Chapter 15: Nursing Care of the Family During Pregnancy My Nursing Test Banks

Lowdermilk: Maternity & Womens Health Care, 10th Edition

Chapter 15: Nursing Care of the Family During Pregnancy

Test Bank

MULTIPLE CHOICE

1. A nurse caring for a newly pregnant woman advises her that ideally prenatal care should begin:

a.

Before the first missed menstrual period

b.

After the first missed menstrual period

c.

After the second missed menstrual period

d.

After the third missed menstrual period

ANS: B

Prenatal care ideally should begin soon after the first missed menstrual period. This offers the greatest opportunities to ensure the health of the expectant mother and her infant.

Prior to missing the first menstrual period is much too early for prenatal care. It is unlikely the woman is even aware of the pregnancy.

Ideally prenatal visits should begin soon after the first period is missed.

After the third missed menstrual period is much too late to begin prenatal care. The woman will have completed the first trimester by that time.

DIF: Cognitive Level: Knowledge REF: 329

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

2. A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2011. Her expected date of birth (EDB) is:

a.

September 17, 2011

b.

November 7, 2011

c.

November 21, 2011

d.

December 17, 2011

ANS: C

Using Ngeles rule, the EDB is calculated by subtracting 3 months from the month of the LMP and adding 7 days + 1 year to the day of the LMP. Therefore, with an LMP of February 14, 2011, her due date is November 21, 2011.

September 17, 2011, is too short a period to complete a normal pregnancy.

Using Ngeles rule, an EDB of November 7, 2011 is 2 weeks early.

December 17, 2011, is almost a month past the correct EDB.

DIF: Cognitive Level: Knowledge REF: 330

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

3. Prenatal testing for the human immunodeficiency virus (HIV) is recommended for which women?

a.

All women, regardless of risk factors

b.

A woman who has had more than one sexual partner

c.

A woman who has had a sexually transmitted infection

d.

A woman who is monogamous with her partner

ANS: A

An HIV test is recommended for all women, regardless of risk factors. The incidence of perinatal transmission from an HIV-positive mother to her fetus ranges from 25% to 35%. Women who test positive for HIV can then be treated.

All women should be tested for HIV, although this client is at increased risk of contracting the disease.

Regardless of sexual history, all women should have an HIV test completed prenatally.

Although this client is apparently monogamous, an HIV test is still recommended.

DIF: Cognitive Level: Comprehension REF: 340

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

4. Which symptom is considered a first-trimester warning sign and should be reported immediately by the pregnant woman to her health care provider?

a.

Nausea with occasional vomiting

b.

Fatigue

c.

Urinary frequency

d.

Vaginal bleeding

ANS: D

Signs and symptoms that must be reported include severe vomiting, fever and chills, burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms may be signs of complications of the pregnancy.

Nausea with occasional vomiting is a normal first-trimester complaint. Although it may be worrisome or annoying to the mother, it usually is not an indication of a problem with the pregnancy.

Fatigue is common during the first trimester.

Because of physiologic changes that happen during pregnancy, clients should be educated that urinary frequency is normal.

DIF: Cognitive Level: Comprehension REF: 342

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Planning

5. A nurse should advise which women about continued condom use during pregnancy?

a.

Unmarried pregnant women

b.

Women at risk for acquiring or transmitting sexually transmitted infections (STIs)

c.

All pregnant women

d.

Women at risk for candidiasis

ANS: B

The objective of safer sex is to provide prophylaxis against the acquisition and transmission of STIs. Because these diseases may be transmitted to the woman and her fetus, condom use is recommended throughout pregnancy if the woman is at risk for acquiring an STI.

Pregnant women are encouraged to practice safer sex behaviors. An unmarried pregnant woman may be in a monogamous relationship and not require the use of a condom.

All pregnant women are encouraged to practice safer sex behaviors. The client should be educated as to what may place both herself and the fetus at risk.

Any pregnant woman might develop candidiasis. This is not related to condom use.

DIF: Cognitive Level: Comprehension REF: 355

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

6. The quadruple-marker test is used to assess the fetus for which condition?

a.

Down syndrome

b.

