Maternal And Child Health Nursing NCLEX Quiz 7

1. A woman who is at 36 weeks of gestation is having a nonstress test. Which statement indicates her correct understanding of the test?

“I will need to have a full bladder for the test to be done accurately.”

“I should have my husband drive me home after the test because I may be nauseated.”

“This test will help to determine whether the baby has Down syndrome or a neural tube defect.”

The nonstress test is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring fetal heart rate in conjunction with fetal activity and movements.Option A: An ultrasound requires a full bladder.Option B: An amniocentesis is a test after which a pregnant woman should be driven home.Option C: A maternal serum alpha-fetoprotein test is used in conjunction with unconjugated estriol levels and human chorionic gonadotropin helps to detect Down syndrome.

Explanation

The nonstress test is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring fetal heart rate in conjunction with fetal activity and movements.Option A: An ultrasound requires a full bladder.Option B: An amniocentesis is a test after which a pregnant woman should be driven home.Option C: A maternal serum alpha-fetoprotein test is used in conjunction with unconjugated estriol levels and human chorionic gonadotropin helps to detect Down syndrome.

2. While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically:

Express a strong need to review the events and her behavior during the process of labor and birth.

Exhibit a reduced attention span. limiting readiness to learn.

Have reestablished her role as a spouse or partner.

One week after birth the woman should exhibit behaviors characteristic of the dependent-independent or taking-hold stage. She still has needs for nurturing and acceptance by others.Options A and B: Wanting to discuss the events of her labor and delivery are characteristics of the taking-in stage. as are a limited readiness to learn and reduced attention span; this stage lasts from the first 24 hours until 2 days after delivery.Option D: Having reestablished her role as a spouse reflects the letting-go stage. which indicates that psychosocial recovery is complete.

Explanation

One week after birth the woman should exhibit behaviors characteristic of the dependent-independent or taking-hold stage. She still has needs for nurturing and acceptance by others.Options A and B: Wanting to discuss the events of her labor and delivery are characteristics of the taking-in stage. as are a limited readiness to learn and reduced attention span; this stage lasts from the first 24 hours until 2 days after delivery.Option D: Having reestablished her role as a spouse reflects the letting-go stage. which indicates that psychosocial recovery is complete.

3. In the past, factors to determine whether a woman was likely to have a high-risk pregnancy were evaluated primarily from a medical point of view. A broader, more comprehensive approach to high-risk pregnancy has been adopted. There are now four categories based on threats to the health of the woman and the outcome of pregnancy. Which of the options listed here is not included as a category?

Biophysical

Psychosocial

Geographic

Environmental

The fourth category is correctly referred to as the sociodemographic risk category.

Explanation

The fourth category is correctly referred to as the sociodemographic risk category.

4. Which of the following is the most common kind of placental adherence seen in pregnant women?

Accreta

Placenta previa

Percreta

Increta

Placenta accreta is the most common kind of placental adherence seen in pregnant women and is characterized by slight penetration of myometrium.Option B: In placenta previa. the placenta does not embed correctly and results in what is known as a low-lying placenta. It can be marginal. partial. or complete in how it covers the cervical os. and it increases the patient’s risk for painless vaginal bleeding during the pregnancy and/or delivery process.Option C: Placenta percreta leads to perforation of the uterus and is the most serious and invasive of all types of accrete.Option D: Placenta increta leads to deep penetration of the myometrium.

Explanation

Placenta accreta is the most common kind of placental adherence seen in pregnant women and is characterized by slight penetration of myometrium.Option B: In placenta previa. the placenta does not embed correctly and results in what is known as a low-lying placenta. It can be marginal. partial. or complete in how it covers the cervical os. and it increases the patient’s risk for painless vaginal bleeding during the pregnancy and/or delivery process.Option C: Placenta percreta leads to perforation of the uterus and is the most serious and invasive of all types of accrete.Option D: Placenta increta leads to deep penetration of the myometrium.

5. A nurse providing care for the antepartum woman should understand that the contraction stress test (CST):

Sometimes uses vibroacoustic stimulation.

Is an invasive test; however. contractions are stimulated.

Is considered to have a negative result if no late decelerations are observed with the contractions.

Is more effective than nonstress test (NST) if the membranes have already been ruptured.

No late decelerations indicate a positive CST result.Option A: Vibroacoustic stimulation is sometimes used with NST.Option B: CST is invasive if stimulation is performed by IV oxytocin but not if by nipple stimulation.Option D: CST is contraindicated if the membranes have ruptured.

Explanation

No late decelerations indicate a positive CST result.Option A: Vibroacoustic stimulation is sometimes used with NST.Option B: CST is invasive if stimulation is performed by IV oxytocin but not if by nipple stimulation.Option D: CST is contraindicated if the membranes have ruptured.

6. A 40-year-old woman with a high body mass index (BMI) is 10 weeks pregnant. Which diagnostic tool is appropriate to suggest to her at this time?

