NR-327 Maternal-Child Nursing - Set 1 - Part 1

Correct Answer: Review her hemoglobin and iron study results

Pica travels closely with iron deficiency anemia, so hemoglobin and iron studies come first. Nonfood intake also displaces nourishing calories and can bring lead exposure, parasites, or bowel obstruction. Option b is incorrect because calling the behavior harmless skips the anemia that usually sits underneath it. Starch also crowds out nutritious food, which puts fetal growth at risk over the remaining weeks. Option c is incorrect because glucose screening answers a different question, and pica carries no link to impaired glucose tolerance. The craving points toward a mineral deficit that a blood count would reveal. Option d is incorrect because psychiatric referral leaps past the simplest explanation. Nonfood cravings in pregnancy most often resolve once iron stores are rebuilt, and a matter of fact conversation gathers more information.

Correct Answer: The measurement roughly matches the weeks of gestation

From about the twentieth week until roughly the thirty-sixth, fundal height in centimeters tracks weeks of gestation within a couple of centimeters. Agreement between tape and dates supports growth that is on schedule. Option a is incorrect because fundal height reflects uterine size, which includes fluid, placenta and fetus together. Estimating weight takes ultrasound biometry, and a tape over the abdomen cannot separate those three contributors. Option b is incorrect because position is judged by palpating the fetal parts through the abdominal wall, a separate maneuver performed later in pregnancy. A single vertical measurement says nothing about how the fetus lies. Option d is incorrect because the tape is a screening tool, not a substitute for imaging. When the number drifts away from the dates by more than a few centimeters, ultrasound is exactly what follows.

Correct Answer: Scarring damaged the cilia that transport the ovum

Fertilization normally happens in the ampulla, and cilia plus peristalsis must move the conceptus onward. Infection scars the tube and destroys cilia, so the blastocyst implants where it stalls. Option b is incorrect because endometrial thickness has no bearing on whether the conceptus reaches the uterus at all. A tubal pregnancy is a transport failure, not a problem with the receiving bed. Option c is incorrect because sperm cannot reach an ovum still inside the follicle. Release comes first, the fimbriae sweep the ovum into the tube, and only then can a sperm penetrate it. Option d is incorrect because progesterone relaxes smooth muscle rather than tightening it. Slowed tubal motility can contribute to delay, but constriction is the opposite of what this hormone does to the tube.

Correct Answer: A surge in luteinizing hormone

Estradiol from the dominant follicle climbs past a threshold and flips feedback to positive, producing the luteinizing hormone surge. Ovulation follows roughly a day to a day and a half later. Option a is incorrect because progesterone falls at the end of the luteal phase, well after the egg has already been released. That withdrawal brings on menstruation rather than opening a follicle. Option b is incorrect because follicle stimulating hormone recruits and grows the cohort of follicles during the first half of the cycle. Recruitment sets the stage, yet rupture of the follicle needs a different signal. Option d is incorrect because estradiol peaks rather than plummets just before release, and the peak is what turns feedback positive. A sudden drop would silence the pituitary and stall the cycle entirely.

Correct Answer: Report the finding so ultrasound can be arranged

A fundus running well ahead of the dates points toward multiple gestation, excess amniotic fluid, a large fetus, or dating that is wrong. Ultrasound sorts those apart, so the finding goes to the provider. Option b is incorrect because normal variation covers a difference of a couple of centimeters, not a gap this wide. Comfort offered before the cause is known can delay recognition of a real problem. Option c is incorrect because waiting weeks allows polyhydramnios or an oversized fetus to progress unwatched. Timing matters in the third trimester, when decisions about surveillance and mode of birth are being made. Option d is incorrect because the number plainly disagrees with the dates, so charting agreement misrepresents the assessment. Accurate documentation of the discrepancy is what triggers the imaging this client needs.

Correct Answer: It lets the fetus move and practice breathing

Fluid gives the fetus room to move, and those movements plus fluid inside the airways are what let the lungs and musculoskeletal system develop normally. Too little fluid produces pulmonary hypoplasia. Option a is incorrect because thermal stability is a genuine function of the fluid, yet warmth alone builds no alveoli. A steady temperature protects metabolism rather than shaping the respiratory tract. Option b is incorrect because cushioning shields the fetus from blunt trauma and keeps the cord from being compressed. Protection of that sort guards existing structures instead of driving their formation. Option d is incorrect because minerals reach the fetus by active transport across the placenta, not from the surrounding fluid. Amniotic fluid is mostly fetal urine after the middle of pregnancy.

