Maternity Nursing An Introductory Text 11th Edition By Gloria Leifer -Test Bank

Maternity Nursing An Introductory Text 11th Edition By Gloria Leifer -Test Bank

 

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Leifer: Maternity Nursing: An Introductory Text, 11th Edition

 

Chapter 05: Health Care and Fetal Assessment During Pregnancy

 

Test Bank

 

MULTIPLE CHOICE

 

1. A nurse is discussing preconception care with a group of women. She tells them that one purpose of preconception care is to:

a.	Encourage healthy lifestyles.
b.	Make certain pregnancy complications do not occur.
c.	Identify women who should not become pregnant.
d.	Make certain that women know about prenatal care.

 

 

ANS:  A

Preconception care is health care and screening conducted before pregnancy occurs so that medical risks or lifestyle behaviors can be identified, managed, or changed before conception. The normalcy of pregnancy is greatly influenced by pre-pregnancy health.

 

DIF:    Cognitive Level: Application           REF:   61                  OBJ:   2

TOP:   Preconception Care                         KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

2. The nurse is interviewing a woman during her first prenatal clinic visit. When the woman asks what will happen during this visit, what response would be appropriate?

a.	“There really isn’t much to do until much later in your pregnancy.”
b.	“An electrocardiogram will be ordered to see if your heart can withstand pregnancy.”
c.	“Blood samples will be taken to test for conditions that could affect your pregnancy.”
d.	“An X-ray will be taken to determine the size of your pelvis.”

 

 

ANS:  C

Blood and urine samples are taken to provide baseline data and to reveal important conditions that could affect the mother during pregnancy or her baby. An electrocardiogram is not usually required. X-raying the pelvis would not be appropriate because radiation exposure can harm the fetus.

 

DIF:    Cognitive Level: Application           REF:   64 | Table 5-1

OBJ:   4                    TOP:   Physical Examination

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Health Promotion and Maintenance

 

3. On her fourth prenatal visit, a patient asks why urine tests are done on every visit. The most appropriate response is:

a.	“Some women have kidney failure during pregnancy.”
b.	“We need to be sure you are not retaining too much fluid.”
c.	“We are testing for diabetes, which sometimes develops during pregnancy.”
d.	“I really don’t know. I suggest you ask your care provider why this is repeatedly ordered.”

 

 

ANS:  C

Some women develop diabetes during pregnancy. The urine tests can reveal signs of diabetes, so that it can be properly managed during the pregnancy.

 

DIF:    Cognitive Level: Application           REF:   64                  OBJ:   5

TOP:   Subsequent Visits                            KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Health Promotion and Maintenance

 

4. The purpose of Leopold’s maneuvers is to determine:

a.	The expected date of delivery
b.	The presentation and position of the fetus
c.	The fetal heart rate
d.	Exact pelvic measurements

 

 

ANS:  B

Leopold’s maneuvers consist of four basic steps in palpating the woman’s abdomen to assess the presentation and position of the fetus.

 

DIF:    Cognitive Level: Knowledge            REF:   64                  OBJ:   5

TOP:   Subsequent Visits                            KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: N/A

 

5. One purpose of ultrasound imaging during pregnancy is to:

a.	Assess the adequacy of placental function.
b.	Detect genetic chromosomal abnormalities.
c.	Rule out fetal abnormalities.
d.	Evaluate fetal lung maturity.

 

 

ANS:  C

Ultrasound imaging provides an image of the fetus and placenta. Therefore, it can be used to rule out some fetal abnormalities. The placental implantation site can be visualized, but adequacy of placental function is assessed using Doppler ultrasound.

 

DIF:    Cognitive Level: Comprehension     REF:   64 | 66 | Table 5-2

OBJ:   16                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A

 

6. Compared with amniocentesis, chorionic villus sampling:

a.	Has a lower risk of abortion
b.	Can be done earlier in pregnancy
c.	Is noninvasive and less painful
d.	Reveals alpha-fetoprotein level

 

 

ANS:  B

Chorionic villus sampling can be done earlier than amniocentesis. It carries a higher (not lower) risk of abortion. Amniocentesis allows the measurement of alpha-fetoprotein, whereas chorionic villus sampling does not. Both procedures are invasive.

