Safe Maternity Pediatric Nursing By Care Palmer Coats – Test Bank

Safe Maternity Pediatric Nursing By Care Palmer Coats – Test Bank

Chapter 6: Nursing Care During Pregnancy

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. The nurse is caring for a pregnant woman who is complaining of nasal stuffiness. Which intervention does the nurse identify as problematic and encourage the patient to stop?

1)

Increased fluid intake

2)

Use of nasal saline drops

3)

Use of a humidifier in the home

4)

Taking a decongestant

____ 2. Which statement made by a pregnant woman who is complaining of increased vaginal discharge should the nurse correct?

1)

“I try to wear loose clothes and avoid anything that too tight fitting.”

2)

“I changed from my usual nylon underwear to cotton underwear.”

3)

“The discharge has gotten so bad that I have to wear panty liners all the time.”

4)

“I’ve started douching at least once a day and sometimes twice a day.”

____ 3. The nurse is providing teaching to a woman during her first prenatal visit. The woman says she has been told to avoid baths and asks if that is true. Which statement made by the nurse is incorrect?

1)

“Baths are safe until the membranes rupture.”

2)

“Apply antiskid devices to the bottom of the tub to prevent injury.”

3)

“Soaking in a hot tub can be very relaxing and can reduce morning sickness.”

4)

“In the third trimester, get help getting out of the bathtub.”

____ 4. When the nurse assesses a pregnant woman, which form of exercise previously enjoyed by the woman should be discouraged?

1)

Running

2)

Skiing

3)

Swimming

4)

Cycling

____ 5. The nurse teaches a pregnant woman about healthy nutrition to prevent neural tube defects in the fetus. The nurse assesses that the patient understood the teaching when which food choices are made for breakfast?

1)

Bacon, eggs, and hash browns

2)

Pancakes with syrup and sausage

3)

Peanut butter on toast and orange juice

4)

Cereal with milk and peanut butter on toast

____ 6. Which question from the nurse is most effective in assessing a pregnant patient for potential pica?

1)

“You’re not eating anything that would be considered a nonfood item, are you?”

2)

“Are you eating anything weird that you didn’t eat before you got pregnant?”

3)

“Some women experience cravings. Are you experiencing anything like that?”

4)

“Pica, a craving to eat nonfood items, is common in pregnancy. What have you experienced?”

____ 7. During a woman’s routine prenatal visit, the nurse notices scratches on her arms and learns she has adopted a kitten. Which teaching should the nurse include during this visit?

1)

Cytomegalovirus prevention

2)

Toxoplasmosis prevention

3)

Rubella prevention

4)

Parvovirus prevention

____ 8. During the prenatal visit of a woman who is 38 weeks pregnant, the pelvic examination reveals active genital herpes. Which anticipatory guidance should the nurse provide?

1)

Potential for the newborn to require neonatal intensive care

2)

Increased risk of congenital anomaly in the neonate

3)

Preparation for Cesarean section

4)

Need to notify the public health department

____ 9. The nurse includes which teaching as the greatest priority when caring for a pregnant woman over age 35?

1)

Healthy nutrition

2)

Proper self-care

3)

Regular prenatal care

4)

Chromosomal testing

____ 10. The nurse is caring for a woman in the first trimester of pregnancy whose body mass index (BMI) is 16.5. Which nutritional counseling should the nurse provide?

1)

Follow a healthy diet low in calories and fat.

2)

Follow a healthy diet low in sodium and calories.

3)

Follow a healthy diet high in protein and fat.

4)

Follow a healthy diet with increased calories and calcium.

____ 11. A pregnant adolescent tells the nurse, “There is something wrong with me. I can’t sit through a class without having to urinate.” A physical examination reveals no urinary or renal problems. What is the nurse’s priority of care?

1)

Telling the patient to reduce fluid intake during the school day

2)

Having the patient attend a pregnant adolescent group class

3)

Encouraging the patient’s mother to monitor her urine output

4)

Telling the patient to have friends take notes in class while she urinates

____ 12. A pregnant adolescent asks the nurse, “Did I hurt the baby because I went to a party last night and had a few beers?” Which is the nurse’s best response?

