Contemporary Maternal Newborn Nursing 9th Edition Test Bank Full Download

Contemporary Maternal-Newborn Nursing 9th Edition Test Bank
Contemporary Maternal-Newborn Nursing 9th Edition

Test Bank
To download the complete and accurate content document, go to:

https://testbankbell.com/download/contemporary-maternal-newborn-nursing-9th-editio
n-test-bank/
Visit TestBankBell.com to get complete for all chapters

Contemporary Maternal-Newborn Nursing, 9e (Ladewig et al.)
Chapter 9 Antepartum Nursing Assessment
1) The pregnant client has completed the prenatal questionnaire and asks the nurse why this form
had to be completed. The best response by the nurse is:
1. "Some people have things that have happened in the past that could impact their current
pregnancy."
2. "The doctor wants all of the pregnant patients to complete the form so that our records are
complete."
3. "We occasionally identify a health problem that puts the current pregnancy at higher risk."
4. "This form is designed to predict who will develop problems with their pregnancy or
delivery."
Answer: 3
Explanation: 1. Although this is true, this statement is too vague to be the best response. It is
best to explain specifically that the impact on the current pregnancy might put the pregnancy at
higher risk.
2. The purpose of the form is to identify which patients have risk factors; the fact that records are
complete is less important than identifying at risk pregnancies.
3. This is the reason for risk assessment during pregnancy, whether it is a patient-completed
questionnaire or a nurse assessment form.
4. The form will identify those patients who have risk factors based on their medical history;
prediction implies seeing into the future without a basis for the concern.
Page Ref: 152-154
Cognitive Level: Understanding
Client Need&Sub: Health Promotion and Maintenance
Standards: QSEN Competencies: Quality Improvement | AACN Essential Competencies:
Essential IV: Information management and application of patient care technology | NLN
Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process:
Assessment/Health teaching and health promotion
Learning Outcome: LO 9.1-Summarize the essential components of a prenatal history.
MNL LO: Assess maternal data for potential risk factors.
1
Copyright © 2017 Pearson Education, Inc.
2) The pregnant client's prenatal record indicates that she is a gravida 4 para 2022. The nurse
understands that this indicates the client had four pregnancies and:
1. Has four living children.
2. Delivered two infants preterm.
3. Is pro-abortion.
4. Delivered two term infants.
Answer: 4
Explanation: 1. In the four-digit number, the fourth number indicates the number of living
children, which is 2.
2. In the four-digit number, the second digit indicates the number of preterm births, so the client
has had no preterm births.
3. In the four-digit number, the third digit indicates the number of abortions the client has
experienced. Because abortion may be spontaneous or therapeutic, this number does not does not
necessarily reflect a woman's stance on surgical abortion.
4. In the four-digit number, the first digit indicates the number of term infants born, which is
two.
Page Ref: 152
Cognitive Level: Analyzing
Standards: QSEN Competencies: Quality Improvement | AACN Essential Competencies:
Essential IV: Information management and application of patient care technology | NLN
Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process:
Learning Outcome: LO 9.2-Define common obstetric terminology found in the history of
maternity patients.
MNL LO: Explore the role of the nurse in maternity care delivery.
2
3) A multigravida gave birth to an 18-week fetus last week. She is in the clinic for follow-up and
notices that her chart states she has had one abortion. The client is upset over the use of this
word. How can the nurse best explain this terminology to the patient?
1. "Abortion is the medical term for all pregnancies that end before 28 weeks."
2. "Abortion is the word we use when someone has miscarried."
3. "Abortion is how we label pregnancies that end in the second trimester."
4. "Abortion is what we call all babies who are stillborn."
Answer: 1
Explanation: 1. Abortions are fetal losses prior to the onset of the third trimester and include
elective induced (medical or surgical) abortions, ectopic pregnancies, and spontaneous abortions
or miscarriages.
2. Abortions are fetal losses prior to the onset of the third trimester and include elective induced
