Test Bank for Introduction to Maternity and Pediatric Nursing, 9th Edition (Chapters 1-34)

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Chapter 01: The Past, Present, and FutureLeifer: Introduction to Maternity and Pediatric Nursing, 9th EditionMULTIPLE CHOICE1.A patient chooses to have the certified nurse-midwife (CNM) provide care during herpregnancy. What does the CNM‘s scope of practice include?a.Practice independent from medical supervisionb.Comprehensive prenatal carec.Attendance at all deliveriesd.Cesarean sectionsANS: BThe CNM provides comprehensive prenatal and postnatal care, attends uncomplicateddeliveries, and ensures that a backup physician is available in case of unforeseen problems.DIF:Cognitive Level: ComprehensionREF:p. 6OBJ: 5TOP:Advance Practice Nursing RolesKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease2.Which medical pioneer discovered the relationship between the incidence of puerperal feverand unwashed hands?a.Karl Credéb.Ignaz Semmelweisc.Louis Pasteurd.Joseph ListerANS: BIgnaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted bythe unwashed hands of physicians and medical students.DIF:Cognitive Level: KnowledgeREF:p. 2OBJ: 1TOP:The PastKEY: Nursing Process Step: N/AMSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control3.A pregnant woman who has recently immigrated to the United States comments to the nurse,“I am afraid of childbirth. It is so dangerous. I am afraid I willdie.”What is the best nursingresponse reflecting cultural sensitivity?a.“Maternal mortality in the United States is extremely low.”b.“Anesthesia is available to relieve pain during labor and childbirth.”c.“Tell me why you are afraid of childbirth.”d.“Your condition will be monitored during labor and delivery.”ANS: CAsking the patient about her concerns helps promote understanding and individualizes patientcare.DIF:Cognitive Level: ApplicationREF:pp. 6-8OBJ: 8TOP:Cross-Cultural CareKEY: Nursing Process Step: ImplementationMSC: NCLEX: Psychosocial Integrity: Psychological Adaptation

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4.An urban area has been reported to have a high perinatal mortality rate. What informationdoes this provide?a.Maternal and infant deaths per 100,000 live births per yearb.Deaths of fetuses weighing more than 500 g per 10,000 births per yearc.Deaths of infants up to 1 year of age per 1000 live births per yeard.Fetal and neonatal deaths per 1000 live births per yearANS: DThe perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.DIF:Cognitive Level: ComprehensionREF: p. 13 | Box 1.6OBJ:9TOP: The Present-Child CareKEY: Nursing Process Step: ImplementationMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care5.What is the focus of current maternity practice?a.Hospital births for the majority of womenb.The traditional family unitc.Separation of labor rooms from delivery roomsd.A quality family experience for each patientANS: DCurrent maternity practice focuses on a high-quality family experience for all families,traditional or otherwise.DIF:Cognitive Level: ComprehensionREF:p. 6OBJ: 5TOP:The Present-Maternity CareKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance6.Who advocated the establishment of the Children‘sBureau?a.Lillian Waldb.Florence Nightingalec.Florence Kellyd.Clara BartonANS: ALillian Wald is credited with suggesting the establishment of a federal Children‘s Bureau.DIF:Cognitive Level: KnowledgeREF:p. 4OBJ: 1 | 2TOP:The PastKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development7.What was the result of research done in the 1930s by the Children‘sBureau?a.Children with heart problems are now cared for by pediatric cardiologists.b.The Child Abuse and Prevention Act was passed.c.Hot lunch programs were established in many schools.d.Children‘s asylums werefounded.ANS: CSchool hot lunch programs were developed as a result of research by the Children‘s Bureau onthe effects of economic depression on children.DIF:Cognitive Level: KnowledgeREF:p. 4OBJ: 2 | 3

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TOP:The PastKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Coordinated Care8.What government program was implemented to increase the educational exposure ofpreschool children?a.WICb.Title XIX of Medicaidc.The Children‘sCharterd.Head StartANS: DHead Start programs were established to increase educational exposure of preschool children.DIF:Cognitive Level: KnowledgeREF:p. 3OBJ: 3TOP:Government Influences in Maternity and Pediatric CareKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development9.What guidelines define multidisciplinary patient care in terms of expected outcome andtimeframe from different areas of care provision?a.Clinical pathwaysb.Nursing outcome criteriac.Standards of cared.Nursing care planANS: AClinical pathways, also known as critical pathways or care maps, are collaborative guidelinesthat define patient care across disciplines. Expected progress within a specified timeline isidentified.DIF:Cognitive Level: KnowledgeREF:p. 13OBJ: 10TOP:Health Care Delivery SystemsKEY: Nursing Process Step: N/AMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care10.A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her mother,and collected admission data. What is the next step the student will take to develop a nursingcare plan for this child?a.Identify measurable outcomes with a timeline.b.Choose specific nursing interventions for the child.c.Determine appropriate nursing diagnoses.d.State nursing actions related to the child‘s medicaldiagnosis.ANS: CThe nurse uses assessment data to select appropriate nursing diagnoses. Outcomes andinterventions are then developed to address the relevant nursing diagnoses.DIF:Cognitive Level: ApplicationREF:p. 12OBJ: 7TOP:Nursing ProcessKEY: Nursing Process Step: Nursing DiagnosisMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care11.A nursing student on an obstetric rotation questions the floor nurse about the definition of theLVN/LPN scope of practice. What resource can the nurse suggest to the student?a.American Nurses Association