1)

“Drinking alcohol can be very harmful to the fetus, but you won’t know if harm was done until the baby is born.”

2)

“Alcohol is a drug, and all drugs have the potential to harm the baby, so they should be avoided throughout pregnancy.”

3)

“It is unlikely that drinking one time hurt the baby, but repeated intake of alcohol can have serious negative effects.”

4)

“Drinking alcohol at your age is illegal, and I am required to report this to the authorities because I’m a nurse.”

____ 13. The nurse is teaching a pregnant adolescent about maintaining a healthy diet. Which statement by the patient indicates further teaching is needed?

1)

“I’ll drink only diet soda until after I have the baby.”

2)

“I will increase my calcium intake by eating more yogurt.”

3)

“I will order a salad when I go to a fast-food place with my friends.”

4)

“I will take a calcium supplement every day until I deliver.”

____ 14. While reviewing a new patient’s medical record prior to her arrival at the clinic, the nurse sees the patient is classified as an AMA and interprets this to mean what?

1)

Advanced medical age

2)

Against medical advice

3)

Always making assumptions

4)

Acute myeloid leukemia

____ 15. The triage nurse receives a call from a woman who is 32 weeks pregnant and reports feeling no fetal movements in the last hour. What should the nurse advise?

1)

See the doctor immediately for an ultrasound examination.

2)

Eat and rest, then do another kick count for 1 hour.

3)

Go to the emergency department immediately.

4)

Get some sleep and try again tomorrow.

____ 16. The nurse reviews a patient’s L/S ratio and sees the results are 4:1. How is this finding interpreted?

1)

Mature fetal lungs

2)

Immature fetal lungs

3)

Inconclusive

4)

Fetal demise

____ 17. Which statement by a laboring patient informs the nurse that the couple is using the Bradley method?

1)

“No matter how severe the pain becomes, I do not want to take anything to control it.”

2)

“I have learned all of the breathing exercises to help me control pain.”

3)

“I have been practicing my relaxation techniques to help me manage the pain.”

4)

“If the pain becomes more than I can handle, I will let you know and will request medication.”

____ 18. Which request does the nurse not expect to find in a birth plan?

1)

Preference to avoid induction

2)

Preference for an epidural to manage pain

3)

Preference to deliver in a birthing chair

4)

Preference for a specific drug for induction

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 19. The nurse is caring for a woman who had a pre-pregnancy BMI of 22.3 and has gained 53 lb. Which assessments are most important for this patient? (Select all that apply.)

1)

Serum glucose

2)

Blood pressure

3)

Urine glucose

4)

Premature rupture of membranes

5)

Fetal anomalies

____ 20. The nurse provides nutritional counseling for a pregnant woman diagnosed with anemia. The woman demonstrates understanding of the dietary changes needed when choosing to increase which foods in her diet? (Select all that apply.)

1)

Chicken

2)

Spinach

3)

Dried apricots

4)

Tofu

5)

Milk

Chapter 6: Nursing Care During Pregnancy

Answer Section

MULTIPLE CHOICE

1. ANS: 4

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Provide guidance to the pregnant patient on managing the common discomforts of pregnancy.

Chapter page reference: 65

Heading: Nasal Stuffiness, Discharge, and Obstruction

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Easy

Feedback

1

Increased fluid intake helps to promote drainage and reduce nasal stuffiness, so this intervention is not problematic.

2

Use of saline nose drops is healthy and is not problematic.

3

A humidifier in the home helps to reduce nasal stuffiness and is not problematic, but the nurse will want to instruct the patient on the importance of regular cleaning of the humidifier.

4

Decongestants are contraindicated in pregnancy because they constrict blood vessels, which can reduce oxygen supply to the fetus, and should be discouraged.

PTS: 1 CON: Pregnancy

2. ANS: 4

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Provide guidance to the pregnant patient on managing the common discomforts of pregnancy.

Chapter page reference: 65

Heading: Increased Leukorrhea

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

Wearing loose-fitting clothing and avoiding anything that is too tight is a good response to increased vaginal discharge and does not need to be corrected.