(medical or surgical) abortions, ectopic pregnancies, and spontaneous abortions or miscarriages.
3. Abortions are fetal losses prior to the onset of the third trimester and include elective induced
(medical or surgical) abortions, ectopic pregnancies, and spontaneous abortions or miscarriages.
4. Third-trimester losses are considered fetal death in utero, and the term abortion is not used.
Page Ref: 152
Cognitive Level: Application
Standards: QSEN Competencies: Patient-centered care | AACN Essential Competencies:
Essential V: Healthcare policy, finance, and regulatory environments | NLN Competencies:
Human flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Quality of
practice
maternity patients.
3
4) Which of the following clients would be considered a multipara?
1. A client at 34 weeks' gestation who previously had one spontaneous abortion
2. A client at 13 weeks' gestation who previously delivered two term infants
3. A client at 28 weeks' gestation with no previous pregnancies
4. A client at 32 weeks' gestation who previously delivered one term infant
Answer: 2
Explanation: 1. A woman who has had no births at more than 20 weeks' gestation is considered
a nullipara.
2. A woman who has had two or more births at more than 20 weeks' gestation is considered a
multipara.
3. A woman who has had no births at more than 20 weeks' gestation is considered a nullipara.
4. A woman who has had one birth at more than 20 weeks' gestation, regardless of whether the
infant was born alive or dead, is considered a primipara.
Page Ref: 152
Essential II: Basic organizational and systems leadership for quality care and patient safety |
NLN Competencies: Human flourishing | Nursing/Integrated Concepts: Nursing Process:
maternity patients.
5) The patient has delivered her first child at 39 weeks. The nurse would explain this to the client
as what type of delivery?
1. Preterm
2. Post-term
3. Term
4. Near term
Answer: 3
Explanation: 1. Preterm deliveries are those that occur prior to 37 completed weeks' gestation.
2. Post-term applies to birth that occur after 42 weeks' gestation.
3. Term births are those that occur from between gestation weeks 38 and 42.
4. Near term is not terminology used to describe birth.
Page Ref: 152
Essential VII: Clinical prevention and population health | NLN Competencies: Human
flourishing | Nursing/Integrated Concepts: Nursing Process: Implementation/Health teaching and
health promotion
maternity patients.
4
6) The prenatal clinic nurse is designing a new prenatal intake information form for pregnant
patients. Which question is best to include on this form?
1. Where was the father of the baby born?
2. Do genetic diseases run in the family of the baby's father?
3. What is the name of the baby's father?
4. Are you married to the father of the baby?
Answer: 2
Explanation: 1. This is not important information for pregnancy.
2. This question has the highest priority because it gets at the physiologic issue of inheritable
genetic diseases that might directly impact the baby.
3. Although it is helpful for the nurse to know the name of the father's baby to include him in the
prenatal care, this is psychosocial information and much less important than possible genetic
diseases that the baby might have inherited.
4. Although the marital status of the client might have cultural significance, this is psychosocial
information and much less important than possible genetic diseases that the baby might have
inherited.
Page Ref: 153
Planning/Health teaching and health promotion
Learning Outcome: LO 9.8-Relate the components of the subsequent prenatal history and
assessment to the progress of pregnancy and the nursing care of the prenatal client.
MNL LO: Perform a comprehensive prenatal assessment.
5
7) The nurse is assessing a primiparous client. The client indicates that her religion is Judaism.
This information is important for the nurse to assess because:
1. Religious and cultural background can impact what a client eats during pregnancy.
2. It provides a baseline from which to ask questions about the client's religious and cultural
background.
3. Knowing what the client's beliefs and behaviors regarding pregnancy are is important.
4. Clients sometimes encounter problems in their pregnancies based on what religion they
practice.
Answer: 2
Explanation: 1. Although this is true, much more than diet is impacted by religious and cultural
background; values, beliefs, expectations for the birth, and acceptance or refusal of medical
