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Maternity Nursing 7th Edition Lowdermilk Perry Test Bank

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Maternity Nursing 7th Edition Lowdermilk Perry Test Bank

 

ISBN-10:

0323033660

ISBN-13:

9780323033664

 

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Maternity Nursing 7th Edition Lowdermilk Perry Test Bank

 

ISBN-10:

0323033660

ISBN-13:

9780323033664

 

 

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Lowdermilk & Perry: Maternity Nursing, 7th Edition

 

Test Bank

 

Chapter 9: Nursing Care during Pregnancy

 

MULTIPLE CHOICE

 

  1. Which of the following statements is accurate?
1. A normal pregnancy lasts about 10 lunar months.
2. A trimester is one third of a year.
3. The prenatal period is between fertilization and conception.
4. EDC, or estimated date of confinement, is how long the mother will have to be bedridden after birth.

 

ANS:   1

  1. A lunar month lasts 28 days or 4 weeks. Pregnancy spans 9 calendar months but 10 lunar months.
  2. A trimester is one third of a normal pregnancy or about 13 to 14 weeks.
  3. The prenatal period covers the full course of pregnancy (prenatal, before birth).
  4. EDC is now called EDB or estimated date of birth. It has nothing to do with duration of bed rest.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 232

 

 

  1. In understanding and guiding the woman through her acceptance of pregnancy, a maternity nurse should be aware that:
1. nonacceptance of the pregnancy very often equates to rejection of the child.
2. mood swings most likely are the result of worries about finances and changed lifestyle as well as of profound hormonal changes.
3. ambivalent feelings during pregnancy are usually found only in emotionally immature or very young mothers.
4. conflicts such as not wanting pregnancy or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth.

 

ANS:   2

  1. A woman may dislike being pregnant, refuse to accept it, and still love and accept the child.
  2. Such mood swings are natural and are likely to affect every woman to some degree.
  3. Ambivalent feelings about pregnancy are normal for mature or immature women, young or older.

 

  1. These conflicts need resolution. The baby ends the pregnancy but not all the issues.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 233

 

 

  1. Concerning the woman’s reordering of personal relationships during pregnancy, a maternity nurse should be aware that:
1. because of the special motherhood bond, a woman’s relationship with her mother is even more important than with the father of the child.
2. nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other.
3. women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father.
4. the woman’s sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier.

 

ANS:   3

  1. The most important person to the pregnant woman is usually the father.
  2. Nurses can facilitate communication between partners about sexual matters if, as is common, they are nervous about expressing their worries and feelings.
  3. Love and support help a woman feel better about her pregnancy.
  4. The second trimester is when a woman’s sense of well-being, along with certain physical changes, increases her desire for sex. Desire is down in the first and third trimesters.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 234

 

 

  1. Which of the following represents a typical progression through the phases of a woman’s establishing a relationship with the fetus?
1. Accepts fetus as distinct from herself—accepts biologic fact of pregnancy—feeling of caring and responsibility
2. Fantasies about child’s sex and personality—views child as part of herself—introspective
3. Views child as part of herself—feelings of well-being—accepts biologic fact of pregnancy
4. “I am pregnant”—“I am going to have a baby”—“I am going to be a mother”

 

ANS:   4

  1. The woman first centers on herself as pregnant, then on the baby as an entity separate from herself, then on her responsibilities as a mother. The expressions “I am pregnant,” “I am going to have a baby,” “I am going to be a mother” sum up the progression through the three phases.
  2. The woman first centers on herself as pregnant, then on the baby as an entity separate from herself, then on her responsibilities as a mother. The expressions “I am pregnant,” “I am going to have a baby,” “I am going to be a mother” sum up the progression through the three phases.
  3. The woman first centers on herself as pregnant, then on the baby as an entity separate from herself, then on her responsibilities as a mother. The expressions “I am pregnant,” “I am going to have a baby,” “I am going to be a mother” sum up the progression through the three phases.
  4. The woman first centers on herself as pregnant, then on the baby as an entity separate from herself, then on her responsibilities as a mother. The expressions “I am pregnant,” “I am going to have a baby,” “I am going to be a mother” sum up the progression through the three phases.

 

DIF:    Cognitive Level: Application             REF:    p. 235

 

 

  1. Concerning the father’s acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that:
1. the father goes through three phases of acceptance of his own.
2. the father’s attachment to the fetus cannot be as strong as the mother’s because it doesn’t start until after birth.
3. in the last 2 months of pregnancy most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home.
4. typically men remain ambivalent about fatherhood right up to the birth of their child.