 

DIF:    Cognitive Level: Comprehension     REF:   67 | Table 5-2

OBJ:   15 | 18            TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A

 

7. A diagnostic test of the amniotic fluid to determine whether the fetus is likely to develop respiratory distress is:

a.	Lecithin/sphingomyelin ratio (L/S ratio)
b.	Alpha-fetoprotein (AFP)
c.	Rh isoimmunization
d.	Triple marker screen

 

 

ANS:  A

The L/S ratio indicates fetal lung maturity, which helps determine whether the fetus is likely to have respiratory distress at birth. AFP levels are used to help identify possible congenital or genetic defects. Tests for Rh isoimmunization may be done if the mother is Rh negative and the fetus is Rh positive. Triple marker screening may be done with the AFP test to identify chromosomal abnormalities.

 

DIF:    Cognitive Level: Comprehension     REF:   67 | Table 5-2

OBJ:   15                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A

 

8. An elevated alpha-fetoprotein (AFP) level is consistent with:

a.	Chromosomal disorders
b.	Neural tube defects
c.	High stress level
d.	Poor placental function

 

 

ANS:  B

An elevated AFP level is found with neural tube defects such as spina bifida or anencephaly. Low levels are associated with chromosomal abnormalities.

 

DIF:    Cognitive Level: Comprehension     REF:   68 | Table 5-2

OBJ:   15                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A

 

9. The biophysical profile (BPP) uses five observations, including:

a.	Alpha-fetoprotein level
b.	Gross body movements
c.	Fetal lung maturity
d.	Estimated length and weight

 

 

ANS:  B

The five observations in the biophysical profile are fetal breathing movements, gross fetal movements, fetal heart rate variability and reactivity, fetal muscle tone, and the amniotic fluid index.

 

DIF:    Cognitive Level: Knowledge            REF:   68 | Table 5-2

OBJ:   19                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A

 

10. During a nonstress test (NST), a monitor records fetal heart rate when the mother senses fetal movement. This test is used to assess:

a.	The effects of maternal drugs on the fetus
b.	Maturity of the fetal heart and lungs
c.	Fetal response to uterine contractions
d.	Fetal oxygenation and autonomic function

 

 

ANS:  D

Increased fetal heart rate associated with movement reflects normal ability of the heart to “speed up” to meet increased oxygen demands. The contraction stress test (CST) assesses fetal response to uterine contractions. Fetal lung maturity is determined by testing amniotic fluid.

 

DIF:    Cognitive Level: Comprehension     REF:   67 | Table 5-2

OBJ:   15 | 20            TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A

 

11. Which statement correctly describes the contraction stress test (CST)?

a.	The fetal heart rate is assessed during maternal exercise.
b.	An artificial larynx is used to stimulate the fetus.
c.	A contraction stress test is indicated if the nonstress test is reactive.
d.	Uterine contractions must be induced.

 

 

ANS:  D

If a nonstress test (NST) is nonreactive, the CST is indicated. Uterine contractions are stimulated and the fetal heart rate response is recorded. During the NST, an artificial larynx may be applied to the mother’s abdomen and activated to stimulate the fetus.

 

DIF:    Cognitive Level: Comprehension     REF:   68 | Table 5-2

OBJ:   15                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A

 

12. To prepare a woman for a contraction stress test using nipple stimulation, an appropriate instruction would be to:

a.	Massage both breasts simultaneously.
b.	Roll the nipple between the thumb and fingers.
c.	Continually stimulate the breasts throughout the test.
d.	Brush your palm across the nipple of one breast for 2 to 3 minutes.

 

 

ANS:  D

The palm of the hand should be used to brush across the nipple. This stimulates the release of oxytocin from the pituitary, which, in turn, causes uterine contractions. Bilateral stimulation may cause excessively long or frequent uterine contractions. The woman should rest for 5 minutes between contractions.

 

DIF:    Cognitive Level: Application           REF:   68 | Table 5-2

OBJ:   15                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Implementation                              MSC:  NCLEX: N/A

 

13. A common discomfort in the first trimester of pregnancy is:

a.	Dyspnea
b.	Leg cramps
c.	Constipation
d.	Leukorrhea

 

 

ANS:  D

Common discomforts in the first trimester include nausea with or without vomiting, urinary frequency, breast tenderness, and leukorrhea (vaginal discharge). Dyspnea, leg cramps, and constipation are more common in the second or third trimesters.

