Student Review Questions, Ricci-Kyle
Chapter 12: Nursing Management During Pregnancy
1.
MULTIPLE CHOICE
A pregnant woman comes to the clinic for a visit. This is her third pregnancy. She had a
miscarriage at 12 weeks and gave birth to a son, now 3 years old, at 32 weeks. Using the
GTPAL system, the nurse would document this woman’s obstetric history as:
31021
*30111
21212
20111
The woman’s obstetric history would be documented as 30111, G (gravida) = 3 (current
pregnancy), T (term pregnancies) = 0, P (number of preterm pregnancies) = 1, A (number
of pregnancies ending before 20 weeks viability) = 1, and L (number of living children) =
1.
2.
MULTIPLE CHOICE
A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which
of the following locations?
Symphysis pubis
Between the symphysis and umbilicus
*At the umbilicus
Just below the ensiform cartilage
At 20 weeks’ gestation, the fundus can be palpated at the umbilicus. A fundus of 12
weeks’ gestation is palpated at the symphysis pubis. At 16 weeks’ gestation, the fundus is
midway between the symphysis pubis and umbilicus. At 36 weeks’ gestation, the fundus
can be palpated just below the ensiform cartilage.
3.
MULTIPLE CHOICE
The diagonal conjugate of a pregnant woman’s pelvis is measured. Which measurement
would suggest a potential problem?
*12.0 cm
12.5 cm
13.0 cm
13.5 cm
The diagonal conjugate, usually 12.5 cm or greater, indicates the anteroposterior diameter
of the pelvic inlet. The diagonal conjugate is the most useful measurement for estimating
pelvic size because a misfit with the fetal head occurs if it is too small.
4.
MULTIPLE CHOICE
A woman is in her early second trimester of pregnancy. The nurse would instruct the
woman to return for a follow-up visit every:
*4 weeks
3 weeks
2 weeks
1 week
The recommended follow-up visit schedule is every 4 weeks up to 28 weeks, every 2
weeks from 29 to 36 weeks, and then every week from 37 weeks to birth.
5.
MULTIPLE CHOICE
After teaching a pregnant woman how to count fetal movements, the nurse determines
that the teaching was successful when the client states which of the following?
“I’ll do the count once a week on a morning that I’m not rushed for work.”
*“I’ll sit comfortably in a recliner or lie on my side when I do the counts.”
“I won’t expect more than three movements to happen in an hour.”
“I’ll do the counts while I’m sitting and watching my son’s basketball game.”
The client should perform the counts in a relaxed environment and a comfortable
position, such as a semi-Fowler’s or side-lying position. The woman needs to do fetal
movement counts consistently, at approximately the same time each day. A woman
should report a count of less than three fetal movements in an hour. A relaxed
environment, a comfortable position, and consistency in performing the counts are
important to identify changes.
6.
MULTIPLE CHOICE
A pregnant woman who is 26 weeks pregnant arrives for a follow-up visit. Which of the
following assessments, in addition to measuring fundal height and fetal heart rate, would
the nurse expect to complete? Select all that apply.
*Blood pressure
*Weight
Edema
*Urine testing
*Blood glucose level
Up to 28 weeks’ gestation, follow-up visits involve assessment of the client’s blood
pressure and weight, urine testing for protein and glucose, along with fundal height and
fetal heart rate. Between weeks 24 and 28, a blood glucose level is obtained. Assessment
for edema is typically done between 29 and 36 weeks’ gestation.
7.
MULTIPLE CHOICE
The nurse is preparing a teaching plan for a pregnant woman about the signs and
symptoms to be reported immediately to her health care provider. Which of the following
would the nurse include? Select all that apply.
*Headache with visual changes in the third trimester
Urinary frequency in the third trimester
*Sudden leakage of fluid during the second trimester
Nausea with vomiting during the first trimester
*Lower abdominal pain with shoulder pain in the first trimester
Backache during the second trimester
Danger signs and symptoms that need to be reported immediately include headache with
visual changes and sudden leakage of fluid in the third trimester, and lower abdominal
pain accompanied by shoulder pain in the first trimester. Urinary frequency in the third
trimester, nausea and vomiting during the first trimester, and backache during the second
trimester are common discomforts of pregnancy.
8.
MULTIPLE CHOICE
When providing preconception care to a client, which medication would the nurse
identify as being safe to continue during pregnancy?
Accutane
Lithium
Warfarin
*Famotidine
Famotidine is a category B drug that has been used frequently during pregnancy and does
not appear to cause major birth defects or other fetal problems. Accutane and warfarin are
category X drugs and should never be taken during pregnancy. Lithium is a category D
drug with clear health risks for the fetus and should be avoided during pregnancy.
9.
MULTIPLE CHOICE
After teaching the pregnant woman about ways to minimize flatulence and bloating
during pregnancy, which statement indicates the need for additional teaching?
“I’ll try to drink more fluids to help move things along.”
*“I’ll switch to chewing gum instead of using mints.”
“I’ll stay away from foods like cabbage and brussels sprouts.”
“I’ll increase my time spent on walking each day.”
Eating mints can help reduce flatulence; chewing gum increases the amount of air that is
swallowed, increasing gas build-up. Increasing fluid intake helps to reduce flatus. Gasforming foods such as beans, cabbage, and onions should be avoided. Increasing physical
exercise, such as walking, aids in reducing flatus.
10.
MULTIPLE CHOICE
When describing the role of a doula to a group of pregnant women, which of the
following would the nurse include?
The doula is a professionally trained nurse hired to provide physical and emotional
support.
The doula can perform any necessary clinical procedures.
*The doula primarily focuses on providing continuous labor support.
The doula is capable of handling high-risk births and emergencies.
Doulas provide the woman with continuous support throughout labor. The doula is a
laywoman trained to provide women and families with encouragement, emotional and
physical support, and information through late pregnancy, labor, and birth. A doula does
not perform any clinical procedures and is not trained to handle high-risk births and
emergencies.