Chapter 9 The Prenatal Assessment

Chapter 9  The Prenatal Assessment

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse places his or her hands on the maternal abdomen to gently palpate the fundal region of the uterus. This action is described as which Leopold maneuver?
A.
First maneuver
B.
Second maneuver
C.
Third maneuver
D.
Fourth maneuver

ANS: A
Leopold maneuvers are a four-part clinical assessment method to determine the lie, presentation, and position of the fetus. The first maneuver determines which fetal body part (e.g., head or buttocks) occupies the uterine fundus. The examiner faces the patient’s head and places the hands on the abdomen, using the palmar surface of the hands to gently palpate the fundal region of the uterus.

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

PTS: 1

2. The nurse includes screening for intimate partner violence in the first prenatal visit for all patients. Which of the following is an appropriate question for the nurse to ask?
A.
“I need to ask you, do you feel safe from abuse right now?”
B.
“Is your partner threatening or harming you in any way right now?”
C.
“This is something we ask everyone: Do you have any abuse in your life right now?”
D.
“We ask everyone this: Do you feel safe in your living environment and relationships?”

ANS: D
Intimate partner violence is a difficult subject to discuss and the nurse may fear insulting or psychologically hurting the patient more. A nonthreatening approach is to ask patients directly whether they feel safe going home and whether they have been hurt physically, emotionally, or sexually by a past or present partner.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Psychosocial Integrity
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate

PTS: 1

3. The clinic nurse talks with a patient about her possible pregnancy. The patient has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. She is convinced she is pregnant and is reluctant to pay for a pregnancy test. Which action by the nurse is best?
A.
Agree that these signs usually signal pregnancy so no test is needed.
B.
Delete the order for the pregnancy test and inform the provider.
C.
Explain that these symptoms can be caused by other conditions.
D.
Inform the woman that this is standard procedure and must be done.

ANS: C
Presumptive signs of pregnancy are those subjectively reported symptoms that could be caused by another condition and include amenorrhea, nausea and vomiting, frequent urination, breast tenderness, perception of fetal movement, skin changes, and fatigue. The nurse should explain this and encourage the woman to have the pregnancy test. Simply telling the woman this is standard procedure does not educate her to make an informed decision.

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

PTS: 1

4. A woman in the prenatal clinical is concerned because her partner, who was supportive and excited about becoming pregnant, has suddenly become more withdrawn and seems ambivalent toward the pregnancy. What response by the nurse is best?
A.
“Are you in a relationship that causes you to be afraid?”
B.
“Oh don’t worry; they all feel this way sometimes.”
C.
“This is a normal reaction to the reality of the pregnancy.”
D.
“Your partner will come around to being excited soon.”

ANS: C
Despite planning a pregnancy, many women (and their partners) become ambivalent when faced with a positive pregnancy result. The reality of the many changes soon to come often causes them to reconsider their desire to become pregnant. There is also an aspect of self-preservation involved; many women still die from complications associated with pregnancy. The best response by the nurse is to help the woman recognize that this is a normal response. There is no need to ask the woman about intimate partner violence at this point. The other two options are dismissive and do not serve to educate the woman.

Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Difficulty: Moderate

PTS: 1

5. A nurse is working with a pregnant woman who has the nursing diagnosis of altered family processes. What statement by the patient indicates that a major goal for this diagnosis has been met?
A.
“At least I’m getting better sleep now that I don’t urinate every 2 hours.”
B.
“My husband has been doing more around the house so I can rest more.”
C.
“The kids are really excited about getting a new baby brother or sister.”
D.
“We finally have the nursery painted and furnished so it’s ready for baby.”

ANS: B
A major goal for this diagnosis is that the family recognizes the demands the pregnancy places on the woman and alters routines and activities to accommodate her. When the patient states that her husband is doing more around the house so she can rest more (a need in pregnancy), this shows resolution of the goal. The other statements are positive ones, but do not show family members adapting to new roles and responsibilities.

Cognitive Level: Evaluation/Evaluating
Content Area: Pediatrics/Maternity
Patient Needs: Psychosocial Integrity
Integrated Process: Nursing Process: Evaluation
Difficulty: Moderate

PTS: 1