 

DIF:    Cognitive Level: Comprehension     REF:   71 | Table 5-3

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: N/A              MSC:  NCLEX: N/A

 

14. On her second prenatal visit, a woman states that she feels like she needs to urinate “all the time, even during the night.” She says she has reduced her fluid intake to control this problem. The nurse should tell her to:

a.	“Drink more fluids during the day and less in the evening.”
b.	“Bring in a urine specimen because you probably have an infection.”
c.	“Decrease your fluid intake until you no longer have to urinate so often.”
d.	“Try to resist the urge to urinate as long as possible to increase your bladder capacity.”

 

 

ANS:  A

The pregnant woman needs additional fluids, so she should not reduce her total intake. Drinking less in the evening will mean fewer nighttime trips to the bathroom. Urinary frequency is caused by the pressure of the enlarging uterus on the bladder and will diminish about the fourth month of pregnancy.

 

DIF:    Cognitive Level: Application           REF:   71 | Table 5-3

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

15. A teaching plan for self-care during pregnancy should include that:

a.	Tub baths may cause infections because bath water enters the vagina.
b.	Pregnancy is a good time to improve fitness and lose weight.
c.	Hot tubs should be avoided because increased body temperature decreases placental blood flow.
d.	Sexual intercourse should be stopped after the fifth month of pregnancy.

 

 

ANS:  C

If the body temperature rises above 38° C (100.4° F), blood is shunted to the mother’s skin and muscles, which decreases circulation to the fetus. Tub baths are not contraindicated unless membranes are ruptured or the mucous plug has been expelled. The goal of exercise during pregnancy should be maintenance of fitness, not improvement of fitness or weight loss. Unless there is a risk for preterm labor, or a rupture of membranes has occurred or labor begun, there is no valid reason to limit sexual activity in a healthy pregnancy.

 

DIF:    Cognitive Level: Application           REF:   73 | NCP 5-2

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Health Promotion and Maintenance

 

16. To minimize heartburn, the pregnant patient should:

a.	Take Alka Seltzer before each meal.
b.	Avoid foods high in protein.
c.	Sit up for 30 minutes after eating.
d.	Eat a snack before bedtime.

 

 

ANS:  C

Heartburn is caused by the gastric contents flowing back into the esophagus. Sitting up for 30 minutes after meals reduces the backflow. Greasy or gas-forming foods are more likely to contribute to heartburn than high-protein foods. Alka Seltzer is not recommended because it is high in sodium and may increase fluid retention.

 

DIF:    Cognitive Level: Comprehension     REF:   71 | Table 5-3

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: N/A              MSC:  NCLEX: N/A

 

17. A woman in her third trimester is troubled by frequent leg cramps. Which measure would the nurse suggest to relieve the cramps?

a.	Increase the intake of foods high in potassium.
b.	Stand with the feet flat on the floor when cramps occur.
c.	Lie down and elevate the feet until cramps resolve.
d.	Flex the knees and ankles to relieve the muscle cramps.

 

 

ANS:  B

Leg cramps are relieved best by dorsiflexion of the foot or standing with the affected foot flat on the floor. In addition, the diet should be evaluated to be certain the woman is getting adequate calcium.

 

DIF:    Cognitive Level: Application           REF:   72 | Table 5-3 | Figure 5-7

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

18. Self-care instruction for a pregnant woman to lessen backache should include:

a.	Wearing low-heeled shoes
b.	Bending over to pick up objects
c.	Doing modified sit-ups to strengthen back muscles
d.	Leaning back to compensate for the enlarging abdomen

 

 

ANS:  A

Advise the woman not to exaggerate the lumbar curve by leaning too far backward or wearing high-heeled shoes. Sit-ups are not recommended. Good body mechanics should be used. The client should squat to pick up objects rather than bend over, which increases back strain.

 

DIF:    Cognitive Level: Application           REF:   71 | Table 5-3

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Health Promotion and Maintenance

 

19. For a healthy pregnancy outcome, the recommended weight gain during pregnancy is:

a.	1.4 to 1.8 kg (3 to 4 lbs) each month in the first trimester, then 0.4 kg (1 lb) per week for a total of 11 to 16 kg (25 to 35 lbs)
b.	0.4 kg (1 lb) each week for a total of 18 kg (40 lbs)
c.	1.4 to 1.8 kg (3 to 4 lbs) each week for the first trimester, then 0.4 kg (1 lb) per month for a total of 19 to 24.5 kg (42 to 54 lbs)
d.	0.4 to 0.8 kg (1 to 2 lbs) per month for a total of 5.5 to 8 kg (12 to 18 lbs)

 

 

ANS:  A

The accepted weight gain is 3 to 4 lbs per month in the first trimester, then 1 lb per week for a total of 25 to 35 lbs.

