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- Since 1995, there has been a significant decrease in the rate of infant death related to which of the following: a. Disorders associated with short gestation and low birth weight b. Accidents c. Sudden infant death d. Newborns affected by complications of placenta, cord, and membranes - ANSWER c
- Tobacco use during pregnancy is associated with adverse effects on the unborn infant, such as intrauterine growth restriction, preterm births, and respiratory problems. By race, which has the highest percentage of smokers? a. American Indian and Alaskan Natives b. Asian or Pacific Islanders c. Non-Hispanic blacks d. Non-Hispanic whites - ANSWER a
- Which of the following women is at the highest risk for health disparity? a. A white, middle-class, 16-year-old woman b. An African American, middle-class, 25-year-old woman c. An African American, upper-middle-class, 19-year-old woman d. An Asian, low-income, 30-year-old woman - ANSWER d
- A neonate born at 36 weeks gestation is classified as which of the following? a. Very premature
b. Moderately premature c. Late premature d. Term - ANSWER c
- The perinatal nurse explains to the student nurse that a goal of the Healthy People 2020 report is to: a. Increase proportion of infants who are breastfed to 93.1%. b. Increase proportion of infants who are breastfed to 90.7%. c. Increase proportion of infants who are breastfed to 85.6%. d. Increase proportion of infants who are breastfed to 83.9%. - ANSWER d
- The perinatal nurse explains to the student nurse that __________ is the leading cause of infant death in the United States. a. Sudden Infant Death Syndrome b. Respiratory distress of newborns c. Disorders related to short gestation and low birth weight d. Congenital malformations and chromosomal abnormalities - ANSWER d
- Which of the following statements are true related to teen pregnancies? (Select all that apply.) a. Teen mothers are at higher risk for HIV. b. Teen mothers are at higher risk for hypertensive problems. c. The birth rate for teenaged women has increased in the past 15 years. d. Infants born to teen mothers are at higher risk for health problems. - ANSWER a, b, d An ethical dilemma unique to perinatal nursing is the: a. Innate conflict between maternal and fetal rights b. Intensive use of technology
d. Phenotype - ANSWER d Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risks to her unborn child from the potential effects of exposure to toxoplasmosis? a. I will avoid rare lamb. b. I will wear a mask when cleaning my cats litter box. c. I understand that exposure to toxoplasmosis can cause blindness in the baby. d. I will avoid rare beef. - ANSWER b
- The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following? a. Ductus venosus b. Foramen ovale c. Ductus arteriosus d. Internal iliac artery - ANSWER c A woman at 40 weeks gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct? a. It indicates that there is a 25% increase in amniotic fluid. b. It indicates that there is a 25% reduction of amniotic fluid. c. It indicates that there is a 50% increase in amniotic fluid. d. It indicates that there is a 50% reduction of amniotic fluid. - ANSWER d
- A diagnostic test commonly used to assess problems of the fallopian tubes is: a. Endometrial biopsy b. Ovarian reserve testing c. Hysterosalpingogram
d. Screening for sexually transmitted infections - ANSWER c The nurse is interviewing a gravid woman during the first prenatal visit. The woman confides to the nurse that she lives with a number of pets. The nurse should advise the woman to be especially careful to refrain from coming in contact with the stool of which of the pets? a. Cat b. Dog c. Hamster d. Bird - ANSWER a A client is to take Clomiphene Citrate for infertility. Which of the following is the expected action of this medication? a. Decrease the symptoms of endometriosis b. Increase serum progesterone levels c. Stimulate release of FSH and LH d. Reduce the acidity of vaginal secretions - ANSWER c The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of __________. a. Unilateral amblyopia b. Subdural hematoma c. Sickle cell anemia d. Glomerular nephritis - ANSWER c A nurse is teaching a woman about her menstrual cycle. The nurse states that __________ is the most important change that happens during the secretory phase of the menstrual cycle. a. Maturation of the graafian follicle
a. Facilitates asymmetrical growth of the fetal limbs b. Cushions the fetus from mechanical injury c. Promotes development of muscle tone d. Promotes adherence of fetal lung tissue - ANSWER b During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from: a. 2 to 8 weeks b. 4 to 12 weeks c. 5 to 10 weeks d. 6 to 15 weeks - ANSWER a
- A major fetal development characteristic at 16 weeks gestation is: a. The average fetal weight is 450 grams b. Lanugo covers entire body c. Brown fat begins to develop d. Teeth begin to form - ANSWER d
- Karen, a 26-year-old woman, has come for preconception counseling and asks about caring for her cat as she has heard that she should not touch the cat during pregnancy. The clinic nurses best response is: a. It is best if someone other than you changes the cats litter pan during pregnancy so that you have no risk of toxoplasmosis during pregnancy. b. It is important to have someone else change the litter pan during pregnancy and also avoid consuming raw vegetables. c. Have you had any flu-like symptoms since you got your cat? If so, you may have already had toxoplasmosis, and there is nothing to worry about. d. Toxoplasmosis is a concern during pregnancy, so it is important to have someone else change the cats litter pan and also to avoid consuming uncooked meat. - ANSWER d
