Chapter 12 NCLEX Questions Maternity-Newborn

Chapter 12 NCLEX Questions (Maternity-Newborn Nursing) Leave the first rating Students also studied Terms in this set (10) Science MedicineNursing Save Maternal/Newborn Test 2 NCLEX Q...87 terms anarae22Preview Maternity Nclex questions 68 terms crystalrose_rivera Preview Our NCLEX questions for Exam 2--O...29 terms julie_latulippe Preview Nursing 53 terms kyle A 25-year-old client at 18 weeks' gestation has returned to the clinic for her second prenatal visit. Her initial pulse was 60. The nurse can expect her pulse to be _______ bpm at term.

70-75.

Rationale: The pulse can increase by 10-15 bpm at term

A nurse is teaching a prenatal client about cardiovascular changes during pregnancy. The client asks the nurse why she becomes dizzy when getting out of a chair or out of bed. What rationale should the nurse provide as to the cause of this dizziness during pregnancy?

• Decreased absorption of hemoglobin in the blood.
• Increased production of fibrinogen and plasma.
• Decreased production of estrogen and progesterone.
• Increased blood volume in the lower extremities.

Increased blood volume in the lower extremities.

Rationale: Increased blood volume in the lower legs can make the pregnant

woman prone to postural hypotension. Hormones, fibrinogen, plasma production, and hemoglobin are not related to orthostatic hypotension.A nurse is assessing a prenatal client's cardiovascular function. When should the nurse expect this client's cardiac output (CO) to begin rising?

• 8-10 weeks.
• 12-18 weeks.
• 31-38 weeks.
• 20-24 weeks.

8-10 weeks.Rationale: Since cardiac output (CO) begins to rise early in pregnancy, 8-10 weeks is the best answer. 12-18, 20-24, and 31-38 weeks are too late.

A nurse is teaching a group of first-trimester prenatal clients about the discomforts of pregnancy. A client asks the nurse, "What causes my nausea and vomiting?" The nurse responds indicating which of the following as contributing factors to first-trimester emesis? Select all that apply.

• Alterations in carbohydrate metabolism.
• Elevated human chorionic gonadotropin.
• Prostaglandins.
• Alterations in taste and smell.
• Estrogen.

Elevated human chorionic gonadotropin.Alterations in carbohydrate metabolism.Alterations in taste and smell.

Rationale: Nausea and vomiting are common during the first trimester because of

elevated human chorionic gonadotropin levels and changed carbohydrate metabolism.Estrogen stimulates the growth of the uterus and breast tissue. Prostaglandins stimulate uterine contractions.A nurse is researching the topic of edema during pregnancy. Which physiologic mechanism contributes to fluid retention?

• Decreased nitrogen retention.
• Increased level of steroid sex hormones.
• Decreased intracapillary pressure and permeability.
• Increased serum protein.

Increased level of steroid sex hormones.Rationale: Increased water retention, a basic alteration of pregnancy, is caused by several interrelated factors. The increased level of steroid sex hormones affects sodium and fluid retention. The lowered serum protein also influences fluid balance, as do increased intracapillary pressure and permeability. Nitrogen retention does not influence fluid balance.A nurse practitioner is taking an initial history of a prenatal client. Which of the following, if detected by the nurse practitioner, would indicate a positive, or diagnostic, sign of pregnancy?

• Uterine enlargement and amenorrhea.
• Goodell's sign.
• Fetal heartbeat with a Doppler at 11 weeks' gestation.
• Positive pregnancy test.

Fetal heartbeat with a Doppler at 11 weeks' gestation.

Rationale: The positive signs of pregnancy are completely objective, cannot be

confused with a pathologic state, and offer conclusive proof of pregnancy. The fetal heartbeat can be detected with an electronic Doppler device as early as weeks' 10-12 of pregnancy. Pregnancy tests detect the presence of hCG in the maternal blood or urine. These are not considered a positive sign of pregnancy, because other conditions can cause elevated hCG levels. Physical changes, like Goodell's sign and uterine enlargement, also can have other causes and do not confirm pregnancy. The subjective changes of pregnancy, like amenorrhea, are the symptoms the woman experiences and reports. Because they can be caused by other conditions, they cannot be considered proof of pregnancy.The nurse in the prenatal clinic assesses a 26-year-old client at 13 weeks' gestation. Which presumptive (subjective) signs and symptoms of pregnancy should the nurse anticipate?

• Excessive fatigue and urinary frequency.
• Chadwick's sign and uterine souffle.
• Hegar's sign and quickening.
• Ballottement and positive pregnancy test

Excessive fatigue and urinary frequency.

Rationale: Excessive fatigue and urinary frequency both are presumptive

(subjective) signs and symptoms of pregnancy. Hegar's sign, ballottement, a positive pregnancy test, Chadwick's sign, and uterine souffle are probable (objective) signs or symptoms of pregnancy.

The nurse is researching the topic of uteroplacental blood flow. Which of the following accurately describes funic souffle?

• Increased blood pulsating through the placenta.
• Increased blood pulsating through the uterine arteries.
• A soft blowing sound of blood that is at the same rate

as the maternal pulse.

• A soft blowing sound of blood that is at the same rate

as the fetal heart rate.A soft blowing sound of blood that is at the same rate as the fetal heart rate.

Rationale: Uterine souffle can be heard when the examiner auscultates the

abdomen over the uterus. It is a soft, blowing sound that occurs at the same rate as the maternal pulse, and is caused by the increased uterine blood flow and blood pulsating through the placenta. It is sometimes confused with the funic souffle; a soft, blowing sound of blood pulsating through the umbilical cord. The funic souffle occurs at the same rate as the fetal heart rate.The nurse in the prenatal clinic is taking a history from a prenatal client at 7 weeks' gestation.The client states, "I don't know if I want this baby. How will I know if I'll be a good mother?" What is the most appropriate response by the nurse?

• "This is a sign of depression, and I'd like you to see a

mental health specialist."

• "Ambivalence can be a normal reaction to parenthood

in the first trimester."

• "This is an abnormal reaction, and I'd like you to speak

with Family Services."

• "This would be the best time to consider an abortion or

adoption." "Ambivalence can be a normal reaction to parenthood in the first trimester."

Rationale: Not knowing if she wants the baby and wondering if she'll be a good

mother are normal reactions to parenthood in the first trimester. Asking a newly pregnant woman to consider an abortion or adoption is a nontherapeutic response. The client did not introduce the topic of abortion or adoption. Not knowing if she wants the baby and wondering if she'll be a good mother are normal reactions to parenthood, not necessarily signs of depression, and do not warrant a referral.The nurse is teaching a parenting class to prospective fathers. The nurse correctly teaches

that couvade refers to the:

• Development of attachment and bonding behaviors in

the father of the baby.

• Development of the physical symptoms of pregnancy

in the father of the baby.

• Expectant father's transition from nonparent to parent.
• Expectant father's fear of hurting the unborn baby

during intercourse.Development of the physical symptoms of pregnancy in the father of the baby.

Rationale: Couvade is the unintentional development of the physical symptoms of

pregnancy in the father of the baby. The expectant father's fear of hurting the unborn baby during intercourse, transition from nonparent to parent, and development of attachment and bonding behaviors are third-trimester paternal concerns.