 

DIF:    Cognitive Level: Comprehension     REF:   80 | Figure 5-10

OBJ:   9                    TOP:   Weight Gain and Fetal Growth         KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

20. Fetal weight increases most during the:

a.	First 2 weeks
b.	First trimester
c.	Second trimester
d.	Third trimester

 

 

ANS:  D

During the first trimester, weight gain is primarily maternal. Weight gain in the second trimester is both maternal and fetal. The fetus’s greatest weight gain is in the third trimester.

 

DIF:    Cognitive Level: Knowledge            REF:   80                  OBJ:   9

TOP:   Weight Gain and Fetal Growth         KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

21. To prevent supine hypotensive syndrome and to promote fetal perfusion during pregnancy, the teaching plan should include:

a.	Eating small meals
b.	Lowering the head
c.	Lying on the left side
d.	Elevating the feet

 

 

ANS:  C

The pressure of the pregnant uterus on the vena cava can impede blood flow, causing hypotension and reducing blood flow to the fetus. Lying on the left side relieves the pressure on the vena cava, thereby improving circulation.

 

DIF:    Cognitive Level: Comprehension     REF:   76 | Table 5-3 | NCP 5-2

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Health Promotion and Maintenance

 

22. Self-care instruction for a pregnant woman often includes the pelvic rocking exercise, which helps:

a.	Strengthen perineal muscles
b.	Strengthen abdominal muscles
c.	Relieve lower back pain
d.	Relax pelvic ligaments

 

 

ANS:  C

The postural changes that occur to maintain balance as the uterus enlarges place strain on the back muscles. Pelvic rocking helps strengthen those muscles.

 

DIF:    Cognitive Level: Comprehension     REF:   71 | Table 5-3

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

23. Self-care instructions for a pregnant woman should include:

a.	Not wearing knee-high stockings
b.	Washing nipples with soap and warm water
c.	Douching once a week to prevent infection
d.	Using a firm toothbrush to toughen gums

 

 

ANS:  A

Knee-high stockings interfere with circulation, leading to edema and increasing the risk of blood clots forming in the legs. Soap should not be used to wash the nipples. Douching is not recommended, unless ordered by the care provider for treatment of a vaginal infection. Douching may actually introduce infection. A soft toothbrush is used because the gums are soft and bleed more easily.

 

DIF:    Cognitive Level: Comprehension     REF:   72 | Table 5-3 | NCP 5-2

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

24. Which factor is likely to contribute to the formation of varicose veins during pregnancy?

a.	Walking
b.	Loosely fitting clothing
c.	Elevation of the legs
d.	Constipation

 

 

ANS:  D

Constipation causes straining during bowel movements, which increases pressure in the veins of the legs and contributes to varicosities. Walking and elevation of the legs promote venous return, which helps prevent varicosities. By preventing pressure on blood vessels, loose clothing also helps prevent varicosities.

 

DIF:    Cognitive Level: Comprehension     REF:   72 | Table 5-3

OBJ:   6                    TOP:   Self-Care and Common Discomforts of Pregnancy

KEY:  Nursing Process Step: N/A              MSC:  NCLEX: N/A

 

25. In a prenatal class, one woman tells the nurse that she is a vegetarian and asks whether this poses a problem in relation to her pregnancy. The nurse’s most appropriate response is:

a.	“All vegetarian diets provide the essential nutrients during pregnancy.”
b.	“Your care provider may order supplemental vitamins and calcium.”
c.	“You cannot continue a vegetarian diet and have a healthy baby.”
d.	“Increasing your fruit intake should make up for any dietary deficiencies.”

 

 

ANS:  B

There are several types of vegetarian diets. Some meet prenatal needs as long as the proper combination of foods is eaten. Depending on the type of vegetarian diet, supplemental vitamin B₁₂ and calcium may be recommended. Simply increasing fruit intake would not provide the most commonly deficient nutrients. People have many reasons for choosing vegetarian diets, and the nurse must respect that choice and work with the patient.

