0B
1.A woman’s obstetric history indicates that she is pregnant for the fourth time and all of her children
from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at
34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity
and parity using the GTPAL system?
a. 3-1-1-1-3 c. 3-0-3-0-3
b. 4-1-2-0-4 d. 4-2-1-0-3
ANS: B
The correct calculation of this woman’s gravidity and parity is 4-1-2-0-4. The numbers reflect the
woman’s gravidity and parity information. Using the GPTAL system, her information is
calculated as:
G: The first number reflects the total number of times the woman has been pregnant; she is
pregnant for the fourth time.
T: This number indicates the number of pregnancies carried to term, not the number of deliveries
at term; only one of her pregnancies has resulted in a fetus at term.
P: This is the number of pregnancies that resulted in a preterm birth; the woman has had two
pregnancies in which she delivered preterm.
A: This number signifies whether the woman has had any abortions or miscarriages before the
period of viability; she has not.
L: This number signifies the number of children born that currently are living; the woman has
four children.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 169
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Health Promotion and Maintenance
2. A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and
symptoms of pregnancy likely will have:
a. Amenorrhea. c. Chadwick’s sign.
b. Positive pregnancy test. d. Hegar’s sign.
ANS: A
Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are felt by the
woman. A positive pregnancy test, the presence of Chadwick’s sign, and the presence of Hegar’s
sign all are probable signs of pregnancy.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 170
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
3. The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of
pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a
positive sign of pregnancy is:
a. A positive pregnancy test.
b. Fetal movement palpated by the nurse-midwife.
c. Braxton Hicks contractions.
d. Quickening.
ANS: B
, Positive signs of pregnancy are attributed to the presence of a fetus, such as hearing the fetal
heartbeat or palpating fetal movement. A positive pregnancy test and Braxton Hicks contractions
are probable signs of pregnancy. Quickening is a presumptive sign of pregnancy.
4.A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?
a. Not palpable above the symphysis at this time
b. Slightly above the symphysis pubis
c. At the level of the umbilicus
d. Slightly above the umbilicus
ANS: B
In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the
symphysis pubis sometime between the twelfth and fourteenth weeks of pregnancy. As the uterus
grows, it may be palpated above the symphysis pubis sometime between the twelfth and
fourteenth weeks of pregnancy. The uterus rises gradually to the level of the umbilicus at 22 to
24 weeks of gestation.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 171
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. During a client’s physical examination the nurse notes that the lower uterine segment is soft on
palpation. The nurse would document this finding as:
a. Hegar’s sign c. Chadwick’s sign
b. McDonald’s sign d. Goodell’s sign
ANS: A
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine
segment occur; this is called Hegar’s sign. McDonald’s sign indicates a fast food restaurant.
Chadwick’s sign is the blue-violet coloring of the cervix caused by increased vascularity; this
occurs around the fourth week of gestation. Softening of the cervical tip is called Goodell’s sign,
which may be observed around the sixth week of pregnancy.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 172
OBJ: Nursing Process: Assessment, Implementation
MSC: Client Needs: Health Promotion and Maintenance
6. Cardiovascular system changes occur during pregnancy. Which finding would be considered
normal for a woman in her second trimester?
a. Less audible heart sounds (S1, S2)
b. Increased pulse rate
c. Increased blood pressure
d. Decreased red blood cell (RBC) production
ANS: B
Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which
persists to term. Splitting of S1 and S2 is more audible. In the first trimester, blood pressure
usually remains the same as at the prepregnancy level, but it gradually decreases up to about 20
weeks of gestation. During the second trimester, both the systolic and the diastolic pressures
decrease by about 5 to 10 mm Hg. Production of RBCs accelerates during pregnancy.
, PTS: 1 DIF: Cognitive Level: Comprehension REF: 175
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
7.Numerous changes in the integumentary system occur during pregnancy. Which change persists after
birth?
a. Epulis c. Telangiectasia
b. Chloasma d. Striae gravidarum
ANS: D
Striae gravidarum, or stretch marks, reflect separation within the underlying connective tissue of
the skin. They usually fade after birth, although they never disappear completely. An epulis is a
red, raised nodule on the gums that bleeds easily. Chloasma, or mask of pregnancy, is a blotchy,
brown hyperpigmentation of the skin over the cheeks, nose, and forehead, especially in dark-
complexioned pregnant women. Chloasma usually fades after the birth. Telangiectasia, or
vascular spiders, are tiny, star-shaped or branchlike, slightly raised, pulsating end-arterioles
usually found on the neck, thorax, face, and arms. They occur as a result of elevated levels of
circulating estrogen. These usually disappear after birth.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 180
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
8. The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can
expect to experience what change?
a. Her center of gravity will shift backward.
b. She will have increased lordosis.
c. She will have increased abdominal muscle tone.
d. She will notice decreased mobility of her pelvic joints.
ANS: B
An increase in the normal lumbosacral curve (lordosis) develops, and a compensatory curvature
in the cervicodorsal region develops to help the woman maintain her balance. The center of
gravity shifts forward. She will have decreased muscle tone. She will notice increased mobility
of her pelvic joints.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 181
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
9. A 31-year-old woman believes that she may be pregnant. She took an OTC pregnancy test 1
week ago after missing her period; the test was positive. During her assessment interview, the
nurse inquires about the woman’s last menstrual period and asks whether she is taking any
medications. The woman states that she takes medicine for epilepsy. She has been under
considerable stress lately at work and has not been sleeping well. She also has a history of
irregular periods. Her physical examination does not indicate that she is pregnant. She has an
ultrasound scan, which reveals that she is not pregnant. What is the most likely cause of the
false-positive pregnancy test result?
a. She took the pregnancy test too early.
b. She takes anticonvulsants.
c. She has a fibroid tumor.
