Chapter 25: Health Promotion and Pregnancy My Nursing Test Banks

Chapter 25: Health Promotion and Pregnancy

Cooper and Gosnell: Foundations and Adult Health Nursing, 7th Edition

MULTIPLE CHOICE

1.Where does implantation of the fertilized ovum usually occur?

a. Lower uterine wall
b. Side of the uterus
c. Fundus of the uterus
d. Body of the uterus

ANS: C

Implantation usually occurs in the fundus of the uterus.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 763

OBJ: 1 TOP: Implantation KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

2.A patient has been diagnosed with a tubal pregnancy. What is the typical outcome of a tubal pregnancy?

a. The patient will carry the pregnancy to term and have a cesarean delivery.
b. The patient will have to remain in bed for the remainder of the pregnancy.
c. The patient will spontaneously abort this ectopic pregnancy.
d. The patient will require surgery to remove the zygote.

ANS: D

Any pregnancy where implantation occurs outside the uterine cavity is called ectopic. Tubal pregnancies usually must be resolved by surgical removal of the zygote.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 763

OBJ: 1 TOP: Pregnancy KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

3.How long does the embryonic stage of pregnancy typically last?

a. 3 weeks
b. 4 weeks
c. 6 weeks
d. 8 weeks

ANS: D

The embryonic stage encompasses the first 8 weeks.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 764

OBJ: 1 TOP: Pregnancy KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

4.Why is the nurse concerned about a patient in her first trimester of pregnancy being exposed to German measles?

a. The disease is capable of causing a spontaneous abortion.
b. The disease is capable of causing birth defects.
c. The disease is capable of causing high fever and convulsions.
d. The disease is capable of interfering with placental implantation.

ANS: B

Rubella is a known teratogen, which can cause birth defects.

PTS: 1 DIF: Cognitive Level: Application REF: Page 764

OBJ: 1 TOP: Teratogen KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance

5.Which hormone is secreted by the placenta?

a. Follicle-stimulating hormone (FSH)
b. Alpha-fetoprotein (AFP)
c. Human chorionic gonadotropin (HCG)
d. Luteinizing hormone (LH)

ANS: C

The placenta functions as an endocrine gland, secreting estrogen, progesterone, and HCG.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 764

OBJ:2TOPlacenta function

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

6.What protects the fetus from most bacterial infections?

a. The yolk sac
b. The placental barrier
c. The cotyledons
d. The chorionic villa

ANS: B

The placental barrier protects the embryo/fetus from most bacteria, but not from viruses or drugs. The cotyledons are sections that make up the placenta. The chorionic villa are tiny vascular projections on the chorionic surface that help form the placenta.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 764

OBJ:2TOPlacental barrier

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

7.What period of the maternity cycle does the intrapartal period cover?

a. Beginning of pregnancy to midterm
b. Conception to third trimester
c. Onset of labor to delivery of the baby
d. Onset of labor to delivery of the placenta

ANS: D

The intrapartal period of the maternity cycle covers the onset of labor to delivery of the placenta. The antepartal period begins at conception and continues until the onset of labor. The postpartal period begins after the delivery of the placenta and continues for approximately 6 weeks, until the reproductive organs return to their prepregnancy state.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 778

OBJ:3TOP:Intrapartal period

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

8.A woman who has just discovered she is pregnant states that the first day of her last menstrual period was July 10. What will be her expected date of birth (EDB)?

a. April 10
b. April 17
c. May 10
d. October 17

ANS: B

To determine the EDB (estimated date of birth), the woman should count from the first day of her last menstrual period. Count back 3 months and forward 7 days.