2

Wearing cotton underwear, which is more porous than nylon, is a good response to increased vaginal discharge and does not need to be corrected.

3

Use of panty liners or pads helps to absorb moisture and is a good response to increased vaginal discharge that does not need correction.

4

Although daily perineal hygiene is needed to prevent infection, douching is dangerous and can result in increased risk of infection; thus, this practice should be discouraged by the nurse.

PTS: 1 CON: Pregnancy

3. ANS: 3

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Promote safe and effective self-care practices during pregnancy.

Chapter page reference: 66

Heading: Personal Hygiene

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

This is a true statement that does not need to be corrected because it is safe to take a bath as long as the amniotic membranes are intact.

2

To reduce the risk of sliding in the tub and afterward, placement of antiskid devices is a good thing to teach this patient and does not need correcting.

3

Hot tubs and excessively hot showers should be avoided to prevent hyperthermia, which can cause neural tube defects, so this is an incorrect statement.

4

In the third trimester, patients should be encouraged to request help when getting out of the bathtub, so this is a correct statement.

PTS: 1 CON: Pregnancy

4. ANS: 2

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Promote safe and effective self-care practices during pregnancy.

Chapter page reference: 67

Heading: Exercise

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Easy

Feedback

1

If the woman was a runner before pregnancy, it is safe for her to continue through pregnancy.

2

Skiing, gymnastics, and other sports that include a risk of falling should be discouraged during pregnancy.

3

Swimming is a safe exercise during pregnancy.

4

Cycling is a safe exercise during pregnancy.

PTS: 1 CON: Pregnancy

5. ANS: 4

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Discuss the nutritional needs of the pregnant patient.

Chapter page reference: 71

Heading: Nutrition in Pregnancy

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Difficult

Feedback

1

Although bacon and eggs are high in protein, foods high in folate are most important for preventing neural tube defects; folate is not found in these foods.

2

Pancakes with syrup and sausage are not high in folate and will not contribute to healthy nutrition to prevent neural tube defects.

3

Although peanuts are high in folate, this is not the best breakfast among those suggested.

4

Cereal is high in folate as are peanuts in peanut butter, so this is the best choice for adequate folate intake to prevent neural tube defects and reflects that the patient understood what she was taught.

PTS: 1 CON: Pregnancy

6. ANS: 4

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Define pica and the dangers for the pregnant patient.

Chapter page reference: 71

Heading: Management of Pica

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

This is a leading question that encourages the woman to say “no.”

2

The nurse’s role is to remain nonjudgmental; using a term such as weird is judgmental and is not likely to elicit an honest response.

3

This question is too broad and is more likely to elicit a response regarding food cravings than what the nurse is trying to assess.

4

This statement is specific to pica, is nonjudgmental, and is open-ended to encourage the woman to share.

PTS: 1 CON: Pregnancy

7. ANS: 2

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Discuss the dangers and prevention of viral infections in pregnancy.

Chapter page reference: 69

Heading: Avoiding Viral Infection

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

Cytomegalovirus is not caused by contact with cats.

2

Toxoplasmosis can be spread through cat feces and is the appropriate teaching to include for this patient.

3

Rubella is not transmitted through contact with cats.

4

Parvovirus is spread through human contact, not from cats, so it is not the priority teaching for this woman.

PTS: 1 CON: Pregnancy

8. ANS: 3

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Discuss the dangers and prevention of viral infections in pregnancy.

Chapter page reference: 69

Heading: Herpes Simplex Virus

Integrated processes: Teaching and Learning

Client need: Reduction of Risk Potential

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Difficult

Feedback

1

There is no reason to suspect that this newborn will have an increased need for neonatal intensive care.

2

There is no reason to expect this neonate to be at higher risk for a congenital anomaly.

3

Most obstetricians will schedule a Cesarean birth if the woman has active herpes at the due date, so the woman should be prepared for this possibility.

4

There is no need to notify the public health department of the woman’s diagnosis of genital herpes.

PTS: 1 CON: Pregnancy

9. ANS: 4

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Identify risks for the pregnant patient over the age of 35.

