Normal pregnancy and its management – Preconception care, genetic counselling, physiological changes in pregnancy, diagnosis of pregnancy, antenatal care and minor disorders of pregnancy.
Time: 15:00
The primary reason for advising a woman to take folic acid supplements during the preconception period and early pregnancy is to prevent:
[a] Iron-deficiency anemia in the mother.
[b] Congenital heart defects in the fetus.
[c] Neural tube defects in the fetus.
[d] Gestational diabetes in the mother.
A pregnant woman in her second trimester has a lower hemoglobin and hematocrit level than her pre-pregnancy values, despite adequate iron intake. This is most likely due to:
[a] A pathological anemic process.
[b] Fetal absorption of maternal iron stores.
[c] Physiological hemodilution of pregnancy.
[d] Inadequate absorption of dietary iron.
Which of the following is considered a positive sign of pregnancy?
[a] Amenorrhea.
[b] A positive urine pregnancy test.
[c] Chadwick's sign.
[d] Visualization of the fetus by ultrasound.
A woman's last menstrual period (LMP) began on June 10. Using Naegele's rule, the nurse calculates her estimated date of delivery (EDD) to be:
[a] March 3.
[b] March 17.
[c] April 10.
[d] April 17.
Which advice is most appropriate for a pregnant woman experiencing nausea and vomiting ("morning sickness") in the first trimester?
[a] "Drink a large glass of water with each meal."
[b] "Eat three large, balanced meals per day."
[c] "Lie down immediately after eating."
[d] "Eat small, frequent meals and snacks, such as dry crackers."
During a pelvic exam, a nurse notes a bluish or purplish discoloration of the cervix and vaginal mucosa. This probable sign of pregnancy is known as:
[a] Goodell's sign.
[b] Chadwick's sign.
[c] Hegar's sign.
[d] McDonald's sign.
Which of the following is a probable sign of pregnancy?
[a] Fetal movement felt by the mother.
[b] Breast tenderness.
[c] A positive serum hCG test.
[d] Fetal heart sounds heard with a Doppler.
During an antenatal visit at 20 weeks of gestation for a woman with a singleton pregnancy, the nurse would expect the fundal height to be at the level of the:
[a] Symphysis pubis.
[b] Xiphoid process.
[c] Umbilicus.
[d] Midway between the symphysis pubis and umbilicus.
A woman in her third trimester complains of heartburn (pyrosis). The nurse's best advice would be to:
[a] Drink a full glass of milk before bedtime.
[b] Avoid spicy or fatty foods and remain upright after meals.
[c] Take an over-the-counter antacid with every meal.
[d] Eat a large meal in the evening to prevent hunger overnight.
What is the primary purpose of genetic counselling for an expectant couple?
[a] To decide whether the couple should continue the pregnancy.
[b] To guarantee the birth of a healthy baby.
[c] To provide information on genetic risks and support informed decision-making.
[d] To perform genetic testing on all expectant parents.
Increased urinary frequency in the first trimester of pregnancy is primarily caused by:
[a] The pressure of the growing uterus on the bladder.
[b] A decrease in the glomerular filtration rate (GFR).
[c] Hormonal changes (hCG and progesterone) that increase blood flow to the kidneys.
[d] An early sign of a urinary tract infection.
A woman reports breast tenderness, fatigue, and a missed menstrual period. These are considered what type of signs of pregnancy?
[a] Positive signs.
[b] Probable signs.
[c] Presumptive signs.
[d] Diagnostic signs.
A key component of the initial antenatal blood work is to determine the mother's blood type and Rh factor to:
[a] Predict the baby's blood type.
[b] Assess for gestational diabetes.
[c] Screen for anemia.
[d] Identify the risk for isoimmunization and hemolytic disease of the newborn.
Which nursing intervention is most appropriate for managing constipation during pregnancy?
[a] Recommending the regular use of stimulant laxatives.
[b] Advising a low-fiber diet to rest the bowels.
[c] Encouraging increased fluid intake, dietary fiber, and regular exercise.
[d] Suggesting a daily enema.
Preconception care for a woman with a chronic illness like diabetes is essential to:
[a] Ensure she gains an appropriate amount of weight.
[b] Prevent minor disorders like morning sickness.
[c] Achieve optimal disease control before pregnancy to reduce risks to mother and fetus.
[d] Guarantee a vaginal delivery.
The dark line of pigmentation that often appears on the abdomen of a pregnant woman, running from the umbilicus to the symphysis pubis, is called:
[a] Chloasma.
[b] Striae gravidarum.
[c] Linea nigra.
[d] Melasma.
During an antenatal visit, which symptom reported by a woman in her third trimester requires immediate investigation?
[a] Ankle edema at the end of the day.
[b] Occasional Braxton Hicks contractions.
[c] Blurred vision and a persistent headache.
[d] Shortness of breath with exertion.
A normal physiological change in the respiratory system during pregnancy is an increase in:
[a] Residual volume.
[b] Tidal volume.
[c] Respiratory rate at rest.
[d] Functional residual capacity.
What is the most appropriate advice for a pregnant woman experiencing leg cramps at night?
[a] Point your toes when the cramp occurs.
[b] Take a calcium supplement before bed.
[c] Dorsiflex the foot and increase hydration during the day.
[d] Keep the leg bent at the knee to relieve the spasm.
Hegar's sign, a probable sign of pregnancy, is described as:
[a] The bluish discoloration of the cervix.
[b] The softening of the cervix.
[c] Fetal movement felt by the examiner.
[d] Softening of the lower uterine segment.
The primary purpose of teaching a pregnant woman to perform daily fetal movement counts ("kick counts") in the third trimester is to:
[a] Determine the sex of the fetus.
[b] Predict the onset of labour.
[c] Estimate the size of the fetus.
[d] Monitor fetal well-being and identify potential hypoxia.
Genetic counselling would be most indicated for which of these women?
[a] A 25-year-old woman with her first pregnancy.
[b] A woman with a history of gestational diabetes.
[c] A 38-year-old woman who has a child with Down Syndrome.
[d] A woman who experienced severe morning sickness.
A nurse advises a pregnant woman in her third trimester to avoid lying flat on her back. This is to prevent:
[a] The onset of premature labour.
[b] An increase in maternal blood pressure.
[c] Supine hypotensive syndrome.
[d] Heartburn and indigestion.
Which intervention is recommended for a pregnant woman experiencing physiological lordosis and backache?
[a] Wearing high-heeled shoes to improve posture.
[b] Performing pelvic tilt exercises.
[c] Sleeping on her stomach.
[d] Lifting heavy objects by bending at the waist.
According to standard antenatal care guidelines for an uncomplicated pregnancy, how often should a woman have check-ups during the first 28 weeks?
[a] Every week.
[b] Every two weeks.
[c] Every four weeks.
[d] Every six weeks.
Legislation in nursing, profession and related organisations.
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