treatment are also influenced by religious or cultural background.
2. This is the best explanation because not all people interpret or live out their religious or
cultural backgrounds the same way. It is imperative to avoid stereotyping clients. Thus, the nurse
should use the information on the client's background as an educated starting point from which to
base further questions about how this specific patient enacts her religious or cultural background.
3. Not all people interpret or live out their religious or cultural backgrounds the same way. It is
imperative to avoid stereotyping patients based on what their background is. The nurse must use
the information on the patient's background as an educated starting point from which to base
further questions about how this specific patient enacts her religious or cultural background.
4. How a patient enacts her religion occasionally will cause problems with pregnancy. But the
most important reason for asking a patient for her religious or cultural background is to have a
starting point from which to base further questions on the specifics of how this patient is
impacted by or enacts her cultural or religious background as a unique individual.
Page Ref: 153
NLN Competencies: Professional identity | Nursing/Integrated Concepts: Nursing Process:
Planning/Quality of practice
Learning Outcome: LO 9.3-Predict the normal physiologic changes a nurse would expect to find
when performing a physical assessment of a pregnant woman.
MNL LO: Recognize maternal cultural and spiritual factors that affect pregnancy.
6
8) The clinic nurse is assisting with an initial prenatal assessment. The following findings are
present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement
of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur
present. What is the best action for the nurse to take based on these findings?
1. Document the findings on the prenatal chart.
2. Have the physician see the patient today.
3. Instruct the patient to avoid direct sunlight.
4. Analyze previous thyroid hormone lab results.
Answer: 2
Explanation: 1. These abnormalities must be reported to the physician immediately.
2. Mottling of the skin is indicative of poor oxygenation and a circulation problem. Skin and nail
bed pallor can indicate either hypoxia or anemia. These abnormalities must be reported to the
physician immediately.
3. Spider nevi are common in pregnancy due to the increased vascular volume and high estrogen
levels. Nasal passages can be inflamed during pregnancy from edema, caused by increased
estrogen levels.
4. The thyroid gland increases in size during pregnancy due to hyperplasia.
Page Ref: 158-165
NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process:
7
9) A 25-year-old primigravida is 20 weeks' gestation. At the clinic, her nurse begins a prenatal
assessment and obtains the following vital signs. Which finding would require the nurse to
contact the physician?
1. Pulse 88/min
2. Respirations 30/min
3. Temperature 37.4°C (99.3°F)
4. Blood pressure 134/82
Answer: 2
Explanation: 1. A slight increase in pulse is an expected finding during pregnancy due to the
increased oxygen consumption to support fetal metabolism.
2. Tachypnea is not a normal finding and requires medical care.
3. Temperature is an expected finding during pregnancy due to the increased oxygen
consumption to support fetal metabolism.
4. The blood pressure is within normal limits.
Page Ref: 158
Essential VII: Clinical prevention and population health | NLN Competencies: Nursing
judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and
health promotion
MNL LO: Explain the expected maternal physiologic adaptations to pregnancy.
8
10) The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected
findings?
1. Primip at 12 weeks with fetal heart tones heard by Doppler fetoscope
2. Multip at 22 weeks who reports no fetal movement felt yet
3. Primip at 26 weeks with fundal height of 30 cm
4. Multip at 12 weeks reports bright red vaginal bleeding.
Answer: 1
Explanation: 1. This is an expected finding because fetal heart tones should be heard by 12
weeks using an ultrasonic Doppler fetoscope.
2. This is an abnormal finding. Fetal movement should be felt by 20 weeks.
3. This is an abnormal finding. Beginning in the second trimester, the fundal height should
correlate with weeks of gestation; thus, at 26 weeks' gestation, the fundal height should be about
26 cm.
4. This is an abnormal finding. Bright red bleeding during pregnancy is never expected.