Chapter page reference: 73

Heading: Risks for Pregnancy in Patients Older Than Age 35

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

Teaching about healthy nutrition is important for all age groups and is not more important for a woman over age 35.

2

Proper self-care should be taught to all age groups and does not take priority in a woman over age 35.

3

Regular prenatal care is an important component of teaching for all age groups, with no greater priority for women over age 35.

4

Chromosomal testing is of particular priority in women over age 35 because of an increased risk in this age group for chromosomal abnormalities.

PTS: 1 CON: Pregnancy

10. ANS: 4

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Teach the pregnant patient about the recommended weight gain in pregnancy.

Chapter page reference: 72

Heading: Recommended Weight Gain

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

A woman with a BMI of 16.5 should not be told to reduce calories.

2

A diet low in sodium is wise for all healthy diets, but a woman with a BMI of 16.5 should not be told to reduce calories.

3

There is no reason to recommend a high-protein, high-fat diet for this patient.

4

A woman with a BMI of 16.5 needs to gain weight and should be encouraged to eat more calories, and all pregnant women should be encouraged to get adequate calcium.

PTS: 1 CON: Pregnancy

11. ANS: 2

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Plan appropriate prenatal care for the pregnant adolescent.

Chapter page reference: 72

Heading: Care of the Pregnant Adolescent

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

It is important for this adolescent to remain hydrated, so this is dangerous advice.

2

Adolescents experience egocentric thinking, in which they consider their experiences unique; so encouraging this patient to attend a group class where discomforts of pregnancy can be shown as common should be the priority of care.

3

The adolescent is aiming for independence, so she should be made responsible for herself rather than using her parents whenever possible.

4

This does not address the issue of the patient thinking frequent urination is abnormal. Also, because the adolescent wants to fit in with peers, it is not a developmentally appropriate response.

PTS: 1 CON: Pregnancy

12. ANS: 2

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Plan appropriate prenatal care for the pregnant adolescent.

Chapter page reference: 72

Heading: Care of the Pregnant Adolescent

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Difficult

Feedback

1

Although this statement is technically true, it is not the best response to the patient’s question because it does not alleviate her fears or encourage alcohol avoidance.

2

This statement is true, encourages better performance throughout pregnancy, and also introduces the idea that all drugs should be avoided; thus, it is the best response to the patient’s question.

3

Although recent evidence shows this may be true, the nurse does not want to give the patient the impression that occasional alcohol intake is acceptable.

4

This statement will destroy the patient’s trust in the nurse and is not true because the nurse has no legal requirement to report this.

PTS: 1 CON: Pregnancy

13. ANS: 1

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Discuss the additional nutritional needs of the pregnant adolescent.

Chapter page reference: 72

Heading: The Nutritional Needs of the Pregnant Adolescent

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

Drinking diet soda should be discouraged because chemicals used for sweeteners can be hazardous to the fetus; this statement indicates the need for further teaching.

2

Increasing calcium intake is particularly important in the adolescent, whose bones are still growing, so this is an accurate statement.

3

This statement reflects healthy nutritional choices and should be encouraged.

4

Adolescents need more calcium than the average pregnant patient because their bones are still growing, so this is an accurate statement reflecting a healthy choice.

PTS: 1 CON: Pregnancy

14. ANS: 1

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Identify risks for the pregnant patient over the age of 35.

Chapter page reference: 73

Heading: Care of the Expectant Couple Older Than Age 35

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Comprehension [Understanding]

Concept: Pregnancy

Difficulty: Easy

Feedback

1

When a pregnant patient is classified as AMA, it means she has advanced medical age, generally indicating the woman is over the age of 35.

2

In this context, AMA does not mean “against medical advice.”

3

In this context, AMA does not mean “always making assumptions.”

4

In this context, AMA does not mean “acute myeloid leukemia.”

PTS: 1 CON: Pregnancy

15. ANS: 2

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Explain the tests used to monitor fetal well-being during the pregnancy.

Chapter page reference: 74

Heading: Fetal Kick Counts

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

Because lack of fetal movement has existed for only an hour, other steps should be taken first before seeing the physician, who may or may not order an ultrasound.

2

The fetus has periods of rest in utero, so the woman should be advised to eat and rest and then do another kick count for 1 hour.