Diaphragmatic hernia

c.

Congenital cardiac abnormality

d.

Anencephaly

ANS: A

The maternal serum level of alpha-fetoprotein is used to screen for Down syndrome, neural tube defects, and other chromosomal anomalies.

The quadruple-marker test will not detect this fetal anomaly. Additional testing, such as ultrasonography is required to diagnose diaphragmatic hernia.

Congenital cardiac abnormality will most likely be identified during an ultrasound examination.

The quadruple-marker test will not detect anencephaly.

DIF: Cognitive Level: Knowledge REF: 344

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

7. A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild to moderate intensity. The nurse recommends that she:

a.

Do Kegel exercises

b.

Do pelvic rock exercises

c.

Use a softer mattress

d.

Stay in bed for 24 hours

ANS: B

Pelvic rock exercises may help stretch and strengthen the abdominal and lower back muscles and relieve low back pain.

Kegel exercises increase the tone of the pelvic area, not the back.

A softer mattress may not provide the support needed to maintain proper alignment of the spine and may contribute to back pain.

Stretching and other exercises to relieve back pain should be performed several times a day.

DIF: Cognitive Level: Application REF: 348

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

8. For what reason is breastfeeding contraindicated?

a.

Hepatitis B

b.

Everted nipples

c.

History of breast cancer 3 years ago

d.

Human immunodeficiency virus (HIV) positive

ANS: D

Women who are HIV positive are discouraged from breastfeeding.

Although hepatitis B antigen has not been shown to be transmitted through breast milk, as an added precaution infants born to HBsAg-positive women should receive the hepatitis B vaccine and immune globulin immediately after birth.

Everted nipples are functional for breastfeeding.

Newly diagnosed breast cancer is a contraindication to breastfeeding.

DIF: Cognitive Level: Comprehension REF: 345

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

9. A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she doesnt know what is happening; one minute she is happy that she is pregnant and the next minute she cries for no reason. Which response by the nurse is most appropriate?

a.

Dont worry about it; youll feel better in a month or so.

b.

Have you talked to your husband about how you feel?

c.

Perhaps you really dont want to be pregnant.

d.

Hormone changes during pregnancy commonly result in mood swings.

ANS: D

Explaining that hormone changes can result in mood swings is an accurate statement and the most appropriate response by the nurse.

Telling the woman not to worry dismisses her concerns and is not the most appropriate response.

Although the woman should be encouraged to share her feelings, asking if she has spoken to her husband about them is not the most appropriate response and does not provide her with a rationale for the psychosocial dynamics of her pregnancy.

Suggesting that the woman doesnt want to be pregnant is completely inappropriate and deleterious to the psychologic well-being of the woman. Hormonal and metabolic adaptations often cause mood swings in pregnancy. The womans responses are normal. She should be reassured about her feelings.

DIF: Cognitive Level: Application REF: 331

OBJ: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Diagnosis

10. A nurse should be aware that a partners main role in pregnancy is:

a.

To provide financial support

b.

To protect the pregnant woman from old wives tales

c.

To support and nurture the pregnant woman

d.

To make sure the pregnant woman keeps prenatal appointments

ANS: C

The partners main role in pregnancy is to nurture the pregnant woman and respond to her feelings of vulnerability.

Although financial support is important, it is not the partners main role in pregnancy.

Protecting the pregnant woman from old wives tales is not the partners role.

The womans partner can encourage the client to keep all appointments; however, this is not the most important role during the pregnancy.

DIF: Cognitive Level: Comprehension REF: 334

OBJ: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Assessment

11. During the first trimester a woman can expect which of the following changes in her sexual desire?

a.

An increase, because of enlarging breasts

b.

A decrease, because of nausea and fatigue

c.

No change

d.

An increase, because of increased levels of female hormones

ANS: B

Maternal physiologic changes, such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses, may affect sexuality and sexual expression. Libido may be depressed in the first trimester but often increases during the second and third trimesters.

During pregnancy the breasts may become enlarged and tender; this tends to interfere with coitus, thereby decreasing the desire to engage in sexual activity.

Libido may be depressed in the first trimester but often increases during the second and third trimesters.