Correct Answer: Two arteries and one vein

The normal cord carries two arteries and a single vein wrapped in Wharton jelly. Counting the vessels at birth matters because a missing artery points toward renal and cardiac anomalies. Option a is incorrect because a single artery paired with one vein describes a two vessel cord, an abnormal finding in about one percent of births that calls for further evaluation of the newborn. Option b is incorrect because the vessel count is reversed here. Arteries outnumber veins in the cord, since two of them return waste laden blood to the placenta while one vein delivers oxygen. Option c is incorrect because no cord contains three arteries. Adding an extra vessel to the expected pattern would be a structural anomaly, and the nurse would report any count other than three vessels total.

Correct Answer: A presumptive sign the client notices herself

Quickening is the client's own perception of fetal movement, and gas or peristalsis feels much the same. Because another cause can explain it, the finding stays presumptive rather than confirmatory. Option b is incorrect because probable signs are objective findings the examiner produces or observes, such as a softened cervix or ballottement. Movement the client alone perceives never falls into that examiner-detected group. Option c is incorrect because only three findings prove a fetus: heart tones heard through a device, fetal movement palpated by the examiner, and the fetus seen on ultrasound. Option d is incorrect because no category of pregnancy signs is called diagnostic, and the label implies certainty that a subjective sensation cannot carry. Confirmation still requires ultrasound or auscultated fetal heart tones.

Correct Answer: Chadwick sign, a venous congestion color change

Chadwick sign is the bluish purple discoloration of cervix, vagina and vulva that follows pelvic venous congestion in early pregnancy. The examiner observes it, which makes it a probable sign. Option a is incorrect because Goodell sign refers to texture rather than color, describing a cervix that feels soft instead of firm. Nothing about softening accounts for a violet hue. Option b is incorrect because Hegar sign is elicited by compressing the isthmus between the examining fingers, and it reports on consistency deep in the uterus. Surface color plays no part in it. Option c is incorrect because ballottement is a maneuver, not an appearance: the examiner taps the cervix and feels the fetus float upward and rebound against the fingers around midpregnancy.

Correct Answer: Relaxin, assisted by progesterone

Relaxin, working with progesterone, softens the cartilage of the symphysis pubis and the sacroiliac joints. The pelvis gains capacity for birth at the cost of instability and pelvic girdle pain. Option a is incorrect because oxytocin and prostaglandins act on the myometrium to produce contractions and ripen the cervix at the end of pregnancy. Pelvic joint laxity appears far earlier than that. Option b is incorrect because estrogen enlarges the uterus and breasts and thickens vascular tissue, while prolactin prepares milk-producing cells. Neither hormone loosens cartilage in the pelvic ring or girdle. Option d is incorrect because these two hormones oppose insulin and shift the mother toward burning fatty acids. Their target is fuel supply for the fetus, not the connective tissue of the pelvis.

Correct Answer: Twins are counted individually as two children

The living children entry counts people rather than pregnancies, so each surviving twin is listed. That is the one place where a multiple birth adds more than one, and the mismatch trips up most students. Option a is incorrect because the single count rule stops at the birth related letters. Applying it here would suggest the client has one child when two are alive and in her care. Option c is incorrect because term births and living children answer different questions. Her twins do belong under term as one birth, yet that entry says nothing about who is alive today. Option d is incorrect because a narrative note cannot replace the coded entry that every provider reads first. The last letter is designed to carry exactly this information in a standard form.

Correct Answer: Stay upright for an hour after eating

Progesterone relaxes the lower esophageal sphincter while the growing uterus raises abdominal pressure. Staying upright after eating uses gravity to keep stomach contents down, along with small meals and an elevated head of bed. Option b is incorrect because reclining right after a meal lets acid travel back up the relaxed sphincter. Rest is fine once an hour or two has passed and the stomach has begun emptying. Option c is incorrect because sodium bicarbonate delivers a sodium load that worsens fluid retention and can push her toward metabolic alkalosis. Calcium carbonate is the antacid chosen in pregnancy instead. Option d is incorrect because large fluid volumes taken with food add to gastric distension, which is one of the triggers. Milk gives brief relief, then stimulates further acid secretion once it clears.

Correct Answer: Walk the aisle every hour or two

Venous stasis is the real hazard of a long trip, since pregnancy already tips the balance toward clotting. Moving about, ankle circles, compression stockings, and steady fluids keep blood from pooling in the legs. Option a is incorrect because cutting fluids thickens the blood and raises clot risk, the very thing the advice is meant to prevent. Hydration is encouraged even though it means more trips to the lavatory. Option b is incorrect because immobility for hours is what allows blood to pool behind the valves of the calf veins. Staying in the seat trades a small fall risk for a far larger one. Option d is incorrect because restrictive garments squeeze superficial veins and worsen the pooling. Loose clothing plus graduated compression stockings, which work on a different principle, are what the nurse recommends.