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b.State‘s Board ofNursingc.Joint Commissiond.Association of Women‘s Health, Obstetric and NeonatalNursesANS: BThe scope of practice of the LVN/LPN is published by the state‘s board of nursing.DIF:Cognitive Level: ComprehensionREF:p. 16OBJ: 2TOP:Critical ThinkingKEY: Nursing Process Step: ImplementationMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care12.What was recommended by Karl Credé in 1884?a.All women should be delivered in a hospital setting.b.Chemical means should be used to combat infection.c.Podalic version should be done on all fetuses.d.Silver nitrate should be placed in the eyes of newborns.ANS: DIn 1884 Karl Credé recommended the use of 2% silver nitrate in the eyes of newborns toreduce the incidence of blindness.DIF:Cognitive Level: KnowledgeREF:p. 2OBJ: 1TOP:Use of Silver NitrateKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease13.What is the purpose of the White House Conference on Children and Youth?a.Set criteria for normal growth patterns.b.Examine the number of live births in minority populations.c.Raise money to support well-child clinics in rural areas.d.Promote comprehensive child welfare.ANS: DWhite House Conferences on Children and Youth are held every 10 years to promotecomprehensive child welfare.DIF:Cognitive Level: KnowledgeREF:p. 4OBJ: 2TOP:White House ConferencesKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease14.How many hours of hospital stay does legislation currently allow for a postpartum patientwho has delivered vaginally without complications?a.24b.48c.36d.72ANS: BPostpartum patients who deliver vaginally stay in the hospital for an average of 48 hours;patients who have had a cesarean delivery usually stay 4 days.DIF:Cognitive Level: KnowledgeREF:p. 6OBJ: 5TOP: Hospital Terms for Postpartum PatientsKEY: Nursing Process Step: Planning

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MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease15.How does the clinical pathway or critical pathway improve quality of care?a.Lists diagnosis-specific implementationsb.Outlines expected progress with stated timelinesc.Prioritizes effective nursing diagnosesd.Describes common complicationsANS: BCritical pathways outline expected progress with stated timelines. Any deviation from thosetimelines is called avariance.DIF:Cognitive Level: ComprehensionREF:p. 13OBJ: 10TOP:Critical PathwayKEY: Nursing Process Step: ImplementationMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care16.A patient asks the nurse to explain what is meant by“gene therapy.”What is the nurse‘s bestresponse?a.Gene therapy can replace missing genes.b.Gene therapy evaluates the parent‘sgenes.c.Gene therapy can change the sex of the fetus.d.Gene therapy supports the regeneration of defective genes.ANS: AGene therapy can replace missing or defective genes.DIF:Cognitive Level: KnowledgeREF:p. 8OBJ: 5TOP:Gene TherapyKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease17.The nurse is clarifying information to a patient regarding diagnosis-related groups (DRGs).What is the nurse‘s best response when the patient asks how DRGs reduce medical care costs?a.By determining payment based on diagnosisb.By requiring two medical opinions to confirm a diagnosisc.By organizing HMOsd.By defining a person who will require hospitalizationANS: ADRGs determine the amount of payment and length of hospital stay based on the diagnosis.DIF:Cognitive Level: ComprehensionREF:p. 8OBJ: 3TOP:DRGsKEY: Nursing Process Step: ImplementationMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care18.How does electronic charting ensure comprehensive charting more effectively thanhandwritten charting?a.Provides a uniform style of chart.b.Requires certain responses before allowing the user to progress.c.All documentation is reflective of the nursing care plan.d.Requires a daily audit by the charge nurse.ANS: B

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Comprehensive electronic documentation is ensured by requiring specific input in designatedcategories before the user can progress through the system.DIF:Cognitive Level: ComprehensionREF:pp. 16-17OBJ: 12TOP:Computer ChartingKEY: Nursing Process Step: ImplementationMSC: NCLEX: Safe, Effective Care Environment: Coordinated Care19.The nurse reminds family members that the philosophy of family-centered care is to providecontrol to the family over health care decisions. What is the appropriate term for this type ofcontrol?a.Empowermentb.Insightc.Regulationd.OrganizationANS: AThe termempowermentrefers to the control a family has over its own health care decisions.DIF:Cognitive Level: KnowledgeREF:p. 1OBJ: 13TOP:EmpowermentKEY: Nursing Process Step: ImplementationMSC: NCLEX: Physiological Integrity: Basic Care and Comfort20.A patient in the prenatal clinic is concerned about losing her job because of her pregnancy.The nurse instructs her that the Family Medical Leave Act (FMLA) allows an employee to beabsent from work without pay. How many weeks does the FMLA allow a woman to recoverfrom childbirth or care for a sick family member without loss of benefits or pay status?a.4b.6c.10d.12ANS: DThe FMLA allows for employees to leave work for up to 12 weeks to recover from childbirthor to care for an ill family member without losing benefits or pay status.DIF:Cognitive Level: KnowledgeREF:p. 3OBJ: 5TOP:FMLAKEY: Nursing Process Step: ImplementationMSC: NCLEX: Psychosocial Integrity: Coping and Adaptation21.What term appropriately describes the nurse who is able to adapt health care practices to meetthe needs of various cultures?a.Culturally awareb.Culturally sensitivec.Culturally competentd.Culturally adaptiveANS: CThe nurse who is able to adapt health care to meet the needs of various cultures is said to beculturally competent.DIF:Cognitive Level: KnowledgeREF:p. 6OBJ: 6TOP:Cultural CompetencyKEY: Nursing Process Step: N/A

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MSC: NCLEX: N/A22.What is one major advantage to the application of critical thinking?a.Problem-free careb.Limitation of approaches to carec.Decreased need for assessmentd.Problem preventionANS: DCritical thinking results in problem prevention in designing nursing care.DIF:Cognitive Level: ComprehensionREF:p. 15OBJ: 11TOP:Critical ThinkingKEY: Nursing Process Step: N/AMSC: NCLEX: N/AMULTIPLE RESPONSE1.What services are birthing centers able to provide? (Select all that apply.)a.Prenatal careb.Labor and delivery servicesc.Classes for new mothersd.Adoption referralse.Family planningANS: A, B, C, EBirthing centers are capable of providing full-service obstetric care, classes for new mothers,and family planning. Birthing centers do not offer adoption services.DIF:Cognitive Level: ComprehensionREF:p. 6OBJ: 5TOP:Birthing CentersKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Coordinated Care2.What developments in the early 20th century encouraged women to seek hospitalization forchildbirth? (Select all that apply.)a.Use of specialized obstetric instrumentsb.Use of anesthesiac.Physicians‘ closer relationships with hospitalsd.Focus on family-centered caree.Insurance coverageANS: A, B, CIn the early 1900s, the development of specialized obstetric instruments, better modes ofanesthesia, and the physician‘s reliance on hospital services were instrumentalin encouragingwomen to seek hospitalization for childbirth.DIF:Cognitive Level: ComprehensionREF:pp. 2-3OBJ: 5TOP:Hospitalization for ChildbirthKEY: Nursing Process Step: ImplementationMSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control3.What non–family-centered policies were prevalent in the 1960s? (Select all that apply.)a.Waiting room for fathersb.Sedation of mother during labor

