Pre-Test 1. The phrase gravida 4, para 2 indicated which of the following prenatal histories? a.

a client has been pregnant 4 times and had 2 miscarriages. b. a client has been pregnant 4 times and had 2 live born children c. a client has been pregnant 4 times and had 2 c-sections d. a client has been pregnant 4 times and 2 spontaneous abortions. *B. Gravida refers to the number of times a client has been pregnant. Para refers to the # of viable children born. Therefore, the client who's gravida 4, para2 has been pregnant 4x and had 2 live born children. 2. Yesha, a 21 y.o. client, 6 weeks pregnant, is diagnosed with hyperemesis gravidum. This excessive vomiting during pregnancy will often result in which of the following? a. bowel perforation b. electrolyte imbalance c. miscarriage d. PIH *B. Excessive vomiting in clients with hyperemesis grav often causes weight loss / fluid and electrolyte, acid base imbalance. PIH and bowel perforation arent r/t hyperemesis gravidarum. The effects of hyperemesis gravidarum on the fetus depend on the severity of the disorder. Clients w/ severe hyperemesis gravidarum may have low birth weight infant, but the disorder isnt life threatening to the fetus. 3. Clients with gestational diabetes are usually managed by which of the following therapies? a. diet b. long acting insulin c. oral hypoglycemic drugs d. oral hypoglycemic drugs/insulin *A. oral hypoglycemics are contraindicated in pregnancy. Long acting insulin usually inst needed for blood glucose control in the client with GDM. 4. Which of the following would the nurse identify as a presumptive sign of pregnancy? a. b. c. d. Hegar sign Nausea and vomiting Skin pigmentation changes Positive serum pregnancy test

*B. Presumptive signs of pregnancy are subjective signs. Of the signs listed, only nausea and vomiting are presumptive signs. Hegar sign, skin pigmentation changes, and a positive serum pregnancy test are considered probably signs, which are strongly suggestive of pregnancy.

5. Woman with a term, uncomplicated pregnancy comes into L&D in early labor saying that she thinks her water broke. Which action should the nurse take? a. prep the woman for delivery b. note color, amt and odor of fluid c. immediately contact doctor d. collect sample of fluid for microbial analysis *B. Noting color, amount and odor of the fluid as well as the time of the rupture, will help guide the nurse in her next action. There's no need to call the doctor immediately or prep the client for delivery if the fluid is clear and delivery isnt imminent.

6. Which of the following terms is used to describe the thinning and shortening of the cervix that occurs just before and during labor? a. Ballottement b. Dilation c. Effacement d. Muliparous *C. Effacement is cervical shortening and thinning while dilation is widening of the cervix both facilitate opening the cervix in prep for delivery. Ballottement is the ability of another individual to move the fetus by externally manipulating the maternal abdomen. A ballotable fetus hasn't yet engaged in the maternal pelvis. Multiparous refers to a woman who has had previous live births.

7. During which of the following would the focus of classes be mainly on physiologic changes, fetal development, sexuality, during pregnancy, and nutrition? a. b. c. d. Prepregnant period First trimester Second trimester Third trimester

*B. First-trimester classes commonly focus on such issues as early physiologic changes, fetal development, sexuality during pregnancy, and nutrition. Some early classes may include pregnant couples. Second and third trimester classes may focus on preparation for birth, parenting, and newborn care.

8.At what gestational age is a conceptus considered viable (able to live outside the womb)? a. 9 weeks b. 14 weeks c. 24 weeks d. 30 weeks

*C. The lungs are developed enough to sometimes maintain extrauterine life. The lungs are the most immature system during the gestational period. 9. Which sign would indicate the neonate was adapting appropriate to extrauterine life w/out difficulty? a. nasal flare b. light audible grunting c. resp rate 40-60 breaths/min d. resp rate 60-80 breaths/min *D. Respiratory rate of 40-60 breaths/min is normal for a neonate during the transitional period nasal flaring, resp rate > 60 and audible grunting = SIGNS OF RESP DISTRESS! 10. A neonate has been diagnosed with caput succedaneum. Which statement is true? a. usually resolves in 3-6 weeks b. collection of blood btw/ skill and periosteum c. doesnt cross the cranial suture line d. it involves swelling of the tissue over the presenting part of the head *D. it involves swelling of the tissue over the presenting part of the head due to sustained pressure this boggy edematous swelling is present at birth, CROSSES the suture line occurs in occipital area a cephalohematoma is a collection of blood btw/ the skill and periosteum that DOESNT cross the suture lines and resolves in 3-6 weeks caput seccedaneum resolves within 3-4 DAYS 11. FHR can be auscultated with a fetoscope as early as which of the following? a. b. c. d. 5 weeks gestation 10 weeks gestation 15 weeks gestation 20 weeks gestation

*D. The FHR can be auscultated with a fetoscope at about 20 weeks gestation. FHR usually is ausculatated at the midline suprapubic region with Doppler ultrasound transducer at 10 to 12 weeks gestation. FHR cannot be heard any earlier than 10 weeks gestation. 12. A 2 month pregnant woman asks about nausea and vomiting. What is an appropriate response? a. It is normal and caused by growth of the uterus b. It generally gets better at 3 months c. It's due to thyroid growth d. It requires testing for creatinine levels *B. Nausea and vomiting are common in the early stages of pregnancy but tend to subside or go away at 3 months.

13. When has a client entered the fourth stage of labor? a. When the baby is being expelled b. After the baby has been expelled c. When contractions first reach 60-90 seconds long d. Soon after the placenta is delivered *D. The fourth stage of labor is after the placenta is delivered. 14. What is the most accurate description of dystocia? a. A difficult labor/childbirth b. When the uterus ruptures c. An infection caused syndrome d. A common cause of eclampsia *A. Dystocia is a general term for a difficult or painful labor/childbirth. As such, answer A is the most accurate description. 15. During which of the following stages of labor would the nurse assess crowning? a. b. c. d. First stage Second stage Third stage Fourth stage

*B. Crowing, which occurs when the newborns head or presenting part appears at the vaginal opening, occurs during the second stage of labor. During the first stage of labor, cervical dilation and effacement occur. During the third stage of labor, the newborn and placenta are delivered. The fourth stage of labor lasts from 1 to 4 hours after birth, during which time the mother and newborn recover from the physical process of birth and the mothers organs undergo the initial readjustment to the nonpregnant state.