 

ANS:   1

  1. A father typically goes through three phases of acceptance: accepting the biologic fact, adjusting to the reality, focusing on his role.
  2. The father-child attachment can be as strong as the mother-child relationship and can also begin during pregnancy.
  3. In the last 2 months of pregnancy, many expectant fathers work hard to improve the environment of the home for the child.
  4. Typically, the expectant father’s ambivalence ends by the first trimester and he progresses to adjusting to the reality of the situation and then focusing on his role.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 236; p. 237

 

 

  1. The phenomenon of someone other than the mother-to-be experiencing pregnancy-like symptoms such as nausea and weight gain applies to the:
1. mother of the pregnant woman.
2. couple’s teenage daughter.
3. sister of the pregnant woman.
4. expectant father.

 

ANS:   4

  1. An expectant father experiencing his partner’s pregnancy-like symptoms is called the couvade syndrome.
  2. An expectant father experiencing his partner’s pregnancy-like symptoms is called the couvade syndrome.
  3. An expectant father experiencing his partner’s pregnancy-like symptoms is called the couvade syndrome.
  4. An expectant father experiencing his partner’s pregnancy-like symptoms is called the couvade syndrome.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 236

 

 

  1. Concerning the initial visit with a patient beginning prenatal care, nurses should be aware that:
1. the first interview is a relaxed, get-acquainted affair in which nurses gather some general impressions.
2. if they observe handicapping conditions, they should be sensitive and not inquire about them because the patient will do that in her own time.
3. nurses should be alert to the appearance of potential parenting problems such as depression or lack of family support.
4. because of legal complications nurses should not ask about illegal drugs; let the doctors do that.

 

ANS:   3

  1. The initial interview needs to be planned, purposeful, and focused on specific content. There is a lot of ground to cover.
  2. Nurses need to be sensitive to special problems, but they do need to inquire because discovering individual needs is important. People with chronic or handicapping conditions forget to mention them because they have adapted to them.
  3. Besides these potential problems nurses need to be alert to the woman’s attitude toward health care.
  4. Getting information on drug use is important and can be done confidentially. Actual testing for drug use requires patient consent.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 240

 

 

  1. Concerning the initial physical exam of a woman beginning prenatal care, maternity nurses should be aware that:
1. only women who show physical signs or meet the sociologic profile should be assessed for physical abuse.
2. the woman’s bladder should be empty before pelvic examination.
3. distribution, amount, and quality of body hair are of no particular importance.
4. size of the uterus is discounted in the initial exam because it is just going to get bigger soon.

 

ANS:   2

  1. All women should be assessed for a history of physical abuse, particularly because the likelihood of abuse increases during pregnancy.
  2. An empty bladder aids in examination, plus it offers an easy opportunity to get a urine sample for a number of tests.
  3. Body hair is important to note because it reflects nutritional status, endocrine function, and hygiene.
  4. Particular attention is paid to the size of the uterus because it is an indication of the duration of gestation.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 247

 

 

  1. Concerning follow-up visits for women on prenatal care, nurses should be aware that:
1. the interview portions become more intensive as the visits become more frequent over the course of the pregnancy.
2. monthly visits are scheduled for the first trimester, every 2 weeks for the second, and weekly for the third.
3. during abdominal examination the nurse should be alert for supine hypotension.
4. for pregnant women a systolic blood pressure of 130 and a diastolic of 80 is sufficient to be considered hypertensive.

 

ANS:   3

  1. The interview portion of follow-up exams is less extensive than the initial prenatal visits, when so much new information must be gathered.
  2. Monthly visits are routinely scheduled for the fist and second trimesters; they increase to every 2 weeks at week 28 and once a week at week 36.
  3. The woman lies on her back during the abdominal exam, which may compress the vena cava and aorta, causing a decrease in blood pressure and a feeling of faintness.
  4. For pregnant women hypertension is defined as systolic 140 or more and diastolic of 90 or greater.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 248

 

 

  1. Concerning assessment of the fetus, the maternity nurse should be aware that:
1. the fetal heart tones are heard (in the second trimester) by a Doppler stethoscope, whereas the fetal heart rate (third trimester) is heard by the ultrasound fetoscope or stethoscope.
2. the measure of fundal height on the woman’s abdomen is a gross measure, and various techniques and procedures can be used on the same patient.
3. there is no need to use ultrasound exams (sonograms) until later in the pregnancy unless there are indications of distress.
4. expectant mothers should count fetal kicks after a meal.