Correct Answer: The uterus has pushed the diaphragm upward

The growing uterus lifts the diaphragm about four centimeters, and oxygen consumption climbs to supply the fetus. Together these produce breathlessness on exertion that eases once lightening lowers the presenting part. Option a is incorrect because respiratory rate barely changes in pregnancy; what rises sharply is tidal volume, so each breath moves more air. A slowed rate would point to something abnormal. Option b is incorrect because pregnancy does not damage lung tissue or its elastic properties. The limitation is mechanical crowding from below, and the chest compensates by widening the subcostal angle. Option c is incorrect because the dilutional fall in hemoglobin is mild and rarely causes exertional breathlessness on its own. Most clients feel this symptom with entirely normal red cell values.

Correct Answer: Ask another household member to change the litter

Oocysts shed in cat feces cause toxoplasmosis, so someone else should empty the box. The cats themselves can stay, since transmission comes from contaminated litter, soil, and undercooked meat rather than petting. Option a is incorrect because giving away a pet is unnecessary and distressing when a simple division of chores solves the problem. Handling the animal itself does not transmit the parasite to the client. Option c is incorrect because weekly emptying lets oocysts mature into their infective form, which takes only a day or two in the box. Daily changing is the fallback when nobody else can help. Option d is incorrect because handwashing alone leaves her exposed while she scoops. If no one else is available she wears gloves and a mask, then washes, rather than dropping the barrier.

Correct Answer: Auscultate the fetal heart rate immediately

Sudden decompression of an overdistended uterus can sweep the cord past the presenting part, so the fetal heart is checked first. A prolapsed cord shows up as an abrupt deep deceleration. Option b is incorrect because temperature tracks infection risk once the barrier is gone, which matters over the following hours rather than in the first minute. Fetal status outranks it right now. Option c is incorrect because nitrazine testing confirms that the fluid is amniotic, and the gush already answers that question. Confirmation of a diagnosis never comes before checking whether the fetus is stable. Option d is incorrect because an estimate of volume adds nothing urgent to the picture. Documenting the amount can wait until the nurse knows the fetus tolerated the sudden loss of fluid.

Correct Answer: "I gave up alcohol and keep coffee to one cup daily."

No amount or type of alcohol is safe at any point, and caffeine stays under two hundred milligrams daily, about one twelve ounce cup of brewed coffee. Her plan meets both limits. Option a is incorrect because the teratogen is ethanol itself, so the beverage chosen changes nothing. Beer, wine, and spirits all deliver alcohol across the placenta, and swapping one for another offers no protection. Option b is incorrect because four cups carry roughly double the daily caffeine allowance, even though she has handled the alcohol correctly. Tea, cola, chocolate, and some headache remedies push the total higher still. Option c is incorrect because a weekly drink still crosses to a fetus that cannot clear it, and no threshold has ever been established. Dropping coffee entirely is optional, since a modest amount is permitted.

Correct Answer: Pressure should be at its lowest point now

Mid pregnancy is the nadir, with pressure lowest around twenty-four to twenty-eight weeks from progesterone driven vasodilation. A value at the top of normal now may represent a real rise from her baseline. Option a is incorrect because the return toward baseline happens in the third trimester, and this client is not there yet. At twenty-six weeks the pressure should still be near its lowest. Option b is incorrect because a single reference range ignores the trajectory pregnancy follows. Judging any pressure means comparing it with the client's own baseline and with the stage she has reached. Option d is incorrect because protein is only one criterion, and gestational hypertension is diagnosed without it. Waiting for protein to appear delays recognition of a pressure that is climbing.

Correct Answer: Give Tdap now and rubella vaccine after birth

Inactivated and recombinant vaccines are safe in pregnancy, so Tdap is given between twenty seven and thirty six weeks for every pregnancy. Rubella vaccine is live, so it waits until after the birth. Option b is incorrect because the rubella component is a live attenuated virus, carrying a theoretical risk of fetal infection. Only the tetanus, diphtheria, and pertussis vaccine belongs at this visit. Option c is incorrect because postponing pertussis protection wastes the window in which maternal antibody crosses to the fetus. The newborn would then face pertussis unprotected until the infant vaccine series begins. Option d is incorrect because the schedule is reversed here. Live vaccines wait for the postpartum period, when rubella can be given before discharge with advice to avoid conception for four weeks, while Tdap belongs now.

Correct Answer: Sitz baths, witch hazel compresses, and added fiber

Sitz baths and witch hazel soothe the engorged veins, while fiber and fluid soften stool so she stops straining. Side lying rest lowers pelvic venous pressure and helps the swelling settle. Option a is incorrect because stimulant laxatives can provoke uterine contractions and repeated enemas irritate an already inflamed rectum. Softening the stool is the aim, not forcing evacuation with harsh preparations. Option c is incorrect because mineral oil blocks absorption of fat soluble vitamins, and long periods on the toilet increase venous pooling in the anal cushions. Both measures work against her. Option d is incorrect because cutting fluid and fiber hardens the stool and guarantees more straining. Immobility adds to venous congestion, so this combination would enlarge the hemorrhoids rather than shrink them.