Maternal and Child Nursing - Antenatal Practice Test With Answers and Rationale
Maternal and Child Nursing - Antenatal Practice Test With Answers and Rationale
Maternal and Child Nursing - Antenatal Practice Test With Answers and Rationale
TEST-TAKING TIP: It is important for a TEST-TAKING TIP: Even though the birth
couple’s needs and wants to match their plan should include issues like the use or
obstetrical care practitioner’s philosophy nonuse of episiotomies, emergent issues
of care. If, for example, the couple is during the delivery may lead to a sudden
interested in the possibility of having a change in plans. For example, if a cesarean
water birth, it is important that the is needed for malpresentation, the
health care provider be willing to perform issue of episiotomy is moot and the
a water birth. If, however, the client will definitely need anesthesia.
woman wants to be “completely pain However, there are some issues that
free,” the health care provider must be should be nonnegotiable. If the father
willing to order pain medications wishes to be in the delivery room no
throughout the labor and delivery. A matter the type of delivery or whether or
birth plan will list the couples’ many not an emergent situation is occurring,
wishes. that should be stated in the plan and
accepted by the health care provider.
55
During a preconception counseling session, the 57
nurse encourages a couple to prepare During a prenatal visit, a gravid client is
a birth plan. Which of the following is the most complaining of ptyalism. Which of the
important goal for this action? following nursing interventions is appropriate?
1. Promote communication between the couple and 1. Encourage the woman to brush her teeth
health care professionals. carefully.
2. Enable the couple to learn about the types of 2. Advise the woman to have her blood pressure
medicine used in labor. checked regularly.
3. Provide the couple with a list of items that they 3. Encourage the woman to wear supportive
should put in a bag for labor. hosiery.
4. Give the high-risk couple a sense of control over 4. Advise the woman to avoid eating rare meat.
having to have a cesarean.
Study These Flashcards
Study These Flashcards 1. Clients who experience ptyalism have
1. Birth plans help to facilitate communication an excess of saliva. They should be
between couples and their advised to be vigilant in the care for
health care providers. their teeth and gums. Ptyalism is often
accompanied by gingivitis and
TEST-TAKING TIP: The earlier a birth plan
nausea and vomiting.
is developed, the better. A pregnant
woman and her partner must feel comfortable
with the communication methods,
TEST-TAKING TIP: Ptyalism is related to
physical care, and health care
the increase in vascular congestion of
philosophies of their obstetrical health
the mucous membranes from increased
care provider. The birth plan is a means
estrogen production. Women with increased
for everyone to clearly understand each
salivation often also experience
step of the birthing process. When the
gingivitis, which is also related to estrogen
client enters the hospital for delivery, the
production. In addition, ptyalism is
birth plan should be presented to the
seen in women with nausea and vomiting. solder. Lead, when consumed either
Because of the caustic affects of gastric through the respiratory tract or the
juices on the enamel of the teeth, the GI tract, can cause permanent damage to
inflammation seen in the gums and the the central nervous system of the unborn
increased salivation, it is essential that child. It is very important, therefore, that
the pregnant woman take special care of the woman not breathe in the air in
her teeth during pregnancy, including rooms that have recently been sanded.
regular visits to the dentist or the dental The paint aerosolizes and the lead can
hygienist. be inhaled. In addition, lead leaches into
hot water more readily than into cold
58
so water from the cold tap should be
A gravid woman who recently emigrated from
consumed—but only after the water has
mainland China is being seen at her
run through the pipes for a minimum of
first prenatal visit. She was never vaccinated in
2 minutes.
her home country. An injection to
prevent which of the following communicable 60
diseases should be administered to After nutrition counseling, a woman, G3 P1101,
the woman during her pregnancy? proclaims that she certainly can’t
1. Influenza. eat any strawberries during her pregnancy. Which
2. Mumps. of the following is the likely
3. Rubella. reason for this statement?
4. Varicella. 1. The woman is allergic to strawberries.
2. Strawberries have been shown to cause birth
Study These Flashcards
defects.