A couple who has sought infertility counseling has been told that the mans sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur? a. The testes are overheated. b. The vas deferens is ligated. c. The prostate gland is enlarged. d. The flagella are segmented. - ANSWER a A nurse working with an infertile couple has made the following nursing diagnosis: Sexual dysfunction related to decreased libido. Which of the following assessments is the likely reason for this diagnosis? a. The couple has established a set schedule for their sexual encounters. b. The couple has been married for more than 8 years. c. The couple lives with one set of parents. d. The couple has close friends who gave birth within the last year. - ANSWER a The perinatal nurse explains to the student nurse that in the fetal circulation, the lowest level of oxygen concentration is found in the umbilical arteries. - ANSWER True
- After birth, the perinatal nurse explains to the new mother that __________ is the hormone responsible for stimulating milk production. - ANSWER prolactin
- During prenatal class, the childbirth educator describes the two membranes that envelop the fetus. The __________ contains the amniotic fluid, and the __________ is the thick, outer membrane. - ANSWER amnion; chorion
- The perinatal nurse is teaching nursing students about fetal circulation and explains that fetal blood flows through the superior vena cava into the right __________ via the __________. - ANSWER atrium; foramen ovale
d. Paternal heart disease - ANSWER a, b The ovarian cycle includes which of the following phases? (Select all that apply.) a. Follicular phase b. Secretory phase c. Ovulatory phase d. Luteal phase e. Menstrual phase - ANSWER a, c, d A couple is undergoing an infertility workup. The semen analysis indicates a decreased number of sperm and immature sperm. Which of the following factors can have a potential effect on sperm maturity? (Select all that apply.) a. The man rides a bike to and from work each day. b. The man takes a calcium channel blocker for the treatment of hypertension. c. The man drinks 6 cups of coffee a day. d. The man was treated for prostatitis 12 months ago and has been symptom free since treatment. - ANSWER a, b The clinic nurse recognizes that pregnant women who are in particular need of support are those who (select all that apply): a. Are experiencing a second pregnancy b. Are awaiting genetic testing results c. Are experiencing a first pregnancy d. Are trying to conceal this pregnancy as long as possible - ANSWER b, d Folic acid supplementation during pregnancy is to: a. Improve the bone density of pregnant women
b. Decrease the incidence of neural tube defects in the fetus c. Decrease the incidence of Down syndrome in the fetus d. Improve calcium uptake in pregnant women - ANSWER b The positive signs of pregnancy are: a. All physiological and anatomical changes of pregnancy b. All subjective signs of pregnancy c. All those physiological changes perceived by the woman herself d. The objective signs of pregnancy that can only be attributed to the fetus - ANSWER d During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to: a. Order an EKG. b. Report this abnormal finding immediately to her care provider. c. Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension. d. Order a nonstress test to assess fetal well-being. - ANSWER c Blood volume expansion during pregnancy leads to: a. Iron-deficiency anemia b. Maternal iron stores being insufficient to meet the demands for iron in fetal development c. Plasma fibrin increase of 40% and fibrinogen increase of 50% d. Physiological anemia of pregnancy - ANSWER d Intimate partner violence (IPV) against women consists of actual or threatened physical or sexual violence and psychological and emotional abuse. Screening for IPV during pregnancy is recommended for: a. Pregnant women with a history of domestic violence
A 26-year-old woman at 29 weeks gestation experienced epigastric pain following the consumption of a large meal of fried fish and onion rings. The pain resolved a few hours later. The most likely diagnosis for this symptom is: a. Cholelithiasis b. Influenza c. Urinary tract infection d. Indigestion - ANSWER a The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks gestation. Tamaras hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as: a. Normal adult values b. Normal pregnancy values for the third trimester c. Increased adult values d. Increased values for 33 weeks gestation - ANSWER b The clinic nurse is aware that the pregnant womans blood volume increases by: a. 20% to 25% b. 30% to 35% c. 40% to 45% d. 50% to 55% - ANSWER c The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurses hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the: a. First maneuver b. Second maneuver
c. Third maneuver d. Fourth maneuver - a. First maneuver The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as: a. Positive signs of pregnancy b. Presumptive signs of pregnancy c. Probable signs of pregnancy d. Possible signs of pregnancy - ANSWER b Lina is an 18-year-old woman at 20 weeks gestation. This is her first pregnancy. Lina is complaining of fatigue and listlessness. Her vital signs are within a normal range: BP = 118/60, pulse = 70, and respiratory rate 16 breaths per minute. Linas fundal height is at the umbilicus, and she states that she is beginning to feel fetal movements. Her weight gain is 25 pounds over the prepregnant weight (110 lb), and her height is 5 feet 4 inches. The perinatal nurses best approach to care at this visit is to: a. Ask Lina to keep a 3-day food diary to bring in to her next visit in 1 week. b. Explain to Lina that weight gain is not a concern in pregnancy, and she should not worry. c. Teach Lina about the expected normal weight gain during pregnancy (approximately 20 pounds by 20 weeks gestation). d. Explain to Lina the possible concerns related to excessive weight gain in pregnancy, including the risk of gestational di - ANSWER a
