Question 1

The nurse is providing care to a client who is entering the second trimester of pregnancy. Which client statement does the nurse anticipate when assessing this client?

Accepted Answer

A)  "We picked out a name for a boy and for a girl." 
B)  "We bought the baby's crib and car seat this past weekend." 
C)  "I am so uncomfortable all the time and I can't seem to sleep at night." 
D)  "I am angry with my husband for not showing more interest in my pregnancy."

Question 2

The nurse is conducting an initial prenatal appointment for a client who believes she is pregnant. Which is considered a positive sign of pregnancy?

Accepted Answer

A)  Linea nigra 
B)  Fetal heartbeat 
C)  Breast tenderness 
D)  Urinary frequency

Question 3

The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she has not had a menstrual cycle for 3 months, and her breasts are getting bigger. What response by the nurse is best?

Accepted Answer

A)  "Lack of menses and breast enlargement are presumptive signs of pregnancy." 
B)  "The changes you are describing are definitely indicators that you are pregnant." 
C)  "Lack of menses can be caused by many things. We need to do a pregnancy test." 
D)  "You're probably not pregnant, but we can check it out if you like."

Question 4

A woman calls the clinic and tells a nurse that she thinks she might be pregnant. She wants to use a home pregnancy test before going to the clinic, and asks the nurse how to use it correctly. What information should the nurse give?

Accepted Answer

A)  The false-positive rate of these tests is quite high. 
B)  If the results are negative, the woman should repeat the test in 2 weeks if she has not started her menstrual period. 
C)  A negative result merely indicates growing trophoblastic tissue and not necessarily a uterine pregnancy. 
D)  The client should follow up with a healthcare provider after taking the home pregnancy test.

Question 5

A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice?

Accepted Answer

A)  Lightening of the nipples and areolas 
B)  Reddish streaks called striae on her abdomen 
C)  A decrease in hair thickness 
D)  Small purplish dots on her face and arms

Question 6

The nurse is listening to the fetal heart tones of a client at 37 weeks' gestation while the client is in a supine position. The client states, "I'm getting lightheaded and dizzy." What is the nurse's best action?

Accepted Answer

A)  Assist the client to sit up. 
B)  Remind the client that she needs to lie still to hear the baby. 
C)  Help the client turn onto her left side. 
D)  Check the client's blood pressure.

Question 7

The pregnant client at 14 weeks' gestation is in the clinic for a regular prenatal visit. Her mother also is present. The grandmother-to-be states that she is quite uncertain about how she can be a good grandmother to this baby because she works full time. Her own grandmother was retired, and was always available when needed by a grandchild. What is the nurse's best response to this concern?

Accepted Answer

A)  "Don't worry. You'll be a wonderful grandmother. It will all work out fine." 
B)  "What are your thoughts on what your role as grandmother will include?" 
C)  "As long as there is another grandmother available, you don't have to worry." 
D)  "Grandmothers are supposed to be available. You should retire from your job."

Question 8

The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

A)  The client's chest circumference has increased by 6 cm during the pregnancy. 
B)  The client has a narrowed subcostal angle. 
C)  The client is using thoracic breathing. 
D)  The client may have epistaxis. 
E)  The client has a productive cough.

Question 9

The introduction of a new baby into the family is often the beginning of which of the following?

Accepted Answer

A)  Sibling rivalry 
B)  Inconsistent childrearing 
C)  Toilet training 
D)  Weaning

Question 10

A client who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the client needs additional information?

Accepted Answer

A)  "Because we heard the baby's heartbeat, I am undoubtedly pregnant." 
B)  "Because I have had a positive pregnancy test, I am undoubtedly pregnant." 
C)  "My last period was 2 months ago, which means I'm 2 months along." 
D)  "The increased size of my uterus means that I am finally pregnant."

Question 11

A prenatal educator is asking a partner about normal psychologic adjustment of an expectant mother during the second trimester of pregnancy. Which answer by the partner would indicate a typical expectant mother's response to pregnancy?

Accepted Answer

A)  "She is very body-conscious, and hates every little change." 
B)  "She daydreams about what kind of parent she is going to be." 
C)  "I haven't noticed anything. I just found out she was pregnant." 
D)  "She has been having dreams at night about misplacing the baby."

Question 12

The client is at 6 weeks' gestation, and is spotting. The client had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order which intervention?

Accepted Answer

A)  A urine pregnancy test 
B)  The client to be seen next week for a full examination 
C)  An antiserum pregnancy test 
D)  An ultrasound

Question 13

The client at 30 weeks' gestation with her first child is upset. She tells the prenatal clinic nurse that she is excited to become a mother, and has been thinking about what kind of parent she will be. But her mother has told her that she doesn't want to be a grandmother because she doesn't feel old enough, while her husband has said that the pregnancy doesn't feel real to him yet, and he will become excited when the baby is actually here. What is the most likely explanation for what is happening within this family?

Accepted Answer

A)  Her husband will not attach with this child and will not be a good father. 
B)  Her mother is rejecting the role of grandparent, and will not help out. 
C)  The client is not progressing through the developmental tasks of pregnancy. 
D)  The family members are adjusting to the role change at their own paces.

Question 14

Nurses who are interacting with expectant families from a different culture or ethnic group can provide more effective, culturally sensitive nursing care by doing what?

Accepted Answer

A)  Recognizing that ultimately it is the family's right to make a woman's healthcare choices. 
B)  Obtaining a medical interpreter of the language the client speaks. 
C)  Evaluating whether the client's healthcare beliefs have any positive consequences for her health. 
D)  Accepting personal biases, attitudes, stereotypes, and prejudices.

Question 15

A client at 16 weeks' gestation has a hematocrit of 35%. Her prepregnancy hematocrit was 40%. Which statement by the nurse best explains this change?

Accepted Answer

A)  "Because of your pregnancy, you're not making enough red blood cells." 
B)  "Because your blood volume has increased, your hematocrit count is lower." 
C)  "This change could indicate a serious problem that might harm your baby." 
D)  "You're not eating enough iron-rich foods like meat."

Question 16

The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take?

Accepted Answer

A)  Reassure the client that this is a normal finding in multigravidas. 
B)  Suggest that she should feel for movement with her fingertips. 
C)  Schedule an appointment for her with her physician for that same day. 
D)  Tell her gently that her fetus is probably dead.

Question 17

The partner of a client at 16 weeks' gestation accompanies her to the clinic. The partner tells the nurse that the baby just doesn't seem real to him, and he is having a hard time relating to his partner's fatigue and food aversions. Which statement would be best for the nurse to make?

Accepted Answer

A)  "If you would concentrate harder, you'd be aware of the reality of this pregnancy." 
B)  "My husband had no problem with this. What was your childhood like?" 
C)  "You might need professional psychological counseling. Ask your physician." 
D)  "Many men feel this way. Feeling the baby move in a few weeks will help make it real to you."

Exam 11: Physical and Psychologic Changes of Pregnancy