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c.Delay of reunion of mother and infantd.Lenient visiting hourse.Restrictions of visitations by minor childrenANS: A, B, C, EHospital policies in the 1960s provided a separate waiting room for fathers while the motherwent through labor in a sedated state. The reunion of mother and infant was delayed forseveral hours because of the sedation. Visiting hours were rigid and disallowed the visitationof minor children.DIF:Cognitive Level: ComprehensionREF:p. 3OBJ: 5TOP:Non–Family-Centered PracticesKEY: Nursing Process Step: ImplementationMSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control4.The nurse is aware that there is a legal responsibility to report certain diseases and conditionsto county or state health authorities. Which would be included? (Select all that apply.)a.Tuberculosisb.Child abusec.Industrial accidentsd.Sexually transmitted diseasese.Foodborne infectionsANS: A, B, D, EThe nurse has a legal responsibility to report communicable diseases (such as tuberculosis andsexually transmitted diseases), foodborne infections, child abuse, and threats of suicide.DIF:Cognitive Level: ComprehensionREF: p. 4 | Legal and Ethical Considerations BoxOBJ:4TOP: Reportable DiseasesKEY: Nursing Process Step: PlanningMSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control5.Practical nursing students are using critical thinking skills to study for an upcoming test. Whatwill these students include when studying? (Select all that apply.)a.Memorization of facts firstb.Prioritizing informationc.Relating facts to other factsd.Making assumptionse.Reviewing before the testANS: B, C, EUsing critical thinking when studying involves understanding facts before memorizing,prioritizing information to be memorized, relating facts to other facts, using all five senses,reviewing before tests, and reading critically. Critical thinking does not involve assumption asdoes general thinking.DIF:Cognitive Level: ComprehensionREF:p. 16OBJ: 8TOP:Critical ThinkingKEY: Nursing Process Step: EvaluationMSC: NCLEX: Safe, Effective Care Environment6.What factors have played a role in meeting the goals ofHealthy People 2030as it relates thegoals for outcomes of pregnancy? (Select all that apply.)a.Early prenatal care

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b.Increased number of surgical birthsc.NICU cared.Use of prenatal glucocorticoidse.Fetal surgeryANS: A, C, D, EEarly prenatal care, fetal surgery, use of prenatal glucocorticoids, technology, and NICU carehave played a role in increasing the positive outcome of pregnancy, and the goals ofHealthyPeople 2030may well be met. Increase in surgical births and multiple gestations do not worktoward meeting the goals ofHealthy People 2030.DIF:Cognitive Level: ComprehensionREF:p. 17OBJ: 13TOP:Healthy People 2030KEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection7.A community health nurse is providing specialized care to patients in the home setting. Whatkind of specialized care may this nurse be providing? (Select all that apply.)a.Glucose monitoringb.Heparin therapyc.Family educationd.Total parenteral nutritione.Provision of referral servicesANS: A, B, DGlucose monitoring, heparin therapy, and total parenteral nutrition are categorized asspecialized care that may be provided by the community health nurse. Family education andprovision of referral are categorized as therapeutic care.DIF:Cognitive Level: ApplicationREF:p. 20OBJ: 14TOP:Community HealthKEY: Nursing Process Step: ImplementationMSC: NCLEX: Physiological Integrity: Basic Care and Comfort

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Chapter 02: Human Reproductive Anatomy and PhysiologyLeifer: Introduction to Maternity and Pediatric Nursing, 9th EditionMULTIPLE CHOICE1.A 14-year-old boy is at the pediatric clinic for a checkup. What physical changes of pubertywill the nurse indicate are related to the production of testosterone?a.Stimulation of production of white cells and plateletsb.Promotion of growth of small bonesc.Increase in muscle mass and strengthd.Decrease in production of sebaceous gland secretionsANS: CTestosterone increases muscle mass, promotes strength and growth of long bones, andenhances production of red blood cells.DIF:Cognitive Level: KnowledgeREF:p. 25OBJ: 1 | 2 | 5TOP:Male Reproductive SystemKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Growth and Development2.The nurse is educating high school students about puberty. What will the nurse indicateregulates the production of sperm and secretion hormones?a.Testesb.Vas deferensc.Ejaculatory ductsd.Prostate glandANS: AThe testes have two functions: manufacture of spermatozoa and secretion of androgens.DIF:Cognitive Level: KnowledgeREF:p. 24OBJ: 3 | 5TOP:Male Reproductive SystemKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development3.The nurse is speaking with a couple trying to conceive a child. What will the nurse remind thecouple is a factor that can decrease sperm production?a.Infrequent sexual intercourseb.The man not being circumcisedc.The penis and testes being smalld.The testes being too warmANS: DThe scrotum is suspended away from the perineum to lower the temperature of the testes forsperm production.DIF:Cognitive Level: ComprehensionREF:p. 25OBJ: 3TOP:Male Reproductive SystemKEY: Nursing Process Step: ImplementationMSC: NCLEX: Physiological Integrity: Reduction of Risk4.When describing the female reproductive tract to a pregnant woman, the nurse would explainthat which uterine layer is involved in implantation?a.Perimetriumb.Endometriumc.Myometriumd.Internal osANS: B

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The endometrium is the inner mucosal layer of the uterus that is governed by cyclicalhormonal changes. It is functional during menstruation and during the implantation of afertilized ovum.DIF:Cognitive Level: KnowledgeREF:p. 27OBJ: 7TOP:Female Reproductive SystemKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development5.A group of nursing students plans to teach a class of sixth-grade girls about menstruation.What correct information will the nursing students teach to the class?a.Menarche usually occurs around 12 years of age.b.Ovulation occurs regularly from the very first cycle.c.A regular cycle is established by the third period.d.Typically, menstrual flow is heavy and lasts up to 10 days.ANS: AThe beginning of menstruation, called menarche,occurs at about 12 years of age. Early cyclesare irregular and anovulatory.DIF:Cognitive Level: ComprehensionREF:p. 30OBJ: 1 | 9TOP: Female Reproductive Cycle and MenstruationKEY: Nursing Process Step: PlanningMSC: NCLEX: Health Promotion and Maintenance: Growth and Development6.A10-year-old girl asks the nurse,“What is the first sign of puberty?”What is the correctnursing response?a.An increase in heightb.Breast developmentc.Appearance of axillary haird.The first menstrual periodANS: BThe first outward change of puberty in girls is the development of breasts at about 10 to 11years of age.DIF:Cognitive Level: KnowledgeREF:p. 24OBJ: 1 | 2TOP:Puberty—FemaleKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development7.A 12-year-old female patient experienced menarche 3 months ago. Her mother voices concernto thepediatric office nurse regarding the irregularity of her daughter‘s menstrual cycle. Whatis the nurse‘s bestresponse?a.“Worrying is not the answer.”b.“I will talk to the pediatrician about a gynecological referral.”c.“I can only discuss this with your daughter.”d.“Early cycles are often irregular.”ANS: DEarly cycles are often irregular and may be anovulatory. Regular cycles are usuallyestablished within 6 months to 2 years of the menarche. In an average cycle, the flow(menses) occurs every 28 days, plus or minus 5 to 10 days.