A pregnant woman usually experiences a decrease, not an increase in libido during the first trimester.

DIF: Cognitive Level: Comprehension REF: 355

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Diagnosis

12. A 3-year-old girls mother is 6 months pregnant. What concern is this child likely to verbalize?

a.

How the baby will get out

b.

What the baby will eat

c.

Whether her mother will die

d.

What color eyes the baby has

ANS: B

By age 3 or 4, children like to be told the story of their own beginning and accept it being compared with the present pregnancy. They like to listen to the fetal heartbeat and feel the baby move. Sometimes they worry about how the baby is being fed and what it wears.

School-age children take a more clinical interest in their mothers pregnancy and may want to know, How did the baby get in there? and How will it get out?

Whether her mother will die does not tend to be the focus of a childs questions about the impending birth of a sibling.

The babys eye color does not tend to be the focus of childrens questions about the impending birth of a sibling.

DIF: Cognitive Level: Comprehension REF: 335

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

13. In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose?

a.

To promote family unity

b.

To ward off the evil eye

c.

To appease the gods of fertility

d.

To protect the mother and fetus during pregnancy

ANS: D

Although many cultures consider pregnancy normal, certain practices are expected of women of all cultures to ensure a good outcome. Cultural prescriptions tell women what to do, and cultural proscriptions establish taboos. The purposes of these practices are to prevent maternal illness resulting from a pregnancy-induced imbalanced state and to protect the vulnerable fetus.

Promoting family unity is important, although not usually the premise for cultural rituals and practices.

Warding off the evil eye may be specific to one particular culture; however, it is not the primary purpose of these practices.

Appeasing the gods of fertility is not the impetus behind cultural rituals.

DIF: Cognitive Level: Comprehension REF: 359

OBJ: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Evaluation

14. Which statement about pregnancy is accurate?

a.

A normal pregnancy lasts about 10 lunar months

b.

A trimester is one third of a year

c.

The prenatal period extends from fertilization to conception

d.

The estimated date of confinement (EDC) is how long the mother will have to be bedridden after birth

ANS: A

A lunar month lasts 28 days, or 4 weeks. Pregnancy spans 9 calendar months but 10 lunar months.

A trimester is one third of a normal pregnancy, or about 13 to 14 weeks.

The prenatal period covers the full course of pregnancy (prenatal means before birth).

The EDC is now called the EDB, or estimated date of birth. It has nothing to do with the duration of bed rest.

DIF: Cognitive Level: Knowledge REF: 330

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

15. With regard to a womans reordering of personal relationships during pregnancy, the maternity nurse should be aware that:

a.

Because of the special motherhood bond, a womans relationship with her mother is even more important than with the father of the child

b.

Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other

c.

Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father

d.

The womans sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier

ANS: C

Love and support help a woman feel better about her pregnancy.

The most important person to the pregnant woman is usually the father.

Nurses can facilitate communication between partners about sexual matters if, as is common, they are nervous about expressing their worries and feelings.

The second trimester is the time when a womans sense of well-being, along with certain physical changes, increases her desire for sex. Desire is down in the first and third trimesters.

DIF: Cognitive Level: Comprehension REF: 331

OBJ: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Planning

16. What represents a typical progression through the phases of a womans establishing a relationship with the fetus?

a.

Accepts the fetus as distinct from herselfaccepts the biologic fact of pregnancyhas a feeling of caring and responsibility

b.

Fantasizes about the childs gender and personalityviews the child as part of herselfbecomes introspective

c.

Views the child as part of herselfhas feelings of well-beingaccepts the biologic fact of pregnancy

d.

I am pregnant I am going to have a babyI am going to be a mother.

ANS: D

The woman first centers on herself as pregnant, then on the baby as an entity separate from herself, and then on her responsibilities as a mother. The expressions I am pregnant, I am going to have a baby, and I am going to be a mother sum up the progression through the three phases.

Accepting the fetus as distinct from herself occurs during the second phase of emotional attachment.

Fantasizing about the childs sex and personality based on fetal activity, occurs during the third phase of attachment.

In phase one the woman views the child as part of herself and not a separate being. This is only the first step of the progression through phases of attachment.

