Deck 5: Pregnancy

Question 1

The baby grows inside the ___________, which is a hollow muscle that grows as pregnancy progresses. The baby is protected by the ____________, and is connected to the __________ by the ___________.

A)Uterus / amniotic sac / placenta / umbilical cord
B)Placenta / amniotic fluid / cervix / uterus
C)Cervix / fundus / umbilical cord / placenta
D)Amniotic sac / uterus / placenta / cervix

Answer 1

Uterus / amniotic sac / placenta / umbilical cord

Question 2

The top of the uterus is usually referred to as the _________. The doctor will measure the distance from this point to the _________ to gauge the progress of the growing fetus.

A)Os / cervix
B)Cervix / mucous plug
C)Placenta / umbilical cord
D)Fundus / pelvic bone

Answer 2

Fundus / pelvic bone

Question 3

Normal changes during the first trimester of pregnancy may include all of the following EXCEPT:

A)Morning sickness
B)Breast tenderness
C)Feeling the baby move
D)Increased need to urinate

Answer 3

Feeling the baby move

Question 4

Treatments for morning sickness, typically at its worst in the first trimester, include all of the following EXCEPT:

A)Eating small, frequent meals.
B)Limiting calories
C)Eating before getting out of bed
D)Ginger

Question 5

How is a woman's due date calculated?

A)By adding nine months to the day she found out she was pregnant
B)By adding 40 weeks to the date of the positive pregnancy test
C)By adding 280 days to the date of her last menstrual period
D)By ultrasound

Question 6

All of the following are changes a woman may experience in the second trimester of pregnancy EXCEPT:

A)BraxtonHicks contractions
B)Increased fatigue
C)Fetal movement
D)Increased weight gain

Question 7

Braxton Hicks contractions can best be defined as:

A)True labor contractions
B)Occasional, mainly painless, contractions that do not cause dilation or effacement of the cervix
C)A warning sign that something is wrong with the pregnancy
D)Painful contractions that require strong coping methods

Question 8

Which of the following is NOT a change that a pregnant woman can expect in the third trimester?

A)Less fatigue
B)An increase in noticeable stretch marks
C)Large weight gain
D)The baby moves lower into the pelvis

Question 9

A client asks you if it is safe to have sex during pregnancy. Your BEST response is:

A)"You probably won't feel very interested in sex."
B)"Your thoughts should be focused on your baby, not your partner."
C)"Sex might bring on labor."
D)"As long as you don't have any risk factors, sex is safe and enjoyable during pregnancy."

Question 10

Which of the following is TRUE about pregnancy hormones?

A)Testosterone acts as a relaxant and an anti-inflammatory.
B)Estrogen production decreases.
C)Relaxin contributes to uterine contractions.
D)Human chorionic gonadotropin (hCG) supports estrogen and progesterone production until the placenta takes over.

Question 11

Car travel during pregnancy is safe, but women should follow all of these precautions EXCEPT:

A)Turn off the air bags.
B)Be sure to always wear a seat belt, with the lap belt positioned over the hips and the shoulder belt between the breasts.
C)Stop and stretch every couple of hours to improve circulation.
D)Move the seat as far back as possible from the steering wheel or dashboard.

Question 12

The benefits of relaxation exercises during pregnancy include all of the following EXCEPT:

A)Improved posture
B)Enhanced mood
C)Reduced energy
D)Increased oxygen to the fetus

Question 13

Pregnant women need, on average, how many extra calories per day?

A)1000
B)300
C)500
D)Zero

Question 14

Average weight gain for pregnancy is _____________ for a woman who starts pregnancy at an ideal weight for her height.

A)About 30 pounds
B)At least 50 pounds
C)No more than 20 pounds
D)Rarely calculated

Question 15

Non-pharmacological ways to treat heartburn during pregnancy include all of the following EXCEPT:

A)Avoiding spicy and fatty foods
B)Drinking only with meals
C)Eating small, frequent meals
D)Avoiding carbonated beverages

Question 16

Which of the following is a non-pharmacological way of treating constipation in pregnancy?

A)Drinking plenty of water
B)Eating protein-rich foods
C)Avoiding cold foods
D)Stopping exercise until your bowel movements return to normal

Question 17

While cravings and aversions are common in pregnancy, the desire to eat non-food substances can be dangerous and should be discussed with a healthcare provider. What is this type of craving called?