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DIF:Cognitive Level: ApplicationREF:p. 30OBJ: 9TOP:Menstrual CycleKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development8.Which hormone initiates the maturation of the ovarian follicle?a.Estrogenb.Follicle-stimulating hormonec.Progesteroned.Luteinizing hormoneANS: BFollicle-stimulating hormone (FSH) stimulates the maturation of a follicle.DIF:Cognitive Level: KnowledgeREF:p. 30OBJ:1|9TOP:Female Reproductive CycleKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development9.What statement indicates a woman has correct information about oogenesis?a.“Women make fewer ova as they age.”b.“Women have all of their ova at the time they are born.”c.“Ova production begins at birth and continues until puberty.”d.“New ova are made every month from puberty to climacteric.”ANS: BOogenesis (formation of immature ova) does not occur after fetal development. Females areborn with about 2 million immature ova, which rapidly reduce by adulthood.DIF:Cognitive Level: ComprehensionREF:p. 28OBJ: 9TOP:Female Reproductive CycleKEY: Nursing Process Step: EvaluationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development10.A pregnant woman asks the nurse,“Will I be able to have a vaginal delivery?”The nurseknows that which is the most favorable pelvic type for vaginal birth?a.Gynecoidb.Androidc.Anthropoidd.PlatypelloidANS: AThe gynecoid pelvis is the typical female pelvis and is most favorable for vaginal birth.DIF:Cognitive Level: KnowledgeREF:p. 28OBJ: 8TOP:Female Reproductive SystemKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease11.A mother is anxious about her ability to breastfeed after her child is born because of her smallbreast size. What would be an important point to teach this mother?a.Milk is produced in ducts and lobules regardless of breast size.b.Supplementing breastfeeding with formula allows the infant to receive adequatenutrition.c.Breast size can be increased with exercise.d.Drinking extra milk during pregnancy allows breasts to produce adequate amounts

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of milk.ANS: ABreast size does not influence the ability to secrete milk.DIF:Cognitive Level: ComprehensionREF:p. 30OBJ: 6TOP:Female Reproductive SystemKEY: Nursing Process Step: ImplementationMSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation12.For what is the decrease in estrogen and progesterone during the menstrual cycle responsible?a.Degeneration of the corpus luteumb.Ovulationc.Follicle maturationd.Shedding of the endometriumANS: DThe fall in estrogen and progesterone causes the endometrium to break down, resulting inmenstruation.DIF:Cognitive Level: ComprehensionREF:p. 30OBJ: 9TOP:Female Reproductive CycleKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development13.The nurse is assisting with pelvic inlet measurements on a pregnant woman. Whatmeasurement will provide the nurse with information about whether the woman can delivervaginally?a.Diagonal conjugateb.Obstetric conjugatec.Transverse diameterd.Anteroposterior diameterANS: BThis measurement determines if the fetus can pass through the birth canal.DIF:Cognitive Level: ComprehensionREF:p. 29OBJ: 8TOP:Female Reproductive SystemKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease14.The nurse has explained menstruation to a 13-year-old girl. What statement indicates the girlneeds additional education?a.“Periods last about 5 days.”b.“My cycle should get regular in 6 months.”c.“I should expect heavy bleeding with clots.”d.“Periods come about every 4 weeks.”ANS: CClots are not normally seen in menstrual discharge. A normal menstrual flow is 30 to 40 mLblood and 30 to 50 mL serous fluid.DIF:Cognitive Level: ComprehensionREF:p. 30OBJ: 9TOP:Female Reproductive CycleKEY: Nursing Process Step: EvaluationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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15.A mother asks the nurse,“When will I know my child has entered puberty?”What will thenurse state based on an understanding of changes associated with puberty?a.“Your daughter will have her first period.”b.“You‘ll recognize puberty by the mood swings.”c.“The child becomes interested in the opposite sex.”d.“Secondary sex characteristics, such as pubic hair, appear.”ANS: DPuberty begins when the secondary sex characteristics appear. Puberty ends when maturesperm are formed in the male and when regular menstrual cycles occur in the female.DIF:Cognitive Level: ComprehensionREF:p. 23OBJ: 1 | 2TOP:PubertyKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development16.A nurse is planning to teach couples about the physiology of the sex act. What correctinformation 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.”ANS: BAfter ovulation, the egg lives for only 24 hours. Sperm must be available during that time iffertilization is to occur.DIF:Cognitive Level: ComprehensionREF:p. 32OBJ: 6 | 7TOP:Physiology of the Sex ActKEY: Nursing Process Step: PlanningMSC: NCLEX: Health Promotion and Maintenance: Growth and Development17.A newly married couple tells the nurse they would like to wait a few years before starting afamily. Which statement made by the man indicates an understanding about sexual activityand pregnancy?a.“My wife can‘t get pregnant if I withdraw before climax.”b.“A man can secrete semen before ejaculation.”c.“If we don‘t have intercourse very often, my wife won‘t get pregnant.”d.“It is safe to ejaculate outside the vagina.”ANS: BSemen may be secreted during sexual intercourse before ejaculation.DIF:Cognitive Level: ComprehensionREF:p. 25OBJ: 4TOP:Male Reproductive SystemKEY: Nursing Process Step: EvaluationMSC: NCLEX: Physiological Integrity: Reduction of Risk18.The nurse is aware that the diagonal conjugate is 12 cm. What is the measurement incentimeters of the obstetric conjugate?a.10 to 10.5b.11 to 11.5c.12.5 to 13d.14 to 14.5