 

DIF:    Cognitive Level: Application           REF:   80-84             OBJ:   9

TOP:   Nutrition        KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

26. The nurse explains to a pregnant woman who does not like milk that other foods are good sources of calcium, such as:

a.	Whole grains
b.	Beef, pork, and chicken
c.	Green, leafy vegetables and tofu
d.	Nuts and legumes

 

 

ANS:  C

Of the choices presented, only leafy, green vegetables and tofu provide significant calcium.

 

DIF:    Cognitive Level: Application           REF:   82-83             OBJ:   9

TOP:   Nutrition        KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

27. Pregnant women need increased vitamin A for fetal cell development, bone growth, and tooth formation. One food that is high in vitamin A is:

a.	Grapefruit
b.	Chicken
c.	Carrots
d.	Liver

 

 

ANS:  C

Of the choices presented, only carrots are high in vitamin A.

 

DIF:    Cognitive Level: Comprehension     REF:   78                  OBJ:   9

TOP:   Nutrition        KEY:  Nursing Process Step: N/A              MSC:  NCLEX: N/A

 

28. A pregnant woman should be instructed that good sources of iron are:

a.	Pork and nuts
b.	Eggs and tomato juice
c.	Seafood and butter
d.	Broccoli and liver

 

 

ANS:  D

Of the choices presented, broccoli and liver are the best iron sources.

 

DIF:    Cognitive Level: Application           REF:   81 | 83            OBJ:   9

TOP:   Nutrition        KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

29. The primary concern with pica in pregnant patients is that:

a.	Nonfood items may be substituted for nutritious foods.
b.	Starch consumption increases the risk of developing diabetes.
c.	There is a high risk of toxicity with common substances consumed with pica.
d.	Pica indicates severe emotional disorders that can affect the outcome of the pregnancy.

 

 

ANS:  A

With pica, substances commonly ingested are starch, red clay, and ice cubes. These substances are not especially harmful but are often substituted for nutritious food.

 

DIF:    Cognitive Level: Comprehension     REF:   84                  OBJ:   10

TOP:   Nutrition        KEY:  Nursing Process Step: N/A              MSC:  NCLEX: N/A

 

30. Which statement by the nurse reflects the current philosophy of childbirth education?

a.	“If you are willing to endure the discomfort, you can deliver without any medications.”
b.	“I will tell you about your options for pain management so you can make a choice.”
c.	“These classes will help you trust us to make the best decisions for you.”
d.	“I will start by telling you about the options that I believe work best.”

 

 

ANS:  B

Offering to tell the woman about her pain management options provides information that empowers the woman and her partner to make decisions in a supportive atmosphere. This is the modern philosophy of childbirth education.

 

DIF:    Cognitive Level: Application           REF:   84-85             OBJ:   12

TOP:   Education for Childbirth                  KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

31. Relaxation exercises, focusing, imagery, and effleurage are taught in childbirth education because they:

a.	Relax the abdominal muscles for delivery.
b.	Reduce Braxton-Hicks contractions.
c.	Relieve nausea during the first trimester.
d.	Are helpful in pain management during labor.

 

 

ANS:  D

These activities help the woman in labor relax and work as distracters from pain.

 

DIF:    Cognitive Level: Comprehension     REF:   84-85             OBJ:   12

TOP:   Education for Childbirth                  KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

32. The basic breathing patterns recommended during the first stage of labor include _____ breathing.

a.	Fast-paced
b.	Expulsion
c.	Modified-paced
d.	Random-paced

 

 

ANS:  C

The three types of breathing patterns recommended for the first stage of labor are slow-paced-breathing, modified-paced breathing, and patterned-paced breathing.

 

DIF:    Cognitive Level: Comprehension     REF:   86-87 | Figure 5-14

OBJ:   13                  TOP:   Breathing Patterns for Labor            KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

33. An exercise that strengthens perineal muscle tone and elasticity is the:

a.	Pelvic tilt
b.	Kegel exercise
c.	Straight leg lift
d.	Muscle relaxation

 

 

ANS:  B

Kegel exercises strengthen perineal muscle tone and improve elasticity. Pelvic tilts strengthen abdominal and back muscles, and straight leg lifts promote venous return. Relaxation exercises do not alter muscle tone or elasticity.

 

DIF:    Cognitive Level: Comprehension     REF:   77 | Box 5-4    OBJ:   7

TOP:   Exercise During Pregnancy              KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

34. Which sign should a pregnant woman report to her health care provider immediately?

a.	Palmar erythema
b.	Anginal pain
c.	Ankle edema
d.	Frequent urination

 

 

ANS:  B

All options are normal during pregnancy except anginal pain.

