1. G = 3, T = 2, P = 0, A = 0, L =1
2. G = 2, T = 0, P = 1, A = 0, L =1
3. G = 1, T = 1. P = 1, A = 0, L = 1
4. G = 2, T = 0, P = 0, A = 0, L = 1
6. A nurse is performing an assessment of a primapira who is being evaluated in
a clinic during her second trimester of pregnancy. Which of the following indicates
an abnormal physical finding necessitating further testing?
1. Consistent increase in fundal height
2. Fetal heart rate of 180 BPM
3. Braxton hicks contractions
4. Quickening
7. A nurse is reviewing the record of a client who has just been told that a
pregnancy test is positive. The physician has documented the presence of a
Goodells sign. The nurse determines this sign indicates:
1. A softening of the cervix
2. A soft blowing sound that corresponds to the maternal pulse during auscultation
of the uterus.
3. The presence of hCG in the urine
4. The presence of fetal movement
8. A nursing instructor asks a nursing student who is preparing to assist with the
assessment of a pregnant client to describe the process of quickening. Which of
the following statements if made by the student indicates an understanding of
this term?
1.
2.
3.
4.
2. I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks
following the last evidence of bleeding.
3. I will count the number of perineal pads used on a daily basis and note the
amount and color of blood on the pad.
4. I will watch for the evidence of the passage of tissue.
1. 15. A prenatal nurse is providing instructions to a group of pregnant client
regarding measures to prevent toxoplasmosis. Which statement if made by one of
the clients indicates a need for further instructions?
1. I need to cook meat thoroughly.
2. I need to avoid touching mucous membranes of the mouth or eyes while
handling raw meat.
3. I need to drink unpasteurized milk only.
4. I need to avoid contact with materials that are possibly contaminated with cat
feces.
1. 16. A homecare nurse visits a pregnant client who has a diagnosis of mild
Preeclampsia and who is being monitored for pregnancy induced hypertension
(PIH). Which assessment finding indicates a worsening of the Preeclampsia and
the need to notify the physician?
1. Blood pressure reading is at the prenatal baseline
2. Urinary output has increased
3. The client complains of a headache and blurred vision
4. Dependent edema has resolved
1. 17. A nurse implements a teaching plan for a pregnant client who is newly
diagnosed with gestational diabetes. Which statement if made by the client
indicates a need for further education?
1. I need to stay on the diabetic diet.
2. I will perform glucose monitoring at home.
3. I need to avoid exercise because of the negative effects of insulin production.
4. I need to be aware of any infections and report signs of infection immediately to
my health care provider.
1. 18. A primagravida is receiving magnesium sulfate for the treatment of pregnancy
induced hypertension (PIH). The nurse who is caring for the client is performing
assessments every 30 minutes. Which assessment finding would be of most
concern to the nurse?
1. Urinary output of 20 ml since the previous assessment
2. Deep tendon reflexes of 2+
3. Respiratory rate of 10 BPM
1. 24. A nurse is caring for a pregnant client with severe preeclampsia who is
receiving IV magnesium sulfate. Select all nursing interventions that apply in the
care for the client.
1. Monitor maternal vital signs every 2 hours
2. Notify the physician if respirations are less than 18 per minute.
3. Monitor renal function and cardiac function closely
4. Keep calcium gluconate on hand in case of a magnesium sulfate overdose
5. Monitor deep tendon reflexes hourly
6. Monitor I and Os hourly
7. Notify the physician if urinary output is less than 30 ml per hour.
1. 25. In the 12th week of gestation, a client completely expels the products of
conception. Because the client is Rh negative, the nurse must:
1. Admister RhoGAM within 72 hours
2. Make certain she receives RhoGAM on her first clinic visit
3. Not give RhoGAM, since it is not used with the birth of a stillborn
4. Make certain the client does not receive RhoGAM, since the gestation only lasted
12 weeks.
1. 26. In a lecture on sexual functioning, the nurse plans to include the fact that
ovulation occurs when the:
1. Oxytocin is too high
2. Blood level of LH is too high
3. Progesterone level is high
4. Endometrial wall is sloughed off.
1. 27. The chief function of progesterone is the:
1. Development of the female reproductive system
2. Stimulation of the follicles for ovulation to occur
3. Preparation of the uterus to receive a fertilized egg
4. Establishment of secondary male sex characteristics
1. 28. The developing cells are called a fetus from the:
1. Time the fetal heart is heard
2. Eighth week to the time of birth
3. Implantation of the fertilized ovum
4. End of the send week to the onset of labor
1. 29. After the first four months of pregnancy, the chief source of estrogen and
progesterone is the:
1. Placenta
2. Adrenal cortex
3. Corpus luteum
4. Anterior hypophysis
1. 30. The nurse recognizes that an expected change in the hematologic system that
occurs during the 2nd trimester of pregnancy is:
1. A decrease in WBCs
2. In increase in hematocrit
3. An increase in blood volume
4. A decrease in sedimentation rate
1. 31. The nurse is aware than an adaptation of pregnancy is an increased blood
supply to the pelvic region that results in a purplish discoloration of the vaginal
mucosa, which is known as:
1. Ladins sign
2. Hegars sign
3. Goodells sign
4. Chadwicks sign
1. 32. A pregnant client is making her first Antepartal visit. She has a two year old
son born at 40 weeks, a 5 year old daughter born at 38 weeks, and 7 year old twin
daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10
weeks. Using the GTPAL format, the nurse should identify that the client is:
1. G4 T3 P2 A1 L4
2. G5 T2 P2 A1 L4
3. G5 T2 P1 A1 L4
4. G4 T3 P1 A1 L4
1. 33. An expected cardiopulmonary adaptation experienced by most pregnant
women is:
1. Tachycardia
2. Dyspnea at rest
3. Progression of dependent edema
4. Shortness of breath on exertion
1. 34. Nutritional planning for a newly pregnant woman of average height and
weighing 145 pounds should include:
1. A decrease of 200 calories a day
2. An increase of 300 calories a day
3. An increase of 500 calories a day
4. A maintenance of her present caloric intake per day
1. 35. During a prenatal examination, the nurse draws blood from a young Rh
negative client and explain that an indirect Coombs test will be performed to
predict whether the fetus is at risk for:
1. Acute hemolytic disease
water and keep them dry. The woman should be instructed to avoid using soap on
the nipples and areola area to prevent the drying of tissues. Wearing a supportive
bra with wide adjustable straps can decrease breast tenderness. Tight-fitting
blouses or dresses will cause discomfort (especially on test days, even if youre
not pregnant. Yo.).