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ANS: AThe obstetric conjugate is approximately 1.5 to 2 cm shorter than the diagonal conjugate.DIF:Cognitive Level: KnowledgeREF:p. 29OBJ: 1 | 8TOP:Obstetric ConjugateKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease19.The nurse uses a diagram to demonstrate the fimbriae when teaching nursing students aboutthe female anatomy. What is true about fimbriae?a.They form the passageway for the sperm to meet the ovum.b.They are the site of fertilization.c.They are fingerlike projections that“capture”the ovum.d.They propel the egg through the fallopian tube.ANS: CFimbriae are the fingerlike projections from the infundibulum that“capture”the ovum atovulation and conduct it into the fallopian tube.DIF:Cognitive Level: ComprehensionREF:p. 28OBJ: 6 | 7TOP:FimbriaeKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development20.What will the nurse explain to a 12-year-old patient when describing what characterizesnocturnal emissions?a.A drop in testosterone levelb.Sexual stimulationc.Absence of sperm in ejaculated.Association with violent dreamsANS: CNocturnal emissions, also known as“wet dreams,”occur without sexual stimulation andcontain no sperm. Testosterone levels are constant until midlife.DIF:Cognitive Level: ComprehensionREF:p. 24OBJ: 2TOP:Nocturnal EmissionsKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development21.The nurse is educating a pregnant patient who expects to breastfeed. The nurse knows thatwhen a patient breastfeeds, which portions of the breast secrete milk?a.Lactiferous sinusesb.Lobesc.Montgomery‘s glandsd.Alveoli lobulesANS: DThe alveoli secrete milk.DIF:Cognitive Level: KnowledgeREF:p. 30OBJ: 6 | 7TOP:Milk SecretionKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development22.Where are the secretions responsible for nourishing sperm excreted from?

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a.Vas deferensb.Epididymisc.Cowper‘sglandd.ScrotumANS: CThe Cowper‘s gland secretions nourish the sperm.DIF:Cognitive Level: KnowledgeREF:p. 25OBJ: 4TOP:Cowper‘s GlandKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development23.What signifies the end of puberty for a male?a.Facial hair is evident.b.Erections can be sustained.c.Ejaculate is greater than 5 mL.d.Mature sperm are formed.ANS: DPuberty ends for a male when mature sperm are formed by the testes.DIF:Cognitive Level: KnowledgeREF:p. 23OBJ: 1 | 2TOP:End of PubertyKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development24.How long does sperm remain viable in the female reproductive tract?a.12 hoursb.1 dayc.2 daysd.4 daysANS: DSperm can remain viable in the reproductive tract of the female for as long as 4 to 5 days.DIF:Cognitive Level: KnowledgeREF:p. 32OBJ: 5TOP:Viability of SpermKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development25.The nurse encourages the members of a prenatal class to seriously consider breastfeeding.What does breast milk provide in addition to nourishment for the infant?a.Maternal antibodiesb.Stimulus for red blood cell productionc.Endorphins that soothe the infantd.Hormones that stimulate growthANS: ABreast milk provides maternal antibodies to the infant that give the child acquired immunityfrom some diseases for several months.DIF:Cognitive Level: ComprehensionREF:p. 29OBJ: 7TOP:Properties of Breast MilkKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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26.A female patient reports her menstrual cycle consistently occurs every 32 days. What day ofher cycle can the woman anticipate ovulation?a.14b.16c.18d.20ANS: COvulation occurs when a mature ovum is released from the follicle about 14 days before theonset of the next menstrual period.DIF:Cognitive Level: AnalysisREF:p. 30OBJ: 9TOP:Menstrual CycleKEY: Nursing Process Step: EvaluationMSC: NCLEX: Health Promotion and Maintenance: Growth and DevelopmentMULTIPLE RESPONSE1.The nurse conducting a sex education class for junior high students describes some culturalrites celebrating the entry to adulthood. What information would the nurse include? (Select allthat apply.)a.Bar mitzvahb.Displays of braveryc.Receiving part of their inheritanced.Ritual circumcisione.Displays of self-defenseANS: A, B, D, ESome cultures celebrate the entry to adulthood with rites such as displays of strength, bravery,self-reliance, and self-defense. Ritual circumcisions and bar and bat mitzvahs are also entryrites to adulthood. Lack of such rituals can sometimes confuse young people because there isno evidence of acceptance as an adult.DIF:Cognitive Level: KnowledgeREF:p. 23OBJ: 2TOP:Rites of PassageKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development2.The nurse is reading a pregnant patient‘s history and physical. What information doesthenurse recognize might indicate the need for a cesarean delivery? (Select all that apply.)a.History of childhood ricketsb.Immobile coccyxc.Prepregnant weight of 100 poundsd.Avid horse ridere.Pelvic fracture 3 years agoANS: A, B, EPelvic conditions that may predispose to a cesarean delivery are childhood rickets, pelvicfracture, and immobile coccyx.DIF:Cognitive Level: ComprehensionREF:pp. 28-29OBJ: 8TOP: Pelvic Conditions Predisposing Cesarean DeliveryKEY: Nursing Process Step: Data Collection