 

DIF:    Cognitive Level: Comprehension     REF:   80                  OBJ:   6 | 14

TOP:   Danger Signs                                   KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

35. Which individual is at greatest risk for a high-risk pregnancy?

a.	A 15-year-old who is a vegetarian
b.	A 35-year-old with varicose veins
c.	A 20-year-old with three healthy children
d.	A 24-year-old in her forty-second week of gestation

 

 

ANS:  A

A woman younger than age 16 and a vegetarian have the most risk factors among the choices presented.

 

DIF:    Cognitive Level: Comprehension     REF:   66 | 81 | Box 5-2

OBJ:   14                  TOP:   Prenatal Fetal Assessment                KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

36. The assumption that all people of a particular culture think and behave in the same way is known as:

a.	Discrimination
b.	Cultural bias
c.	Cultural stereotyping
d.	Racism

 

 

ANS:  C

Cultural stereotyping is the assumption that all people of a particular culture think and behave in the same manner. Although specific cultural groups have certain commonalities of belief and behavior, individual differences exist and should be identified and respected.

 

DIF:    Cognitive Level: Comprehension     REF:   62                  OBJ:   4

TOP:   Cultural Competence                       KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

37. The pregnant woman asks why she should not receive a rubella virus immunization until after delivery. Which response would be the most appropriate?

a.	“Live virus vaccines have a high risk of teratogenic effects.”
b.	“The pain of the vaccine could cause stress to the fetus.”
c.	“You don’t have to worry about getting rubella while you’re pregnant.”
d.	“It will be easier for you to have the vaccine after delivery.”

 

 

ANS:  A

Live virus vaccines have a high risk for causing potentially severe birth defects (teratogenic effects).

 

DIF:    Cognitive Level: Application           REF:   78                  OBJ:   11

TOP:   Immunizations During Pregnancy    KEY:  Nursing Process Step: N/A

MSC:  NCLEX: N/A

 

38. A nurse is explaining nonstress testing to expectant parents. Which statement indicates that further teaching is necessary?

a.	“If the fetal heart rate increases in response to fetal movement, the test is considered to be reactive.”
b.	“If there is little or no increase in fetal heart rate with fetal movement, the test is considered to be nonreactive.”
c.	“A reactive nonstress test means that further assessment will be required.”
d.	“A reactive stress test indicates that the fetus is well oxygenated with autonomic functions.”

 

 

ANS:  C

A reactive nonstress test is considered normal. Further assessment would be necessary with a nonreactive nonstress test result.

 

DIF:    Cognitive Level: Application           REF:   67 | Table 5-2

OBJ:   15                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance

 

MULTIPLE RESPONSE

 

39. At a prenatal visit, the patient discusses her vegetarian diet with the nurse and states that she does not feel her diet includes enough protein. Which food(s) should the nurse suggest she add to her diet? (Select all that apply.)

a.	Peanut butter
b.	Cottage cheese
c.	Chicken
d.	Eggs
e.	Rice

 

 

ANS:  A, B, D

Peanut butter, cottage cheese, and eggs are good sources of protein. Chicken would not be included on a vegetarian diet. Rice is not high in protein.

 

DIF:    Cognitive Level: Application           REF:   83                  OBJ:   5

TOP:   Medications   KEY:  Nursing Process Step: N/A              MSC:  NCLEX: N/A

 

40. Amniocentesis is one diagnostic tool used to assess fetal health and well-being, and it is used for what reason(s)? (Select all that apply.)

a.	Assessment of a genetic disorder
b.	Determining alpha-fetoprotein levels
c.	Assessment of fetal lung maturity
d.	Assessment of placental insufficiency
e.	Determining location of placenta

 

 

ANS:  A, B, C

Amniocentesis is used to assess for genetic disorders, to determine alpha-fetoprotein levels (elevated level may mean a neural tube defect; decreased level may indicate a chromosomal disorder or gestational trophoblastic disease), and to check for fetal lung maturity. Placental insufficiency is assessed using a Doppler ultrasound. Ultrasound imaging is used to determine the location of the placenta.

 

DIF:    Cognitive Level: Application           REF:   66 | Table 5-2

OBJ:   17                  TOP:   Prenatal Fetal Assessment

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: N/A