PTS: 1 DIF: Cognitive Level: Application REF: Page 780

OBJ:4TOP:Estimated date of birth (EDB)

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

9.Which is a positive sign of pregnancy?

a. Positive pregnancy test
b. Positive Chadwick sign
c. Ultrasonic tracing of the fetus
d. Positive Goodell sign

ANS: C

A positive sign of pregnancy is an ultrasonic tracing of the fetus. A positive pregnancy test, positive Chadwick sign, and positive Goodell sign are all probable signs of pregnancy.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 780

OBJ:4TOPositive signs of pregnancy

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

10.What is the cause of frequent urination in early pregnancy?

a. Increased fluid intake
b. The fetuss kidneys functioning
c. Retention of fluid
d. Increased circulating volume

ANS: D

Early in pregnancy, the increase in circulating volume and the enlarging uterus placing pressure on the bladder cause urinary frequency.

PTS: 1 DIF: Cognitive Level: Application REF: Page 786

OBJ:7TOP:Frequency of urination

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

11.A woman asks the nurse about the safety of sexual intercourse during her pregnancy. Which response by the nurse is the most correct?

a. Sexual activity should be avoided after the first trimester.
b. Sexual activity should be ceased in the case of vaginal bleeding.
c. Sexual activity should be avoided in the second trimester.
d. Sexual activity should be limited to activity that does not include intercourse.

ANS: B

Sexual intercourse can be enjoyed throughout pregnancy unless it is contraindicated by other conditions. In the case of vaginal bleeding, sexual activity should cease until the cause of the bleeding is determined by the doctor.

PTS: 1 DIF: Cognitive Level: Analysis REF: Pages 787, 788

OBJ:5TOP:Sexual activity during pregnancy

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

12.A woman tells the nurse that this is her third pregnancy. She has had twin girls at full term and one miscarriage. How does the nurse record the information?

a. G2, T2, L3
b. G4, T3, A1, L1
c. G3, T3, A2, L1
d. G3, T1, A1, L2

ANS: D

Standard obstetrical terminology is: G = gravida, T = term birth, P = preterm birth, A = abortion, L = living children.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Pages 780-781, Box 25-6

OBJ:3TOP:Terminology

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

13.During which gestational week can a primigravida expect to first feel fetal movement?

a. 8
b. 10
c. 16
d. 20

ANS: C

At about 16 to 18 weeks, the sensation of the first movement is felt.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 779

OBJ: 4 TOP: Quickening KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

14.At what week of fetal development can the nurse expect to first hear fetal heart tones with an amplified stethoscope?

a. 10
b. 12
c. 14
d. 16

ANS: D

During week 16, the fetal heart can be heard with an amplified stethoscope.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 780, Box 25-5

OBJ: 4 TOP: Fetal age KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

15.The nurse assures an anxious primigravida that during fetal development from week 34 and beyond, maternal antibodies are transferred to the baby. How long will these antibodies provide the baby with immunity?

a. 1 month
b. 3 months
c. 4 months
d. 6 months

ANS: D

The maternal antibodies that are transferred to the baby provide immunity for 6 months.

PTS: 1 DIF: Cognitive Level: Application REF: Page 771, Table 25-1

OBJ: 2 TOP: Pregnancy KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

16.Early in the first trimester, a woman complains of morning sickness. What does the nurse suggest to aid with the discomfort?

a. Eating something with a high-fat content
b. Eating dry crackers before getting up
c. Eating three well-balanced meals
d. Getting rest and taking antiemetics

ANS: B

A remedy for morning sickness is to eat a few dry crackers before getting up.

PTS: 1 DIF: Cognitive Level: Application REF: Page 783

OBJ:7TOP:Morning sickness

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

17.What does the increase in circulating blood volume during pregnancy cause in the mother?

a. Shortness of breath
b. Frontal headaches
c. Decreased white blood cell count
d. Decreased hemoglobin

ANS: D

Maternal circulating volume increases 30% to 40%, causing a virtual decrease in hemoglobin.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 786, Table 25-5

OBJ:2TOPecreased Hgb

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

18.A woman entering the 22nd week of pregnancy complains that she has become unsightly because of chloasma. What should the nurse recommend to reduce the appearance of the chloasma?

