Deck 16: The Expectant Family: Needs and Care

Question 1

A patient at 36-weeks' gestation is complaining of dyspnea when lying flat. The clinical reason for this complaint is:

A) Maternal hypertension.
B) Fundal height.
C) Hydramnios.
D) Congestive heart failure.

Answer 1

Fundal height.

Question 2

The nurse is teaching an early pregnancy class for patients in the first trimester of pregnancy. Which statement requires immediate intervention by the nurse?

A) "When my nausea is bad, I will drink some ginger tea."
B) "The fatigue I am experiencing will improve in the second trimester."
C) "It is normal for my vaginal discharge to be green-colored."
D) "I will urinate less often during the middle of my pregnancy."

Answer 2

"It is normal for my vaginal discharge to be green-colored."

Question 3

During home care of a low-risk pregnant patient, the nurse provides care by assessing the patient's:

A) Urine.
B) Weight.
C) Diet.
D) Pelvic measurements.
E) Physical activity.

Answer 3

Urine.
Weight.
Diet.
Physical activity.

Question 4

A patient at 34 weeks' gestation complains about pyrosis. The nurse teaches the patient that approaches to relieve the pyrosis include:

A) Eat small, frequent meals.
B) Use high-sodium antacids.
C) Avoid fried, fatty foods.
D) Take sodium bicarbonate after meals.
E) Do not lie down after eating.

Question 5

A couple in their late 30s are pregnant for the first time. In evaluating the care delivered, the nurse assesses whether the mother:

A) Makes appropriate healthcare choices.
B) Receives effective healthcare through the pregnancy.
C) Has a partner who is not interested in child care.
D) Cannot cope with her life change.
E) Wishes to have amniocentesis done.

Question 6

A patient in her third trimester of pregnancy reports frequent leg cramps. What strategy would be most appropriate for the nurse to suggest?

A) Point the toes of the affected leg.
B) Increase intake of protein-rich foods.
C) Limit her activity for several days.
D) Flex the foot to stretch the calf.

Question 7

Remedies for back pain in pregnancy that are supported by research evidence and may safely be taught to any pregnant woman by the nurse include:

A) Pelvic tilt.
B) Water aerobics.
C) Sit-ups.
D) Proper body mechanics.
E) Maintaining good posture.

Question 8

The nurse is caring for a pregnant patient. The patient's husband has come to the prenatal visit. Which is the best for the nurse to use to assess the father's adaptation to the pregnancy?

A) "What kind of work do you do?"
B) "What furniture have you gotten for the baby?"
C) "How moody has your wife been lately?"
D) "How are you feeling about becoming a father?"

Question 9

A Navajo patient who is 36 weeks pregnant meets with a traditional healer as well as her physician. The nurse understands this to mean that the patient:

A) Is seeking spiritual direction.
B) Does not trust her physician.
C) Will not adapt to mothering well.
D) Is experiencing complications of pregnancy.

Question 10

The OB-GYN nurse works in a clinic with a culturally diverse group of patients whose specific actions during pregnancy are often determined by cultural beliefs. The nurse recognizes that these beliefs about pregnancy and childbirth fall into which categories?

A) Prescriptive beliefs
B) Restrictive beliefs
C) Taboos
D) Cultural humility
E) Folk treatment beliefs

Question 11

The primiparous patient has told the nurse that she is afraid she will develop hemorrhoids during pregnancy because her mother did. Which statement would be best for the nurse to make?

A) "It is not unusual for women to develop hemorrhoids during pregnancy."
B) "Most women don't have any problem until after they've delivered."
C) "If your mother had hemorrhoids, you will get them, too."
D) "If you get hemorrhoids, you probably will need surgery to get rid of them."

Question 12

Which statement, if made by a pregnant patient, would indicate that she understands health promotion during pregnancy?

A) "I lie down after eating to relieve heartburn."
B) "I try to limit my fluid intake to 3 or 4 glasses each day."
C) "I elevate my legs while sitting at my desk."
D) "I am avoiding exercise to stay well rested."