 

ANS:   4

  1. Fetal heart tones can be heard by a fetoscope in the first trimester; by the second trimester fetal heart rate can be heard by the Doppler stethoscope.
  2. The fundal height is an important measure that should be determined with precision, consistently using the same technique and positioning of the patient.
  3. Routine use of ultrasounds is recommended in early pregnancy; it dates the pregnancy and provides useful information on the health of the fetus.
  4. Regular fetal movement is a reliable indicator of fetal health. Four kicks an hour is a good benchmark.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 252

 

 

  1. Concerning their role in the personal hygiene of the expectant mother, maternity nurses should be aware that:
1. tub bathing is permitted even in late pregnancy, unless membranes have ruptured.
2. the perineum should be wiped from back to front.
3. bubble bath and bath oils are okay because they add an extra soothing and cleansing action to the bath.
4. expectant mothers should use specially treated soap to cleanse the nipples.

 

ANS:   1

  1. The main danger from taking baths is falling in the tub.
  2. The perineum should be wiped from front to back.
  3. Bubble baths and bath oils should be avoided because they may irritate the urethra.
  4. Soap, alcohol, ointments, and tinctures should not be used to cleanse nipples because they remove protective oils. Warm water is sufficient.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 255

 

 

  1. The pinch test is applied to:
1. check the sensitivity of the nipples.
2. determine whether the nipple is everted or inverted.
3. calculate the adipose buildup in the abdomen.
4. see whether the fetus has become inactive.

 

ANS:   2

1, 3, 4. Incorrect. The pinch test is used to determine whether the nipple is everted or inverted. Nipples must be everted to breastfeed the baby.

  1. Correct. The pinch test is used to determine whether the nipple is everted or inverted. Nipples must be everted to breastfeed the baby.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 256

 

 

  1. Concerning dental care during pregnancy, maternity nurses should be aware that:
1. dental care can be dropped on the priority list because the woman has enough to worry about and is getting a lot of calcium anyway.
2. dental surgery in particular is contraindicated because of the psychologic stress it engenders.
3. if dental treatment is necessary, the woman will be most comfortable with it in the second trimester.
4. dental care will interfere with the expectant mother’s need to practice conscious relaxation.

 

ANS:   3

  1. Dental care, such as brushing with a fluoride toothpaste, is especially important during pregnancy because nausea during pregnancy may lead to poor oral hygiene.
  2. Emergency dental surgery is okay; however, risks and benefits must be clearly understood.
  3. The second trimester is best for dental treatment because that is when the woman will be able to sit most comfortably in the dental chair.
  4. Conscious relaxation is useful, and it might even help her get through any dental appointments, but it is not a reason to avoid them.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 257

 

 

  1. Concerning work and travel during pregnancy, nurses should be aware that:
1. women should sit for as long as possible and cross their legs at the knees from time to time for exercise.
2. women should avoid seat belts and shoulder restraints in the car because they press on the fetus.
3. metal detectors at airport security checkpoints can harm the fetus if passed through a number of times.
4. while working or traveling in a car or plane, women should arrange to walk around at least every hour or so.

 

ANS:   4

  1. Pregnant women should avoid sitting or standing for long periods and crossing the legs at the knees.
  2. Pregnant women must wear lap belts and shoulder restraints. The most common injury to the fetus comes from injury to the mother.
  3. Metal detectors at airport security do not harm fetuses.
  4. Periodic walking helps avoid thrombophlebitis.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 259

 

 

  1. Concerning medications, herbs, shots, and other substances normally encountered, a maternity nurse should be aware that:
1. both prescription and OTC drugs that are otherwise harmless can be made hazardous by metabolic deficiencies of the fetus.
2. the greatest danger of drug-caused developmental deficits in the fetus occurs in the final trimester.
3. killed-virus vaccines (e.g., tetanus) should not be used during pregnancy, but live-virus vaccines (e.g., measles) are okay.
4. no convincing evidence exists to show that secondhand smoke is potentially dangerous to the fetus.

 

ANS:   1

  1. This is especially true for new medications and combinations of drugs.
  2. The greatest danger of drug-caused developmental defects occurs from fertilization through the first trimester when a woman may not realize she is pregnant.
  3. Live-virus vaccines should be part of postpartum care; killed-virus vaccines may be administered during pregnancy.
  4. Secondhand smoke is associated with fetal growth restriction and increases in infant mortality.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 263

 

 

  1. Which of the following statements concerning multifetal pregnancy is not accurate?
1. The expectant mother often develops anemia because the fetuses have a greater demand for iron.
2. Twin pregnancies come to term with the same frequency as single pregnancies.
3. The mother should be counseled to increase nutrition and gain more weight.
4. Backache and varicose veins are often more pronounced.