1. The woman should receive the influenza
3. The woman believes in old wives’ tales.
injection. The nasal spray,
4. The premature baby died because the woman
however, should not be administered
ate strawberries
to a pregnant woman
Study These Flashcards
3. The woman believes in old wives’
TEST-TAKING TIP: It is very important for tales.
pregnant women to be protected from the flu by
receiving the inactivated influenza
injection. The fetus will not be TEST-TAKING TIP: There are a number of
injured from the shot and the woman old wives’ tales that pregnant women believe
will be protected from the many sequelae in and live by. One of the common
that can develop from the flu. However, tales relates to the ingestion of strawberries:
the live nasal flu spray should not be Women who eat strawberries have
administered to pregnant women. It is babies with strawberry marks on their
contraindicated to vaccinate pregnant
bodies. Unless old-wives’ tales have the
women with many other vaccines, including
potential to impact the health of the baby
the measles-mumps-rubella
and/or mother, it is ill advised and unnecessary
(MMR) and the varicella vaccines.
to argue with the mother
See http://www.acog.org/from_home/
about her beliefs.
publications/misc/bco282.pdf
61
59
A woman is planning to become pregnant. Which of
A gravid woman and her husband inform the nurse
the following actions should
that they have just moved into a
she be counseled to take before stopping birth
three-story home that was built in the 1930s.
control? Select all that apply.
Which of the following is critical for
1. Take a daily multivitamin.
the nurse to advise the woman in order to protect
2. See a medical doctor.
the unborn child?
3. Drink beer instead of vodka.
1. Stay out of any rooms that are being renovated.
4. Stop all over-the-counter medications.
2. Drink water only from the hot water tap.
5. Stop smoking cigarettes.
3. Refrain from entering the basement.
4. Climb the stairs only once per day. Study These Flashcards
1, 2, and 5 are correct.
Study These Flashcards
1. It is very important that women, before
1. The woman should stay out of rooms
attempting to become pregnant,
that are being renovated.
begin taking daily multivitamin
tablets.
2. Women who wish to become pregnant
TEST-TAKING TIP: Antique houses often
should first see a medical doctor
contain lead-based paint and water
for a complete check-up
piping that has been soldered with leadbased
5. Women who wish to become pregnant TEST-TAKING TIP: There are many skin
should be counseled to stop changes that occur normally during
smoking. pregnancy. Most of the changes—such
TEST-TAKING TIP: Because the embryo is as linea nigra, melasma, and hyperpigmentation
very sensitive during the first trimester of the areolae—are related
of pregnancy, women should be advised to an increase in the melanin-producing
to be vigilant about their health even before bodies of the skin as a result of
becoming pregnant. For example, stimulation by the female hormones,
folic acid, a vitamin in multivitamin estrogen and progesterone. The
tablets, helps to prevent neural tube defects. presence of petechiae is usually related
Women of childbearing age often to a pathological condition, such as
fail to go for complete physical examinations. thrombocytopenia.
It is important to discover the
64
presence of any medical illnesses before
A pregnant woman informs the nurse that her last
the pregnancy begins, however, so
normal menstrual period was on
women should be counseled to have a
September 20, 2006. Using Nagele’s rule, the nurse
complete physical before stopping birth
calculates the client’s estimated
control methods.
date of delivery as:
62 1. May 30, 2007.
The nurse discusses sexual intimacy with a 2. June 20, 2007.
pregnant couple. Which of the following 3. June 27, 2007.
should be included in the teaching plan? 4. July 3, 2007.
1. Vaginal intercourse should cease by the
Study These Flashcards
beginning of the third trimester.
3. The estimated date of delivery is June
2. Breast fondling should be discouraged because
27, 2007
of the potential for preterm labor.
3. The couple may find it necessary to experiment
with alternate positions.
4. Vaginal lubricant should be used sparingly TEST-TAKING TIP: Nagele’s rule is a simple
throughout the pregnancy. method used to calculate a client’s
estimated date of confinement (EDC) or
Study These Flashcards estimated date of delivery (EDD) from
3. With increasing size of the uterine the last normal menstrual period (LMP).
body, the couple may need counseling The nurse learns the date of the last
regarding alternate options for sexual menstrual period from the client. He or
intimacy. she then subtracts 3 months from the
date, adds 7 days to the date, and adjusts
TEST-TAKING TIP: Pregnancy lasts 10
lunar months. It is essential that the
nurse counsel clients on ways to maintain
health and well-being in the many the year, if needed. For the example
facets of their lives. Sexual intimacy is given:
one of the important aspects of a married Last normal menstrual
couple’s life together. The couple period—September 20, 2006 = 9 - 20 - 2006
can be counseled to use alternate positions, 37
engage in mutual masturbation, 6 27
or other means to satisfy their needs for adjust the year 6 - 27 - 2007
sexual expression during the pregnancy June 27, 2007
period. 65
63 A father experiencing couvade syndrome is likely
Which of the following skin changes should the to exhibit which of the following
nurse highlight for a pregnant symptoms/behaviors?
woman’s health care practitioner? 1. Heartburn.
