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Reproductive Nursing

Total questions: 50

Worksheet time: 2hrs 49mins

Name
Class
Date
1.

The nurse is speaking with a couple trying to conceive a child. What will the nurse remind the couple is a factor that can decrease sperm production?

a)

Infrequent sexual intercourse

b)

The man not being circumcised

c)

The penis and testes being small

d)

The testes being too warm

2.

When describing the female reproductive tract to a pregnant woman, the nurse would explain that which uterine layer is involved in implantation?

a)

Perimetrium

b)

Endometrium

c)

Myometrium

d)

Internal os

3.

A nurse is planning to teach couples about the physiology of the sex act. What correct information will the nurse provide?

a)

“Fertilization of an ovum requires penetration by several sperm.”

b)

“An ovum must be fertilized within 24 hours of ovulation.”

c)

It takes 4 to 5 days for sperm to reach the fallopian tubes.”

d)

“Sperm live for only 24 hours following ejaculation.”

4.

What are considered to be functions of the fallopian tubes? (Select all that apply.)

a)

Passage for sperm to meet ova

b)

Passage for ovum to uterus

c)

Safe environment for zygote

d)

Restriction for only one ovum to enter uterus

e)

Site for fertilization

5.

What is the most common site for fertilization? (Not the bedroom...)

a)

Lower segment of the uterus

b)

Outer third of the fallopian tube near the ovary

c)

Upper portion of the uterus

d)

Area of the fallopian tube farthest from the ovary

6.

The nurse is reviewing fetal circulation with a pregnant patient and explains that blood circulates through the placenta to the fetus. What vessel(s) carry blood to the fetus?

a)

One umbilical vein

b)

Two umbilical veins

c)

One umbilical artery

d)

Two umbilical arteries

7.

What is the embryonic membrane that contains fingerlike projections on its surface, which attach to the uterine wall?

a)

Amnion

b)

Yolk sac

c)

Chorion

d)

Decidua basalis

8.

Which hormone is responsible for converting the endometrium into decidual cells for implantation?

a)

Estrogen

b)

Human chorionic gonadotropin

c)

Human placental lactogen

d)

Progesterone

9.

A patient asks the nurse when her fetus's heart will begin to pump blood. What will the nurse reply?

a)

By the end of week 3

b)

Beginning in week 8

c)

At the end of week 16

d)

Beginning in week 24

10.

At what point in prenatal development do the lungs begin to produce surfactant?

a)

17 weeks

b)

20 weeks

c)

25 weeks

d)

30 weeks

11.

A woman missed her menstrual period 1 week ago and has come to the doctor’s office for a pregnancy test. Which placental hormone is measured in pregnancy tests?

a)

Progesterone

b)

Estrogen

c)

Human chorionic gonadotropin

d)

Human placental lactogen

12.

When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent?

a)

Congenital heart defects

b)

Neural tube defects

c)

Mental retardation

d)

Premature birth

13.

The school nurse is counseling a group of adolescent girls. What does the nurse explain about sperm ejaculated near the cervix?

a)

They are destroyed by the acidic pH of the vagina.

b)

They survive up to 5 days and can cause pregnancy.

c)

They lose their motility in about 12 hours after intercourse.

d)

They are usually pushed out of the vagina by the muscular action of the vaginal wall.

14.

Of what is the normal umbilical cord comprised?

a)

1 artery carrying blood to the fetus and 1 vein carrying blood away from the fetus

b)

1 artery carrying blood to the fetus and 2 veins carrying blood away from the fetus

c)

2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetus

d)

2 arteries carrying blood to the fetus and 2 veins carrying blood away from the fetus

15.

What are the functions of amniotic fluid? (Select all that apply.)

a)

Maintaining an even temperature

b)

Impeding excessive fetal movement

c)

Lubricating fetal skin

d)

Acting as a reservoir for nutrients

e)

Acting as a cushion for the fetus

16.

During the physical examination for the first prenatal visit, it is noted that Chadwick’s sign is present. What is Chadwick’s sign?

a)

Bluish or purplish discoloration of the vulva, vagina, and cervix

b)

Presence of early fetal movements

c)

Darkening of the areola and breast tenderness

d)

Palpation of the fetal outline

17.

A woman reports that her last normal menstrual period began on August 5, 2013. What is this woman’s expected delivery date using Nägele’s rule?

a)

April 30, 2014

b)

May 5, 2014

c)

May 12, 2014

d)

May 26, 2014

18.