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MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease3.What are considered to be functions of the fallopian tubes? (Select all that apply.)a.Passage for sperm to meet ovab.Passage for ovum to uterusc.Safe environment for zygoted.Restriction for only one ovum to enter uteruse.Site for fertilizationANS: A, B, C, EThe fallopian tube provides passage for both sperm and ova, offering an optimum place forfertilization and a safe environment for the zygote.DIF:Cognitive Level: KnowledgeREF:p. 28OBJ: 7TOP:Function of Fallopian TubesKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development4.The nurse is providing an in-service to students beginning their obstetric clinical rotation.Using a diagram, the nurse points out parts of the female pelvis. What will the nurse include?(Select all that apply.)a.Two innominatesb.Obstetric conjugatec.Sacrumd.Perimetriume.CoccyxANS: A, C, EThe bones of the pelvis are two innominates, the sacrum, and the coccyx.DIF:Cognitive Level: KnowledgeREF:p. 28OBJ: 6 | 8TOP:Bones of the PelvisKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development5.The nurse explains that testosterone is responsible for males exceeding females in whichaspects? (Select all that apply.)a.Strengthb.Heightc.Mental concentrationd.Hematocrit levelse.AgilityANS: A, B, DTestosterone has the following effects not directly related to sexual reproduction: increasesmuscle mass and strength, promotes growth of long bones, increases basal metabolic rate,enhances production of red blood cells, produces enlargement of vocal cords, and affects thedistribution of body hair. These effects result in greater strength and stature and a higherhematocrit level in males than in females.DIF:Cognitive Level: KnowledgeREF:p. 25OBJ: 2TOP:Effects of TestosteroneKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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6.A patient is being seen by her health care provider for a suspected vaginal infection. What willthe nurse include when educating this patient on factors that affect the vaginal pH? (Select allthat apply.)a.Antibiotic therapyb.Frequent douchingc.Exercised.Jet lage.Use of vaginal spraysANS: A, B, EThe vagina is self-cleansing and during the reproductive years maintains a normal acidic pHof 4 to 5. The self-cleansing activity may be altered by antibiotic therapy, frequent douching,and excessive use of vaginal sprays, deodorant sanitary pads, or deodorant tampons.DIF:Cognitive Level: ApplicationREF:p. 26OBJ: 7TOP:Female Reproductive OrgansKEY: Nursing Process Step: AssessmentMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

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Chapter 03: Fetal DevelopmentLeifer: Introduction to Maternity and Pediatric Nursing, 9th EditionMULTIPLE CHOICE1.What is the total number of chromosomes contained in a mature sperm or ovum?a.22b.23c.44d.46ANS: BGametes (sex cells) contain 23 chromosomes.DIF:Cognitive Level: KnowledgeREF:p. 34OBJ: 2TOP:GametogenesisKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development2.A pregnant woman states,“My husband hopesIwill give him a boy because we have threegirls.”What will the nurse explain to this woman?a.The sex chromosome of the fertilized ovum determines the gender of the child.b.When the sperm and ovum are united, there is a 75% chance the child will be agirl.c.When the pH of the female reproductive tract is acidic, the child will be a girl.d.If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.ANS: DWhen a Y-bearing sperm fertilizes an ovum, a male child is produced.DIF:Cognitive Level: ComprehensionREF:p. 36OBJ: 3TOP:Sex DeterminationKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development3.What is the most common site for fertilization?a.Lower segment of the uterusb.Outer third of the fallopian tube near the ovaryc.Upper portion of the uterusd.Area of the fallopian tube farthest from the ovaryANS: BFertilization takes place in the outer third of the fallopian tube, which is closest to the ovary.DIF:Cognitive Level: KnowledgeREF:pp. 35-36OBJ: 3TOP:FertilizationKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development4.The embryo is termed a fetus at which stage of prenatal development?a.2 weeksb.4 weeksc.9 weeksd.16 weeksANS: CThe fetus (third stage of prenatal development) begins at the ninth week and continues untilthe 40th week of gestation or until birth.DIF:Cognitive Level: KnowledgeREF:p. 39OBJ: 4

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KEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development5.The nurse is reviewing fetal circulation with a pregnant patient and explains that bloodcirculates through the placenta to the fetus. What vessel(s) carry blood to the fetus?a.One umbilical veinb.Two umbilical veinsc.One umbilical arteryd.Two umbilical arteriesANS: AThe umbilical vein transports richly oxygenated blood from the placenta to the fetus.DIF:Cognitive Level: KnowledgeREF:p. 43OBJ: 7TOP:Fetal CirculationKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development6.Where is the usual location for implantation of the zygote?a.Upper section of the posterior uterine wallb.Lower portion of the uterus near the cervical osc.Inner third of the fallopian tube near the uterusd.Lateral aspect of the uterine wallANS: AThe zygote usually implants in the upper section of the posterior uterine wall.DIF:Cognitive Level: KnowledgeREF:p. 38OBJ: 3TOP:ImplantationKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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7.What is the embryonic membrane that contains fingerlike projections on its surface, whichattach to the uterine wall?a.Amnionb.Yolk sacc.Choriond.Decidua basalisANS: CThe chorion is a thick membrane with fingerlike projections (villi) on its outermost surface.DIF:Cognitive Level: KnowledgeREF:p. 38OBJ: 4TOP: Accessory Structures of Pregnancy KEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development8.Which hormone is responsible for converting the endometrium into decidual cells forimplantation?a.Estrogenb.Human chorionic gonadotropinc.Human placental lactogend.ProgesteroneANS: DAt high levels, progesterone maintains the endometrial lining for implantation of the zygote.DIF:Cognitive Level: KnowledgeREF:p. 42OBJ: 6TOP:PlacentaKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development9.A pregnant patient asks the nurse when her infant‘s heart will begin to pump blood. Whatwillthe nurse reply?a.By the end of week 3b.Beginning in week 8c.By the end of week 16d.Beginning in week 24ANS: AThe fetal heart begins to pump by week 3 of gestation.DIF:Cognitive Level: KnowledgeREF:p. 43OBJ: 5TOP:Prenatal DevelopmentKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development10.What organ does the ductus venosus shunt blood away from in fetal circulation?a.Liverb.Heartc.Lungsd.KidneysANS: AFetal blood bypasses the liver through the ductus venosus by carrying blood directly to theinferior vena cava.

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DIF:Cognitive Level: KnowledgeREF:p. 43OBJ: 7TOP:Prenatal DevelopmentKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development11.What complication can result from untreated respiratory distress in the newborn?a.Esophageal atresiab.Gastric dilationc.Cold stressd.Reopening of the foramen ovaleANS: DRespiratory distress can cause increased pressure in the right ventricle, causing reopening ofthe foramen ovale.DIF:Cognitive Level: ComprehensionREF:p. 43OBJ: 7TOP:Fetal CirculationKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development12.During an ultrasound, two amnions and two placentas are observed. What will be the mostlikely result of this pregnancy?a.Dizygotic twinsb.Monozygotic twinsc.Conjoined twinsd.High–birth weight twinsANS: ADizygotic twins always have two amnions and two chorions (placentas).DIF:Cognitive Level: ComprehensionREF:p. 45OBJ: 8TOP:Multifetal PregnancyKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Growth and Development13.A woman who is 25 weeks pregnant asks the nurse what her fetus looks like. What does thenurse explain is one physical characteristic present in a 25-week-old fetus?a.Lanugo covering the bodyb.Constant motionc.Skin that is pink and smoothd.Eyes that are closedANS: ABy 25 weeks, the body of the fetus is covered with lanugo, the eyes are open, the skin iswrinkled, and the fetus has definite periods of movement and sleeping.DIF:Cognitive Level: ComprehensionREF: p. 41 | Table 3.1OBJ:5TOP: Prenatal DevelopmentKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development14.At what point in prenatal development do the lungs begin to produce surfactant?a.17 weeksb.20 weeks

