Question 1

The postpartum nurse is mentoring a new graduate nurse. They are working with a Muslim family who had their first child yesterday. The new graduate asks the family what supplies they have at home. The husband responds that they have not yet purchased anything for their baby. How should the mentoring nurse explain this finding to the new graduate nurse?

Accepted Answer

A)   This family is irresponsible, and should have acquired all the items they will need for the new baby prior to going into labor.
B)   The woman did not communicate what her due date was to her husband because of cultural issues.
C)   Income seems to be a problem for this family; social services should be contacted to assist the family.
D)   Muslims don't buy baby items prior to birth because they believe it is God's will, not their own decision, whether a baby will live. D

Question 2

A patient 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 B

Question 3

The clinic nurse is assessing how the prenatal patient is meeting developmental tasks. The nurse uses Rubin's tasks, which include:

Accepted Answer

A)   Ensuring safe passage through pregnancy, labor, and birth.
B)   Turning in on oneself to focus on the child.
C)   Seeking commitment and acceptance of self as mother to the infant.
D)   Completing the tasks of nesting at the appropriate time.
E)   Seeking acceptance of the child by others. A,C,E

Question 4

On examination of the prenatal patient, the nurse is aware that she will assess for a bluish pigmentation of the vagina. This objective (probable) sign of pregnancy is also known as:

Accepted Answer

A)   Hegar's sign.
B)   Chadwick's sign.
C)   Nightingale's sign.
D)   Goodell's sign.

Question 5

It is 1 week before a pregnant patient's due date. The nurse notes on the chart that the patient's pulse rate was 74-80 before pregnancy. Today, the patient's pulse rate at rest is 90. What action should the nurse should take?

Accepted Answer

A)   Chart the findings.
B)   Notify the physician of tachycardia.
C)   Prepare the patient for an electrocardiogram (EKG) .
D)   Prepare the patient for transport to the hospital.

Question 6

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 instruction should the nurse give?

Accepted Answer

A)   Use a urine specimen just before going to bed at night.
B)   Drink a lot of fluids and wait at least 4 hours before voiding and taking a specimen.
C)   If the patient is diabetic, the urine pregnancy test will not be accurate.
D)   Use the first voided specimen when first getting up in the morning.

Question 7

The pregnant patient 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. The best response to this concern would be:

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 examing a pregnant woman in the third trimester. What skin changes should the nurse highlight as an alteration for the woman's healthcare provider?

Accepted Answer

A)   Linea nigra
B)   Melasma
C)   Petechiae
D)   Spider nevi

Question 9

The clinic nurse is culturally sensitive when, while assessing the pregnant patient, he asks about:

Accepted Answer

A)   The family's expectations of the healthcare system.
B)   Which cultural practices should be incorporated into care.
C)   Any alternative healer who should be consulted.
D)   Positive consequences of the patient's healthcare beliefs.
E)   The patient's giving up her practices and adopting the practices of the dominant culture.

Question 10

The nurse recognizes that subjective pregnancy changes such as amenorrhea can be caused by:

Accepted Answer

A)   Goodell's sign.
B)   Anemia.
C)   Pseudocyesis.
D)   Thyroid dysfunction.
E)   Fetal heartbeat.

Question 11

The nurse in the prenatal clinic will tell the 38-weeks'-gestation patient to lie on her left side when the patient complains of:

Accepted Answer

A)   Nausea.
B)   Pallor.
C)   Clamminess.
D)   Constipation.
E)   Dizziness.

Question 12

The nurse is caring for a pregnant patient who speaks little English. Which action should the nurse take to make certain that the patient understands the plan of care?

Accepted Answer

A)   Write all of the instructions down and send them home with the patient.
B)   Obtain a medical interpreter of the language the patient speaks.
C)   Ask a housekeeper who speaks this language to interpret.
D)   Use gestures and facial expressions to get the plan across.

Question 13

The pregnant patient has moved to the United States from another country. She states that her grandmother has provided herbs for her to take during pregnancy. The patient asks the nurse whether the herbs are safe. How should the nurse respond?

Accepted Answer

A)   "Some herbs are not safe for use during pregnancy."
B)   "Herbal supplements during pregnancy do not cause problems."
C)   "Your grandmother wouldn't give you anything that was dangerous."
D)   "Natural supplements should not be used during pregnancy or labor."

Question 14

The nurse understands that a patient's pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks' gestation?

Accepted Answer

A)   The joints of the pelvis have relaxed, causing a waddling gait.
B)   The cervix is firm and blue-purple in color.
C)   The uterus vasculature contains one sixth of the total maternal blood volume.
D)   Gastric emptying time is prolonged, and the patient complains of constipation and bloating.
E)   Supine hypotension, creating dizziness, occurs when the patient lies on her back.

Question 15

To answer a patient's about home pregnancy tests and their accuracy, the nurse must know that accuracy is affected by:

Accepted Answer

A)   Unclear directions.
B)   Language above the 4th-grade level.
C)   Blood in the specimen giving a false reading.
D)   Completing the test too late.
E)   Tagged antibodies becoming outdated.

Question 16

The nurse has completed a community presentation about the changes of pregnancy, and knows that the lesson was successful when a community member states, "One probable or objective change of pregnancy is:

Accepted Answer

A)   "Enlargement of the uterus."
B)   "Hearing the baby's heart rate."
C)   "Increased urinary frequency."
D)   "Nausea and vomiting."

Question 17

A patient at 28 weeks' gestation asks the nurse why she has backaches. To help explain the changes, the nurse shows her a picture of the shape of her back. Which picture does the nurse use?Standard Text: Click on the correct area on the image.

Accepted Answer

The answer of A patient at 28 weeks' gestation asks...

Question 18

The adolescent patient reports to the clinic nurse that her period is late, but that her home pregnancy test is negative. What should the nurse explain that these findings most likely indicate?

Accepted Answer

A)   "This means you are not pregnant."
B)   "You might be pregnant, but it might be too early for your home test to be accurate."
C)   "We don't trust home tests. Come to the clinic for a blood test."
D)   "Most people don't use the tests correctly. Did you read the instructions?"

Question 19

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

Accepted Answer

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

Question 20

During her first months of pregnancy, a patient tells the nurse, "It seems like I have to go to the bathroom every 5 minutes." The nurse explains to the patient that this is because:

Accepted Answer

A)   The patient probably has a urinary tract infection.
B)   Bladder capacity increases throughout pregnancy.
C)   The growing uterus puts pressure on the bladder.
D)   Some women are very sensitive to body function changes.

Exam 14: Physical and Psychologic Changes of Pregnancy