Deck 7: Antepartum Assessment, Care, and Education

Question 1

Which information is covered by early pregnancy classes offered in the first and second trimesters?

A) Methods of pain relief
B) The phases and stages of labor
C) Coping with common discomforts of pregnancy
D) Prebirth and postbirth care of a patient having a cesarean birth

Answer 1

Coping with common discomforts of pregnancy

Question 2

Use Nägele's rule to determine the EDD (estimated day of birth) for a patient whose last menstrual period started on April 12.

A) February 19
B) January 19
C) January 21
D) February 7

Answer 2

January 19

Question 3

A patient, gravida 2, para 1, comes for a prenatal visit at 20 weeks of gestation. Her fundus is palpated 3 cm below the umbilicus. This finding is

A) appropriate for gestational age.
B) a sign of impending complications.
C) lower than normal for gestational age.
D) higher than normal for gestational age.

Answer 3

lower than normal for gestational age.

Question 4

Which suggestion is most helpful for the pregnant patient who is experiencing heartburn?

A) Drink plenty of fluids at bedtime.
B) Eat only three meals a day so the stomach is empty between meals.
C) Drink coffee or orange juice immediately on arising in the morning.
D) Use Tums or Rolaids to obtain relief, as directed by the health care provider.

Question 5

Which advice to the patient is one of the most effective methods for preventing venous stasis?

A) Sit with the legs crossed.
B) Rest often with the feet elevated.
C) Sleep with the foot of the bed elevated.
D) Wear elastic stockings in the afternoon.

Question 6

When documenting a patient encounter, which term will the nurse use to describe the woman who is in the 28th week of her first pregnancy?

A) Multigravida
B) Multipara
C) Nullipara
D) Primigravida

Question 7

Which of the patient health behaviors in the first trimester would the nurse identify as a risk factor in pregnancy?

A) Sexual intercourse two or three times weekly
B) Moderate exercise for 30 minutes daily
C) Working 40 hours a week as a secretary in a travel agency
D) Relaxing in a hot tub for 30 minutes a day, several days a week

Question 8

A patient with an IUD in place has a positive pregnancy test. When planning care, the nurse will base decisions on which anticipated action?

A) A therapeutic abortion will need to be scheduled since fetal damage is inevitable.
B) Hormonal analyses will be done to determine the underlying cause of the false-positive test result.
C) The IUD will need to be removed to avoid complications such as miscarriage or infection.
D) The IUD will need to remain in place to avoid injuring the fetus.

Question 9

A patient in her third trimester of pregnancy is asking about safe travel. Which statement should the nurse provide regarding safe travel during pregnancy?

A) "Only travel by car during pregnancy."
B) "Avoid use of the seat belt during the third trimester."
C) "You can travel by plane until your 38th week of gestation."
D) "If you are traveling by car stop to walk every 1 to 2 hours."

Question 10

What is the rationale for a woman in her first trimester of pregnancy to expect to visit her health care provider every 4 weeks?

A) Problems can be eliminated.
B) She develops trust in the health care team.
C) Her questions about labor can be answered.
D) The conditions of the expectant mother and fetus can be monitored.

Question 11

A patient who smokes one pack of cigarettes daily has a positive pregnancy test. The nurse will explain that smoking during pregnancy increases the risk of which condition?

A) Congenital anomalies
B) Death before or after birth
C) Neonatal hypoglycemia
D) Neonatal withdrawal syndrome

Question 12

A gravida 1 patient at 32 weeks of gestation reports that she has severe lower back pain. What should the nurse's assessment include?

A) Palpation of the lumbar spine
B) Exercise pattern and duration
C) Observation of posture and body mechanics
D) Ability to sleep for at least 6 hours uninterrupted

Question 13

Which complaint made by a patient at 35 weeks of gestation requires additional assessment?

A) Abdominal pain
B) Ankle edema in the afternoon
C) Backache with prolonged standing
D) Shortness of breath when climbing stairs

Question 14

When a pregnant woman develops ptyalism, which guidance should the nurse provide?

A) Chew gum or suck on lozenges between meals.
B) Eat nutritious meals that provide adequate amounts of essential vitamins and minerals.
C) Take short walks to stimulate circulation in the legs and elevate the legs periodically.
D) Use pillows to support the abdomen and back during sleep.

Question 15

Which laboratory result would be a cause for concern if exhibited by a patient at her first prenatal visit during the second month of her pregnancy?

A) Rubella titer, 1:6
B) Platelets, 300,000/mm3
C) White blood cell count, 6000/mm3
D) Hematocrit 38%, hemoglobin 13 g/dL

Question 16

Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one infant at 32 weeks' gestation, and one infant at 38 weeks' gestation.

A) G5 T1 P2 A2 L 2
B) G5 T1 P1 A1 L2
C) G5 T0 P2 A2 L2
D) G5 T1 P1 A2 L2

Question 17

What is the gravida and para for a patient who delivered triplets 2 years ago and is now pregnant again?