13.1. Severe Preeclampsia can trigger disseminated intravascular coagulation (DIC;
remember the Peds lecture?) because of the widespread damage to vascular
integrity. Bleeding is an early sign of DIC and should be reported to the M.D.
14.1. Strict bed rest throughout the remainder of pregnancy is not required. The
woman is advised to curtail sexual activities until the bleeding has ceased, and for
2 weeks following the last evidence of bleeding or as recommended by the
physician. The woman is instructed to count the number of perineal pads used
daily and to note the quantity and color of blood on the pad. The woman also
should watch for the evidence of the passage of tissue.
15.3. All pregnant women should be advised to do the following to prevent the
development of toxoplasmosis. Women should be instructed to cook meats
thoroughly, avoid touching mucous membranes and eyes while handling raw
meat; thoroughly wash all kitchen surfaces that come into contact with uncooked
meat, wash the hands thoroughly after handling raw meat; avoid uncooked eggs
and unpasteurized milk; wash fruits and vegetables before consumption, and
avoid contact with materials that possibly are contaminated with cat feces, such
as cat litter boxes, sand boxes, and garden soil.
16.3. If the client complains of a headache and blurred vision, the physician should
be notified because these are signs of worsening Preeclampsia.
17.3. Exercise is safe for the client with gestational diabetes and is helpful in
lowering the blood glucose level.
18.3. Magnesium sulfate depresses the respiratory rate. If the respiratory rate is less
than 12 breaths per minute, the physician or other health care provider needs to
be notified, and continuation of the medication needs to be reassessed. A urinary
output of 20 ml in a 30 minute period is adequate; less than 30 ml in one hour
needs to be reported. Deep tendon reflexes of 2+ are normal. The fetal heart rate
is WNL for a resting fetus.
19.3. The immediate care during a seizure (eclampsia) is to ensure a patent airway.
The other options are actions that follow or will be implemented after the seizure
has ceased.
20.1 and 3. The three classic signs of preeclampsia are hypertension, generalized
edema, and protenuria. Increased respirations are not a sign of preeclampsia.
peak blood volume occurs between 30 and 34 weeks of gestation. The hematocrit
decreases as a result of the increased blood volume.
31.4. A purplish color results from the increased vascularity and blood vessel
engorgement of the vagina.
32.3. 5 pregnancies; 2 term births; twins count as 1; one abortion; 4 living children.
33.4. This is an expected cardiopulmonary adaptation during pregnancy; it is caused
by an increased ventricular rate and elevated diaphragm.
34.2. This is the recommended caloric increase for adult women to meet the
increased metabolic demands of pregnancy.
35.1. When an Rh negative mother carries an Rh positive fetus there is a risk for
maternal antibodies against Rh positive blood; antibodies cross the placenta and
destroy the fetal RBCs.
36.2. The increase of estrogen during pregnancy causes hyperplasia of the vaginal
mucosa, which leads to increased production of mucus by the endocervical
glands. The mucus contains exfoliated epithelial cells.
37.3. The alpha-fetoprotein test detects neural tube defects and Down syndrome.
38.2. Ambulation relieves Braxton Hicks.
39.2. This is because impedance of venous return by the gravid uterus, which
causes hypotension and decreased systemic perfusion.
40.1. Prolactin is the hormone from the anterior pituitary gland that stimulates
mammary gland secretion. Oxytocin, a posterior pituitary hormone, stimulates the
uterine musculature to contract and causes the let down reflex.
41.4. The chorionic villi of a molar pregnancy resemble a snowstorm pattern on
ultrasound. Bleeding with a hydatidiform mole is often dark brown and may occur
erratically for weeks or months.
42.4. The dilated arterioles that occur during pregnancy are due to the elevated
level of circulating estrogen. The linea nigra is a pigmented line extending from
the symphysis pubis to the top of the fundus during pregnancy.
43.3. Hemoglobin and hematocrit levels decrease during pregnancy as the increase
in plasma volume exceeds the increase in red blood cell production.
44.2. Excessive vomiting in clients with hyperemesis gravidarum often causes
weight loss and fluid, electrolyte, and acid-base imbalances.
45.1. Clients with gestational diabetes are usually managed by diet alone to control
their glucose intolerance. Oral hypoglycemic agents are contraindicated in
pregnancy. NPH isnt usually needed for blood glucose control for GDM.
46.1. Calcium gluconate is the antidote for magnesium toxicity. Ten ml of 10%
calcium gluconate is given IV push over 3-5 minutes. Hydralazine is given for