Biophysical profile

Amniocentesis

Maternal serum alpha-fetoprotein (MSAFP)

Transvaginal ultrasound

An ultrasound is the method of biophysical assessment of the infant that is performed at this gestational age. Transvaginal ultrasound is especially useful for obese women. whose thick abdominal layers cannot be penetrated adequately with the abdominal approach.Option A: A biophysical profile is a method of biophysical assessment of fetal well-being in the third trimester.Option B: An amniocentesis is performed after the fourteenth week of pregnancy.Option C: A MSAFP test is performed from week 15 to week 22 of the gestation (weeks 16 to 18 are ideal).

Explanation

An ultrasound is the method of biophysical assessment of the infant that is performed at this gestational age. Transvaginal ultrasound is especially useful for obese women. whose thick abdominal layers cannot be penetrated adequately with the abdominal approach.Option A: A biophysical profile is a method of biophysical assessment of fetal well-being in the third trimester.Option B: An amniocentesis is performed after the fourteenth week of pregnancy.Option C: A MSAFP test is performed from week 15 to week 22 of the gestation (weeks 16 to 18 are ideal).

7. The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool useful in confirming the diagnosis?

Doppler blood flow analysis

Contraction stress test (CST)

Amniocentesis

Daily fetal movement counts

Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and the placenta. It is a helpful tool in the management of high-risk pregnancy due to intrauterine growth restriction (IUGR). diabetes mellitus. multiple fetuses. or preterm labor.Option B: Because of the potential risk of inducing labor and causing fetal distress. a CST is not performed on a woman whose fetus is preterm.Option C: Indications for an amniocentesis include diagnosis of genetic disorders or congenital anomalies. assessment of the pulmonary maturity. and the diagnosis of fetal hemolytic disease. not IUGR.Option D: Fetal kick count monitoring is performed to monitor the fetus in pregnancies complicated by conditions that may affect fetal oxygenation. Although it may be a useful tool at some point later in this woman’s pregnancy. it is not used to diagnose IUGR.

Explanation

Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and the placenta. It is a helpful tool in the management of high-risk pregnancy due to intrauterine growth restriction (IUGR). diabetes mellitus. multiple fetuses. or preterm labor.Option B: Because of the potential risk of inducing labor and causing fetal distress. a CST is not performed on a woman whose fetus is preterm.Option C: Indications for an amniocentesis include diagnosis of genetic disorders or congenital anomalies. assessment of the pulmonary maturity. and the diagnosis of fetal hemolytic disease. not IUGR.Option D: Fetal kick count monitoring is performed to monitor the fetus in pregnancies complicated by conditions that may affect fetal oxygenation. Although it may be a useful tool at some point later in this woman’s pregnancy. it is not used to diagnose IUGR.

8. What is an appropriate indicator for performing a contraction stress test?

Increased fetal movement and small for gestational age

Maternal diabetes mellitus and postmaturity

Adolescent pregnancy and poor prenatal care

History of preterm labor and intrauterine growth restriction

Option A: Decreased fetal movement is an indicator for performing a contraction stress test; the size (small for gestational age) is not an indicator.Option C: Although adolescent pregnancy and poor prenatal care are risk factors for poor fetal outcomes. they are not indicators for performing a contraction stress test.Option D: Intrauterine growth restriction is an indicator; history of a previous stillbirth. not preterm labor. is another indicator.

Explanation

Option A: Decreased fetal movement is an indicator for performing a contraction stress test; the size (small for gestational age) is not an indicator.Option C: Although adolescent pregnancy and poor prenatal care are risk factors for poor fetal outcomes. they are not indicators for performing a contraction stress test.Option D: Intrauterine growth restriction is an indicator; history of a previous stillbirth. not preterm labor. is another indicator.

9. Which behaviors would be exhibited during the letting-go phase of maternal role adaptation. Select all that apply.

Emergence of family unit

Dependent behaviors

Sexual intimacy relationship continuing

Defining one’s individual roles

Being talkative and excited about becoming a mother

The emergence of family unit. sexual intimacy relationship continuing and defining one’s individual roles represent interdependent behaviors associated with the letting-go phase.Option B: Dependent behaviors are exhibited in the taking-in phase.Option E: Being talkative and excited about becoming a mother represents the taking-hold phase and is an example of dependent-independent behaviors.

Explanation

The emergence of family unit. sexual intimacy relationship continuing and defining one’s individual roles represent interdependent behaviors associated with the letting-go phase.Option B: Dependent behaviors are exhibited in the taking-in phase.Option E: Being talkative and excited about becoming a mother represents the taking-hold phase and is an example of dependent-independent behaviors.

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10. A nurse is providing instruction for an obstetrical patient to perform a daily fetal movement count (DFMC). Which instructions could be included in the plan of care? Select all that apply.Which one do you like?

The fetal alarm signal is reached when there are no fetal movements noted for 5 hours.

The patient can monitor fetal activity once daily for a 60-minute period and note activity.

Count all fetal movements in a 12-hour period daily until 10 fetal movements are noted.

The fetal alarm signal is reached when no fetal movements are noted for a period of 12 hours.

Explanation

The fetal alarm signal is reached when no fetal movements are noted for a period of 12 hours.

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