 

ANS:   2

  1. The mother often develops anemia, suffers more or greater backaches, and needs to gain more weight. Counseling is needed to adjust to these conditions.
  2. Twin pregnancies often end in prematurity. Serious efforts should be made to bring the pregnancy to term.
  3. The mother often develops anemia, suffers more or greater backaches, and needs to gain more weight. Counseling is needed to adjust to these conditions.
  4. The mother often develops anemia, suffers more or greater backaches, and needs to gain more weight. Counseling is needed to adjust to these conditions.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 278

 

 

  1. Prenatal care should ideally begin:
1. before the first missed menstrual period.
2. after the first missed menstrual period.
3. after the second missed menstrual period.
4. after the third missed menstrual period.

 

ANS:   2

1, 3, 4. Incorrect. Regular prenatal visits, ideally beginning soon after the first missed menstrual period, offer opportunities to ensure the health of the expectant mother and her infant.

  1. Correct. Prenatal care should ideally begin soon after the first missed menstrual period.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 232

 

 

  1. A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2007. Her expected date of birth (EDB) would be:
1. September 17, 2007.
2. November 7, 2007.
3. November 21, 2007.
4. December 17, 2007.

 

ANS:   3

1, 2, 4. Incorrect. Using Nägele’s rule, calculate EDB by subtracting 3 months from the month of the LMP and adding 7 days plus 1 year to the day of the LMP. Therefore, LMP of February 14, 2007:

 

2 (February) 14 (date) 2007
-3 months + 7 days + 1 year
= November = 21st of the month = 2007

 

  1. Correct. Using Nägele’s rule, this is the correct expected date of birth.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 233

 

 

  1. Which of the following symptoms would be considered a first trimester warning sign and should be reported immediately by the pregnant woman to her health care provider?
1. Nausea with occasional vomiting
2. Fatigue
3. Urinary frequency
4. Vaginal bleeding

 

ANS:   4

1, 2, 3. Incorrect. These are normal first-trimester complaints of pregnancy. Although they may be worrisome or annoying to the mother, they are not usually an indication of a problem with the pregnancy.

  1. Correct. Signs and symptoms that are to be reported include severe vomiting, fever and chills, burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms may be signs of potential complications of the pregnancy.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 250

 

 

  1. A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse informs her:
1. “You do not need to modify your exercising any time during your pregnancy.”
2. “Stop exercising because it will harm the fetus.”
3. “You may find that you need to modify your exercise to walking later in your pregnancy around the seventh month.”
4. “Jogging is too hard on your joints; switch to walking now.”

 

ANS:   3

  1. The nurse needs to inform the woman that she may need to decrease her exercise level as the pregnancy progresses.
  2. Physical activity promotes a feeling of well-being in the pregnant woman. It improves circulation, promotes relaxation and rest, and counteracts boredom.
  3. Typically, it is suggested that running be replaced with walking around the seventh month of pregnancy.
  4. Simple measures should be initiated to prevent injuries, such as warm-up and stretching exercises to prepare the joints for more strenuous exercise.

 

DIF:    Cognitive Level: Application             REF:    p. 258

 

 

  1. Condoms should be used in pregnancy by:
1. unmarried pregnant women.
2. women at risk for acquiring or transmitting sexually transmitted infections.
3. all pregnant women.
4. women at risk for candidiasis.

 

ANS:   2

1, 3, 4. Incorrect. Women are encouraged to practice safer sex behaviors. Women at risk for acquiring or conveying STIs are encouraged to use condoms during sexual intercourse throughout pregnancy.

  1. Correct. The objective of safer sex is to provide prophylaxis against the acquisition and transmission of STIs. Because these diseases may be transmitted to the woman and her fetus, the use of condoms is recommended throughout pregnancy if the woman is at risk for acquiring an STI.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 271

 

 

  1. Which of the following blood pressure (BP) assessment findings during the second trimester indicates a risk for preeclampsia?
1. Baseline BP 120/80, current BP 126/85
2. Baseline BP 100/70, current BP 130/85
3. Baseline BP 140/85, current BP 130/80
4. Baseline BP 110/60, current BP 110/60

 