Question 13

The nurse is preparing a class for expectant fathers. Which information should the nurse include?

A) Siblings adjust readily to the new baby.
B) Sexual activity is safe for normal pregnancy.
C) The expectant mother decides the feeding method.
D) Fathers are expected to be involved in labor and birth.

Question 14

The nurse assessing a pregnant African American woman in the first trimester understands that a cultural practice is:

A) Use of herbs like dandelion during pregnancy to increase lactation.
B) Drinking ginseng tea for dizziness.
C) Eating clay to supply dietary minerals.
D) Consulting a spiritual advisor to ensure a healthy pregnancy and birth.

Question 15

Specific culturally sensitive nursing considerations the nurse integrates into care of the pregnant patient include:

A) Counseling about home remedies.
B) Discussing components of a balanced diet.
C) Refusing to discuss birthing choices.
D) Encouraging use of support systems.
E) Instructing the patient to use no home remedies.

Question 16

The nurse is presenting a class to women who are currently pregnant or are planning pregnancy in the near future. Which patient's statement indicates that additional teaching is required?

A) "The older a woman is when she conceives, the safer the pregnancy is."
B) "Pregnant teens can have additional nutritional needs."
C) "A woman whose sisters all had hypertension will be watched carefully."
D) "Pregnancy may be more difficult to achieve spontaneously in my 40s."

Question 17

A Chinese woman who is 12 weeks pregnant reports to the nurse that ginseng and bamboo leaves help reduce her anxiety. How should the nurse respond to this patient?

A) Advise the patient to give up the bamboo leaves but to continue taking ginseng.
B) Advise the patient to give up all herbal remedies during the first trimester except for ginger.
C) Tell the patient that her remedies have no scientific foundation.
D) Assess where the patient obtains her remedy, and investigate the source.

Question 18

The husband of a pregnant woman accompanies her to prenatal visits. The nurse collaborates with and includes the father to alleviate:

A) Alienation.
B) Helplessness.
C) Guilt.
D) Anxiety.
E) Developmental barriers.

Question 19

A 38-year-old patient in her second trimester states a desire to begin an exercise program to decrease her fatigue. What is the most appropriate nursing response?

A) "Fatigue should resolve in the second trimester, but walking daily might help."
B) "Avoid a strenuous exercise regimen at your age. Drink coffee to combat fatigue."
C) "Avoid an exercise regimen due to your pregnancy. Try to nap daily."
D) "Fatigue will increase as pregnancy progresses, but running daily might help."

Question 20

The nurse in a prenatal clinic finds that four patients have called with complaints related to their pregnancies. Which call should the nurse return first?

A) Primip at 7 weeks' gestation reporting nasal stuffiness
B) Multip at 38 weeks experiencing rectal itching and hemorrhoids
C) Primip at 15 weeks with nausea and vomiting and a 15-pound weight loss
D) Multip at 32 weeks treating constipation with prune juice

Question 21

A first-trimester pregnant patient asks the nurse whether she may continue her yoga classes. The best answer the nurse could give is:

A) "Yoga positions are safe during pregnancy."
B) "Care must be taken when you perform yoga positions that require balance."
C) "Stretching that accompanies yoga is safe during pregnancy."
D) "Positions lying on the back must be avoided, but other positions are safe."

Question 22

The pregnant patient has asked the nurse what kinds of medications cause birth defects. Which statement would best answer this question?

A) "Birth defects are very rare. Don't worry; your doctor will watch for problems."
B) "To be safe, don't take any medication without talking to your doctor."
C) "Too much vitamin C is one of the most common issues."
D) "Almost all medications will cause birth defects in the first trimester."

Question 23

The nurse is discussing sexual intimacy with a pregnant couple. What should be included in the teaching plan?

A) Intercourse should stop by the beginning of the third trimester.
B) Breast fondling should be discouraged due to the potential for preterm labor.
C) The couple might need to experiment with different positions.
D) Use vaginal lubricant sparingly.