DIF: Cognitive Level: Application REF: 332

OBJ: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Diagnosis

17. The phenomenon of someone other than the mother-to-be experiencing pregnancy-like symptoms such as nausea and weight gain applies to the:

a.

Mother of the pregnant woman

b.

Couples teenage daughter

c.

Sister of the pregnant woman

d.

Expectant father

ANS: D

An expectant fathers experiencing of his partners pregnancy-like symptoms is called the couvade syndrome.

The mother of the pregnant woman is unlikely to experience this phenomenon. She may be excited about becoming a grandmother or see this as a reminder that she is getting old.

A couples teenage daughter is usually preoccupied with her own sexual development and may have difficulty accepting the overwhelming evidence of her parents sexual activity.

It is the father of the pregnant woman, not the sister, who experiences these symptoms.

DIF: Cognitive Level: Knowledge REF: 333

OBJ: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Diagnosis

18. During the initial visit with a client who is beginning prenatal care, nurses should be aware that:

a.

The first interview is a relaxed, get-acquainted affair in which nurses gather some general impressions

b.

If nurses observe handicapping conditions, they should be sensitive and not inquire about them because the client will do that in her own time

c.

Nurses should be alert to the appearance of potential parenting problems, such as depression or lack of family support

d.

Because of legal complications, nurses should not ask about illegal drug use; that is left to physicians

ANS: C

Besides these potential problems, nurses need to be alert to the womans attitude toward keeping regular health care appointments. If the client lacks insurance, the nurse may be able to direct her to resources that provide assistance for pregnant women (i.e., Women, Infants, and Children [WIC], Medicaid).

The initial interview needs to be planned, purposeful, and focused on specific content. A lot of ground must be covered.

Nurses must be sensitive to special problems, but they do need to inquire because discovering individual needs is important. People with chronic or handicapping conditions forget to mention them because they have adapted to them.

Obtaining information on drug use is important and can be done confidentially. Actual testing for drug use requires the clients consent.

DIF: Cognitive Level: Comprehension REF: 339

OBJ: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Assessment

19. A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expectant parents class. Which aspect of their birth plan would be considered unrealistic and require further discussion with the nurse?

a.

My husband and I have agreed that my sister will be my coach because he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure everything is okay.

b.

We plan to use the techniques taught in the Lamaze classes to reduce the pain experienced during labor.

c.

We want the labor and birth to take place in a birthing room. My husband will come in the minute the baby is born.

d.

We do not want the fetal monitor used during labor because it will interfere with movement and doing effleurage.

ANS: D

Because monitoring is essential to assess fetal well-being, it is not a factor that can be determined by the couple. The nurse should fully explain its importance. The option for intermittent electronic monitoring could be explored if this is a low risk pregnancy and as long as labor is progressing normally. The birth plan is a tool with which parents can explore their childbirth options; however, the plan must be viewed as tentative.

Having the womans sister as her coach with her husband nearby is an acceptable request for a laboring woman.

Using breathing techniques to alleviate pain is a realistic part of a birth plan.

Not all fathers are able to be present during the birth; however, this couple has made a realistic plan that works for their specific situation.

DIF: Cognitive Level: Application REF: 365

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Implementation

20. With regard to the initial physical exam of a woman beginning prenatal care, maternity nurses should be aware that:

a.

Only women who show physical signs or meet the sociologic profile should be assessed for physical abuse

b.

The woman should empty her bladder before the pelvic examination

c.

The distribution, amount, and quality of body hair are of no particular importance

d.

The size of the uterus is discounted in the initial examination because it is just going to get bigger soon

ANS: B

An empty bladder facilitates the examination; also, this is an opportunity to get a urine sample easily for a number of tests.

All women should be assessed for a history of physical abuse, particularly because the likelihood of abuse increases during pregnancy.

Noting body hair is important because body hair reflects nutritional status, endocrine function, and hygiene.

Particular attention is paid to the size of the uterus because it is an indication of the duration of gestation.

DIF: Cognitive Level: Comprehension REF: 341

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

21. A woman who is 16 weeks pregnant has come in for a follow-up visit with her significant other. In order to reassure the client regarding fetal well-being it is best for the nurse to:

a.

