Maternal and Child Health Nursing 7th Edition By Pillitteri – Test Bank

1. During a prenatal examination, the nurse learns that a pregnant patient has a supernumerary nipple. What should the nurse teach the patient about this finding?
A) Such growths fade with menopause.
B) Bleeding from such growths is not uncommon.
C) Such growths deepen in color during pregnancy.
D) The tendency for supernumerary nipples is genetic.
Ans: C
Feedback:
Breast changes may be one of the first things women notice in pregnancy. Any supernumerary nipples may become darker and enlarge in size. There is no information to support that supernumerary nipples fade with menopause or bleed. There is also no information to support that supernumerary nipples are genetic in origin.

2. While conducting the first prenatal health history visit, the nurse learns that a pregnant patient is taking various herbal remedies and over-the-counter medications for minor ailments. Which nursing diagnosis should the nurse identify as being appropriate for the patient at this time?
A) Risk for injury to fetus related to lifestyle choices
B) Deficient knowledge regarding exposure to teratogens during pregnancy
C) Health-seeking behaviors related to strong cultural desire to have a healthy child
D) Health-seeking behaviors related to guidelines for nutrition and activity during pregnancy
Ans: B
Feedback:
The patient is taking herbal remedies and over-the-counter medications, many of which can be teratogenic to the developing fetus. This is the most appropriate nursing diagnosis for the nurse to select for this assessment finding. There is no enough information to determine if the fetus is at risk because of the patient’s lifestyle choices. The patient has not asked for specific information so health-seeking behavior diagnoses would not be appropriate for the patient at this time.

3. When explaining what will occur during the first prenatal visit physical examination, a pregnant patient asks why a Papanicolaou smear is being done at this time. What should the nurse respond to the patient?
A) It helps to date the pregnancy.
B) It detects if uterine cancer is present.
C) It predicts whether cervical cancer will occur.
D) It detects cancer cells of the cervix, vulva, or vagina.
Ans: D
Feedback:
A Pap smear is taken from the endocervix at a first prenatal visit to be certain a precancerous or cancerous condition of the uterine cervix, vulva, or vagina is not present. A Pap smear is not used to date a pregnancy, detect uterine cancer, or predict if cervical cancer will occur.

4. The nurse in a community clinic is identifying ways to achieve the 2020 National Health Goals to support prenatal care. Which nursing actions would support the achievement of these goals? (Select all that apply.)
A) Urge female patients to ingest an adequate intake of folic acid.
B) Recommend pregnant patients attend developmental childbirth classes.
C) Discuss strategies to avoid intimate partner violence with every pregnant patient.
D) Provide a play area in the waiting room for the children of patients waiting to be seen.
E) Support pregnant patients to achieve the recommended weight gain during pregnancy.
Ans: A, B, D, E
Feedback:
A number of 2020 National Health Goals speak directly to the importance of prenatal care to include increasing the proportion of pregnant women who attend a series of prepared childbirth classes, increasing the proportion of women of childbearing potential who have an intake of at least 400 mcg of folic acid from fortified foods or dietary supplements before pregnancy, increasing the proportion of mothers who achieve a recommended weight gain during their pregnancies, and making sites for prenatal care “family friendly” or maximally receptive to women and families. Strategies to avoid intimate partner violence will not help the nurse achieve the 2020 National Health Goals for prenatal care.

5. Which question should the nurse include when conducting a review of systems with a patient during the first prenatal visit?
A) “Do you have a peptic ulcer?”
B) “Have you ever had a heart attack?”
C) “Have you had any neurologic diseases?”
D) “Have you had any urinary tract infections?”
Ans: D
Feedback:
Urinary tract infections are associated with preterm birth. If the patient has a history of this type of infection, then interventions can be directed to help the patient avoid a urinary tract infection while pregnant. Although a part of the review of systems, asking about peptic ulcers, heart attacks, and neurologic diseases may not have as significant an impact on the developing fetus as having urinary tract infections.

6. The nurse manager of a prenatal clinic has implemented interventions to individualize the prenatal care experience. Which patient statement indicates that the nurse’s efforts have been successful?
A) “It was so nice to not have to wait long in the waiting room.”
B) “I really hate having my weight and blood pressure measured around other people.”
C) “Why does everyone push breastfeeding and natural childbirth? What about what I want?”
D) “I thought you would have more reading material on labor and delivery in the waiting room.”
Ans: A
Feedback:
Strategies to individualize prenatal care include trying to schedule appointments so there won’t be a long wait time, providing privacy for weight and blood pressure assessments, educating on care options and encouraging participating in decisions about care, and providing materials on pregnancy in the waiting room.

7. The nurse is collecting a urine specimen from a pregnant patient during a prenatal visit. For what will the nurse test this patient’s urine? (Select all that apply.)
A) Protein
B) Glucose
C) Bacteria
D) Drug levels
E) White blood cells
Ans: A, B, C, E
Feedback:
Urine is tested for proteinuria, glycosuria, nitrites, and pyuria. All of these can be done by means of test strips. The nurse will not test the patient’s urine for drug levels as part of a routine prenatal visit.

8. At the conclusion of a prenatal assessment, the nurse determines that a patient is at risk during the pregnancy. Which data from the patient’s past illness history does the nurse use to make this decision? (Select all that apply.)
A) Seizure disorder
B) Previous cesarean birth
C) Hypertension for 10 years
D) History of abnormal Pap smear
E) Previous treatment for gonorrhea
Ans: A, C, E
Feedback:
Past illness history criteria that place a patient at risk during pregnancy include a seizure disorder, a chronic disease such as hypertension, and sexually transmitted infections. A previous cesarean birth and a history of abnormal Pap smears are criteria for the obstetrical history, which can place the patient at risk during pregnancy.

9. How should the nurse record the obstetric history for a pregnant patient who previously delivered two live infants at term and had one abortion at 12 weeks’ gestation?
A) Gravida 3, para 2
B) Gravida 3, para 3
C) Gravida 4, para 2
D) Gravida 4, para 3
Ans: A
Feedback:
Gravida is defined as a woman who has been pregnant. Para is defined as the number of pregnancies that have reached viability, regardless of whether the infants were born alive. The patient was pregnant three times. The patient delivered two live births. The aborted fetus is not included in the para count. The patient was not pregnant four times.

10. A pregnant patient has an anthropoid pelvis. How should the nurse explain this finding to the patient?
A) Transverse narrow
B) Ideal for childbearing
C) Similar in shape to a male
D) Has weaker bones than normal
Ans: A
Feedback:
In an anthropoid pelvis, the transverse diameter is narrow. A gynecoid pelvis has an inlet that is well rounded forward and backward and has a wide pubic arch. This pelvic type is ideal for childbirth. An android pelvis is similar in shape to that of a male. The shape of the pelvis does not determine the strength of the bones.