1. A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular
menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a
day, but she tells you that she is trying to cut down. Her laboratory data are within normal ...
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular
menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a
day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits.
What diagnostic technique could be used with this pregnant woman at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein screening (MSAFP)
c. Amniocentesis
d. Nonstress test (NST)
____ 2. 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?
a. Doppler blood flow analysis c. Amniocentesis
b. Contraction stress test (CST) d. Daily fetal movement counts
____ 3. A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool
would yield more detailed information about the fetus?
a. Ultrasound for fetal anomalies
b. Biophysical profile (BPP)
c. Maternal serum alpha-fetoprotein screening (MSAFP)
d. Percutaneous umbilical blood sampling (PUBS)
____ 4. At 35 weeks of pregnancy a woman experiences preterm labor. Although tocolytics are administered
and she is placed on bed rest, she continues to experience regular uterine contractions, and her cervix
is beginning to dilate and efface. What would be an important test for fetal well-being at this time?
a. Percutaneous umbilical blood sampling (PUBS)
b. Ultrasound for fetal size
c. Amniocentesis for fetal lung maturity
d. Nonstress test
____ 5. A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to suggest
to her at this time?
a. Biophysical profile
b. Amniocentesis
c. Maternal serum alpha-fetoprotein (MSAFP)
d. Transvaginal ultrasound
____ 6. A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions
that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min
without any decelerations. The interpretation of this test is said to be:
a. Negative. c. Satisfactory.
b. Positive. d. Unsatisfactory.
,____ 7. 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?
a. 2-0-0-1-1 c. 3-1-0-1-0
b. 2-1-0-1-0 d. 3-0-1-1-0
____ 8. A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and
symptoms of pregnancy likely will have:
a. Amenorrhea. c. Chadwick’s sign.
b. Positive pregnancy test. d. Hegar’s sign.
____ 9. The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of
pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a
positive sign of pregnancy is:
a. A positive pregnancy test.
b. Fetal movement palpated by the nurse-midwife.
c. Braxton Hicks contractions.
d. Quickening.
____ 10. A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?
a. Not palpable above the symphysis at this time
b. Slightly above the symphysis pubis
c. At the level of the umbilicus
d. Slightly above the umbilicus
____ 11. During a client’s physical examination the nurse notes that the lower uterine segment is soft on
palpation. The nurse would document this finding as:
a. Hegar’s sign c. Chadwick’s sign
b. McDonald’s sign d. Goodell’s sign
____ 12. A number of changes in the integumentary system occur during pregnancy. What change persists
after birth?
a. Epulis c. Telangiectasia
b. Chloasma d. Striae gravidarum
____ 13. 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.
____ 14. A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal
viability is called a:
a. Primipara. c. Multipara.
b. Primigravida. d. Nulligravida.
____ 15. The mucous plug that forms in the endocervical canal is called the:
a. Operculum. c. Funic souffle.
b. Leucorrhea. d. Ballottement.
____ 16. 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.
____ 17. 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.
____ 18. A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The
client tells the nurse that she is afraid that she is going into premature labor because she is beginning
to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the
client that this type of contraction:
a. Is painless. c. Causes cervical dilation.
b. Increases with walking. d. Impedes oxygen flow to the fetus.
____ 19. A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period (LMP)
was February 14, 2010. Her expected date of birth (EDB) would be:
a. September 17, 2010. c. November 21, 2010.
b. November 7, 2010. d. December 17, 2010.
____ 20. Prenatal testing for the human immunodeficiency virus (HIV) is recommended for:
a. All women, regardless of risk factors.
b. A woman who has had more than one sexual partner.
c. A woman who has had a sexually transmitted infection.
d. A woman who is monogamous with her partner.
____ 21. Which symptom is considered a first-trimester warning sign and should be reported immediately by
the pregnant woman to her health care provider?
a. Nausea with occasional vomiting c. Urinary frequency
b. Fatigue d. Vaginal bleeding
____ 22. Which blood pressure (BP) finding during the second trimester indicates a risk for pregnancy-
induced hypertension?
a. Baseline BP 120/80, current BP 126/85
b. Baseline BP 100/70, current BP 130/85
c. Baseline BP 140/85, current BP 130/80
d. Baseline BP 110/60, current BP 110/60
____ 23. A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing
occasional backaches of mild-to-moderate intensity. The nurse would recommend that she:
a. Do Kegel exercises. c. Use a softer mattress.
b. Do pelvic rock exercises. d. Stay in bed for 24 hours.
____ 24. For what reason would breastfeeding be contraindicated?
a. Hepatitis B
b. Everted nipples
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