Page Ref: 162
Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Human flourishing
| Nursing/Integrated Concepts: Nursing Process: Assessment/Health teaching and health
promotion
MNL LO: Explain the expected maternal physiologic adaptations to pregnancy.
9
11) The nurse receives a phone call from a client who thinks she is pregnant. The client reports
that she has regular menses that occur every 28 days and last 5 days. The first day of her last
menses was April 10. What is the client's estimated date of delivery (EDD)?
1. November 13
2. January 17
3. January 10
4. December 3
Answer: 2
Explanation: 1. Naegele's rule is to add 7 days to the last menstrual period and subtract 3
months. The LMP is April 10; therefore, January 17 is the EDD.
2. Naegele's rule is to add 7 days to the last menstrual period and subtract 3 months. The LMP is
April 10; therefore, January 17 is the EDD.
Page Ref: 165, 166
promotion
Learning Outcome: LO 9.4-Calculate the estimated date of birth using the common methods.
MNL LO: Relate various factors to their effect on pregnancy outcomes.
10
12) The nurse explains to a pregnant woman that her antepartum assessment will include
assessment of clinical pelvimetry. Which client response reflects understanding of the reason for
this test?
1. "It will help understand how big a baby I can have."
2. "It will be used to find out whether my baby has a chromosomal abnormality."
3. "It will help tell whether my pelvis is big enough to deliver my baby vaginally."
4. "It will be used to screen for gestational diabetes."
Answer: 3
Explanation: 1. Clinical pelvimetry is performed to estimate the adequacy of pelvic size for the
purpose of vaginal delivery; delivery of larger infants may be accommodated via Cesarean
section.
2. Clinical pelvimetry involves estimating the adequacy of pelvic size for facilitating vaginal
birth.
3. Clinical pelvimetry is performed to estimate the ease or difficulty associated with vaginal
delivery of an infant.
4. Screening for maternal gestational diabetes requires some form of glucose screening.
Page Ref: 167, 168
flourishing | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and
health promotion
Learning Outcome: LO 9.5-Describe the essential measurements that can be determined by
clinical pelvimetry.
11
13) The nurse is assisting a physician during a prenatal examination. The physician seeks to
estimate the adequacy of the client's pelvis for birth. The nurse understands that the physician
will need to perform which measurement vaginally?
1. True conjugate
2. Diagonal conjugate
3. Transverse outlet diameter
4. Obstetrical conjugate
Answer: 2
Explanation: 1. The true conjugate is a measurement of the pelvic inlet and cannot be directly
measured.
2. The diagonal conjugate is measured from the lower edge of the symphysis to the sacral
promontory.
3. The transverse outlet diameter is measured externally.
4. The obstetrical is a measurement of the pelvic inlet and cannot be directly measured.
Page Ref: 167, 168
| Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion
Learning Outcome: LO 9.5-Describe the essential measurements that can be determined by
clinical pelvimetry.
14) The nurse is working with a prenatal client. Which statement indicates that additional
teaching is necessary?
1. "I will have Rh testing, even though this is my first pregnancy."
2. My vagina will be cultured at 36 weeks for group B strep."
3. "Because I am married, I won't have the STI screening."
4. "My blood will be checked for hemoglobin level."
Answer: 3
Explanation: 1. This is a true statement. All clients are screened for blood type, Rh factor, and
Rh antibodies, regardless of how many previous pregnancies (if any) they have had.
2. This is a true statement. Women are tested for group B strep to prevent neonatal infection.
3. All women should be screened for syphilis, gonorrhea, and hepatitis B.
4. This is a true statement. All women will have their hemoglobin assessed.
Page Ref: 167
health promotion
Learning Outcome: LO 9.6-Summarize the major screening tests used during the prenatal period
in the assessment of the prenatal patient.
12
15) Which phone call should the prenatal clinic nurse return first?
1. Primipara at 32 weeks, reports headache and blurred vision
2. Multipara at 18 weeks, reports no fetal movement this pregnancy
3. Primipara at 16 weeks, reports increased urinary frequency
4. Multipara at 40 weeks, reports sudden gush of fluid and contractions