a. Use heavy makeup
b. Take extra doses of vitamin A
c. Avoid exposure to the sun
d. Reduce caffeine intake

ANS: C

At week 22, skin pigment changes called chloasma are found. Avoiding exposure to the sun will reduce the pigmentation.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 784

OBJ: 7 TOP: Chloasma KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity

19.During the final weeks of pregnancy, urinary frequency may return due to the enlarged uterus, compressing the bladder against the pelvic bones. What does the nurse suggest to aid in relieving the urinary frequency?

a. Decrease fluid intake
b. Use the knee-chest position
c. Sleep on her side
d. Avoid fluid intake in evening

ANS: C

The patient should decrease pressure on the bladder at night by sleeping on her side. Fluids should not be decreased unless directed by a physician.

PTS: 1 DIF: Cognitive Level: Application REF: Page 787

OBJ: 7 TOP: Frequency KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

20.A pregnant teenager presents with the following complaints. Which complaint could be an indicator of a serious complication?

a. Painful hemorrhoids
b. Linea nigra
c. Visual disturbances
d. Low back pain

ANS: C

Visual disturbances may be an indicator of increased blood pressure and retained fluids. These are indicators of eclampsia. Hemorrhoids, linea nigra, and back pain are common discomforts of pregnancy.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 783, Box 25-10

OBJ:5TOPanger signs

KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

21.During the last trimester of pregnancy, the nurse recommends that the woman wear low-heeled shoes. What is the nurse trying to prevent with this recommendation?

a. Lower back pain
b. Leg cramps
c. Leg swelling
d. Joint pain

ANS: A

A remedy for backache is to wear low-heeled shoes.

PTS: 1 DIF: Cognitive Level: Application REF: Page 786

OBJ:7TOP:Low back pain

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

22.The newly diagnosed primigravida who is 6 weeks pregnant states, I dont feel like I have a real baby inside me. To reassure the mother, the nurse provides reassurance that which of the following is functioning in the 6-week-old embryo?

a. Brain
b. Lungs
c. Hands
d. Heart

ANS: D

At 6 weeks, the fetus has a pumping heart.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 765, Table 25-1

OBJ:1TOP:Fetal development

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

23.Smoking by the mother can have what effect in the fetus?

a. Hearing deficits
b. Neuromuscular deformities
c. Cerebral palsy
d. Low birth weight

ANS: D

Smoking has been proven to cause slow intrauterine growth and low birth weight.

PTS: 1 DIF: Cognitive Level: Application REF: Page 782

OBJ: 5 TOP: Smoking KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

24.When can the sex of the fetus be confirmed?

a. Conception
b. 2 weeks
c. 6 weeks
d. 9 weeks

ANS: D

At 9 weeks the genitalia are well defined.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 766, Table 25-1

OBJ:1TOP:Fetal sex determination

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

25.The physician decides to send the mother for a test to determine the fetal lung maturity. What is the name of this fetal well-being test?

a. Biophysical profile
b. Alpha-fetoprotein
c. Amniocentesis
d. Ultrasound

ANS: C

Amniocentesis helps determine the maturity of the fetal lungs.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 773, Table 25-2

OBJ: 3 TOP: Amniocentesis KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

26.When the young primigravida asks about how to adjust her diet for her pregnancy, what should the nurse suggest the mother add to her diet?

a. Leafy green vegetables and fruit
b. Beef and poultry
c. Foods high in sodium and potassium
d. Bread and grains

ANS: A

A pregnant woman should eat foods containing roughage, such as raw fruits, vegetables, and cereals with bran.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 770, Table 25-1

OBJ: 6 TOP: Diet KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

27.Which of the following discomforts of a pregnant woman should be reported to the physician at the first occurrence?

a. Leg cramps
b. Pelvic discomfort
c. Vaginal bleeding
d. Urinary frequency

ANS: C

Vaginal bleeding at any time during pregnancy should be reported to the physician. Leg cramps, pelvic discomfort, and urinary frequency are common discomforts of pregnancy and not a cause for immediate concern.

