Maternal Newborn Nursing Practice Quiz 1

Maternal Newborn Question 1 With regard to chromosome abnormalities, nurses should be aware that:! Abnormalities of number are the leading cause of pregnancy loss. Aneuploidy is an abnormality of number that also is the leading genetic cause of mental retardation. Chromosome abnormalities occur in less than 1% of newborns. Down syndrome is the most common form of trisomal abnormality, an abnormality of chromosome number (47 chromosomes). Unbalanced translocation is an abnormality of chromosome structure that often has serious clinical effects. Question 2 With regard to the development of the respiratory system, maternity nurses should understand that:! Maternal hypertension can reduce maternal-placental blood flow, accelerating lung maturity. A reduction in placental blood flow stresses the fetus, increases blood levels of corticosteroids, and accelerates lung maturity. Development of the respiratory system begins during the embryonic phase and continues into childhood. The infant’s lungs are mature when the L/S ratio is 2:1, at about 35 weeks. Lung movements have been seen on ultrasound scans at 11 weeks. Question 3 The mucous plug that forms in the endocervical canal is called the:! Operculum The operculum protects against bacterial invasion. Leukorrhea is the mucus that forms the endocervical plug (the operculum). The funic souffle is the sound of blood flowing through the umbilical vessels. Ballottement is a technique for palpating the fetus. Question 4 In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that: Mood swings most likely are the result of worries about finances and a changed lifestyle as well as profound hormonal changes. Mood swings are natural and are likely to affect every woman to some degree. A woman may dislike being pregnant, refuse to accept it, and still love and accept the child. Ambivalent feelings about pregnancy are normal for mature or immature women, younger or older women. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need to be resolved. The baby ends the pregnancy but not all the issues. Question 5 With regard to the initial physical examination of a woman beginning prenatal care, maternity nurses should be aware that: orrect! The woman should empty her bladder before the pelvic examination is performed. An empty bladder facilitates the examination; this is also an opportunity to get a urine sample easily for a number of tests. All women should be assessed for a history of physical abuse, particularly because the likelihood of abuse increases during pregnancy. Noting body hair is important because body hair reflects nutritional status, endocrine function, and hygiene. Particular attention is paid to the size of the uterus because it is an indication of the duration of gestation. Question 6 Maternal nutritional status is an especially significant factor of the many factors that influence the outcome of pregnancy because:! It is an important preventive measure for a variety of problems. Nutritional status draws so much attention not only for its effect on a healthy pregnancy and birth but also because significant changes are within relatively easy reach. Question 7 A client asks her nurse, “My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean?” The best response by the nurse is: Correct! “Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby.” An accurate and appropriate response is, “Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby.” Although “Your placenta isn’t working properly, and your baby is in danger” may be valid, it does not reflect therapeutic communication techniques and is likely to alarm the client. An ultrasound, not an amniocentesis, is the method of assessment used to determine placental maturation. The response “Don’t worry about it. Everything is fine” is not appropriate and discredits the client’s concerns. Question 8 Transvaginal ultrasonography is often performed during the first trimester. While preparing your 6-week gestation patient for this procedure, she expresses concerns over the necessity for this test. The nurse should explain that this diagnostic test may be indicated for a number of situations, including: (Select all that apply).Correct! Obesity Ectopic pregnancy Multifetal gestation. Fetal abnormalities Transvaginal ultrasound is useful in obese women whose thick abdominal layers cannot be penetrated with traditional abdominal ultrasound. This procedure is also used for identifying multifetal gestation, ectopic pregnancy, estimating gestational age, confirming fetal viability, and identifying fetal abnormalities. Amniotic fluid volume is assessed during the second and third trimester. Conventional ultrasound would be used. Question 9 A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system?! 3-1-0-1-0 The correct calculation of this woman’s gravidity and parity is 3-1-0-1-0. Using the GTPAL system, this client’s gravidity and parity information is calculated as follows: G: Total number of times the woman has been pregnant (she is pregnant for the third time) T: Number of pregnancies carried to term (she has had only one pregnancy that resulted in a fetus at term) P: Number of pregnancies that resulted in a preterm birth (none) A: Abortions or miscarriages before the period of viability (she has had one) L: Number of children born who are currently living (she has no living children) Question 10 A newly pregnant patient visits her provider’s office for the first prenatal appointment. To estimate accurate weight gain throughout the pregnancy, the nurse will be evaluating the appropriateness of weight for height using the body mass index (BMI). The patient weighs 51 kg and is 1.57 m tall. The BMI is: 20.7 BMI = weight divided by height squared. BMI = 51 kg/(1.57m)2, or 20.7. Prepregnant BMI can be classified into the following categories: <18.5, underweight or low; 18.5-24.9, normal; 25-29.9 overweight or high; and >30, obese