health care provider
  1. Hyperglycemia results from poor diabetes control during pregnancy and can result in perinatal morbidity and mortality. When evaluating the pregnant client, the nurse knows that the recommended serum glucose range during pregnancy is:
    1. 70 mg/dL to 120 mg/dL
    2. 50 mg/dL to 140 mg/dL
    3. 140 mg/dL to 200 mg/dL
    4. 60 mg/dL to 80 mg/dL
  1. The physician orders a maternal blood test for alpha-fetoprotein (AFP) for your diabetic client at 16 weeks of gestation. When asked about the rationale of the test, your explanation will be based on the understanding that this test is used to detect which of the following?
    1. Neural tube defects
    2. Chromosomal defects
    3. Fetal diabetes mellitus
    4. Lecithin-sphingomyelin ratio
  1. An old primigravida is ordered to have amniocentesis at 16 weeks. Which preparation for amniocentesis will you include in your plan?
    1. Witness the signing of the consent
    2. Instruct the mother to empty the bladder
    3. Encourage the expression of fears and concerns
    4. All of the above

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