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c.25 weeksd.30 weeksANS: CDuring week 25, the alveoli begin to produce surfactant, which enables the alveoli to stayopen for adequate lung oxygenation to occur.DIF:Cognitive Level: KnowledgeREF: p. 41 | Table 3.1OBJ:5TOP:Prenatal DevelopmentKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development15.A woman missed her menstrual period 1 week ago and has come to the doctor‘s office forapregnancy test. Which placental hormone is measured in pregnancy tests?a.Progesteroneb.Estrogenc.Human chorionic gonadotropind.Human placental lactogenANS: CHuman chorionic gonadotropin is the basis for most pregnancy tests. It is detectable inmaternal blood as soon as implantation occurs, usually 7 to 9 days after fertilization.DIF:Cognitive Level: KnowledgeREF:p. 42OBJ: 6TOP: Accessory Structures of Pregnancy KEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Growth and Development16.When preparing to teach a class about prenatal development, the nurse would includeinformation about folic acid supplementation. What is folic acid known to prevent?a.Congenital heart defectsb.Neural tube defectsc.Mental retardationd.Premature birthANS: BIt is now known that folic acid supplements can prevent neural tube defects such as spinabifida.DIF:Cognitive Level: ComprehensionREF:p. 39OBJ: 5TOP:Prenatal DevelopmentKEY: Nursing Process Step: PlanningMSC: NCLEX: Health Promotion and Maintenance: Growth and Development17.The nurse is educating a class of expectant parents about fetal development. What isconsidered fetal age of viability?a.14 weeksb.20 weeksc.25 weeksd.30 weeksANS: BBy 20 weeks of gestation, the lungs have matured enough for the fetus to survive outside theuterus (age of viability).

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DIF:Cognitive Level: KnowledgeREF:p. 39OBJ: 5TOP:Prenatal Developmental MilestonesKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development18.The nurse is presenting a conference on gene dominance. What does the nurse report as thepercentage of children carrying the dominant gene if one parent has a dominant gene and theother parent does not?a.10%b.25%c.50%d.100%ANS: CIf one parent has a dominant trait and the other does not, then 50% of the children will inheritthe trait.DIF:Cognitive Level: ComprehensionREF:p. 37OBJ: 4TOP:Dominant TraitsKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development19.The nurse explains that the birth weight of monozygotic twins is frequently below average.What is the most likely cause?a.Inadequate space in the uterusb.Inadequate blood supplyc.Inadequate maternal healthd.Inadequate placental nutritionANS: DThe single placenta may not be able to provide adequate nutrition to two fetuses.DIF:Cognitive Level: ComprehensionREF:p. 45OBJ: 8TOP:Low Birth-Weight TwinsKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development20.The school nurse is counseling a group of adolescent girls. What does the nurse explain aboutsperm 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 vaginalwall.ANS: BSperm ejaculated near the cervix can survive up to 5 days and cause pregnancy even beforeovulation.DIF:Cognitive Level: ComprehensionREF:p. 36OBJ: 3TOP:FertilizationKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development21.What does the nurse explain can affect the survival of the X- and Y-bearing sperm afterintercourse?

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a.Ageb.Estrogen levelc.Body temperatured.Level of feminine hygieneANS: BEstrogen levels and the pH of the female reproductive tract can affect the survival of the X-and Y-bearing sperm as well as their motility.DIF:Cognitive Level: KnowledgeREF:p. 36OBJ: 3TOP:FertilizationKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development22.Of what is the normal umbilical cord comprised?a.1 artery carrying blood to the fetus and 1 vein carrying blood away from the fetusb.1 artery carrying blood to the fetus and 2 veins carrying blood away from the fetusc.2 arteries carrying blood away from the fetus and 1 vein carrying blood to the fetusd.2 arteries carrying blood to the fetus and 2 veins carrying blood away from thefetusANS: CThe umbilical cord is comprised of 2 arteries carrying blood away from the fetus and 1 veincarrying blood to the fetus.DIF:Cognitive Level: KnowledgeREF:p. 43OBJ: 6TOP:Fetal CirculationKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development23.What part of the fetal body derives from the mesoderm?a.Nailsb.Oil glandsc.Musclesd.Lining of the bladderANS: CThe mesoderm is responsible for the development of muscles. Nails and oil glands derivefrom the ectoderm. The lining of the bladder derives from the endoderm.DIF:Cognitive Level: KnowledgeREF: p. 39 | Box 3.1OBJ:4TOP:Embryonic DevelopmentKEY: Nursing Process Step: N/AMSC: NCLEX: Health Promotion and Maintenance: Growth and Development24.A couple just learned they are expecting their first child and are curious if they are having aboy or a girl. At what point of development can the couple first expect to see the sex of theirchild on ultrasound?a.4 weeks‘ gestationalageb.6 weeks‘ gestationalagec.10 weeks‘gestational aged.16 weeks‘ gestationalageANS: C

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The fetal period begins at the 9th week, and by the 10th week the external genitalia are visibleto ultrasound examination.DIF:Cognitive Level: KnowledgeREF:p. 39OBJ: 5TOP:Fetal DevelopmentKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Growth and DevelopmentMULTIPLE RESPONSE1.A nurse is teaching a lesson on fetal development to a class of high school students andexplains the primary germ layers. What are the germ layers? (Select all that apply.)a.Ectodermb.Endodermc.Mesodermd.Plastoderme.BlastodermANS: A, B, CThe zygote transforms its embryonic disc into three layers: the ectoderm, the mesoderm, andthe endoderm.DIF:Cognitive Level: KnowledgeREF: p. 39 | Box 3.1OBJ:4TOP: Primary Germ LayersKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development2.What are the functions of amniotic fluid? (Select all that apply.)a.Maintaining an even temperatureb.Impeding excessive fetal movementc.Lubricating fetal skind.Acting as a reservoir for nutrientse.Acting as a cushion for the fetusANS: A, EThe amniotic fluid provides maintenance of even temperature; prevents amnion from adheringto fetal skin; allows buoyancy, symmetrical growth, and fetal movement; and acts as acushion for the fetus. Although the fetus does swallow amniotic fluid, it has no nutritionalvalue.DIF:Cognitive Level: KnowledgeREF:p. 38OBJ: 6TOP:Amniotic FluidKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Growth and Development3.A patient at the obstetric office has just learned she is pregnant with dizygotic twins. Whatfacts will the nurse include when educating this patient? (Select all that apply.)a.Dizygotic twins are the same sex.b.Dizygotic twins share a placenta.c.Dizygotic pregnancies tend to repeat in families.d.Dizygotic twins have separate chorions.e.Dizygotic twin incidence decreases with maternal age.