- A woman presents to a prenatal clinic appointment at 10 weeks gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy? a. Occipital headache b. Urinary frequency c. Diarrhea
b. Blood pressure of 100/ c. Hematocrit of 29% d. Pulse rate of 76 bpm - ANSWER c A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct? a. The woman is experiencing a normal pregnancy. b. The woman may be having difficulty accepting this pregnancy. c. The woman must see a nutritionist as soon as possible. d. The woman will likely miscarry the conceptus. - ANSWER a
- A patient at 37 weeks gestation is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be palpated? a. At the xiphoid process b. At a point between the umbilicus and the xiphoid c. At the umbilicus d. At a level directly above the symphysis pubis - ANSWER a A nurse is performing an assessment on a pregnant woman during a prenatal visit. Which of the following findings would lead the nurse to report to the obstetrician that the patient may be experiencing intrauterine growth restriction (IUGR)? a. Leopolds maneuvers: Hard round object in the fundus, flat object on left of uterus, small parts on right of uterus, soft round object above the symphysis b. Weight gain: 6-pound increase over 4-week period c. Fundal height measurement: 22 cm at 26 weeks gestation d. Alpha-fetoprotein assessment: level is one-half normal, accompanied by complaints of severe nausea and vomiting - ANSWER c
A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2007. Using Naegeles rule, which of the following would the nurse determine to be the patients estimated date of delivery: a. January 9, 2008 b. April 13, 2008 c. April 20, 2008 d. September 6, 2008 - ANSWER b Which of the following findings, seen in pregnant women in the third trimester, would the nurse consider to be within normal limits? a. Diplopia b. Epistaxis c. Bradycardia d. Oliguria - ANSWER b A primigravida patient is 39 weeks pregnant. Which of the following symptoms would the nurse expect the patient to exhibit? a. Nausea b. Dysuria c. Urinary frequency d. Intermittent diarrhea - ANSWER c The nurse has taken a health history on four multigravida patients at their first prenatal visits. It is high priority that the patient whose first child was diagnosed with which of the following diseases receives nutrition counseling? a. Development dysplasia of the hip b. Achondroplastic dwarfism
a. 12 weeks b. 20 weeks c. 28 weeks d. 36 weeks - ANSWER b A patient at 28 weeks gestation was last seen in the prenatal clinic at 24 weeks gestation. Which of the following changes should the nurse bring to the attention of the Certified Nurse Midwife? a. Weight change from 128 pounds to 132 pounds b. Pulse change from 88 bpm to 92 bpm c. Blood pressure change from 110/70 to 140/ d. Respiratory change from 16 rpm to 20 rpm - ANSWER c The clinic nurse includes screening for domestic violence in the first prenatal visit for all patients. An appropriate question would be: a. This is something that we ask everyone. Do you feel safe in your current living environment and relationships? b. This is something we ask everyone. Do you have any abuse in your life right now? c. Is your partner threatening or harming you in any way right now? d. I need to ask you, do you feel safe from abuse right now? - ANSWER a An 18-year-old woman at 23 weeks gestation tells the nurse that she has fainted two times. The nurse teaches about the warning signs that often precede syncope so that she can sit or lie down to prevent personal injury. Warning signs include (select all that apply): a. Sweating b. Nausea c. Chills d. Yawning - ANSWER a, b, d
- The perinatal nurse teaches the student nurse about the physiological changes in pregnancy that most often contribute to the increased incidence of urinary tract infections. These changes include (select all that apply): a. Relaxation of the smooth muscle of the urinary sphincter b. Relaxation of the smooth muscle of the bladder c. Inadequate emptying of the bladder d. Increased incidence of bacteriuria - ANSWER a, b, c, d The clinic nurse discusses normal bladder function in pregnancy with a 22- year-old pregnant woman who is now in her 29th gestational week. The nurse explains that at this time in pregnancy, it is normal to experience (select all that apply): a. Urinary frequency b. Urinary urgency c. Nocturia d. Incontinence - ANSWER a, b, c A 32-year-old woman now at 32 weeks gestation is complaining of right-sided sharp abdominal pain. The patient is examined by the clinic nurse and given information about abdominal discomfort in pregnancy. She is also instructed to seek immediate attention if she (select all that apply): a. Has heartburn b. Has chills or a fever c. Feels decreased fetal movements d. Has increased abdominal pain - ANSWER b, c, d The clinic nurse talks with Suzy, a pregnant woman at 9 weeks gestation who has just learned of her pregnancy. Suzys nausea and vomiting are most likely caused by (select all that apply): a. Increased levels of estrogen