Answer: 1
Explanation: 1. Headache and blurred vision are signs of pre-eclampsia, which is potentially
life-threatening for both mother and fetus. This client has top priority.
2. Fetal movement should be felt by 19 to 20 weeks. Multiparas sometimes feel fetal movement
prior to 19 weeks, but the lack of fetal movement prior to 20 weeks is considered normal. This
client is a lower priority.
3. Increased urinary frequency is common during pregnancy as the increased size of the uterus
puts pressure on the urinary bladder. Urinary frequency is expected. If the client were reporting
dysuria or hematuria, a UTI would be suspected, but this client is only reporting increased
urinary frequency. This client is a lower priority.
4. A term client who is experiencing contractions and a sudden gush of fluid is in labor.
Although laboring clients should be in contact with their provider for advice on when to go to the
hospital, labor at term is an expected finding. This client is a lower priority.
Page Ref: 173
Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Nursing judgement
| Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: LO 9.7-Relate the danger signs of pregnancy to their possible causes.
13
16) The nurse is completing an assessment for a prenatal visit. Which statement indicates that
further teaching is necessary?
1. "Because I'm in my third trimester, I should return to the clinic in a month."
2. "Now that I've felt fetal movement, I should feel movement regularly."
3. "Before I take any over-the-counter medications, I should contact my doctor."
4. "Alcohol is possibly harmful to my baby, even at the end of my pregnancy."
Answer: 1
Explanation: 1. This statement is incorrect because prenatal visits during the third trimester are
every 2 weeks from 26 to 36 weeks, and every week from 36 weeks to delivery.
2. This is a true statement. Once fetal movement is perceived, it should be felt regularly. Initially,
this might not be every day, but in the third trimester, fetal movement should be noticeable
several times per day.
3. This is a true statement. Regardless of the gestational age, over-the-counter medications can
have deleterious effects on mom or baby; thus, it is important for a pregnant woman to consult
her provider prior to taking any over-the-counter medications throughout the pregnancy.
4. This is a true statement. Alcohol should be avoided throughout pregnancy and lactation.
Page Ref: 170
health promotion
Learning Outcome: LO 9.8-Relate the components of the subsequent prenatal history and
assessment to the progress of pregnancy and the nursing care of the prenatal client.
17) A client's first pregnancy ended in a spontaneous abortion at 15 weeks, subsequently she
became pregnant and delivered at 37+6 weeks' gestation. The client is now pregnant for the third
time. Using the traditional approach her obstetrical history would be recorded as ________.
Answer: gravida 3, para 1, ab 1
Explanation: This client has been pregnant 3 times, gravida 3. She now has 1 living child, para 1
and aborted 1 pregnancy, ab 1.
Page Ref: 152
maternity patients.
14
Contemporary Maternal-Newborn Nursing 9th Edition Test Bank
18) The clinic nurse is completing a prenatal history. The client reports that she has regular
menses that occur every 28 days and last 5 days. The first day of her last menses was June 20,
2016. What is the client's estimated due date (EDD)?
1. 3/20/17
2. 3/27/17
3. 3/25/17
4. 3/15/17
Answer: 2
Explanation: 1. June 20 minus 3 months = March 20 plus 7 days = March 27, adjust for the year
= March 27, 2017
2. June 20 minus 3 months = March 20 plus 7 days = March 27, adjust for the year = March 27,
2017
2017
2017
Page Ref: 165
promotion
Learning Outcome: LO 9.4-Calculate the estimated date of birth using the common methods.
MNL LO: Relate various factors to their effect on pregnancy outcomes.
15
Visit TestBankBell.com to get complete for all chapters

Contemporary Maternal Newborn Nursing 9th Edition Test Bank Full Download

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Contemporary Maternal Newborn Nursing 9th Edition Test Bank Full Download

Uploaded by

Copyright:

Available Formats

Contemporary Maternal-Newborn Nursing 9th Edition Test Bank

Contemporary Maternal-Newborn Nursing 9th Edition

To download the complete and accurate content document, go to:

Visit TestBankBell.com to get complete for all chapters

Visit TestBankBell.com to get complete for all chapters

You might also like