Assess the fetal heart tones with a Doppler stethoscope

b.

Measure the girth of the womans abdomen

c.

Complete an ultrasound examination (sonogram)

d.

Offer the woman and her family the opportunity to listen to the fetal heart tones

ANS: D

To provide the parents with the greatest sense of reassurance, the nurse should offer to have the client and her spouse the chance to listen to their babys heartbeat.

Fetal heart tones can be heard with a fetoscope in the first trimester; by the second trimester, the fetal heart rate can be heard with the Doppler stethoscope. This should be performed as part of routine fetal assessment.

Abdominal girth is not a valid measure for determining fetal well-being. Fundal height is an important measure that should be determined with precision, with the same technique and positioning of the client used consistently. This should be completed at every prenatal visit.

Routine ultrasound examinations are recommended in early pregnancy; they date the pregnancy and provide useful information about the health of the fetus. They are not necessary at each prenatal visit.

DIF: Cognitive Level: Comprehension REF: 341

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

22. During labor, a doula is expected to:

a.

Help the woman do Lamaze breathing techniques and provide support to the woman and her partner

b.

Check the fetal monitor tracing for effects of the labor process on the fetal heart rate

c.

Take the place of the father as a coach and support provider

d.

Administer pain medications as needed by the woman

ANS: A

A doula is professionally trained to provide labor support, including physical, emotional, and informational, to women and their partners during labor and birth.

The doula does not become involved with clinical tasks.

The doula provides support to both the woman and her partner.

The doula does not become involved with clinical tasks.

DIF: Cognitive Level: Comprehension REF: 364

OBJ: Client Needs: Safe and Effective Care Environment

TOP: Nursing Process: Planning, Implementation

23. When instructing a pregnant client regarding personal hygiene, it is important for a maternity nurse to be aware that:

a.

Tub bathing is permitted even in late pregnancy unless membranes have ruptured

b.

The perineum should be wiped from back to front

c.

Bubble bath and bath oils are permissible because they add an extra soothing and cleansing action to the bath

d.

Expectant mothers should use specially treated soap to cleanse the nipples

ANS: A

The main danger from taking baths is falling in the tub.

The perineum should be wiped from front to back.

Bubble baths and bath oils should be avoided because they may irritate the urethra.

Soap, alcohol, ointments, and tinctures should not be used to cleanse the nipples because they remove protective oils. Warm water is sufficient.

DIF: Cognitive Level: Knowledge REF: 345

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Planning

24. The nurse should be aware that the pinch test is used to:

a.

Check the sensitivity of the nipples

b.

Determine whether the nipple is everted or inverted

c.

Calculate the adipose buildup in the abdomen

d.

See whether the fetus has become inactive

ANS: B

The pinch test is used to determine whether the nipple is everted or inverted. Nipples must be everted to allow breastfeeding.

The pinch does not determine the level of sensitivity of the nipples.

The pinch test is not used to determine the level of adipose tissue in the abdomen.

Fetal activity is not determined by using the pinch test.

DIF: Cognitive Level: Knowledge REF: 345, 346

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

25. Dental care during pregnancy is an important component of good prenatal care. Maternity nurses reinforce this by providing which of the following instructions to their clients:

a.

Regular brushing and flossing may not be necessary during early pregnancy because it may stimulate the woman who is already nauseated to vomit. A cleaning is all that is necessary

b.

Dental surgery, in particular, is contraindicated during pregnancy and should be delayed until after delivery

c.

If dental treatment is necessary, the woman will be most comfortable with it in the second trimester

d.

If a woman has dental anxiety, dental care may interfere with the expectant mothers need to practice conscious relaxation and preparation for labor

ANS: C

The second trimester is best for dental treatment because that is when the woman will be able to sit most comfortably in the dental chair.

Dental care, such as brushing with fluoride toothpaste, is especially important during pregnancy. Periodontal disease has been linked to both preterm labor and low birth weights.

Emergency dental surgery is permissible; however, the mother must clearly understand the risks and benefits.

