MCN Exam #1
Ch. 4: goals of prenatal care (list) correct answers promote health of mother, fetus,
newborn, and family; ensure a safe birth for mother and child by promoting good health
habits and reducing risk factors; teaching health habits that may be continued after
pregnancy; educating in self-care for pregnancy; developing a partnership with parents
and family to provide continuous and coordinated health care; providing physical care;
preparing the parents for the responsibilities of parenthood
list what the complete history during preconception care includes correct answers
obstetric history (number and outcomes of past pregnancies); menstrual history usual
frequency and duration of flow, including first day of last normal menstrual period and
any spotting since then; contraceptive history (type used); medical and surgical history
(infections, procedures, and trauma involving reproductive organs or pelvis); family
history of woman and partner; health history of woman and partner; psychosocial history
of woman and partner (ability to parent)
at what point in gestation should urine cultures be obtained and what are they screening
for? correct answers 12-16 weeks; asymptomatic bacteruria
at what point in gestation should a vaginal and rectal swab be done to detect Group B
streptococcus (GBS)? correct answers 35-37 weeks
what is the recommended schedule for prenatal visits in an uncomplicated pregnancy?
correct answers conception to 28 weeks (every 4 weeks); 29 to 36 weeks (every two
weeks); 37 weeks to birth (weekly)
list the routine assessments made at each prenatal visit correct answers review of
known risk factors and assessment for new ones; vital signs; weight to determine if
pattern of gain is normal; urinalysis for protein, glucose, and ketone levels; blood
glucose screening (between 24-28 weeks of gestation); fundal height (to determine if
the fetus is growing as expected and the volume of amniotic fluid is appropriate);
Leopold's maneuvers (to assess the presentation and position of the fetus by abdominal
palpation, usually at 36 weeks); fetal heart rate (in early pregnancy, with a Doppler
transducer and in late pregnancy with a fetoscope); review of nutrition; discomforts or
problems that have arisen since last visit
what is the average duration of term pregnancy? correct answers 40 weeks (280 days)
after the first day of the LNMP
,state Nagele's rule to determine the estimated date of delivery (EDD) correct answers
determine the first day of the LNMP, count backward 3 months, add 7 days, and correct
the year if necessary
what are presumptive signs of pregnancy? correct answers those from which a definite
diagnosis of pregnancy cannot be made (signs and symptoms common in pregnancy
but can often be caused by other conditions): amenorrhea, nausea, breast tenderness,
deepening pigmentation, urinary frequency, and quickening
amenorrhea correct answers the cessation of menses; can also be caused by
strenuous exercise, changes in metabolism and endocrine dysfunction, chronic disease,
certain medications, anorexia nervosa, early menopause, or serious psychological
disturbances
what could nausea and vomiting result from other than gestation? correct answers
emotional problems or GI upset
describe the duration of "morning sickness" correct answers the nausea begins abut 4
weeks after the LNMP and usually improves by the end of the twentieth week
why are there breast changes (tenderness and tingling) during pregnancy? correct
answers hormones from the placenta stimulate growth of the ductal system in
preparation for breastfeeding; similar changes occur premenstrually
describe pigmentation changes occurring during pregnancy correct answers occur
primarily in dark-skinned women; includes chloasma (increased pigmentation of face),
breasts (darkening of areolae), and abdomen (linea nigra, a line extending in the midline
of the abdomen from above umbilicus to symphysis pubis)
why does urinary frequency occur in pregnancy? correct answers the enlarging uterus,
along with increased blood supply to the pelvic area, exerts pressure n the bladder
what is the believed cause as to why women feel fatigue early in pregnancy? correct
answers increased metabolic needs of the woman and fetus
what is quickening? correct answers fetal movement felt by the mother, first perceived
at 16-20 weeks as a faint fluttering in the lower abdomen; marks the midpoint of the
pregnancy
what are probable signs of pregnancy? correct answers provide stronger evidence:
goodell's sign, chadwick's sign, hegar's sign, mcdonald's sign, abdominal enlargement,
braxton hicks contractions, ballottement, striae, and positive pregnancy test
Goodell's sign correct answers the softening of the cervix and the vagina caused by
increased vascular congestion
, Chadwick's sign correct answers the purplish or bluish discoloration of the cervix,
vagina, and vulva caused by increased vascular congestion
what could also cause Goodell's or Chadwick's sign (unrelated to pregnancy)? correct
answers hormonal imbalance or infection
Hegar's sign correct answers a softening of the lower uterine segment
McDonald's sign correct answers the ease of flexing the body of the uterus against the
cervix because of Hegar's sign
Braxton Hick's contractions correct answers irregular, painless uterine contractions that
begin in the second trimester; give the sensation of the abdomen being hard and tense;
they become progressively more noticeable as term approaches and are more
pronounced in multiparas; uterine fibroids (benign tumors) could also cause these
ballotteement correct answers a maneuver by which the fetal part is displaced by a light
tap of the examining finger on the cervix, and then the part rebounds quickly; uterine or
cervical polyps (small tumors) could also cause the sensation
fetal outline correct answers may be identified by palpation after the 24th week; it is
possible to mistake a tumor for a fetus
abdominal striae correct answers stretch marks; fine, pinkish white or purplish gray
lines that some women develop when the elastic tissue of the skin has been stretched
to its capacity; increased amounts of estrogen cause a rise in adrenal gland activity and
stretching are thought to be the cause of breakdown and atrophy of the underlying
connective tissue in the skin
pregnancy tests correct answers use maternal urine or blood to determine the
presence of human chorionic gonadotropin (hCG), a hormone produced by the choionic
villi of the placenta; a highly reliable test is the radioimmunoassay (RIA)
which factors can interfere with the accuracy of pregnancy tests? correct answers
medications such as antianxiety, anticonvulsant drugs, blood in the urine, malignant
tumors, or premature menopause
what are the positive signs of pregnancy? correct answers only a developing fetus can
cause these, includes: demonstration of fetal heart activity, fetal movements felt by an
examiner, and visualization of the fetus with ultrasound
fetal heart beat correct answers may be detected as early as 10 weeks of pregnancy
using the Doppler device; it can be detected during the 18-20th week if the examiner
uses a fetoscope