1. Linea nigra. 2. Promiscuity.
2. Melasma. 3. Hypertension.
3. Petechiae. 4. Indifference.
4. Spider nevi. Study These Flashcards
Study These Flashcards 1. Heartburn is a common symptom
3. Petechiae are pinpoint red or purple
spots on the skin. They are seen in
hemorrhagic conditions. TEST-TAKING TIP: Heartburn is a subjective
complaint that fathers often experience
during their partners’ pregnancies.
Fathers who are experiencing couvade
symptoms are exhibiting a strong affiliation
between themselves and their partners.
TEST-TAKING TIP: Gravidity refers to
It is inappropriate for prospective
pregnancy and parity refers to delivery.
fathers to engage in illicit relationships
Every time a woman is pregnant, it is
and/or indifference toward their partners’
counted as one gravida (G). The results
pregnancies. They should be fully
of each pregnancy are then documented
engaged in the process. Hypertension, an
as a para (P) in the following order. The
objective sign, should be investigated
first number refers to full-term births or
further. The father may have developed a
births ≥ 38 weeks’ gestation; the second
pathologic condition.
number refers to preterm births or
66 births between 20 and 37 weeks’ gestation;
A nurse is advising a pregnant woman about the the third number refers to abortions,
danger signs of pregnancy. whether spontaneous or therapeutic;
The nurse should teach the mother that she should and the fourth number refers to the
notify the physician immediately number of living children. The client has
if she experiences which of the following been pregnant 5 times (G5); she birthed
signs/symptoms? Select all that 1 son, 1 daughter, had 1 miscarriage, had
apply. 1 first trimester abortion, and is currently
1. Convulsions. pregnant. Her parity (P1122) accurately
2. Double vision. reflects her obstetrical history:
3. Epigastric pain. 1 full-term delivery (daughter at
4. Persistent vomiting. 39 weeks), 1 preterm delivery (son at
5. Polyuria. 28 weeks), 2 abortions (1 miscarriage,
1 first-trimester abortion), and,
Study These Flashcards
1, 2, 3, and 4 are correct. 68
1. Convulsions are a danger sign of The partner of a gravida accompanies her to her
pregnancy. prenatal appointment. The nurse
2. Double vision is a danger sign of notes that the father of the baby has gained weight
pregnancy. since she last saw him. Which of
3. Epigastric pain is a danger sign of the following comments is most appropriate for
pregnancy. the nurse to make to the father?
4. Persistent vomiting is a danger sign of 1. “I see that you are gaining weight right along
pregnancy. with your partner.”
2. “You and your partner will be able to go on a diet
together after the baby is born.”
TEST-TAKING TIP: The danger signs of 3. “I can see that you are a bad influence on your
pregnancy are signs or symptoms that can partner’s eating habits.”
occur in an otherwise healthy pregnancy 4. “I am so glad to see that you are taking so much
that are likely due to serious pregnancy interest in your partner’s
complications. For example, double vision, pregnancy.”
epigastric pain, and blurred vision are
Study These Flashcards
symptoms of the hypertensive illnesses of
4. This is an appropriate comment to
pregnancy, and persistent vomiting is a
make at this time.
symptom of hyperemesis gravidarum.
TEST-TAKING TIP: This father is exhibiting
67 a sign of couvade; i.e., weight gain. This
A woman provides the nurse with the following is a positive response since it shows that
obstetrical history: Delivered a son, he is exhibiting a sympathetic response to
now 7 years old, at 28 weeks’ gestation; delivered his partner’s pregnancy. In addition, this
a daughter, now 5 years old, at father is accompanying his partner to the
39 weeks’ gestation; had a miscarriage 3 years prenatal visit, another positive sign.
ago, and had a first-trimester
69
abortion 2 years ago. She is currently pregnant.
The nurse is caring for a pregnant client who is a
Which of the following portrays
vegan. Which of the following
an accurate picture of this woman’s gravidity and
foods should the nurse suggest the client consume
parity?
as substitutes for restricted
1. G4 P2121.
foods?
2. G4 P1212.
1. Tofu, legumes, broccoli.
3. G5 P1122.
2. Corn, yams, green beans.
4. G5 P2211.
3. Potatoes, parsnips, turnips.
Study These Flashcards 4. Cheese, yogurt, fish.
3. This accurately reflects this woman’s
Study These Flashcards
gravidity and parity—G5P1122.
1. Tofu, legumes, and broccoli are excellent 2. Vitamin D supplementation can be
substitutes for the restricted harmful during pregnancy.
foods.