Conscious relaxation is useful, and it may even help the woman get through any dental appointments; it is not a reason to avoid them.

DIF: Cognitive Level: Comprehension REF: 346

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Planning

26. Many pregnant women have questions regarding work and travel during pregnancy. Nurse should instruct clients that:

a.

Women should sit for as long as possible and cross their legs at the knees from time to time for exercise

b.

Women should avoid seat belts and shoulder restraints in the car because they press on the fetus

c.

Metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times

d.

While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so

ANS: D

Periodic walking helps prevent thrombophlebitis.

Pregnant women should avoid sitting or standing for long periods and crossing the legs at the knees.

Pregnant women must wear lap belts and shoulder restraints. The most common injury to the fetus comes from injury to the mother.

Metal detectors at airport security checkpoints do not harm fetuses.

DIF: Cognitive Level: Comprehension REF: 351

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

27. In response to requests by the U.S. Public Health Service for new models of prenatal care, an innovative new approach to prenatal care known as centering pregnancy was developed. Which statement accurately applies to the centering model of care?

a.

Group sessions begin with the first prenatal visit.

b.

At each visit blood pressure, weight, and urine dipsticks are obtained by the nurse.

c.

Eight to 12 women are placed in gestational-age cohort groups.

d.

Outcomes are similar to traditional prenatal care.

ANS: C

Gestational-age cohorts comprise the groups, with approximately 8 to 12 women in each group. This group remains intact throughout the pregnancy. Individual follow-up visits are scheduled as needed.

Group sessions begin at 12 to 16 weeks of gestation and end with an early postpartum visit. Prior to group sessions, the client has an individual assessment, physical examination, and history.

At the beginning of each group meeting, clients measure their own blood pressure, weight, and urine dips and enter these in their record. Fetal heart rate assessment and fundal height are obtained by the nurse.

Results evaluating this approach have been very promising. In a recent study of adolescent clients, there was a decrease in low-birth-weight (LBW) infants and an increase in breastfeeding rates.

DIF: Cognitive Level: Application REF: 336, 337

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Implementation

MULTIPLE RESPONSE

1. Signs and symptoms that a woman should report immediately to her health care provider include (choose all that apply):

a.

Vaginal bleeding

b.

Rupture of membranes

c.

Heartburn accompanied by severe headache

d.

Decreased libido

e.

Urinary frequency

ANS: A, B, C

Vaginal bleeding, rupture of membranes, and severe headaches are signs of potential complications in pregnancy. Clients should be advised to report these signs to their health care provider.

Decreased libido and urinary frequency are common discomforts of pregnancy that do not require immediate health care interventions.

DIF: Cognitive Level: Analysis REF: 342

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Planning, Implementation

2. A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview you discover that she has not had any immunizations. Which immunizations should she receive at this point in her pregnancy? Choose all that apply.

a.

Tetanus

b.

Diphtheria

c.

Chickenpox

d.

Rubella

e.

Hepatitis B

ANS: A, B, E

Vaccines consisting of killed viruses may be used. Those that may be administered during pregnancy include tetanus, diphtheria, recombinant hepatitis B, and rabies vaccines.

Immunization with live or attenuated viruses is contraindicated during pregnancy because of its potential teratogenicity. Live-virus vaccines include those for measles (rubeola and rubella), chickenpox, and mumps.

DIF: Cognitive Level: Analysis REF: 351

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Implementation

TRUE/FALSE

1. Pregnant women who become ill with seasonal respiratory influenza (flu) are more likely than other persons to develop serious complications, such as pneumonia. Is this statement true or false?

ANS: T

All women whose pregnancy will take place from November through March should be offered a flu vaccination.

DIF: Cognitive Level: Application REF: 351

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

2. An obese woman who has become pregnant is at the same risk for delivering an infant with congenital anomalies as a woman who is not obese. Is this statement true or false?

ANS: F

Obese women should be advised regarding the risk of complications for themselves and the increased risk for congenital anomalies in their infant. These women should receive counseling related to appropriate weight gain and nutrition.

DIF: Cognitive Level: Knowledge REF: 338

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

Mosby items and derived items 2012, 2007, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.

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