Maternal Newborn Nursing Test Maternity Nursing: Antepartum 4 — Questions and Answers
Question 1: A client with chronic hypertension becomes pregnant. The nurse knows that which antihypertensive medication is CONTRAINDICATED during pregnancy?
- Methyldopa (Aldomet)
- Labetalol
- Nifedipine
- Lisinopril (ACE inhibitor) (Correct answer)
Correct answer: Lisinopril (ACE inhibitor)
ACE inhibitors are teratogenic and can cause fetal renal dysgenesis, oligohydramnios, and neonatal renal failure; they are absolutely contraindicated in pregnancy.
Question 2: A nurse assesses a client at 22 weeks gestation who reports round ligament pain. Which description is MOST consistent with this condition?
- Constant, dull suprapubic pressure worsened by rest
- Sharp, brief pain in the lower abdomen or groin with movement (Correct answer)
- Colicky flank pain radiating to the groin
- Burning epigastric pain after meals
Correct answer: Sharp, brief pain in the lower abdomen or groin with movement
Round ligament pain is characteristically sharp, brief, and occurs with sudden movement as the ligaments supporting the uterus stretch.
Question 3: A client at 18 weeks gestation asks about amniocentesis. The nurse explains the PRIMARY purpose of amniocentesis in the second trimester is to:
- Assess fetal lung maturity
- Evaluate fetal chromosomal abnormalities (Correct answer)
- Measure fetal blood glucose
- Determine placental location
Correct answer: Evaluate fetal chromosomal abnormalities
Second-trimester amniocentesis is primarily used for genetic diagnosis of chromosomal abnormalities such as Down syndrome (trisomy 21).
Question 4: During a prenatal visit at 10 weeks, a client discloses she drinks two glasses of wine per day. The nurse's BEST response is:
- That is acceptable as long as it does not exceed three drinks per day
- Advise the client that no amount of alcohol is known to be safe during pregnancy (Correct answer)
- Suggest switching to beer which is lower in alcohol content
- Reassure her that alcohol only affects the fetus in the third trimester
Correct answer: Advise the client that no amount of alcohol is known to be safe during pregnancy
There is no established safe level of alcohol consumption during pregnancy; alcohol crosses the placenta and can cause fetal alcohol spectrum disorders at any gestational age.
Question 5: A client at 34 weeks gestation is admitted with abruptio placentae. Which assessment finding distinguishes abruption from placenta previa?
- Painless, bright-red vaginal bleeding
- Rigid, board-like abdomen with dark-red bleeding (Correct answer)
- Soft, nontender uterus with heavy bleeding
- Fetal heart rate accelerations with movement
Correct answer: Rigid, board-like abdomen with dark-red bleeding
Abruptio placentae typically presents with sudden-onset, severe abdominal pain and a rigid, board-like uterus due to retroplacental hemorrhage, unlike the painless bleeding of previa.
Question 6: The nurse teaches a client in her first trimester about physiologic changes of pregnancy. Which cardiovascular change is EXPECTED?
- Increase in blood pressure throughout pregnancy
- Decrease in plasma volume by 10%
- Increase in heart rate by 10–15 bpm (Correct answer)
- Decrease in cardiac output in the second trimester
Correct answer: Increase in heart rate by 10–15 bpm
Maternal heart rate normally increases by 10–15 beats per minute during pregnancy to meet increased metabolic demands.
Question 7: A client at 28 weeks gestation is undergoing a biophysical profile (BPP). Which score indicates fetal well-being and no need for immediate intervention?
- Score of 4 out of 10
- Score of 6 out of 10
- Score of 8 out of 10 (Correct answer)
- Score of 2 out of 10
Correct answer: Score of 8 out of 10
A BPP score of 8–10 out of 10 is considered normal and reassuring, indicating no fetal asphyxia.
Maternal Newborn Nursing Test Maternity Nursing: Antepartum 4
A client with chronic hypertension becomes pregnant.
The nurse knows that which antihypertensive medication is CONTRAINDICATED during pregnancy?