INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 31
Chapter 04: Prenatal Care and Adaptations to Pregnancy
MULTIPLE CHOICE
1. A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2-year-old
son and had one previous spontaneous abortion. How would the nurse document the patients obstetric history
using the TPALM system?
a. Gravida 2, para 20120
b. Gravida 3, para 10011
c. Gravida 3, para 10110
d. Gravida 2, para 11110
ANS: C
Refer to Box 4-1 in the textbook for the TPALM system of identifying gravida and para.
DIF: Cognitive Level: Application REF: Page 51
OBJ: 1 TOP: Definition of Terms
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
2. A woman calls her health care provider to schedule prenatal visits in an uncomplicated pregnancy. How
frequently will the nurse assist the patient to schedule these appointments?
a. Every 3 weeks until the 6th month, then every 2 weeks until delivery
b. Every 4 weeks until the 7th month, after which appointments will become more frequent
c. Monthly until the 8th month
d. Every 2 to 3 weeks for the entire pregnancy
ANS: B
Monthly visits are scheduled up to 28 weeks, and then visits increase to every 2 to 3 weeks through 36 weeks.
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From 36 weeks until delivery, visits are weekly.
DIF: Cognitive Level: Application REF: Page 49
TOP: Prenatal Visits KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
3. During the physical examination for the first prenatal visit, it is noted that Chadwicks sign is present. What
is Chadwicks sign?
a. Bluish or purplish discoloration of the vulva, vagina, and cervix
b. Presence of early fetal movements
c. Darkening of the areola and breast tenderness
d. Palpation of the fetal outline
ANS: A
Chadwicks sign is the purplish or bluish discoloration of the cervix and vagina.
DIF: Cognitive Level: Knowledge REF: Page 52
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. After the examination is completed, the patient asks the nurse why Chadwicks sign occurs during
pregnancy. What would the nurse explain as the cause of Chadwicks sign?
a. Enlargement of the uterus
b. Progesterone action on the breasts
c. Increasing activity of the fetus
d. Vascular congestion in the pelvic area
ANS: D
Chadwicks sign is caused by increased vascular congestion in the cervical and vaginal area.
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:47 GMT -05:00
https://www.coursehero.com/file/59641785/TB-Chapter-04-Prenatal-Care-and-Adaptations-to-Pregnancy1pdf/
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, INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 32
DIF: Cognitive Level: Comprehension REF: Page 52
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that
the woman understands the information?
a. Blood pressure goes up toward the end of pregnancy.
b. My breathing will get deeper and a little faster.
c. Ill notice a decreased pigmentation in my skin.
d. There will be a curvature in the upper spine area.
ANS: B
The pregnant woman breathes more deeply, and her respiratory rate may increase slightly.
DIF: Cognitive Level: Comprehension REF: Page 55
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. A woman reports that her last normal menstrual period began on August 5, 2013. What is this womans
expected delivery date using Ngeles rule?
a. April 30, 2014
b. May 5, 2014
c. May 12, 2014
d. May 26, 2014
ANS: C
To determine the expected date of delivery, count backward 3 months from the first day of the last menstrual
period, then add 7 days and change the year ifNURSINGTB.COM
necessary.
DIF: Cognitive Level: Analysis REF: Page 51
OBJ: 5 TOP: Determining Estimated Date of Delivery
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
7. During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler
device. How early might fetal heart tones be detected with an electronic Doppler device?
a. 4 weeks
b. 8 weeks
c. 10 weeks
d. 14 weeks
ANS: C
The fetal heartbeat can be detected as early as 10 weeks of pregnancy using a Doppler device.
DIF: Cognitive Level: Knowledge REF: Page 53
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
8. In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart
rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. What is the
nurses first action?
a. Ask if the patient has taken a sedative.
b. Notify the physician.
c. Turn the patient to her right side.
d. Record the rate as a normal finding.