PTS: 1 DIF: Cognitive Level: Application REF: Page 788

OBJ:5TOPanger indicators

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

28.What do the arteries in the umbilical cord carry?

a. Nutrients to the fetus from the placenta
b. Oxygenated blood to perfuse the placenta
c. Antibodies from the fetus to the mother
d. Deoxygenated blood back to the placenta

ANS: D

The arteries of the umbilical cord are unique in that they carry deoxygenated blood back to the placenta.

PTS: 1 DIF: Cognitive Level: Comprehension REF: Page 772

OBJ:2TOP:Umbilical arteries

KEY:Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

29.What should a nurse instruct the patient to do before assessing fundal height?

a. Press her lower back against the examination table
b. Empty her bladder
c. Take a deep breath and hold it
d. Bear down

ANS: B

The bladder should be emptied before the measurement of the fundal height.

PTS: 1 DIF: Cognitive Level: Application REF: Page 773

OBJ:3TOP:Fundal height

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

MULTIPLE RESPONSE

30.The nurse concludes that the prenatal patient has no need for further instruction when she correctly states that amniocentesis can determine which of the babys characteristics? (Select all that apply.)

a. Sex
b. Maturity
c. Approximate weight
d. Health
e. Genetic defects

ANS: A, B, D, E

The amniocentesis can reveal the sex, maturity, health, and some genetic defects.

PTS: 1 DIF: Cognitive Level: Analysis REF: Page 776

OBJ:3TOP:Amniocentesis

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

31.Which of the following demonstrate culturally competent care of the pregnant patient? (Select all that apply.)

a. Discuss beliefs with the patient and incorporate them in the plan of care.
b. Prohibit visits from anyone other than immediate family members.
c. Require the patients participation in every aspect of the health care system.
d. Maintain the patients modesty at all times.
e. Strive to maintain a harmonious environment for the patient.

ANS: A, D, E

The nurse should discuss the patients cultural beliefs and incorporate as many as possible into the plan of care. Modesty is important in almost all cultures, and the nurse should take measures to ensure the patients modesty. Absence of a stressful environment is important for a positive outcome for both mother and baby, and the nurse should strive to  alleviate stress and maintain a harmonious environment. Many cultures will foster relationships, and visits from extended family members may be important. The patient may not participate in all aspects of the health care system due to cultural issues.

PTS: 1 DIF: Cognitive Level: Application REF: Page 791

OBJ:8TOP:Cultural considerations

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

COMPLETION

32.The nurse instructor reminds the nursing student that the Shiny Schultz is a name given to the _____________ side of the placenta.

ANS:

fetal

The fetal side of the placenta is called the Shiny Schultz and the maternal side is called the Dirty Duncan.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 764

OBJ:1TOPlacental sides

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

33.The chorion and the amnion are the two components of the ________ __________.

ANS:

fetal membrane

The fetal membrane is composed of the chorion and the amnion.

PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 764

OBJ: 1 TOP: Fetal membrane KEY: Nursing Process Step: N/A

MSC:NCLEX: N/A

34.During the 30th week of gestation, the nurse would anticipate that the fundal height would be _____ centimeters above the symphysis.

ANS:

30

thirty

The fundal height is equal to the weeks of gestation.

PTS: 1 DIF: Cognitive Level: Application REF: Page 773

OBJ:3TOP:Fundal height

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

35.The nurse assesses a reactive result to a nonstress test when the fetal heart rate increases _____ beats per minute.

ANS:

15

fifteen

The reactive criterion is that the fetal heart rate will increase 15 beats per minute when stimulated in the nonstress test.

PTS: 1 DIF: Cognitive Level: Application REF: Page 776

OBJ:3TOP:Nonstress test

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

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