During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with an electronic Doppler device. How early might fetal heart tones be detected with an electronic Doppler device?

a)

4 weeks

b)

8 weeks

c)

10 weeks

d)

14 weeks

19.

In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/min from a rate of 160 beats/min earlier in the pregnancy. What is the nurse’s first action?

a)

Ask if the patient has taken a sedative.

b)

Notify the physician.

c)

Turn the patient to her right side.

d)

Record the rate as a normal finding.

20.

A pregnant woman is experiencing nausea in the early morning. What recommendations would the nurse offer to alleviate this symptom?

a)

Eat three well-balanced meals per day and limit snacks.

b)

Drink a full glass of fluid at the beginning of each meal.

c)

Have crackers handy at the bedside, and eat a few before getting out of bed.

d)

Eat a bland diet and avoid concentrated sweets.

21.

A woman tells the nurse that she is quite sure she is pregnant. The nurse recognizes which as a positive sign of pregnancy?

a)

Amenorrhea

b)

Uterine enlargement

c)

HCG detected in the urine

d)

Fetal heartbeat

22.

A woman pregnant for the first time asks the nurse, “When will I begin to feel the baby move?” What is the nurse’s best response?

a)

“You may notice the baby moving around the 4th or 5th month.”

b)

“Quickening varies with every woman.”

c)

“You’ll feel something by the end of the first trimester.”

d)

“The baby will be big enough for you to feel in your 8th month.”

23.

The nurse explains that the softening of the cervix and vagina is a probable sign of pregnancy. What is the appropriate term for this sign?

a)

Chadwick’s

b)

Hegar’s

c)

McDonald’s

d)

Goodell’s

24.

A pregnant woman is attending her second postpartum visit. Prenatal lab work indicates she is not immune to the rubella virus. What is the most appropriate nursing intervention?

a)

Provide the rubella vaccine as ordered by the physician immediately.

b)

Inform the woman she should receive the vaccine in the hospital after delivery.

c)

Hold all immunizations until 1 month postpartum.

d)

Encourage the patient to decide whether or not to get the rubella vaccine prenatally.

25.

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

b)

4-1-2-0-4

c)

3-0-3-0-3

d)

4-2-1-0-3

26.

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

27.

Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth?

a)

Epulis

b)

Chloasma

c)

Telangiectasia

d)

Striae gravidarum

28.

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.

29.

The nurse caring for the pregnant client must understand that the hormone essential for maintaining pregnancy is:

a)

Estrogen.

b)

Human chorionic gonadotropin (hCG).

c)

Oxytocin.

d)

Progesterone.

30.

A patient at 24 weeks of gestation contacts the nurse at her obstetric provider’s office to complain that she has cravings for dirt and gravel. The nurse is aware that this condition is known as ________ and may indicate anemia.

a)

Ptyalism

b)

Pyrosis

c)

Pica

d)

Decreased peristalsis

31.

To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that:

a)

A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear.

b)

Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.

c)

Palpitations are twice as likely to occur in twin gestations.

d)

All of the above changes likely will occur.

32.

Some pregnant clients may complain of changes in their voice and impaired hearing. The nurse can tell these clients that these are common reactions to:

a)

A decreased estrogen level.

b)

Displacement of the diaphragm, resulting in thoracic breathing.

c)

Congestion and swelling, which occur because the upper respiratory tract has become more vascular.

d)

Increased blood volume.

33.

The maternity nurse understands that vascular volume increases 40% to 60% during pregnancy to:

a)

Compensate for decreased renal plasma flow.

b)

Provide adequate perfusion of the placenta.

c)

Eliminate metabolic wastes of the mother..

d)

Prevent maternal and fetal dehydration

34.

Physiologic anemia often occurs during pregnancy as a result of:

a)

Inadequate intake of iron.

b)

Dilution of hemoglobin concentration.

c)

The fetus establishing iron stores.

d)

Decreased production of erythrocytes.

35.

The diagnosis of pregnancy is based on which positive signs of pregnancy (Select all that apply)?

a)

Identification of fetal heartbeat

b)

Palpation of fetal outline

c)

Visualization of the fetus

d)

Verification of fetal movement

e)

Positive hCG test

36.

During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criteria? Select all that apply.

a)

Leukorrhea

b)

Development of the operculum

c)

Quickening

d)

Ballottement

e)

Lightening

37.

