1. Prenatal Care Review Questions Ana H. Corona, MSN, FNP-C Nursing Instructor February 2009

2. A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the first day of her last menstrual period was September 19, 2005. Using Nagele’s rule, the nurse determines the estimated date of confinement as: a. July 26, 2006 b. June 12, 2007 c. June 26, 2006 d. July 12, 2007

3. answer is c

4. A nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse measures the fundal height in centimeters and expects the findings to be which of the following: a. 22 cm b. 30 cm c. 36 cm d. 40 cm

5. answer is b

6. A pregnant client is seen in a health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions and the nurse determines that she is experiencing Braxton Hicks contractions. Based on this finding, which nursing actions is most appropriate: a. instruct the client to maintain bed rest for the remainder of the pregnancy. b. inform the client that these are common and may occur throughout the pregnancy c. contact the physician d. call the maternity unit and inform them that the client will be admitted in a pre-labor condition.

7. answer is b

8. A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The physician has documented the presence of Goodell’s sign. The nurse determines that this sign indicates: a. softening of the cervix b. a soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus. c. the presence of human chorionic gonadotropin in the urine. d. the presence of fetal movement.

9. Answer is a

10. A nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant client to describe the process of quickening. Which of the following statements if made by the student indicates an understanding of this term? a. It is the irregular, painless contractions that occur throughout pregnancy b. It is the soft blowing sound that can be heard when the uterus is auscultated c. it is the fetal movement that is felt by the mother d. it is the thinning of the lower uterine segment.

11. Answer is C

12. A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? a. auscultating for fetal heart sounds b. Palpating the abdomen for fetal movement c. assessing the cervix for thinning d. initiating a gentle upward tap on the cervix

13. Answer is D

14. A pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. The nurse responds by telling the mother that the fetal movement will be noted between: a. 6 and 8 weeks b. 8 and 10 weeks c. 10 and 12 weeks d. 14 and 16 weeks

15. The answer is D

16. Softening of the cervix is: a. Hegar’s Sign b. Quickening c. Goodell’s Sign d. Chadwick’s Sign

17. The answer is C

18. A 36 week pregnant woman with a 3 year old, a 1 year old and has a miscarriage at 7 weeks would be: a. G4P2A1 b. G4P2A0 c. G3P2A1 d. G4P4A0

19. Answer is A

20. A nursing instructor is conducting lecture and is reviewing the functions of the female reproductive system. She asks Mark to describe the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). Mark accurately responds by stating that: 1.FSH and LH are released from the anterior pituitary gland. 2.FSH and LH are secreted by the corpus luteum of the ovary 3.FSH and LH are secreted by the adrenal glands 4.FSH and LH stimulate the formation of milk during pregnancy

21. Answer is 1 1. FSH and LH, when stimulated by gonadotropin-releasing hormone from the hypothalamus, are released from the anterior pituitary gland to stimulate follicular growth and development, growth of the graafian follicle, and production of progesterone.

22. A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately tells the client that fetal circulation consists of: 1.Two umbilical veins and one umbilical artery 2.Two umbilical arteries and one umbilical vein 3.Arteries carrying oxygenated blood to the fetus 4.Veins carrying deoxygenated blood to the fetus

23. Answer is 2 2. Blood pumped by the embryo’s heart leaves the embryo through two umbilical arteries. Once oxygenated, the blood then is returned by one umbilical vein. Arteries carry deoxygenated blood and waste products from the fetus, and veins carry oxygenated blood and provide oxygen and nutrients to the fetus.

24. A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Select all probable signs of pregnancy. 1.Uterine enlargement 2.Fetal heart rate detected by nonelectric device 3.Outline of the fetus via radiography or ultrasound 4.Chadwick’s sign 5.Braxton Hicks contractions 6.Ballottement

25. Answer is 1,4,5 and 6 The probable signs: Uterine enlargement, Hegar’s sign, Goodell’s sign, Chadwick’s sign, ballottement, Braxton Hicks contractions and a positive pregnancy test measuring for hCG. Positive signs of pregnancy include fetal heart rate detected by Doppler at 10-12 weeks, active fetal movements palpable by the examiner, and an outline of the fetus via radiography or ultrasound.

26. A client in the 1st trimester of pregnancy arrives at a clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education? 1.“I will maintain strict bedrest throughout the remainder of pregnancy.” 2.“I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding.” 3.“I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad.” 4.“I will watch for the evidence of the passage of tissue.”

27. Answer is 1 Strict bed rest throughout the remainder of pregnancy is not required. The woman is advised to curtail sexual activities until the bleeding has ceased, and for 2 weeks following the last evidence of bleeding or as recommended by the physician. The woman is instructed to count the number of perineal pads used daily and to note the quantity and color of blood on the pad. The woman also should watch for the evidence of the passage of tissue.

28. In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the: 1.Oxytocin is too high 2.Blood level of LH is too high 3.Progesterone level is high 4.Endometrial wall is sloughed off.

29. Answer is 2 It is the surge of LH secretion in midcycle that is responsible for ovulation.

30. The chief function of progesterone is the: 1.Development of the female reproductive system 2.Stimulation of the follicles for ovulation to occur 3.Preparation of the uterus to receive a fertilized egg 4.Establishment of secondary male sex characteristics

31. Answer is 3 Progesterone stimulates differentiation of the endometrium into a secretory type of tissue.