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:47 GMT -05:00
https://www.coursehero.com/file/59641785/TB-Chapter-04-Prenatal-Care-and-Adaptations-to-Pregnancy1pdf/
NURSINGTB.COM
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 31
Chapter 04: Prenatal Care and Adaptations to Pregnancy
MULTIPLE CHOICE
1. A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a 2-year-old
son and had one previous spontaneous abortion. How would the nurse document the patients obstetric history
using the TPALM system?
a. Gravida 2, para 20120
b. Gravida 3, para 10011
c. Gravida 3, para 10110
d. Gravida 2, para 11110
ANS: C
Refer to Box 4-1 in the textbook for the TPALM system of identifying gravida and para.
DIF: Cognitive Level: Application REF: Page 51
OBJ: 1 TOP: Definition of Terms
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
2. A woman calls her health care provider to schedule prenatal visits in an uncomplicated pregnancy. How
frequently will the nurse assist the patient to schedule these appointments?
a. Every 3 weeks until the 6th month, then every 2 weeks until delivery
b. Every 4 weeks until the 7th month, after which appointments will become more frequent
c. Monthly until the 8th month
d. Every 2 to 3 weeks for the entire pregnancy
ANS: B
Monthly visits are scheduled up to 28 weeks, and then visits increase to every 2 to 3 weeks through 36 weeks.
NURSINGTB.COM
From 36 weeks until delivery, visits are weekly.
DIF: Cognitive Level: Application REF: Page 49
TOP: Prenatal Visits KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
3. During the physical examination for the first prenatal visit, it is noted that Chadwicks sign is present. What
is Chadwicks sign?
a. Bluish or purplish discoloration of the vulva, vagina, and cervix
b. Presence of early fetal movements
c. Darkening of the areola and breast tenderness
d. Palpation of the fetal outline
ANS: A
Chadwicks sign is the purplish or bluish discoloration of the cervix and vagina.
DIF: Cognitive Level: Knowledge REF: Page 52
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. After the examination is completed, the patient asks the nurse why Chadwicks sign occurs during
pregnancy. What would the nurse explain as the cause of Chadwicks sign?
a. Enlargement of the uterus
b. Progesterone action on the breasts
c. Increasing activity of the fetus
d. Vascular congestion in the pelvic area
ANS: D
Chadwicks sign is caused by increased vascular congestion in the cervical and vaginal area.
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:47 GMT -05:00
https://www.coursehero.com/file/59641785/TB-Chapter-04-Prenatal-Care-and-Adaptations-to-Pregnancy1pdf/
NURSINGTB.COM
, INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 32
DIF: Cognitive Level: Comprehension REF: Page 52
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. The nurse has explained physiological changes that occur during pregnancy. Which statement indicates that
the woman understands the information?
a. Blood pressure goes up toward the end of pregnancy.
b. My breathing will get deeper and a little faster.
c. Ill notice a decreased pigmentation in my skin.
d. There will be a curvature in the upper spine area.
ANS: B
The pregnant woman breathes more deeply, and her respiratory rate may increase slightly.
DIF: Cognitive Level: Comprehension REF: Page 55
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. A woman reports that her last normal menstrual period began on August 5, 2013. What is this womans
expected delivery date using Ngeles rule?
a. April 30, 2014
b. May 5, 2014
c. May 12, 2014
d. May 26, 2014
ANS: C
To determine the expected date of delivery, count backward 3 months from the first day of the last menstrual
period, then add 7 days and change the year ifNURSINGTB.COM
necessary.
DIF: Cognitive Level: Analysis REF: Page 51
OBJ: 5 TOP: Determining Estimated Date of Delivery
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
7. During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler
device. How early might fetal heart tones be detected with an electronic Doppler device?
a. 4 weeks
b. 8 weeks
c. 10 weeks
d. 14 weeks
ANS: C
The fetal heartbeat can be detected as early as 10 weeks of pregnancy using a Doppler device.
DIF: Cognitive Level: Knowledge REF: Page 53
TOP: Normal Physiological Changes in Pregnancy
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
8. In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart
rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. What is the
nurses first action?
a. Ask if the patient has taken a sedative.
b. Notify the physician.
c. Turn the patient to her right side.
d. Record the rate as a normal finding.
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:47 GMT -05:00
https://www.coursehero.com/file/59641785/TB-Chapter-04-Prenatal-Care-and-Adaptations-to-Pregnancy1pdf/
NURSINGTB.COM
