Select the correct answer for each question.

A pregnant woman at 25 weeks of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is most accurate?
“That must have been a coincidence; babies can’t respond like that.”
“The fetus is demonstrating the aural reflex.”
“Babies respond to sound starting at about 24 weeks of gestation.”
“Let me know if it happens again; we need to report that to your midwife.”

A woman asks the nurse, “What protects my baby’s umbilical cord from being squashed while the baby’s inside of me?” Which would be the nurse’s best response?
“Your baby’s umbilical cord is surrounded by connective tissue called Wharton jelly, which prevents compression of the blood vessels and ensures continued nourishment of your baby.”
“Your baby’s umbilical floats around in blood anyway.”
“You don’t need to be worrying about things like that.”
“The umbilical cord is a group of blood vessels that are very well protected by the placenta.”

A woman who is 8-months pregnant asks the nurse, “Does my baby have any antibodies to fight infection?” What is the most appropriate response by the nurse?

“Your baby has all the immunoglobulins necessary: IgG, IgM, and IgA.”

“Your baby won’t receive any antibodies until he is born and you breastfeed him.”
“Your baby does not have any antibodies to fight infection.”
“Your baby has IgG and IgM immunoglobulins.”
Sally comes in for her first prenatal examination. This is her first child. She asks you (the nurse), “How does my baby get air inside my uterus?” What would be the correct response? “The baby’s lungs work in utero to exchange oxygen and carbon dioxide.”
“The baby absorbs oxygen from your blood system.”
“The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream.”
“The placenta delivers oxygen-rich blood through the umbilical artery to the baby’s abdomen.”
Which statement made by a lactating woman leads the nurse to believe that the woman might have lactose intolerance? “I always have heartburn after I drink milk.”

“If I drink more than a cup of milk, I usually have abdominal cramps and bloating.”
“Drinking milk usually makes me break out in hives.”
“Sometimes I notice that I have bad breath after I drink a cup of milk.”
A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. What advice can she expect to receive? “Discontinue all contraception now.”
“Lose weight so that you can gain more during pregnancy.”
“You may take any medications you have been taking regularly.”
“Make sure you include adequate folic acid in your diet.”
To prevent gastrointestinal (GI) upset, patients should be instructed to take iron supplements on a full stomach

at bedtime
after eating a meal
with milk
After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so that you can assess her understanding of the instructions given. Which statement indicates that she understands the role of protein in her pregnancy? “Protein will help my baby grow.”
“Eating protein will prevent me from becoming anemic.”
“Eating protein will make my baby have strong teeth after he is born.”
“Eating protein will prevent me from being diabetic.”

Pregnant adolescents are at high risk for _______________ due to lower body mass indexes (BMIs) and fad dieting. Obesity
Gestational diabetes

Low-birth-weight babies
High-birth-weight babies
Which minerals and vitamins usually are recommended to supplement a pregnant woman’s diet? Fat-soluble vitamins A and D
Water-soluble vitamins C and B6
Iron and folate
Calcium and zinc
Nutrition is one of the most significant factors in influencing the outcome of a pregnancy. Nutrition is alterable and an important preventive measure for a variety of potential problems such as low birth weight and prematurity. While completing the physical assessment of the pregnant patient, the nurse can evaluate the patient’s nutritional status by observing a number of physical signs. Which sign indicates that the patient has unmet nutritional needs? Normal heart rate, rhythm, and blood pressure

Bright, clear, shiny eyes
Alert, responsive, and good endurance
Edema, tender calves, and tingling

Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. There are times when the nurse or midwife should refer a patient to a registered dietitian for in-depth nutritional counseling. These pregnant women include those with (choose all that apply) preexisting or gestational illness such as diabetes
ethnic or cultural food patterns
obesity
vegetarian diets

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 recommends that she do Kegel exercises

do pelvic rock exercises
use a softer mattress
stay in bed for 24 hours
A woman is 3 months pregnant. At her prenatal visit she tells the nurse that she doesn’t know what is happening; one minute she is happy that she is pregnant and the next minute she cries for no reason. Which response by the nurse is most appropriate? “Don’t worry about it; you’ll feel better in a month or so.”
“Have you talked to your husband about how you feel?”
“Perhaps you really don’t want to be pregnant.”
“Hormone changes during pregnancy commonly result in mood swings.”
What represents a typical progression through the phases of a woman’s establishing a relationship with the fetus? Accepts the fetus as distinct from herself—accepts the biologic fact of pregnancy—has a feeling of caring and responsibility

Fantasizes about the child’s gender and personality—views the child as part of herself—becomes introspective
Views the child as part of herself—has feelings of well-being—accepts the biologic fact of pregnancy
“I am pregnant”— “I am going to have a baby”—“I am going to be a mother.

Grading Rubric