A)Hyperemesis gravidarum
B)Pica
C)Gestational diabetes
D)Preeclampsia

Question 18

All of the following are food borne illnesses that can be dangerous to pregnant mothers EXCEPT:

A)Listeriosis
B)Toxoplasmosis
C)Campylobacteriosis
D)Vaginosis

Question 19

A pregnant mother should avoid all of the following foods EXCEPT:

A)Raw sprouts
B)Soft cheeses
C)Undercooked meats
D)Fish

Question 20

Which of the following is most likely to cause the "aches and pains" many women experience in pregnancy?

A)Too much exercise
B)Decreased blood volume
C)A shift in her center of gravity
D)Changing hormones

Question 21

Exercise during pregnancy can alleviate many common aches and pains. Which of the following is NOT a benefit of exercise in pregnancy?

A)Shorter, less complicated labor
B)Reduced back pain
C)Improved circulation
D)Enhanced appetite

Question 22

Pelvic floor exercises that promote better muscle tone, which can aid in the birth of the baby, are called:

A)Kegels
B)Isometrics
C)Braxton Hicks
D)Aerobics

Question 23

All of the following are good exercises during pregnancy EXCEPT:

A)High impact aerobics
B)Swimming
C)Yoga
D)Walking

Question 24

The American Congress of Obstetricians and Gynecologists recommends how much moderate exercise every day?

A)An hour
B)30 minutes or more
C)At least 45 minutes
D)No more than 60 minutes

Question 25

The term for regular contractions that start before 37 weeks of pregnancy is?

A)Preterm labor
B)True labor
C)Braxton Hicks
D)Non-progressing

Question 26

Which of the following is NOT TRUE about the Alpha Fetoprotein (AFP) screening test?

A)It can diagnose spinal tube defects.
B)It is typically done between 15 and 18 weeks of pregnancy.
C)It has a high rate of false-positive results.
D)It may also be referred to as a "triple screen" or "quad screen"

Question 27

A glucosescreening test is typically done around 28 weeks of pregnancy to identify an increased risk for which of the following conditions?

A)Hyperemesis gravidarum
B)Gestational diabetes
C)Pregnancy induced hypertension
D)Neural tube defects

Question 28

All of the following are true about the group B strep test EXCEPT:

A)The test screens for a bacteria that is commonly found in the genitourinary tract.
B)It is typically performed in week 36 of pregnancy.
C)It requires a blood draw.
D)A positive result will likely lead to prophylactic antibiotics during labor.

Question 29

Which of the following is NOT a reason amniocentesis might be performed?

A)To turn a breech baby
B)To assess fetal lung maturity
C)To determine if the baby has a chromosomal disorder
D)To assess for intrauterine infection

Question 30

CVS, or chorionic villus sampling, may be used instead of amniocentesis to test for which of the following?

A)Genetic disorders in the fetus
B)Pregnancy induced hypertension
C)Gestational diabetes
D)Placenta previa

Question 31

Which of the following is NOT a reason ultrasound is used during pregnancy?

A)To more accurately estimate a woman's due date
B)To evaluate the location of the placenta, especially if a woman has bleeding during pregnancy
C)To assess the fetus's physical development
D)To help mother bond with her fetus before birth

Question 32

Smoking during pregnancy increases the risk of all of the following EXCEPT:

A)Preterm labor
B)Sudden Infant Death Syndrome (SIDS)
C)High blood pressure
D)Lowbirth-weight

Question 33

Alcohol consumption during pregnancy has been linked to which of the following conditions?

A)Birth defects
B)Diabetes
C)SIDS
D)Hypertension

Question 34

Pregnant women need 30 mg of iron per day. Which of the following is a good source of iron?

A)Fruit
B)Red meat
C)Milk
D)Dietary supplements

Question 35

Which of the following is true about calcium in pregnancy?

A)Pregnant moms need at least six servings of calcium rich foods per day.
B)A woman can never get enough calcium from food sources alone.
C)A woman should always take a calcium supplement.
D)Calcium regulates maternal and fetal heart rate.

Question 36

Protein is essential for growing a baby! Which of the following is a good source of protein?

A)Meat, fish, and soy
B)Citrus fruits
C)Dark green leafy vegetables
D)Olive oil

Question 37

While caffeine consumption is safe during pregnancy, pregnant moms should limit their consumption to:

A)150-300 mg per day
B)Less than 100 mg per day
C)Almost none
D)No more than 500 mg

Question 38

While fish is a great source of essential fatty acids, pregnant women should limit their consumption to:

A)One serving per week
B)Only tuna
C)Fish from local waters
D)12 ounces per week

Question 39

What can a woman do during pregnancy to prepare her body for breastfeeding?