A) 2, 3
B) 1, 2
C) 2, 1
D) 1, 3

Question 18

The health care provider reports that the primigravida's fundus can be palpated at the umbilicus. Which priority question will the nurse include in the patient's assessment?

A) "Have you noticed that it is easier for you to breathe now?"
B) "Would you like to hear the baby's heartbeat for the first time?"
C) "Have you felt a fluttering sensation in your lower pelvic area yet?"
D) "Have you recently developed any unusual cravings, such as for chalk or dirt?"

Question 19

The nurse is scheduling the next appointment for a healthy primigravida currently at 28 weeks gestation. When will the nurse schedule the next prenatal visit?

A) 1 week
B) 2 weeks
C) 3 weeks
D) 4 weeks

Question 20

You are performing assessments for an obstetric patient who is 5 months pregnant with her third child. Which finding would cause you to suspect that the patient was at risk?

A) Patient states that she doesn't feel any Braxton Hicks contractions like she had in her prior pregnancies.
B) Fundal height is below the umbilicus.
C) Cervical changes, such as Goodell's sign and Chadwick's sign, are present.
D) She has increased vaginal secretions.

Question 21

Calculate the estimated date of birth (EDD) in October using Nägele's rule for a patient whose last normal menstrual period (LNMP) began on January 1. Record your answer as a whole number. _______

Question 22

The labor nurse is reviewing breathing techniques with a primiparous patient admitted for induction of labor. When is the best time to encourage the laboring patient to use slow, deep chest breathing with contractions?

A) During labor, when she can no longer talk through contractions
B) During the first stage of labor, when the contractions are 3 to 4 minutes apart
C) Between contractions, during the transitional phase of the first stage of labor
D) Between her efforts to push to facilitate relaxation between contractions

Question 23

A pregnant patient reports that she works in a long-term care setting and is concerned about the impending flu season. She asks about receiving the flu vaccine. As the nurse, you are aware that some immunizations are safe to administer during pregnancy, whereas others are not. Which vaccines could this patient receive? (Select all that apply.)

A) Tetanus
B) Varicella
C) Influenza
D) Hepatitis A and B
E) Measles, mumps, rubella (MMR)

Question 24

In a prenatal education class, the nurse is reviewing the importance of using relaxation techniques during labor. Which patient statement will the nurse need to correct?

A) "We will practice relaxation techniques only in a quiet setting so I can focus."
B) "Relaxation is important during labor because it will help me conserve my energy."
C) "If I relax in between contractions, my baby will get more oxygen during labor."
D) "My partner and I will practice relaxation throughout the remainder of my pregnancy."

Question 25

Which is the method of childbirth that helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor?

A) Bradley
B) Lamaze
C) Leboyer
D) Dick-Read

Question 26

The prenatal nurse educator is teaching couples the technique of applying sacral pressure during labor. Which should be included in the teaching session? (Select all that apply.)

A) The technique can be combined with heat to the area.
B) A jiggling motion should be used while applying the pressure.
C) Tennis balls may be used to apply the pressure to the sacral area.
D) The pressure against the sacrum should be intermittent during the contraction.
E) The hand may be moved slowly or remain positioned directly over the sacrum.

Question 27

Which type of cutaneous stimulation involves massage of the abdomen?

A) Imagery
B) Effleurage
C) Mental stimulation
D) Thermal stimulation

Question 28

The nurse is planning care for a patient in her first trimester of pregnancy. The patient is experiencing nausea and vomiting. Which interventions should the nurse plan to share with this patient? (Select all that apply.)

A) Suck on hard candy.
B) Take prenatal vitamins in the morning.
C) Try some herbal tea to relieve the nausea.
D) Drink fluids frequently but separate from meals.
E) Eat crackers or dry cereal before arising in the morning.

Question 29

Which technique would provide the best pain relief for a pregnant woman with an occiput posterior position?

A) Neuromuscular disassociation
B) Effleurage
C) Psychoprophylaxis
D) Sacral pressure

Question 30

A relaxation technique that can be used during the childbirth experience to decrease maternal pain perception is

A) using increased environmental stimulation as a method of distraction.
B) restricting family and friends from visiting during the labor period to keep the patient focused on breathing techniques.
C) medicating the patient frequently to reduce pain perception.
D) assisting the patient in breathing methods aimed at taking control of pain perception based on the contraction pattern.

Question 31

Which factors contribute to the presence of edema in the pregnant patient? (Select all that apply.)

A) Diet consisting of processed foods
B) Hemoconcentration
C) Increase in colloid osmotic pressure
D) Last trimester of pregnancy
E) Decreased venous return

Question 32

What does a birth plan help the parents accomplish?

A) Avoidance of an episiotomy
B) Determining the outcome of the birth
C) Assuming complete control of the situation
D) Taking an active part in planning the birth experience