Assessment Of The Pregnant Patient

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Question 1

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Multiple Choice

A patient who is 30 weeks pregnant tells the nurse, "I have had low blood pressure all my life, and now it is 136/74. What's wrong with me?" What is the most appropriate response by this nurse?

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"A woman's blood pressure usually drops several points during pregnancy, but yours hasn't."

"The blood pressure increases because your blood volume increases to supply you and the baby with enough blood."

"Yes, this is a significant change from your baseline, and I advise you to see your obstetrician at your earliest convenience."

"If you spend more time lying down, I think your blood pressure should return to normal in a few days."

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Question 2

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Multiple Choice

A nurse instructs the patient about which expected skin changes during pregnancy?

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Nipples becoming thicker

Hands and feet becoming pale and cool

Blotchy, brown pigmentation of the abdomen

Stretch marks on the expanding abdomen

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Question 3

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Multiple Choice

How does a nurse determine the Goodell sign?

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Assesses the softening of the lower uterine segment

Palpates for softening of the cervix

Assesses the breasts for fullness and tenderness

Inspects the cervix for a bluish coloration

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Question 4

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Multiple Choice

The nurse recognizes which clinical manifestation as a positive sign of pregnancy?

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Cessation of menstruation

Visualization of the fetus by ultrasound

Nausea and increased abdominal girth

Positive pregnancy test (hCG)

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Question 5

Free

Multiple Choice

Using Nägele's rule, what is the estimated delivery date of a patient whose last menstrual period started on December 1?

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August 1

August 10

September 4

September 8

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Question 6

Multiple Choice

What is the meaning of "G5, T1, P0, A3, L1" found in a patient's history?

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One birth at term

Three living children

Five grown children

One delivery not at term

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Question 7

Multiple Choice

A pregnant woman who drinks alcoholic beverages while pregnant increases the risk for which disorder?

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Low infant birth weight

Birth defects

Abruptio placentae

Gestational diabetes mellitus

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Question 8

Multiple Choice

A nurse refers which pregnant patient for additional assessment?

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A woman at 36 weeks of gestation who has 30% effacement of the cervix

A woman at 19 weeks of gestation who has noticed fetal movement every day this week

A woman at 20 weeks of gestation who has gained 4 lb in the last 2 weeks

A woman at 28 weeks of gestation who has a systolic blood pressure of 40 mg Hg over baseline

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Question 9

Multiple Choice

A patient's prepregnant weight was 131 lb, within the desirable range for her height. What is the expected weight for this pregnant patient?

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131 lb at 1 week postpartum

140 lb at the end of the first trimester

145 lb at the end of the second trimester

176 lb at the beginning of the third trimester

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Question 10

Multiple Choice

A pregnant patient presents to the clinic with a 3 lb/week weight gain for 2 successive weeks. The nurse is most concerned that this patient is demonstrating signs of which condition?

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Gestational diabetes mellitus

Preeclampsia

Placenta enlargement

Multiple gestations

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Question 11

Multiple Choice

A pregnant woman's weight before becoming pregnant was 137 lb. What weight is expected for this woman during her second trimester?

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149 lb

151 lb

155 lb

164 lb

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Question 12

Multiple Choice

A nurse documents as abnormal which finding of a pregnant patient?

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Facial swelling in a woman who is 20 weeks pregnant

1+ pitting ankle edema in a woman who is 26 weeks pregnant

Pinkish-red blotches of the hands in a woman at 32 weeks gestation

Blotchy, brownish pigmentation of the face in a woman at 36 weeks gestation

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Question 13

Multiple Choice

In prioritizing patient care, the nurse would give immediate attention to the pregnant patient with which clinical manifestation?

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Darkened eyelids

Seeing spots

Excessive eye dryness

Pale conjunctiva

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Question 14

Multiple Choice

The nurse documents which clinical finding as an expected change associated with advancing pregnancy?

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Slight persistent ankle edema

Hypoplasia of the thyroid gland

Increased diaphragmatic excursion

Heart murmur after 20 weeks of gestation

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Question 15

Multiple Choice

A patient at 20 weeks of gestation is concerned about a discharge from her nipples. What is the nurse's appropriate response to this patient?

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"That is expected. It is milk production that begins at the onset of pregnancy."

"A nipple discharge is unusual. I advise you to consult your obstetrician."

"I suggest you decrease your fluid intake for several days to see if this makes a difference."

"After the first trimester a thin, yellow fluid called colostrum may be secreted from the nipples."

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Question 16

Multiple Choice

A woman who is 16 weeks pregnant with her first child is concerned because she has not felt the fetus move. What is the most appropriate explanation for a nurse to give this patient?

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Movement of a fetus in the first pregnancy often does not occur until the twenty-fourth week of pregnancy.

A referral to an obstetrician should be made for further evaluation of this finding.

Movement of the fetus is not expected until the nineteenth week of pregnancy.

Movement of the fetus is related to fundal height; the greater the fundal height, the sooner the fetal movement.

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Question 17

Multiple Choice

In measuring fundal height, the nurse documents which finding as abnormal?

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29 cm at week 30

28 cm at week 26

34 cm at week 38

26 cm at week 24

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Question 18

Multiple Choice

A nurse assesses fetal heart rates when patients are examined in the maternity clinic. The nurse determines which fetus needs further assessment?

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The fetus with a heart rate of 150 beats/min

The fetus with a heart rate of 140 beats/min

The fetus with a heart rate of 130 beats/min

The fetus with a heart rate of 110 beats/min

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Question 19

Multiple Choice

To perform Leopold maneuvers, the nurse uses which assessment technique?

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Percussing over the symphysis pubis

Auscultating all four abdominal quadrants

Palpating the fundus

Measuring from symphysis pubis to the umbilicus

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Question 20

Multiple Choice

The nurse correlates which clinical manifestation with the diagnosis of polyhydramnios?

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Difficulty palpating fetal parts

Increased fetal movement

Weight gain of less than estimated by gestational age

Increase of 2 cm in fundal height in 1 week

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