A)Use a washcloth daily to toughen her nipples
B)Start using an electric breast pump
C)Know whether she has flat or inverted nipples
D)Stop taking all medications

Question 40

Which of the following is NOT a normal pregnancy change?

A)Blurred vision
B)Swelling in the feet and hands
C)Nasal congestion
D)Increased breast size

Question 41

Which of the following is an abnormal physical change during pregnancy that should be checked by a healthcare provider?

A)Increased white or clear vaginal discharge
B)Dizziness or faintness at rest
C)Visual disturbances
D)Frequent urination

Question 42

When considering whom to choose as a care provider for pregnancy and birth, all of the following are true EXCEPT:

A)A woman should ask a potential provider about his or her rates of interventions, such as Caesarean sections or episiotomy.
B)A woman should choose someone with a birth philosophy like her own.
C)Birth can safely take place in a hospital or birthing center, or at home with a trained attendant.
D)A woman's care provider and place of birth do not affect her confidence.

Question 43

Once a woman has decided she would like to conceive, she should consider all of the following lifestyle changes EXCEPT:

A)Determining what to do about hormonal birth control
B)Beginning to take a dietary supplement containing folic acid
C)Cutting down on her exercise routine
D)Pursuing smoking cessation

Question 44

Dental hygiene is important during pregnancy because:

A)A mother's teeth don't get enough calcium.
B)Pregnancy hormones can increase a mother's risk of gingivitis, which can lead to pregnancy complications.
C)A mother wants to look her best to keep from feeling bad about her changing body shape.
D)A pregnant woman must not use tooth whiteners at home.

Question 45

Leg cramps are a common problem during pregnancy. Which of the following is NOT a treatment for leg cramps?

A)Gentle massage
B)Stretching
C)Heat
D)Analgesics

Question 46

While discussing nutrition, a client mentions that her healthcare provider recommended she eat fresh fruits and green, leafy vegetables before conceiving. The provider also recommended 400 mcg of folic acid a day pre-pregnancy, with an increase to 600 mcg per day during the first trimester. Which of the following is NOT a benefit of folic acid supplementation before and during pregnancy?

A)It prevents the formation of large, but ineffective, red blood cells.
B)It prevents neural tube defects.
C)It decreases the baby's risk for cleft lip or palate.
D)It ensures proper functioning of the thyroid gland.

Question 47

A client who is eight weeks pregnant tells a doula that she has a strange craving for laundry starch. The client says, "I think I am losing my mind, but I need to tell someone about this odd behavior." Which of the following interventions is the most appropriate for the client?

A)Encourage the client to stop eating laundry starch.
B)Inform the client her behavior is an indirect way of calling attention to the pregnancy.
C)Suggest she may need iron supplementation.
D)Suggest she eat a high-carbohydrate diet.

Question 48

The doula is creating a dietary plan with a pregnant vegan client. Which of the following interventions for this client is inaccurate?

A)The client should increase her intake of dark-green vegetables.
B)Vitamin B12 supplementation is recommended.
C)Instruct the client to combine different protein sources in one meal.
D)Instruct the client to go outside the house for 20 to 30 minutes in the early morning sun.

Question 49

After an ultrasound, a client in labor is informed that she has a low-lying placenta. Which of the following statements accurately describes the client's diagnosis?

A)The placenta is improperly implanted in the upper uterine segment.
B)The placenta attaches in the lower uterine segment but it does not reach the cervical os.
C)Only the edge of the placenta extends to the os.
D)The internal os is covered entirely by the placenta.

Question 50

A 20-year-old female client is pregnant for the first time. The client is a marathon runner and has been on a rigorous exercise and training program. The client asks the doula if she could still exercise while pregnant. Which of the following statements by the doula is the most appropriate for the client?

A)"You should stop exercising when pregnant as it can cause miscarriage or intrauterine growth retardation."
B)"If you are an athlete, you may proceed with your pre-pregnancy exercise program without limitations."
C)"You may continue exercising, but make sure to decrease the intensity of exercises. You may return to your pre-pregnancy exercise program two weeks after delivery."
D)"You should modify the intensity and type of your exercises. Non-weight-bearing exercises are recommended. Always check with your doctor or midwife first, though, to be sure there are no contraindications."

Question 51

A 32-year-old female client at 28 weeks' gestation complains of backache, especially at night. The doula teaches which of the following exercises to relieve the discomfort?

A)Tailor sitting
B)Kegel exercises
C)Pelvic rocking
D)Squatting

Question 52

A doula is teaching a pregnant client safe techniques for exercising. Which of the following is NOT a safe way of exercising when pregnant?