Question 24

A pregnant patient complains to the clinic nurse that her varicose veins are causing more discomfort than before. The nurse teaches the patient to: Note: Credit will be given only if all correct and no incorrec choices are selected. Standard Text:

A) Increase the time she stands.
B) Walk on a daily basis.
C) Not cross her legs at the knees.
D) Wear support hose.
E) Hyperextend her knee with her feet up.

Question 25

The nurse is evaluating the effectiveness of teaching the patient to monitor fetal activity. The nurse's documentation will include:

A) Specific information given to the patient regarding when to call the physician.
B) Types of teaching methods used.
C) Verbalization of understanding by the patient.
D) Recognition of fetal movements.
E) Counting fetal movement 1 hour after a meal.

Question 26

After teaching a pregnant patient about the effects of smoking on pregnancy, the nurse knows that the patient needs further education when she states, "I am at increased risk for:

A) "Preeclampsia."
B) "Preterm birth."
C) "Placenta previa."
D) "Abruptio placentae."

Question 27

The nurse is presenting a prenatal class to a group of women pregnant for the first time who are all over 35 years of age. The nurse knows that the advantage of waiting until later to start a family is:

A) That the woman will have an easier labor and delivery.
B) That the baby will be at less of a risk for congenital anomalies.
C) That the woman is more likely to be financially secure.
D) That the woman will be more fertile than a younger woman would.

Question 28

A 43-year-old patient has just had a positive pregnancy test. She cries, and states, "I just don't know what I'll do. I can't be pregnant." Which nursing diagnosis would be the most appropriate?

A) Decisional Conflict related to unexpected pregnancy
B) Deficient Knowledge related to advanced maternal age
C) Depression related to unexpected pregnancy
D) Ineffective Health Maintenance related to advanced maternal age

Question 29

The nurse working in a prenatal clinic knows that first-time mothers, no matter their age, have some of the same concerns. What would be a concern of any first-time mother?

A) Whether they will have the energy to care for a baby
B) The ability to afford all they need for the baby
C) Feeling "different" by being the only one in the peer group having a baby
D) Concern about the well-being of the fetus and the ability to be a parent

Question 30

The prenatal patient in her third trimester tells the clinic nurse that she works 8 hours a day as a cashier and stands when at work. What response by the nurse is best?

A) "No problem. Your baby will be fine."
B) "Do you get regular breaks for eating?"
C) "Your risk of preterm labor is higher."
D) "Standing might increase ankle swelling."

Question 31

The nurse teaches the pregnant patient that positions for sexual intercourse might need modification during later pregnancy. An appropriate position for intercourse during the third trimester is:

A) Lithotomy.
B) Fowler's.
C) Supine.
D) Side-lying.

Question 32

A pregnant patient who swims 3-5 times per week asks the nurse whether she should stop this activity. What is the appropriate nursing response?

A) "You should decrease the number of times you swim per week."
B) "Continuing your exercise program would be beneficial."
C) "You should discontinue your exercise program immediately."
D) "You should consider a less strenuous type of exercise."

Question 33

The pregnant patient in her second trimester states, "I didn't know my breasts would become so large. How do I find a good bra?" The best answer for the nurse to make would be:

A) "Avoid cotton fabrics and get an underwire bra; they fit everyone best."
B) "Just buy a bra one cup size bigger than usual, and it will fit."
C) "Look for wide straps and cups big enough for all of your breast tissue."
D) "There isn't much you can do for comfort. Try not wearing a bra at all."

Question 34

The nurse is presenting a class of important "dos and don'ts" during pregnancy, including travel considerations. What method of travel does the nurse recommend as most appropriate for a patient in her 25th week of pregnancy?

A) Automobile
B) Airplane
C) Train
D) None; this patient should not travel.

Question 35

The nurse working with mothers over 35 having their first baby knows there are some disadvantages. For what disadvantage would the nurse carefully assess in each patient?

A) What kind of insurance the patient has for maternity care
B) Whether the patient is married
C) Whether the patient will continue working after the baby arrives
D) Whether the patient has any chronic disease that will have to be addressed