Question 1

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

Accepted Answer

A)  "Because we heard the baby's heartbeat, I am undoubtedly pregnant." 
B)  "Since I haven't felt the baby move yet, we don't know whether I'm 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 2

The nurse is assessing a new patient in the clinic. The nurse knows that the subjective (presumptive) signs and symptoms of pregnancy include:

Accepted Answer

A)  Positive urine pregnancy test, enlarged abdomen, and Braxton Hicks contractions. 
B)  Positive urine pregnancy test, amenorrhea, fatigue, and softening of the cervix. 
C)  Increase in urination, amenorrhea, fatigue, breast enlargement, and quickening. 
D)  Enlarged abdomen and fetal heartbeat.

Question 3

A patient at 32 weeks' gestation comes to the clinic with urinary burning and frequency. The nurse explains that urinary tract infections are common in pregnancy due to:

Accepted Answer

A)  Ureteral atonia. 
B)  Stasis of urine. 
C)  Increased glomerular filtration rate. 
D)  Excretion of amino acids. 
E)  Increased clearance of urea.

Question 4

The partner of a pregnant patient comes to the clinic with her. He complains to the nurse that he is experiencing different physical changes. The nurse determines he is experiencing couvade when he describes:

Accepted Answer

A)  Fatigue. 
B)  Increased appetite. 
C)  Headache. 
D)  Backache. 
E)  High anxiety level.

Question 5

The nurse notes the following findings in a 12-weeks'-gestation patient. Which of the findings would enable the nurse to tell the patient that she is diagnostically pregnant?

Accepted Answer

A)  Fetal heart rate by Doppler 
B)  Positive pregnancy test 
C)  Positive Chadwick's sign 
D)  Montgomery gland enlargement

Question 6

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

Accepted Answer

A)  Reassure the patient 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 7

A patient with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. The nurse should tell the patient that recommended weight gain during pregnancy should be:

Accepted Answer

A)  25-35 pounds, regardless of a patient's prepregnant weight. 
B)  More than 25-35 pounds for an overweight woman. 
C)  Up to 40 pounds for an underweight woman. 
D)  The same for a normal weight woman as for an overweight woman.

Question 8

A 16-year-old is seen at her 10-weeks'-gestation visit. She tells the nurse that she felt the baby move that morning. What response by the nurse is appropriate?

Accepted Answer

A)  "That is very exciting. The baby must be very healthy." 
B)  "Would you please describe what you felt for me?" 
C)  "That is impossible. The baby is not big enough yet." 
D)  "Would you please let me see whether I can feel the baby?"

Question 9

A patient 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 10

The patient 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 patient is not progressing through the developmental tasks of pregnancy. 
D)  The family members are adjusting to the role change at their own paces.

Question 11

The nurse asks a woman how her husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which statement?

Accepted Answer

A)  "My husband is ready for the pregnancy to end so that we can have sex again." 
B)  "My husband has gained quite a bit of weight during this pregnancy." 
C)  "My husband seems more worried about our finances now than he was before the pregnancy." 
D)  "My husband plays his favorite music for my belly so the baby will learn to like it."

Question 12

A prenatal educator is asking a partner about normal psychological 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 13

The nurse is assessing a patient who is at 35 weeks' gestation. What does the nurse expect the patient to report at this phase of pregnancy?

Accepted Answer

A)  Nausea and vomiting 
B)  Maternal ambivalence 
C)  Emotional shifts from highs to lows 
D)  Stretch marks on the abdomen

Question 14

The partner of a patient at 16 weeks' gestation accompanies her to the clinic. The partner tells you 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 will help make it real."

Question 15

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

Accepted Answer

A)  A urine pregnancy test. 
B)  The patient to be seen next week for a full examination. 
C)  A serum pregnancy test. 
D)  An ultrasound to be done.

Question 16

The patient 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."

Exam 14: Physical and Psychologic Changes of Pregnancy