A)Pointing the toes when exercising
B)Avoiding exercises that hyperextend the lower back
C)Avoiding practicing second stage pushing
D)When rising from the floor, roll over to the side first and then push up

Question 53

A doula is teaching a client at 20 weeks' gestation how to perform abdominal muscle contractions. Which of the following is NOT a benefit of this exercise?

A)It stretches the perineal muscles.
B)It prevents constipation.
C)It alleviates back pain.
D)It helps restore abdominal muscle tone after pregnancy.

Question 54

A 23-year-old female client at eight weeks' gestation is pregnant for the first time. The client asks the doula for the recommended safe limit of alcohol per day during early pregnancy. Which of the following statements by the doula is the most appropriate?

A)"You should not drink any form of alcoholic beverages when pregnant."
B)"Women who drink alcohol when pregnant usually have babies with birth defects."
C)"Women should not drink more than 14 units of alcohol per week or no more than three units per day."
D)"The recommended safe limit of alcohol per day for pregnant women during early pregnancy is not known."

Question 55

A clinically obese client with a BMI of 32 is pregnant for the first time at 10 weeks' gestation, She asks the doula how much weight she should gain by the end of her pregnancy. The most appropriate statement by the doula is:

A)"You need to lose weight during your pregnancy to avoid gestational diabetes. We need to come up with a diet plan that can help you restrict your food intake."
B)"Your doctor or midwife will likely instruct you to gain no more than 20 pounds during your pregnancy. Let's consider how you might meet this goal without going over."
C)"This is not the best time to go on a diet. It does not matter how much you gain. What is more important is that you eat healthy food throughout your pregnancy."
D)"You may gain 25 pounds during your pregnancy. The quality of your foods is more important than the amount of your food intake per day."

Question 56

A doula is teaching a pregnant woman about good personal hygiene during pregnancy. Which of the following statements made by the woman indicates that the teaching has been successful?

A)"If increased vaginal discharge makes me feel uncomfortable, I can douche one to two times a week."
B)"I need to avoid hot showers. The temperature may initiate labor."
C)"I can have tub baths during pregnancy, unless I am at risk for premature rupture of membranes."
D)"I need to see my dentist right after birth."

Question 57

A client at 32 weeks' gestation complains of easy fatigability. During the history taking, the client tells the doula that she has been frequently awakened from sleep almost every night for the past week due to fetal activity. The client also reports shortness of breath every time she sleeps flat in bed. Which of the following suggestions given by the doula is the LEAST appropriate when managing the client's sleeping problems?

A)"Sleep on two pillows, or on a couch with an armrest."
B)"Sleep in a modified Sims' position, with the top leg forward."
C)"Schedule a rest period during the afternoon."
D)"When sitting or lying down, rest with the knees sharply bent."

Question 58

A client at 28 weeks' gestation complains of back pain. The client's most recent doctor's visit reveals normal findings. Which of the following suggestions from the doula would be LEAST effective at alleviating the client's back pain?

A)"Walk with the pelvis tilted backward."
B)"Wear shoes with low to moderate heels."
C)"Perform pelvic rocking."
D)"Slide a board under the mattress."

Question 59

A client learns that she is pregnant with twins after an ultrasound. The client asks the doula how much weight she should gain during the pregnancy. Which of the following statements made by the doula is the most accurate?

A)"You need to gain one pound per month during the first trimester, and then one pound per week during the last two trimesters."
B)"You need to gain one pound per month on all three trimesters."
C)"While your doctor or midwife will provide you with guidelines, a woman pregnant with twins ideally gains one pound per week during the entire pregnancy."
D)"You need to control your weight gain. You must not gain more than fifteen pounds during the entire pregnancy."

Question 60

A movie actress meets with a doula for her first prenatal visit. The client is seven weeks pregnant and has a BMI of 28. The doula suggests that the client needs to add 300 calories to her daily diet. The client is concerned about getting fat. She asks the nurse why it is important to add calories to her diet during pregnancy. Which of the following responses made by the doula is the LEAST appropriate?

A)"The added calories are needed to supply energy for the fetus and placenta."
B)"Carrying extra weight can be physically demanding. You need the added calories help you keep up with the increasing workload."
C)"The thyroid function increases during pregnancy. You must have a sufficient amount of calories to keep up with the demands of having an elevated metabolic rate."
D)"If you were obese, you would have been instructed to eat 1,200 calories per day. However, having a BMI of 28 shows that you need to add 300 more calories to support your pregnancy needs."