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ANS: C, DDizygotic twins tend to repeat in families and have separate chorions. They can be the samesex or different sexes and have their own placenta. Incidence increases with maternal age.DIF:Cognitive Level: ComprehensionREF:p. 45OBJ: 8TOP:Dizygotic TwinsKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Growth and DevelopmentCOMPLETION1.The normal volume of amniotic fluid is approximatelymL at 37weeks‘gestation.ANS:1000The volume of amniotic fluid steadily increases from about 30 mL at 10 weeks of pregnancyto 350 mL at 20 weeks. The volume of fluid is about 1000 mL at 37 weeks. In the latter partof pregnancy, the fetus may swallow up to 400 mL of amniotic fluid per day and normallyexcretes urine into the fluid.DIF:Cognitive Level: KnowledgeREF:p. 38OBJ: 6TOP:Amniotic FluidKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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Chapter 04: Prenatal Care and Adaptations to PregnancyLeifer: Introduction to Maternity and Pediatric Nursing, 9th EditionMULTIPLE CHOICE1.A woman who is 7 weeks pregnant tells the nurse that this is not her first pregnancy. She has a2-year-old son and had one previous spontaneous abortion. How would the nurse documentthe patient‘s obstetric history using the TPALMsystem?a.Gravida 2, para 20120b.Gravida 3, para 10011c.Gravida 3, para 10110d.Gravida 2, para 11110ANS: CRefer to Box 4-1 in the textbook for the TPALM system of identifying gravida and para.DIF:Cognitive Level: ApplicationREF: p. 51 | Box 4.1OBJ:1TOP: Definition of TermsKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease2.A woman calls her health care provider to schedule prenatal visits in an uncomplicatedpregnancy. How frequently will the nurse assist the patient to schedule these appointments?a.Every 3 weeks until the 6th month, then every 2 weeks until deliveryb.Every 4 weeks until the 7th month, after which appointments will become morefrequentc.Monthly until the 8th monthd.Every 2 to 3 weeks for the entire pregnancyANS: BMonthly visits are scheduled up to 28 weeks, and then visits increase to every 2 weeksthrough 36 weeks. From 36 weeks until delivery, visits are weekly.DIF:Cognitive Level: ApplicationREF:p. 49OBJ: 2 | 3TOP:Prenatal VisitsKEY: Nursing Process Step: ImplementationMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease3.During the physical examination for the first prenatal visit, it is noted that Chadwick‘s sign ispresent. What is Chadwick‘ssign?a.Bluish or purplish discoloration of the vulva, vagina, and cervixb.Presence of early fetal movementsc.Darkening of the areola and breast tendernessd.Palpation of the fetal outlineANS: AChadwick‘s sign is the purplish or bluish discoloration of the cervix, vulva and vagina.DIF:Cognitive Level: KnowledgeREF:p. 53OBJ: 7TOP: Normal Physiological Changes in PregnancyKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Physiological Integrity: Physiological Adaptation4.After the examination is completed, the patient asks the nurse why Chadwick‘s signoccursduring pregnancy. What would the nurse explain asthe cause of Chadwick‘ssign?a.Enlargement of the uterusb.Progesterone action on the breastsc.Increasing activity of the fetus

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d.Vascular congestion in the pelvic areaANS: DChadwick‘s sign is caused by increased vascular congestion in the cervical and vaginalarea.DIF:Cognitive Level: ComprehensionREF:p. 53OBJ: 6 | 7TOP: Normal Physiological Changes in PregnancyKEY: Nursing Process Step: ImplementationMSC: NCLEX: Physiological Integrity: Physiological Adaptation5.The nurse has explained physiological changes that occur during pregnancy. Which statementindicates that the woman understands the information?a.“Blood pressure goes up toward the end of pregnancy.”b.“My breathing will get deeper and a little faster.”c.“I‘ll noticea decreased pigmentation in my skin.”d.“There will be a curvature in the upper spine area.”ANS: BThe pregnant woman breathes more deeply, and her respiratory rate may increase slightly.DIF:Cognitive Level: ComprehensionREF:p. 57OBJ: 7 | 13TOP: Normal Physiological Changes in PregnancyKEY: Nursing Process Step: EvaluationMSC: NCLEX: Physiological Integrity: Physiological Adaptation6.A woman reports that her last normal menstrual period began on August 5, 2013. What is thiswoman‘s expected delivery date using Nägele‘s rule?a.April 30, 2014b.May 5, 2014c.May 12, 2014d.May 26, 2014ANS: CTo determine the expected date of delivery, count backward 3 months from the first day of thelast menstrual period, then add 7 days and change the year if necessary.DIF:Cognitive Level: AnalysisREF: p. 52 | Box 4.2OBJ:5TOP: Determining Estimated Date of DeliveryKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Growth and Development7.During the second prenatal visit, the nurse attempts to locate the fetal heartbeat with anelectronic Doppler device. How early might fetal heart tones be detected with an electronicDoppler device?a.4 weeksb.8 weeksc.10 weeksd.14 weeksANS: CThe fetal heartbeat can be detected as early as 10 weeks of pregnancy using a Doppler device.DIF:Cognitive Level: KnowledgeREF:p. 54OBJ: 3 | 6TOP: Normal Physiological Changes in PregnancyKEY: Nursing Process Step: Data CollectionMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease8.In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices thatthe fetal heart rate (FHR) has dropped to 120 beats/minute from a rate of 160 beats/minute

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