Chapter 10 Promoting a Healthy Pregnancy

Chapter 10  Promoting a Healthy Pregnancy

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The prenatal clinic nurse visits with a 32-year-old man. His partner is pregnant with her first child and is now at 12 weeks of gestation. The man states that he has been experiencing nausea and vomiting, fatigue, and weight gain. Which action by the nurse is most appropriate?
A.
Ask the woman’s health-care provider to prescribe the man anti-nausea medication.
B.
Assess for cancer risk factors, as weight gain and vomiting are unusual together.
C.
Encourage the man to make an appointment with his primary health-care provider.
D.
Explain that these symptoms are normal and often seen in men with pregnant partners.

ANS: D
Couvade syndrome is when a male partner experiences the same maternal signs and symptoms as the woman. The nurse should reassure the man that this is an often-occurring finding. The nurse would not need to encourage the man to make an appointment with his health-care provider unless the symptoms became severe. The woman’s primary health-care provider does not need to prescribe anti-emetics, nor does the nurse need to assess the man further for cancer risk factors.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Implementation
Difficulty: Easy

PTS: 1

2. After questioning a pregnant woman about her fluid intake, the nurse discovers that the patient is drinking four glasses of diet cola per day. Which response by the nurse is best?
A.
“As long as you get enough fluid, soda is all right to drink.”
B.
“Less than two cups of caffeine a day is probably OK.”
C.
“The major worry with soda is the sugar content.”
D.
“You really should switch to decaffeinated colas.”

ANS: B
The primary sources of caffeine for pregnant women are coffee, tea, and soda. Research shows that small amounts of caffeine (less than 2 cups a day) are probably safe; however, higher amounts cause central nervous system stimulation and can increase the chance of spontaneous abortions, stress the fetus’s metabolic system, and decrease blood flow to the placenta. Women should be encouraged to restrict their intake of caffeinated beverages and taught that even decaffeinated beverages still contain some caffeine.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Moderate

PTS: 1

3. A perinatal nurse is assessing a pregnant woman’s medications and finds that one of them is categorized as Category D. What information should the nurse provide this patient?
A.
“Studies have not found human fetal risk, although animal fetuses are harmed by it.”
B.
“There are no associated fetal risks with this drug and it is safe to take in pregnancy.”
C.
“There haven’t been any studies of this drug in human fetuses; I wouldn’t take it.”
D.
“We have to decide if the benefits of this drug outweigh the risk, as it can harm the fetus.”

ANS: D
There are five categories of drugs based on fetal risk: Category A: no associated fetal risk, safe to take during pregnancy; Category B: no associated fetal risk in animals, fetal risk in humans not identified; Category C: evidence of adverse effects in animal fetuses, fetal risk in humans not identified; Category D: evidence of adverse effects and fetal risk in humans, benefits and risks must be considered before prescribing; and Category X: evidence of fetal risk and congenital anomalies in humans, risks outweigh the benefits, should not be prescribed during pregnancy.

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Teaching/Learning
Difficulty: Moderate

PTS: 1

4. The nurse explains to the prenatal class attendees that at full term about 10 to 11% of the maternal weight gain is attributed to which of the following?
A.
Blood, uterine, and breast tissue
B.
Fetal tissue
C.
Maternal reserves
D.
Placental fluid

ANS: D
During early pregnancy, maternal weight gain is related to an increased blood volume, which is necessary to supply the enlarging uterus and to support fetal growth and development. As the pregnancy progresses, enlargement of the placenta and fetal body add to the woman’s increase in weight. By term, maternal extracellular fluid, blood, uterine tissue, and breast tissue comprise 35% of the gestational weight gain; the maternal reserves comprise 27%; fetal tissue comprises 27%; and placental fluid comprises 11% of the total maternal weight gain (Cunningham et al., 2010).

Cognitive Level: Comprehension/Understanding
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy

PTS: 1

5. The prenatal clinic nurse meets with a 30-year-old woman who is experiencing her first pregnancy. The patient’s quadruple-marker screen result is positive at 17 weeks of gestation. Which action by the nurse is most important?
A.
Call the social worker for a consultation.
B.
Document the findings in the woman’s chart.
C.
Facilitate a referral to a genetics counselor.
D.
Prepare the woman for intrauterine death.

ANS: C
Feedback: All women should be offered screening with maternal serum markers. The triple-marker screen and the quadruple-marker screen test for the presence of alpha-fetoprotein, estradiol, human chorionic gonadotropin, and other markers. These tests screen for potential neural tube defects, Down syndrome, and trisomy 18. If the screen is positive, the woman should be referred to a genetics specialist for counseling and further testing, such as chorionic villus sampling or amniocentesis, should be performed (ACOG, 2007). There is no indication that the woman needs a social work consult or that she will experience intrauterine death. Documentation should be complete, but is not the most important action for the nurse to take.

Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Nursing Process: Implementation
Difficulty: Difficult

PTS: 1