NR509 WEEK 7 EXAM QUESTIONS AND DETAILED
EXAM 2024 UPDATE
During the examination of a woman in her second trimester of pregnancy, the nurse notices the
presence of a small amount of yellow drainage from the nipples. The nurse knows that this is:
a. An indication that the woman's milk is coming in.
b. A sign of possible breast cancer in a pregnant woman.
c. Most likely colostrum and considered a normal finding at this stage of the pregnancy.
d. Too early in the pregnancy for lactation to begin and refers the woman to a specialist.
c. Most likely colostrum and considered a normal finding at this stage of the pregnancy.
A woman in her second trimester of pregnancy complains of heartburn and indigestion. When
discussing this with the woman, the nurse considers which explanation for these problems?
a. Tone and motility of the gastrointestinal tract increase during the second trimester.
b. Sluggish emptying of the gallbladder, resulting from the effects of progesterone, often causes
heartburn.
c. Lower blood pressure at this time decreases blood flow to the stomach and gastrointestinal tract.
d. Enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.
d. Enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.
A patient who is 20 weeks' pregnant tells the nurse that she feels more shortness of breath as her
pregnancy progresses. The nurse recognizes which statement to be true?
a. High levels of estrogen cause shortness of breath.
b. Feelings of shortness of breath are abnormal during pregnancy.
c. Hormones of pregnancy cause an increased respiratory effort.
d. The patient should get more exercise in an attempt to increase her respiratory reserve.
c. Hormones of pregnancy cause an increased respiratory effort.
,The nurse auscultates a functional systolic murmur, grade II/IV, on a woman in week 30 of her
pregnancy. The remainder of her physical assessment is within normal limits. The nurse would:
a. Consider this finding abnormal, and refer her for additional consultation.
b. Ask the woman to run briefly in place and then assess for an increase in intensity of the murmur.
c. Know that this finding is normal and is a result of the increase in blood volume during pregnancy.
d. Ask the woman to restrict her activities and return to the clinic in 1 week for re-evaluation.
c. Know that this finding is normal and is a result of the increase in blood volume during pregnancy.
A woman who is 28 weeks' pregnant has bilateral edema in her lower legs after working 8 hours a day as
a cashier at a local grocery store. She is worried about her legs. What is the nurse's best response?
a. "You will be at risk for development of varicose veins when your legs are edematous."
b. "I would like to listen to your heart sounds. Edema can indicate a problem with your heart."
c. "Edema is usually the result of too much salt and fluids in your diet. You may need to cut down on
salty foods."
d. "As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with
prolonged standing."
d. "As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs
with prolonged standing."
When assessing a woman who is in her third trimester of pregnancy, the nurse looks for the classic
symptoms associated with preeclampsia, which include:
a. Edema, headaches, and seizures.
b. Elevated blood pressure and proteinuria.
c. Elevated liver enzymes and high platelet counts.
d. Decreased blood pressure and edema.
b. Elevated blood pressure and proteinuria.
,The nurse knows that the best time to assess a woman's blood pressure during an initial prenatal visit is:
a. At the end of the examination when she will be the most relaxed.
b. At the beginning of the interview as a nonthreatening method of gaining rapport.
c. During the middle of the physical examination when she is the most comfortable.
d. Before beginning the pelvic examination because her blood pressure will be higher after the pelvic
examination.
a. At the end of the examination when she will be the most relaxed.
When examining the face of a woman who is 28 weeks' pregnant, the nurse notices the presence of a
butterfly-shaped increase in pigmentation on the face. The proper term for this finding in the
documentation is:
a. Striae.
b. Chloasma.
c. Linea nigra.
d. Mask of pregnancy.
b. Chloasma.
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Which finding is considered normal and expected when the nurse is performing a physical examination
on a pregnant woman?
a. Palpable, full thyroid
b. Edema in one lower leg
c. Significant diffuse enlargement of the thyroid
d. Pale mucous membranes of the mouth
a. Palpable, full thyroid
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When auscultating the anterior thorax of a pregnant woman, the nurse notices the presence of a
murmur over the second, third, and fourth intercostal spaces. The murmur is continuous but can be
obliterated by pressure with the stethoscope or finger on the thorax just lateral to the murmur. The
nurse interprets this finding to be:
a. Murmur of aortic stenosis.
b. Most likely a mammary souffle.
c. Associated with aortic insufficiency.
d. Indication of a patent ductus arteriosus.
b. Most likely a mammary souffle.
When the nurse is assessing the deep tendon reflexes (DTRs) on a woman who is 32 weeks' pregnant,
which of these would be considered a normal finding on a 0 to 4+ scale?
a. Absent DTRs
b. 2+
c. 4+
d. Brisk reflexes and the presence of clonus
b. 2+
When performing an examination of a woman who is 34 weeks' pregnant, the nurse notices a midline
linear protrusion in the abdomen over the area of the rectus abdominis muscles as the woman raises
her head and shoulders off of the bed. Which response by the nurse is correct?
a. The presence of diastasis recti should be documented.
b. This condition should be discussed with the physician because it will most likely need to be surgically
repaired.
c. The possibility that the woman has a hernia attributable to the increased pressure within the
abdomen from the pregnancy should be suspected.
d. The woman should be told that she may have a difficult time with delivery because of the weakness in
her abdominal muscles.
a. The presence of diastasis recti should be documented.
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