ANS:   2

  1. An increase in the systolic BP of 30 mm Hg or more than the baseline pressure or in the diastolic BP of 15 mm Hg more than the baseline pressure is a significant finding, regardless of the absolute values. The slight increase in the BP does not meet the criteria for concern.
  2. An increase in the systolic BP of 30 mm Hg or more than the baseline pressure or in the diastolic BP of 15 mm Hg more than the baseline pressure is a significant finding, regardless of the absolute values. The current BP indicates that an increase in both the diastolic and systolic pressures has occurred.
  3. Although the initial BP is of concern (an absolute systolic BP of 140 mm Hg or more and a diastolic BP of 90 mm Hg or more suggest the presence of hypertension), the subsequent pressures have decreased, not increased.
  4. The BP is within normal limits in both values and is not a concern.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 250

 

 

  1. The triple marker test is used to assess the fetus for which condition?
1. Down syndrome
2. Diaphragmatic hernia
3. Congenital cardiac abnormality
4. Anencephaly

 

ANS:   1

  1. Correct. Maternal serum level of alpha-fetoprotein levels are used to screen for Down syndrome, neural tube defects, and other chromosomal anomalies.

2, 3, 4. Incorrect. The triple marker does not detect these fetal anomalies. Additional testing such as ultrasonography and amniocentesis is required to diagnose them.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 252

 

 

  1. A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be:
1. constipation.
2. alteration in the pattern of fetal movement.
3. heart palpitations.
4. edema in ankles and feet at the end of the day.

 

ANS:   2

1, 3, 4. Incorrect. These are all normal discomforts of pregnancy that occur in the second and third trimesters.

  1. Correct. An alteration in the pattern or amount of fetal movement may indicate fetal jeopardy.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 252

 

 

  1. A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. You would tell her:
1. “Since you are in your second trimester, there is no problem with having one drink with dinner.”
2. “One drink every night is too much. One drink three times a week should be fine.”
3. “Since you are in your second trimester, you can drink as much as you’d like.”
4. “Because no one knows how much or how little alcohol it takes to cause fetal problems, it is recommended that you abstain throughout your pregnancy.”

 

ANS:   4

1, 2, 3. Incorrect. A safe level of alcohol consumption during pregnancy has not yet been established. Although the consumption of occasional alcoholic beverages may not be harmful to the mother or her developing fetus, complete abstinence is strongly advised.

  1. Correct. This is an accurate statement.

 

DIF:    Cognitive Level: Application             REF:    p. 263

 

 

  1. A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild to moderate intensity. The nurse should recommend that she:
1. do Kegel exercises.
2. do pelvic rock exercises.
3. use a softer mattress.
4. stay in bed for 24 hours.

 

ANS:   2

  1. Incorrect. Kegel exercises increase the tone of the pelvic area, not the back.
  2. Correct. Pelvic rock exercises may help to stretch and strengthen the abdominal and lower back muscles and relieve low back pain.
  3. Incorrect. The use of a softer mattress may not provide the support needed to keep proper spine alignment and may contribute to back pain.
  4. Incorrect. Stretching and other exercises to relieve back pain should be performed several times a day.

 

DIF:    Cognitive Level: Application             REF:    p. 258

 

 

  1. A woman is 3 months pregnant. At her prenatal visit, she tells the nurse that she doesn’t know what is happening; one minute she is happy that she is pregnant, and the next minute she cries for no reason. Which of the following responses by the nurse is most appropriate?
1. “Don’t worry about it; you’ll feel better in a month or so.”
2. “Have you talked to your husband about how you feel?”
3. “Perhaps you really don’t want to be pregnant.”
4. “Hormone changes during pregnancy commonly result in mood swings.”

 

ANS:   4

  1. This statement dismisses the client’s concerns and is not the most appropriate response.
  2. Although women should be encouraged to share their feelings, most appropriate response and does not provide a rationale to the client regarding the psychosocial dynamics of her pregnancy.
  3. This response is completely inappropriate and deleterious to the psychologic well-being of the woman. Hormonal and metabolic adaptation offer cause mood swings in pregnancy. The woman’s response is normal. She should be reassured about her feelings.
  4. This is an accurate statement and the most appropriate response by the nurse.

 

DIF:    Cognitive Level: Application             REF:    p. 233

 

 

  1. Which of the following is the partner’s main role in pregnancy?
1. Provide financial support.
2. Protect the pregnant woman from “old wives’ tales”.
3. Support and nurture the pregnant woman.
4. Ensure that the pregnant woman keeps prenatal appointments.

