- The middle school nurse is reviewing the phases of the endometrial cycle with a group of female students. Which statement by a student will the nurse need to correct?
a. “The proliferative phase occurs when the ovum is maturing.”
b. “The expulsion phase occurs when the ovum is discharged from the ovary.”
c. “The secretory phase occurs during the second half of the menstrual cycle.”
d. “The menstrual phase occurs after the levels of estrogen and progesterone fall.”
ANS: B
The menstrual cycle has only three phases: proliferative, secretory, and menstrual. Occurrences of each of the three phases have been described. There is no expulsion phase in the menstrual cycle.
A nurse is conducting prenatal education classes for a group of expectant parents. Which information should the nurse include in her discussion of the purpose of amniotic fluid? (Select all that apply.)
a. Cushions the fetus
b. Protects the skin of the fetus
c. Provides nourishment for the fetus
d. Allows for buoyancy for fetal movement
e. Maintains a stable temperature for the fetus
ANS: A, D, E
The amniotic fluid provides cushioning for the fetus against impacts to the maternal abdomen. It provides a stable temperature and allows room and buoyancy for fetal movement. Vernix caseosa, the cheeselike coating on the fetus, provides skin protection. The placenta provides nourishment for the fetus.
- The patient has just learned that she is pregnant and overhears the gynecologist saying that she has a positive Chadwick’s sign. When the patient asks the nurse what this means, how would the nurse respond?
a. “Chadwick’s sign signifies an increased risk of blood clots in pregnant women
because of a congestion of blood.”
b. “That sign means the cervix has softened as the result of tissue changes that
naturally occur with pregnancy.”
c. “This means that a mucus plug has formed in the cervical canal to help protect you
from uterine infection.”
d. “This sign occurs normally in pregnancy, when estrogen causes increased blood
flow in the area of the cervix.”
ANS: D
Increasing levels of estrogen cause hyperemia (congestion with blood) of the cervix, resulting in the characteristic bluish purple color that extends to include the vagina and labia. This discoloration, referred to as Chadwick’s sign, is one of the earliest signs of pregnancy. Although Chadwick’s sign occurs with hyperemia (congestion with blood), the sign does not signify an increased risk of blood clots. The softening of the cervix is called Goodell’s sign, not Chadwick’s sign. Although the formation of a mucus plug protects from infection, it is not called Chadwick’s sign.
- Which physiologic adaptation of pregnancy may lead to increased constipation during the pregnancy?
a. Increased emptying time in the intestines
b. Abdominal distention and bloating
c. Decreased absorption of water
d. Decreased motility in the intestines
ANS: D
Decreased motility in the intestines leading to increased water absorption would cause constipation. Increased emptying time in the intestines leads to increased nutrient absorption. Abdominal distention and bloating are a result of increased emptying time in the intestines. Decreased absorption of water would not cause constipation.
- Which findings are presumptive signs of pregnancy? (Select all that apply.)
a. Quickening
b. Amenorrhea
c. Ballottement
d. Goodell’s sign
e. Chadwick’s sign
ANS: A, B, E
Quickening, amenorrhea, andNChRadwIickG’s sBig.n Care Mpresumptive signs of pregnancy.
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Ballottement and Goodell’s sign are probable signs of pregnancy.
Which is the method of childbirth that helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor?
a. Bradley
b. Lamaze
c. Leboyer
d. Dick-Read
ANS: D
The Dick-Read method helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor. The Lamaze method involves concentration and conditioning to help the woman respond to contractions with relaxation to decrease pain. Viewing childbirth as a traumatic experience, the Leboyer method uses decreased light and noise to help the newborn adapt to extrauterine life more easily. The Bradley method teaches women to use abdominal muscles to increase relaxation and breath control; it emphasizes avoidance of all medications and interventions.
- The labor nurse is reviewing breathing techniques with a primiparous patient admitted for induction of labor. When is the best time to encourage the laboring patient to use slow, deep chest breathing with contractions?
a. During labor, when she can no longer talk through contractions
b. During the first stage of labor, when the contractions are 3 to 4 minutes apart
c. Between contractions, during the transitional phase of the first stage of labor
d. Between her efforts to push to facilitate relaxation between contractions
ANS: A NURSINGTB.COM
Focused breathing techniques should not be used in labor until they are actually needed, which is usually when the woman can no longer walk and talk during a contraction. If breathing techniques are used too early, the woman tends to move through the different techniques too quickly, and she may stop using them. In addition, the use of the more complex breathing patterns in latent labor may increase fatigue. Women should be encouraged to adapt the techniques to their own comfort and needs. Breathing deeply between contractions or pushing can increase the possibility of carbon dioxide retention and make the patient dizzy
- A pregnant patient has lactose intolerance. Which recommendation will the nurse provide to best help the patient meet dietary needs for calcium?
a. Add foods such as nuts, dried fruit, and broccoli to the diet.
b. Consume dairy products but take an over-the-counter anti-gas product.
c. Increase the intake of dark leafy vegetables, such as spinach and chard.
d. Use powdered milk instead of liquid forms of milk.
ANS: A
Calcium is present in legumes, nuts, dried fruits, and broccoli, so these foods can be added to increase calcium intake. Although dark leafy vegetables contain calcium, they also contain oxalates that decrease the availability of calcium. Powdered milk contains lactase, similar to the nondehydrated varieties. Milk products should be avoided by patients with lactose intolerance. Adequate calcium may be obtained from food and supplements. Some patients may be able to tolerate lactose free dairy products.
When is the earliest interval that chorionic villus sampling (CVS) can be performed during pregnancy?
a. 4 weeks
b. 8 weeks
c. 10 weeks
d. 14 weeks
ANS: C
CVS is normally performed between 10 and 13 weeks gestation. The fetal villus tissue can be analyzed directly for chromosomal, metabolic, or DNA abnormalities. It is too early to perform CVS at 4 or 8 weeks of pregnancy. The test can no longer be performed a 14 weeks gestation. Results are available within 24 to 48 hours.
- The results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result?
a. Repeat the test in 1 week so that results can be trended based on this baseline
result.
b. Contact the health care provider to discuss birth options for the patient.
c. Send the patient out for a meal and repeat the test to confirm that the results are
valid.
d. Ask the patient to perform a fetal kick count assessment for the next 30 minutes
and then reassess the patient
ANS: B
A positive CST test is an abnormal finding, and the provider should be notified so that birth options can be initiated. A positive CST indicates possible fetal compromise.