3

Because fetal movements have been lacking for only an hour, it is not necessary for the woman to rush to the emergency department.

4

Lack of fetal movements can be a serious problem, so the woman should not wait until tomorrow to do another kick count.

PTS: 1 CON: Pregnancy

16. ANS: 1

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Explain the tests used to monitor fetal well-being during the pregnancy.

Chapter page reference: 75

Heading: Amniocentesis: Explanation

Integrated processes: Clinical Problem-Solving Process

Client need: Reduction of Risk Potential

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1

An L/S ratio greater than 2:1 indicates mature fetal lungs.

2

An L/S ratio less than 2:1 indicates immature fetal lungs, but that is not the case in this situation.

3

The L/S ratio is not inconclusive but points to specific findings.

4

There is no indication of fetal demise in this L/S ratio.

PTS: 1 CON: Pregnancy

17. ANS: 1

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Compare and contrast the Bradley method and Lamaze method of childbirth education.

Chapter page reference: 78-79

Heading: Lamaze and The Bradley Method

Integrated processes: Clinical Problem-Solving Process

Client need: Physiological Integrity

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Difficult

Feedback

1

The Bradley method discourages use of pain medications, so this statement differentiates it from Lamaze, which helps with pain control but does not promote medication-free labor.

2

The Bradley method does not emphasize breathing but focuses on relaxation, so this indicates the Lamaze method was studied.

3

Both Lamaze and Bradley methods teach relaxation techniques, so this does not emphasize the Bradley method exclusively.

4

Because the Bradley method discourages use of pain medication, this statement indicates another method is being used.

PTS: 1 CON: Pregnancy

18. ANS: 4

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Discuss the components of a birth plan.

Chapter page reference: 79

Heading: Birth Plan

Integrated processes: Communication and Documentation

Client need: Physiological Integrity

Cognitive level: Comprehension [Understanding]

Concept: Pregnancy

Difficulty: Easy

Feedback

1

Women often include their preference on induction in the birth plan.

2

Pain management is something that should be included in the birth plan before labor begins so decisions can be made logically.

3

How the woman wants to deliver, whether in a birthing chair, bed, or squatting, should be included in the birth plan.

4

The specific drug used for induction will be determined by the physician on the basis of the woman’s health history and condition and other factors and is not normally included in the birth plan.

PTS: 1 CON: Pregnancy

MULTIPLE RESPONSE

19. ANS: 1, 2, 3

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Teach the pregnant patient about the recommended weight gain in pregnancy.

Chapter page reference: 72

Heading: Recommended Weight Gain

Integrated processes: Clinical Problem-Solving Process

Client need: Health Promotion and Maintenance

Cognitive level: Application [Applying]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1.

This woman has gained almost double what she should for her BMI, causing increased risk of gestational diabetes; her serum glucose levels should be carefully followed.

2.

As a result of excessive weight gain, this woman is at increased risk for pregnancy-associated hypertension and should have her blood pressure carefully followed.

3.

Excessive weight gain puts this woman at increased risk of gestational diabetes; this will result in glucose spillage into the urine, which should be monitored.

4.

Excessive weight gain and obesity are not associated with premature rupture of the membranes.

5.

Excessive weight gain is not associated with fetal anomalies.

PTS: 1 CON: Pregnancy

20. ANS: 1, 2, 3

Chapter number and title: 6: Nursing Care During Pregnancy

Chapter learning objective: Discuss the nutritional needs of the pregnant patient.

Chapter page reference: 71

Heading: Nutrition in Pregnancy

Integrated processes: Teaching and Learning

Client need: Health Promotion and Maintenance

Cognitive level: Analysis [Analyzing]

Concept: Pregnancy

Difficulty: Moderate

Feedback

1.

Chicken is high in iron and is a good choice.

2.

Spinach is high in iron and is a good choice.

3.

Dried fruit, such as apricots, is a good choice.

4.

Tofu is high in protein, but it is not high in iron and is not a good choice.

5.

Milk is high in calcium and vitamin D but is not high in iron and is not a good choice.

PTS: 1 CON: Pregnancy