 

ANS:   3

1, 2, 4. Incorrect. In older societies, the man enacted the ritual couvade. Changing cultural and professional attitudes over the past 30 years have encouraged fathers’ participation in the birth experience.

  1. Correct. The partner’s main role in pregnancy is to nurture and respond to the pregnant woman’s feelings of vulnerability.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 234

 

 

  1. During the first trimester of pregnancy, a woman can expect which of the following changes in her sexual desire?
1. An increase because of enlarging breasts
2. A decrease because of nausea and fatigue
3. No change in the first trimester
4. An increase because of increased levels of female hormones

 

ANS:   2

  1. During pregnancy, the breasts may become enlarged and tender; this tends to interfere with coitus, thereby decreasing the desire to engage in sexual activity.
  2. Maternal physiologic changes, such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses, may affect sexuality and sexual expression. Libido may be depressed in the first trimester but often increases during the second and third trimesters.
  3. Libido may be depressed in the first trimester but often increases during the second and third trimesters.
  4. Maternal physiologic changes, such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses, may affect sexuality and sexual expression.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 271

 

 

  1. A 3-year-old girl’s mother is 6 months pregnant. Which of the following concerns is this young girl likely to verbalize?
1. How the baby will “get out”
2. What the baby eats
3. Whether her mother will die
4. What color eyes the baby has

 

ANS:   2

  1. Incorrect. School-age children take a more clinical interest in their mother’s pregnancy and may want to know, “How did the baby get in there?” and “How will it get out?”
  2. Correct. By age 3 or 4, children like to be told the story of their own beginning and accept it being compared with the present pregnancy. They like to listen to the fetal heartbeat and feel the baby move. Sometimes they worry about how the baby is being fed and what it wears.

3, 4. Incorrect. This does not tend to be the focus of children’s inquisition regarding the impending birth of a sibling.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 238

 

 

  1. In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which of the following statements best describes that purpose?
1. To promote family unity
2. To ward off the “evil eye”
3. To appease the gods of fertility
4. To protect the mother and fetus during pregnancy

 

ANS:   4

1, 2, 3. Incorrect. Although many consider pregnancy normal, certain practices are expected of women of all cultures to ensure a good outcome. Cultural prescriptions tell women what to do and cultural proscriptions establish taboos. The purposes of these practices are to prevent maternal illness resulting in a pregnancy-induced imbalanced state and to protect the vulnerable fetus.

  1. Correct. The purpose of all cultural practices is to protect the mother and fetus during pregnancy.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 274

 

 

  1. What type of cultural concern is the most likely deterrent to many women seeking prenatal care?
1. Religion
2. Modesty
3. Ignorance
4. Belief that physicians are evil

 

ANS:   2

1, 3, 4. Incorrect. Many cultural variations are found in prenatal care. Even if the prenatal care described is familiar to a womanRemember,me practices may conflict with the beliefs and practices of a subculture group to which she belongs.

  1. Correct. A concern for modesty is a deterrent to many women seeking prenatal care. For some women, exposing body parts, especially to a man, is considered a major violation of their modesty.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 274

 

SHORT ANSWER

 

  1. Signs and symptoms that a woman should report immediately to her health care provider include which of the following? (Choose all that apply.)
  2. Vaginal bleeding
  3. Rupture of membranes
  4. Heartburn accompanied by severe headache
  5. Decreased libido
  6. Urinary frequency

 

ANS:

1, 2, 3

1, 2, 3. Correct. Vaginal bleeding, rupture of membranes, and severe headaches are all signs of potential complications in pregnancy. Clients should be advised to report these signs to their health care provider.

4, 5. Incorrect. Decreased libido and urinary frequency are common discomforts of pregnancy that do not require immediate health care interventions.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 250

 

 

  1. Juanita has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview, you discover that Juanita has not had any immunizations. Which of the following immunizations should Juanita receive at this point of her pregnancy? (Choose all that apply.)
  2. Tetanus
  3. Diphtheria
  4. Chickenpox
  5. Rubella
  6. Hepatitis B

 

ANS:

1, 2, 5

1, 2, 5. Correct. Immunization with live or attenuated live viruses is contraindicated during pregnancy because of its potential teratogenicity. Vaccines consisting of killed viruses may be used. Those that may be administered during pregnancy include tetanus, diphtheria, recombinant hepatitis B, and rabies vaccines.

3, 4. Incorrect. Immunization with live or attenuated viruses is contraindicated during pregnancy because of its potential teratogenicity. Live-virus vaccines include those for measles (rubeola and rubella), chickenpox, and mumps.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 263

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