1.A woman’s obstetric history indicates that she is pregnant for the fourth time and all of her children
from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at
34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity
and parity using the GTPAL system?
a. 3-1-1-1-3 c. 3-0-3-0-3
b. 4-1-2-0-4 d. 4-2-1-0-3
ANS: B
The correct calculation of this woman’s gravidity and parity is 4-1-2-0-4. The numbers reflect the
woman’s gravidity and parity information. Using the GPTAL system, her information is
calculated as:
G: The first number reflects the total number of times the woman has been pregnant; she is
pregnant for the fourth time.
T: This number indicates the number of pregnancies carried to term, not the number of deliveries
at term; only one of her pregnancies has resulted in a fetus at term.
P: This is the number of pregnancies that resulted in a preterm birth; the woman has had two
pregnancies in which she delivered preterm.
A: This number signifies whether the woman has had any abortions or miscarriages before the
period of viability; she has not.
L: This number signifies the number of children born that currently are living; the woman has
four children.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 169
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Health Promotion and Maintenance
2. A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and
symptoms of pregnancy likely will have:
a. Amenorrhea. c. Chadwick’s sign.
b. Positive pregnancy test. d. Hegar’s sign.
ANS: A
Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are felt by the
woman. A positive pregnancy test, the presence of Chadwick’s sign, and the presence of Hegar’s
sign all are probable signs of pregnancy.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 170
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
3. The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of
pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a
positive sign of pregnancy is:
a. A positive pregnancy test.
b. Fetal movement palpated by the nurse-midwife.
c. Braxton Hicks contractions.
d. Quickening.
ANS: B
, Positive signs of pregnancy are attributed to the presence of a fetus, such as hearing the fetal
heartbeat or palpating fetal movement. A positive pregnancy test and Braxton Hicks contractions
are probable signs of pregnancy. Quickening is a presumptive sign of pregnancy.
4.A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?
a. Not palpable above the symphysis at this time
b. Slightly above the symphysis pubis
c. At the level of the umbilicus
d. Slightly above the umbilicus
ANS: B
In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the
symphysis pubis sometime between the twelfth and fourteenth weeks of pregnancy. As the uterus
grows, it may be palpated above the symphysis pubis sometime between the twelfth and
fourteenth weeks of pregnancy. The uterus rises gradually to the level of the umbilicus at 22 to
24 weeks of gestation.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 171
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. During a client’s physical examination the nurse notes that the lower uterine segment is soft on
palpation. The nurse would document this finding as:
a. Hegar’s sign c. Chadwick’s sign
b. McDonald’s sign d. Goodell’s sign
ANS: A
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine
segment occur; this is called Hegar’s sign. McDonald’s sign indicates a fast food restaurant.
Chadwick’s sign is the blue-violet coloring of the cervix caused by increased vascularity; this
occurs around the fourth week of gestation. Softening of the cervical tip is called Goodell’s sign,
which may be observed around the sixth week of pregnancy.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 172
OBJ: Nursing Process: Assessment, Implementation
MSC: Client Needs: Health Promotion and Maintenance
6. Cardiovascular system changes occur during pregnancy. Which finding would be considered
normal for a woman in her second trimester?
a. Less audible heart sounds (S1, S2)
b. Increased pulse rate
c. Increased blood pressure
d. Decreased red blood cell (RBC) production
ANS: B
Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which
persists to term. Splitting of S1 and S2 is more audible. In the first trimester, blood pressure
usually remains the same as at the prepregnancy level, but it gradually decreases up to about 20
weeks of gestation. During the second trimester, both the systolic and the diastolic pressures
decrease by about 5 to 10 mm Hg. Production of RBCs accelerates during pregnancy.
, PTS: 1 DIF: Cognitive Level: Comprehension REF: 175
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
7.Numerous changes in the integumentary system occur during pregnancy. Which change persists after
birth?
a. Epulis c. Telangiectasia
b. Chloasma d. Striae gravidarum
ANS: D
Striae gravidarum, or stretch marks, reflect separation within the underlying connective tissue of
the skin. They usually fade after birth, although they never disappear completely. An epulis is a
red, raised nodule on the gums that bleeds easily. Chloasma, or mask of pregnancy, is a blotchy,
brown hyperpigmentation of the skin over the cheeks, nose, and forehead, especially in dark-
complexioned pregnant women. Chloasma usually fades after the birth. Telangiectasia, or
vascular spiders, are tiny, star-shaped or branchlike, slightly raised, pulsating end-arterioles
usually found on the neck, thorax, face, and arms. They occur as a result of elevated levels of
circulating estrogen. These usually disappear after birth.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 180
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
8. The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can
expect to experience what change?
a. Her center of gravity will shift backward.
b. She will have increased lordosis.
c. She will have increased abdominal muscle tone.
d. She will notice decreased mobility of her pelvic joints.
ANS: B
An increase in the normal lumbosacral curve (lordosis) develops, and a compensatory curvature
in the cervicodorsal region develops to help the woman maintain her balance. The center of
gravity shifts forward. She will have decreased muscle tone. She will notice increased mobility
of her pelvic joints.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 181
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
9. A 31-year-old woman believes that she may be pregnant. She took an OTC pregnancy test 1
week ago after missing her period; the test was positive. During her assessment interview, the
nurse inquires about the woman’s last menstrual period and asks whether she is taking any
medications. The woman states that she takes medicine for epilepsy. She has been under
considerable stress lately at work and has not been sleeping well. She also has a history of
irregular periods. Her physical examination does not indicate that she is pregnant. She has an
ultrasound scan, which reveals that she is not pregnant. What is the most likely cause of the
false-positive pregnancy test result?
a. She took the pregnancy test too early.
b. She takes anticonvulsants.
c. She has a fibroid tumor.