The perinatal nurse explains the function of Wharton’s jelly to a class of expectant parents. What description is most accurate?

a)

Collection of blood from the maternal circulation

b)

Gooey uterine substance that cushions the fetus

c)

Precursor cells from which blood cells originate

d)

Protects the umbilical cord from compression

38.

During preconception counseling, the nurse explains that the fetus is most vulnerable to the effects of teratogens during which time period?

a)

2 to 8 weeks

b)

4 to 12 weeks

c)

5 to 10 weeks

d)

6 to 15 weeks

39.

The birthing center nurse is assisting with pain management for a laboring woman at 18 weeks’ gestation. The fetus is born and the weight is 450 gm. The nurse would document this birth as which of the following?

a)

Abortion

b)

Fetal loss

c)

Neonatal death

d)

Stillbirth

40.

A 26-year-old woman has come for preconception counseling and asks about caring for her cat, because she has heard that she “should not touch the cat during pregnancy.” Which of the following is the nurse’s best response?

a)

“If someone else changes the litter box you should be okay.”

b)

“It is more important to avoid eating raw vegetables now.”

c)

“That is correct; in fact, you should give the cat away.”

d)

“You probably already have had toxoplasmosis from the cat.”

41.

The nursing instructor is explaining the function of the placenta in hormone production. Which hormones does the instructor include in this discussion? (Select all that apply.)

a)

Estrogens

b)

Human chorionic gonadotropin

c)

Human placental lactogen

d)

Luteinizing hormone

e)

Progesterone

42.

A perinatal nurse is assessing a woman who is approximately 10 weeks pregnant. The woman smells like cigarette smoke. What actions by the nurse are best? (Select all that apply.)

a)

Advise her to stop smoking now so that the baby can be of normal weight.

b)

Ask the woman if either she or her partner smokes.

c)

Determine how many cigarettes she smokes a day.

d)

Describe the behavior problems her child may develop.

e)

Explain that nicotine deprives the fetus of oxygen.

43.

A nurse is teaching a woman who is in her first trimester of pregnancy about physical changes she can expect. Which information should the nurse provide?

a)

Diminishing sexual interest occurs.

b)

Harmful agents are able to invade the uterus.

c)

Leukorrhea is an abnormal condition.

d)

Pregnant women are more susceptible to yeast infections.

44.

A pregnant woman in the perinatal clinic complains of occasional fainting. Which action by the nurse is best?

a)

Educate her that this is a frequent occurrence in pregnancy.

b)

Encourage her to carry small snacks with her at all times.

c)

Instruct her to lie down when the warning signs occur.

d)

Tell her to lie down on her left side if she has warning signs.

45.

A woman in the third trimester of her first pregnancy complains of excessive fatigue. Her hemoglobin is 11.2 g/dL. What action by the nurse is best?

a)

Arrange hospital admission for blood transfusions.

b)

Assess the woman’s diet for adequate iron and protein.

c)

Inform the woman that this is a normal finding in pregnancy.

d)

Tell the woman to get more sleep at night and to take naps.

46.

A pregnant woman is complaining of frequent heartburn. What statement by the patient indicates to the nurse that teaching has been effective?

a)

“Drinking less alcohol should prevent this.”

b)

“Eating larger, less frequent meals will help.”

c)

“I should take antacids before each meal.”

d)

“I will not lie down for 1 hour after eating.”

47.

What information should the nurse plan to teach a pregnant woman regarding safety in the third trimester?

a)

Don’t drive after dark.

b)

Exercise to maintain good posture.

c)

Use handrails when using the stairs.

d)

Wear supportive shoes.

48.

The nursing instructor explains to a class of students that the pituitary gland has many functions related to pregnancy. Which of the following functions are performed by hormones secreted by this gland? (Select all that apply.)

a)

Cause the corpus luteum to produce progesterone

b)

Influence ovarian follicular development

c)

Maintain the pregnancy

d)

Prompt ovulation

e)

Stimulate the uterine lining

49.

A nurse is providing anticipatory guidance to a pregnant woman regarding normal changes in the nose and nasal passages. What information should the nurse provide? (Select all that apply.)

a)

Blow your nose gently.

b)

Dry mucous membranes cause bleeding.

c)

Increase your fluid intake.

d)

Stuffiness is common.

e)

Use decongestant spray.

50.

A patient is complaining of constipation. What teaching should the nurse plan to provide? (Select all that apply.)

a)

Avoid vigorous exercise.

b)

Drink 8 to 10 glasses of water each day.

c)

Don’t strain to move your bowels.

d)

Eat small, frequent meals.

e)

Increase your fiber intake.