Chapter 14: Nursing Care of the Family During Pregnancy Lowdermilk: Maternity & Women’s Health Care, 11th Edition

TEST BANK FOR MATERNITY & WOMEN’S HEALTH CARE 11TH EDITION BY LOWDERMILK Chapter 14: Nursing Care of the Family During Pregnancy Lowdermilk: Maternity & Women’s Health Care, 11th Edition MULTIPLE CHOICE 1. Ideally, when should prenatal care begin? a. Before the first missed menstrual period b. After the first missed menstrual period c. After the second missed menstrual period d. After the third missed menstrual period CORRECT ANSWER: B Prenatal care should begin soon after the first missed menstrual period. This offers the greatest opportunities to ensure the health of the expectant mother and her infant. Prenatal care before missing the first menstrual period is too early. It is unlikely the woman is even aware of the pregnancy. Ideally, prenatal visits should begin soon after the first period is missed. Beginning prenatal care after the third missed menstrual period is too late. The woman will have completed the first trimester by that time. DIF: Cognitive Level: Remember REF: p. 301 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 2. A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2015. What is the client‘s expected date of birth (EDB)? a. September 17, 2015 b. November 7, 2015 c. November 21, 2015 d. December 17, 2015 CORRECT ANSWER: C Using the Nägele‘s rule, the EDB is calculated by subtracting 3 months from the month of the LMP and adding 7 days + 1 year to the day of the LMP. Therefore, with an LMP of February 14, 2015, her due date is November 21, 2015. September 17, 2015, is too short a period to complete a normal pregnancy. Using the Nägele‘s rule, an EDB of November 7, 2015, is 2 weeks early. December 17, 2015, is almost a month past the correct EDB. DIF: Cognitive Level: Apply REF: p. 302 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 3. Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)? a. All women, regardless of risk factors b. Women who have had more than one sexual partner c. Women who have had a sexually trCORRECT ANSWERmitted infection (STI) d. Woman who are monogamous with one partner CORRECT ANSWER: A An HIV test is recommended for all women, regardless of risk factors. The incidence of perinatal trCORRECT ANSWERmission from an HIV-positive mother to her fetus ranges from 25% to 35%.Women who test positive for HIV can then be treated. DIF: Cognitive Level: Understand REF: pp. 312, 313 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 4. Which sign or symptom is considered a first-trimester warning sign and should be immediately reported by the pregnant woman to her health care provider? a. Nausea with occasional vomiting b. Fatigue c. Urinary frequency d. Vaginal bleeding CORRECT ANSWER: D Signs and symptoms that must be reported include severe vomiting, fever and chills, burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms may be signs of complications of the pregnancy. Nausea with occasional vomiting is a normal first-trimester complaint. Although it may be worrisome or annoying to the mother, it is not usually an indication of a problem with the pregnancy. Fatigue is common during the first trimester. Because of physiologic changes that happen during pregnancy, clients should be taught that urinary frequency is normal. DIF: Cognitive Level: Understand REF: p. 314 TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity 5. Which client might be well advised to continue condom use during intercourse throughout her pregnancy? a. Unmarried pregnant women b. Women at risk for acquiring or trCORRECT ANSWERmitting STIs c. All pregnant women d. Women at risk for candidiasis CORRECT ANSWER: B The objective of safer sex is to provide prophylaxis against the acquisition and trCORRECT ANSWERmission ofSTIs. Because these diseases may be trCORRECT ANSWERmitted to the woman and then to her fetus, condom use is recommended throughout the pregnancy if the woman is at risk for acquiring an STI. Pregnant women are encouraged to practice safer sex behaviors. An unmarried pregnant woman may be in a monogamous relationship and not require the use of a condom. The client should be educated as to what may place both herself and her fetus at risk. Any pregnant woman can develop candidiasis, which is an infection not related to condom use. DIF: Cognitive Level: Apply REF: p. 330 TOP: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 6. Which condition is likely to be identified by the quadruple marker screen? a. Down syndrome b. Diaphragmatic hernia c. Congenital cardiac abnormality d. Anencephaly CORRECT ANSWER: A The maternal serum level marker of alpha-fetoprotein is used to screen for Down syndrome, trisomy 18, neural tube defects, and other chromosomal anomalies. The quadruple-marker screen will not detect diaphragmatic hernia. Additional testing, such as ultrasonography, is required to diagnose diaphragmatic hernia. Congenital cardiac abnormality will most likely be identified during an ultrasound examination. The quadruple-marker screen will not detect anencephaly. DIF: Cognitive Level: Knowledge REF: p. 316 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance