413 EXAM 4 (FINAL) PRACTICE QUESTIONS

A 30-week-gestation multigravida, G3P1011, is admitted to the labor suite. She is contracting every 5 minutes 40 seconds. Which of the comments by the client would be most informative regarding the etiology of the client's present condition? A. "For the past day I have felt burning when I urinate." B. "I have a daughter who is 2 years old." C. "I jogged 11⁄2 miles this morning." D. "My miscarriage happened a year ago today."

A. "For the past day I have felt burning when I urinate."

A client who works as a waitress and is 35 weeks' gestation, telephones the labor suite after getting home from work and states, "I am feeling tightening in my groin about every 5 to 6 minutes." Which of the following comments by the nurse is appropriate at this time? A. "Please lie down and drink about four full glasses of water or juice." B. "You are having false labor pains so you need not worry about them." C. "It is essential that you get to the hospital immediately." D. "That is very normal for someone who is on her feet all day."

A. "Please lie down and drink about four full glasses of water or juice."

A nurse remarks to a 38-week-gravid client, "It looks like your face and hands are swollen." The client responds, "Yes, you're right. Why do you ask?" The nurse's response is based on the fact that the changes may be caused by which of the following? A. Altered glomerular filtration B. Cardiac failure C. Hepatic insufficiency D. Altered splenic circulation

A. Altered glomerular filtration

A pregnant diabetic has been diagnosed with hydramnios. Which of the following would explain this finding? A. Excessive fetal urination B. Recurring hypoglycemic episode C. Fetal sacral agenesis D. Placental vascular damage.

A. Excessive fetal urination

A 32-weeks' gestation client states that she "thinks" she is leaking amniotic fluid. Which of the following tests could be performed to determine whether the membranes had ruptured? A. Fern test B. Biophysical profile C. Amniocentesis D. Kernig sign.

A. Fern test

A gravid woman has been diagnosed with listeriosis. She eats rare meat and raw smoked seafood. Which of the following signs/symptoms would this woman exhibit? A. Fever and muscle aches B. Rash and thrombocytopenia C. Petechiae and anemia D. Amnionitis and epistaxis.

A. Fever and muscle aches

A 39-year-old, 16-week-gravid woman has had an amniocentesis. Before discharge, the nurse teaches the woman to call her doctor if she experiences any of the following side effects? Select all that apply. A. Fever or chills B. Lack of fetal movement C. Abdominal pain D. Rash or pruritus E. Vaginal bleeding.

A. Fever or chills B. Lack of fetal movement C. Abdominal pain E. Vaginal bleeding.

A client with 4+ protein and 4+ reflexes is admitted to the hospital with severe preeclampsia. The nurse must closely monitor the woman for which of the following? A. Grand mal seizure B. High platelet count C. Explosive diarrhea D. Fractured pelvis

A. Grand mal seizure

In anticipation of a complication that may develop in the second half of pregnancy, the nurse teaches an 18-week gravid client to call the office if she experiences which of the following? A. Headache and decreased output B. Puffy feet C. Hemorrhoids and vaginal discharge D. Backache.

A. Headache and decreased output

A gravid woman, 36 weeks' gestation with type 1 diabetes, has just had a biophysical profile (BPP). Which of the following results should be reported to the obstetrician? A. One fetal heart acceleration in 20 minutes B. Three episodes of fetal rhythmic breathing in 30 minutes C. Two episodes of fetal extension and flexion of 1 arm D. One amniotic fluid pocket measuring 3 cm.

A. One fetal heart acceleration in 20 minutes

A client, 32 weeks' gestation with placenta previa, is on total bed rest. The physician expects her to be hospitalized on bed rest until her cesarean section, which is scheduled for 38 weeks' gestation. To prevent complications while in the hospital, the nurse should do which of the following? Select all that apply. A. Perform passive range of motion exercises B. Restrict the fluid intake of the client C. Decorate the room with pictures of family D. Encourage the client to eat a high-fiber diet E. Teach the client deep breathing exercises.

A. Perform passive range of motion exercises C. Decorate the room with pictures of family D. Encourage the client to eat a high-fiber diet E. Teach the client deep breathing exercises.

A nurse works in a clinic with a high adolescent pregnancy population. The nurse provides teaching to the young women in order to prevent which of the following high risk complications of pregnancy? A. Preterm birth B. Gestational diabetes C. Macrosomic babies D. Polycythemia.

A. Preterm birth

On ultrasound, it is noted that the pregnancy of a hospitalized woman who is carrying monochorionic twins is complicated by twin-to-twin transfusion. The nurse should carefully monitor this client for which of the following? A. Rapid fundal growth B. Vaginal bleeding C. Projectile vomiting D. Congestive heart failure.

A. Rapid fundal growth

The physician has ordered a non-stress test (NST) to be done on a 41-week- gestation client. During the 1⁄2 hour test, the nurse observed three periods of fetal heart accelerations that were 15 beats per minute above the baseline and that lasted 15 seconds each. No contractions were observed. Based on these results, what should the nurse do next? A. Send the client home and report positive results to the MD. B. Perform a nipple stimulation test to assess the fetal heart in response to contractions. C. Prepare the client for induction with IV oxytocin or endocervical prostaglandins. D. Place the client on her side with oxygen via face mask.

A. Send the client home and report positive results to the MD.

A woman's glucose challenge test (GCT) results are 155 mg/dL at 1 hour post- glucose ingestion. Which of the following actions, as ordered by the physician, is appropriate? A. Send the woman for a glucose tolerance test B. Teach the woman how to inject herself with insulin C. Notify the woman of the normal results D. Provide the woman with oral hypoglycemic agents.

A. Send the woman for a glucose tolerance test

A nurse who is caring for a pregnant diabetic should carefully monitor the client for which of the following? A. Urinary tract infection B. Multiple gestation C. Metabolic alkalosis D. Pathological hypotension.

A. Urinary tract infection

A type 1 diabetic client has developed polyhydramnios. The client should be taught to report which of the following? A. Uterine contractions B. Reduced urinary output C. Marked fatigue D. Puerperal rash

A. Uterine contractions

A 25-week-pregnant client, who had eaten a small breakfast, has been notified that her glucose challenge test results were 132 mg/dL 1 hour after ingesting the glucose. Which of the following is appropriate for the nurse to say at this time? A. "Because you ate before the test, the results are invalid and will need to be repeated." B. "Because your test results are higher than normal, you will have to have another more specific test." C. "Because of the results you will have to have weekly glycohemoglobin testing done." D. "Because your results are within normal limits you need not worry about gestational diabetes."

B. "Because your test results are higher than normal, you will have to have another more specific test."

In analyzing the need for health teaching in a client, G5P4004 with gestational diabetes, the nurse should ask which of the following questions? A. "How old were you at your first pregnancy?" B. "Do you exercise regularly?" C. "Is your partner diabetic?" D. "Do you work outside of the home?"

B. "Do you exercise regularly?"

A client, G2P1001, telephones the gynecology office complaining of left-sided pain. Which of the following questions by the triage nurse would help to determine whether the one-sided pain is due to an ectopic pregnancy? A. "When did you have your pregnancy test done?" B. "When was the first day of your last menstrual period?" C. "Did you have any complications with your first pregnancy?" D. "How old were you when you first got your period?"

B. "When was the first day of your last menstrual period?"

Which of the following pregnant clients is most high risk for preterm premature rupture of the membranes (PPROM)? A. 30-week gestation with prolapsed mitral valve (PMV) B. 32-week gestation with urinary tract infection (UTI) C. 34-week gestation with gestational diabetes (GDM) D. 36-week gestation with deep vein thrombosis (DVT).

B. 32-week gestation with urinary tract infection (UTI)

A gestational diabetic, who requires insulin therapy to control her blood glucose levels, telephones the triage nurse complaining of dizziness and headache. Which of the following actions should the nurse take at this time? A. Have the client proceed to the office to see her physician B. Advise the client to drink a glass of milk and then call back C. Instruct the client to inject herself with regular insulin D. Tell the client immediately to telephone her medical doctor.

B. Advise the client to drink a glass of milk and then call back

A woman with a diagnosis of ectopic pregnancy is to receive medical intervention rather than a surgical interruption. Which of the following intramuscular medications would the nurse expect to administer? A. Decadron (desamethasone) B. Amethopterin (methotrexate) C. Pergonal (menotropins) D. Prometrium (progesterone).

B. Amethopterin (methotrexate)

A client's admitting medical diagnosis is third-trimester bleeding: rule out placenta previa. Each time the nurse enters the client's room, the woman asks: "Please tell me, do you think the baby will be all right?" Which of the following is an appropriate nursing diagnosis for this client? A. Hopelessness related to possible fetal loss B. Anxiety related to unidentified diagnosis C. Situational low self-esteem related to blood loss D. Potential for altered parenting related to inexperience.

B. Anxiety related to unidentified diagnosis

The nurse is caring for a 32-week G8P7007 with placenta previa. Which of the following interventions would the nurse expect to perform? Select all that apply. A. Daily contraction stress tests B. Blood type and cross match C. Bed rest with passive range of motion exercises D. Daily serum electrolyte assessments E. Weekly biophysical profiles.

B. Blood type and cross match C. Bed rest with passive range of motion exercises E. Weekly biophysical profiles.

A 15-year-old client is being seen for her first prenatal visit. Because of this client's special nutritional needs, the nurse evaluates the client's intake of: A. Protein and magnesium B. Calcium and iron C. Carbohydrates and zinc D. Pyroxidine and thiamine.

B. Calcium and iron

An ultrasound is being done on an Rh-negative woman. Which of the following pregnancy findings would indicate that the baby has developed erythroblastosis fetalis? A. Caudal agenesis B. Cardiomegaly C. Oligohydramnios D. Hyperemia.

B. Cardiomegaly

A gravid client, 27 weeks' gestation, has been diagnosed with gestational diabetes. Which of the following therapies will most likely be ordered for this client? A. Oral hypoglycemic agents B. Diet control with exercise C. Regular insulin injections D. Inhaled insulin.

B. Diet control with exercise

A diabetic client is to receive 5 units regular and 15 units NPH insulin at 0800. In order to administer the medication appropriately, what should the nurse do? A. Draw 5 units regular in one syringe and 15 units NPH in a second syringe and inject in different locations. B. Draw 5 units regular first and 15 units NPH second into the same syringe and inject. C. Draw 15 units NPH first and 5 units regular second into the same syringe and inject. D. Mix 5 units regular and 15 units NPH in a vial before drawing the full 20 units into a syringe and inject.

B. Draw 5 units regular first and 15 units NPH second into the same syringe and inject.

A women with a history of congestive heart disease is 36 weeks pregnant. which of the following findings should the nurse report to the primary health care practitioner? A. Presence of striae gravidarum B. Dyspnea on exertion C. 4-pound weight gain in a month D. Patellar reflexes +2.

B. Dyspnea on exertion

An obese gravid woman is being seen in the prenatal clinic. The nurse will monitor this client carefully throughout her pregnancy because she is high risk for which of the following complications of pregnancy? A. Placenta previa B. Gestational diabetes C. Abruptio placentae D. Chromosomal defects.

B. Gestational diabetes

Which of the following findings should be reported to the primary health care practitioner when assessing a first-trimester gravida suspected of having gestational trophoblastic disease (hydatiform mole)? A. Hematocrit 39% B. Grape-like clusters passed from the vagina C. White blood cell count 8000/mm3 D. Hypertrophied breast tissue.

B. Grape-like clusters passed from the vagina

A lecithin:sphingomyelin (L/S) ratio has been ordered by a pregnant woman's obstetrician. Which of the following data will the nurse learn from this test? A. Coagulability of maternal blood B. Maturation of the fetal lungs C. Potential for fetal development of erythroblastosis fetalis D. Potential for maternal development of gestational diabetes.

B. Maturation of the fetal lungs

A 30-year-old gravida, G3P1101, 6 weeks' gestation, states that her premature baby boy, born 8 years ago, died shortly after delivery from an infection secondary to spina bifida. Which of the following interventions is most important for this client? A. Grief counseling B. Nutrition counseling C. Infection control counseling D. Genetic counseling.

B. Nutrition counseling

A client is being admitted to the labor suite with a diagnosis of eclampsia. Which of the following actions by the nurse is appropriate at this time? A. Tape a tongue blade to the head of the bed B. Pad the side rails and head of the bed C. Provide the client with needed stimulation D. Provide the client with grief counseling.

B. Pad the side rails and head of the bed

A 29-week-gestation woman diagnosed with severe preeclampsia is noted to have blood pressure of 170/112, 4 proteinuria, and a weight gain of 10 pounds over the last 2 days. Which of the following signs/symptoms would the nurse also expect to see? A. Fundal height of 32 cm B. Papilledema C. Patellar reflexes of +2. D. Nystagmus.

B. Papilledema

A pregnant woman mentions to the clinic nurse that she and her husband enjoy working together on projects around the house and, "I always wear protective gloves when I work." The nurse should advise the woman that, even when wearing gloves, which of the following projects could be high risk to the baby's health? A. Replacing a light fixture in the nursery. B. Sanding the paint from an antique crib C. Planting tulip bulbs in the side garden D. Shoveling snow from the driveway.

B. Sanding the paint from an antique crib

A client, G8P3406, 14 weeks' gestation, is being seen in the prenatal clinic. During the nurse's prenatal teaching session, the nurse will emphasize that the woman should notify the obstetric office immediately if she notes which of the following? A. Change in fetal movement B. Signs and symptoms of labor C. Swelling of feet and ankles D. Appearance of spider veins.

B. Signs and symptoms of labor

A nurse is caring for four prenatal clients in the clinic. Which of the clients is high risk for placenta previa? A. Jogger with low body mass index B. Smoker carrying fraternal triplets C. Registered professional nurse D. Police officer on foot patrol.

B. Smoker carrying fraternal triplets

A 24-week-gravid client is being seen in the prenatal clinic. She states, "I have had a terrible headache for the past 2 days." Which of the following is the most appropriate action for the nurse to perform next? A. Inquire whether or not the client has allergies B. Take the woman's blood pressure C. Assess the woman's fundal height D. Ask the woman about stressors at work.

B. Take the woman's blood pressure

A 16-year-old woman is being seen for the first time in the obstetric office. Which of the following comments by the young woman is highest priority for the nurse to respond to? A. "My favorite lunch is a burger with fries." B. "I've been dating my new boyfriend for 2 weeks." C. "On weekends we go out and drink a few beers." D. "I dropped out of school about 3 months ago."

C. "On weekends we go out and drink a few beers."

Which finding should the nurse expect when assessing a client with placenta previa? A. Severe occipital headache B. History of renal disease C. Previous premature delivery. D. Painless vaginal bleeding.

D. Painless vaginal bleeding.

A client with mild preeclampsia, who has been advised to be on bed rest at home, asks why it is necessary. Which of the following is the best response for the nurse to give the client? A. "Bed rest will help you to conserve energy for your labor." B. "Bed rest will help to relieve your nausea and anorexia." C. "Reclining will increase the amount of oxygen that your baby gets." D. "The position change will prevent the placenta from separating."

C. "Reclining will increase the amount of oxygen that your baby gets."

The nurse is grading a woman's reflexes. Which of the following grades would indicate reflexes that are slightly brisker than normal? A. +1 B. +2 C. +3 D. +4

C. +3

The nurse has assessed four primigravid clients in the prenatal clinic. Which of the women would the nurse refer to the nurse midwife for further assessment? A. 10 weeks' gestation, complains of fatigue with nausea and vomiting B. 26 weeks' gestation, complains of ankle edema and chloasma C. 32 weeks' gestation, complains of epigastric pain and facial edema D. 37 weeks' gestation, complains of bleeding gums and urinary frequency.

C. 32 weeks' gestation, complains of epigastric pain and facial edema

A patient who is 24 weeks pregnant has been diagnosed with syphilis. She asks the nurse how the infection will affect the baby. The nurse's response should be based on which of the following? A. She is high risk for premature rupture of the membranes B. The baby will be born with congenital syphilis C. Penicillin therapy will reduce the risk to the fetus D. The fetus will likely be born with a cardiac defect.

C. Penicillin therapy will reduce the risk to the fetus

A woman has just been admitted to the emergency department subsequent to a head-on automobile accident. Her body appears to be uninjured. The nurse carefully monitors the woman for which of the following complications of pregnancy? A. Placenta previa B. Transverse fetal lie C. Placental abruption D. Severe preeclampsia.

C. Placental abruption

A woman has been diagnosed with a ruptured ectopic pregnancy. Which of the following signs/symptoms is characteristic of this diagnosis? A. Dark brown rectal bleeding B. Severe nausea and vomiting C. Sharp unilateral pain D. Marked hyperthermia.

C. Sharp unilateral pain

The nurse caring for a type 1 diabetic client who wishes to become pregnant notes that the client's glycohemoglobin, or glycosylated hemoglobin (HgbA1c), result was 15% today and the fasting blood glucose result was 100 mg/dL. Which of the following interpretations by the nurse is correct in relation to these data? A. The client has been hyperglycemic for the last 3 months and is hyperglycemic today. B. The client has been normoglycemic for the last 3 months and normoglycemic today. C. The client has been hyperglycemic for the last 3 months and normoglycemic today. D. The client has been normoglycemic for the last 3 months and hyperglycemic today.

C. The client has been hyperglycemic for the last 3 months and normoglycemic today.

During a prenatal examination, the nurse notes scarring on and around the woman's genitalia. Which of the following questions is most important for the nurse to ask in relation to this observation? A. "Have you ever had a severe infection of your sex organs?" B. "Have you worn any piercings in your genital area?" C. "Have you had a tattoo removed from your genital area?" D. "Have you ever been forced to have sex without your permission?"

D. "Have you ever been forced to have sex without your permission?"

A nurse is caring for a 25-year-old client who has just had a spontaneous first trimester abortion. Which of the following comments by the nurse is appropriate? A. "You can try again very soon." B. "It is probably better this way." C. "At least you weren't very far along." D. "I'm here to talk if you would like."

D. "I'm here to talk if you would like."

A client has just been diagnosed with gestation diabetes. She cries, "Oh no! I will never be able to give myself shots!!" Which of the following responses by the nurse is appropriate at this time? A. "I am sure you can learn for your baby." B. "I will work with you until you feel comfortable giving yourself the insulin." C. "We will be giving you pills for the diabetes." D. "If you follow your diet and exercise you will probably need no insulin."

D. "If you follow your diet and exercise you will probably need no insulin."

Which of the following statements is appropriate for the nurse to say to a patient with a complete placenta previa? A. "During the first phase of labor you will do slow chest breathing." B. "You should ambulate in the halls at least two times each day." C. "The doctor will deliver you once you reach 25 weeks' gestation." D. "Please remember to tell me if you become constipated."

D. "Please remember to tell me if you become constipated."

An obese client is being seen by the nurse during her prenatal visit. Which of the following comments by the nurse is appropriate at this time? A. "We will want you to gain the same amount of weight we would encourage any pregnant woman to gain." B. "To have a healthy baby we suggest that you go on a weight reduction diet right away." C. "To prevent birth defects we suggest that you gain weight during the first trimester and then maintain your weight for the rest of the pregnancy." D. "We suggest that you gain weight throughout your pregnancy but not quite as much as other women."

D. "We suggest that you gain weight throughout your pregnancy but not quite as much as other women."

The nurse notes that the results of a gravid woman's contraction stress test are equivocal. How should the nurse interpret the finding? A. Baby is acidotic and should be delivered B. Fetal heart rate accelerated once during the test C. Baby is preterm but the heart rate is normal D. Additional data is needed to make a diagnosis.

D. Additional data is needed to make a diagnosis.

A 25-year-old client is admitted with the following history: 12 weeks pregnant, vaginal bleeding, no fetal heart beat seen on ultrasound. The nurse would expect the doctor to write an order to prepare the client for which of the following? A. Cervical cerclage B. Amniocentesis C. Non-stress testing D. Dilation and curettage

D. Dilation and curettage

A 26-week-gestation woman is diagnosed with severe preeclampsia with HELLP syndrome. The nurse will assess for which of the following signs/symptoms? A. Low serum creatinine B. High serum protein C. Bloody stools D. Epigastric pain.

D. Epigastric pain.

A 12-week-gravid client presents in the emergency department with abdominal cramps and scant dark red bleeding. What should the nurse assess this client for? A. Shortness of breath B. Enlarging abdominal girth C. Hyperreflexia and clonus D. Fetal heart dysrhythmias.

D. Fetal heart dysrhythmias.

The nurse is providing health teaching to a group of women of childbearing age. One woman, who states that she is a smoker, asks about its impact on the pregnancy. The nurse responds that which of the following fetal complications can develop if the mother smokes? A. Genetic changes in the fetal reproductive system B. Extensive central nervous system damage C. Addiction to the nicotine inhaled from the cigarette D. Fetal intrauterine growth restriction.

D. Fetal intrauterine growth restriction.

An insulin-dependent diabetic woman will require higher doses of insulin as which of the following pregnancy hormones increases in her body? A. Estrogen B. Progesterone C. Human chorionic gonadotropin D. Human placental lactogen.

D. Human placental lactogen.

The nurse is caring for a client who was just admitted to the hospital to rule out ectopic pregnancy. Which of the following orders is the most important for the nurse to perform? A. Assess the client's temperature B. Document the time of the client's last meal C. Obtain urine for urinalysis and culture D. Report complaints of dizziness or weakness.

D. Report complaints of dizziness or weakness.

A woman, 8 weeks pregnant, is admitted to the obstetric unit with a diagnosis of threatened abortion. Which of the following tests would help to determine whether the woman is carrying a viable or a nonviable pregnancy? A. Luteinizing hormone level B. Endometrial biopsy C. Hysterosalpinogram D. Serum progesterone level.

D. Serum progesterone level.

A gravid woman is carrying monochorionic twins. For which of the following complications should this pregnancy be monitored? A. Oligohydramnios B. Placenta previa C. Cephalopelvic disproportion D. Twin-to-twin transfusion.

D. Twin-to-twin transfusion.

A client has severe preeclampsia. The nurse would expect the primary health care practitioner to order tests to assess the fetus for which of the following? A. Severe anemia B. Hypoprothrombinemia C. Craniosynostosis D. Intrauterine growth restriction.

D. Intrauterine growth restriction.

A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit? A. Nausea B. Dyspnea C. Urinary frequency D. Leg cramping

D. Leg cramping

A gravid woman with sickle cell anemia is admitted in vasoocclusive crisis. Which of the following is the priority intervention that the nurse must perform? A. Administer narcotic analgesics B. Apply heat to swollen joints C. Place on strict bed rest D. Infuse intravenous solution.

D. Infuse intravenous solution.

A nurse midwife has advised a 39-week gestation gravid to take evening primrose oil 2500 mg daily as a complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions? A. Relieve back strain B. Improve development of colostrum C. Ripen the cervix D. Reduce the incidence of hemorrhoids

C. Ripen the cervix

The nurse asks a woman about how the woman's husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which of the following statements? A. "My husband is ready for the pregnancy to end so that we can have sex again." B. "My husband has gained quite a bit of weight during this pregnancy." C. "My husband seems more worried about our finances now than before the pregnancy." D. "My husband plays his favorite music for my belly so the baby will learn to like it."

A. "My husband is ready for the pregnancy to end so that we can have sex again."

The nurse is teaching a couple about fetal development. Which statement by the nurse is correct about the morula stage of development? A. "The fertilized egg has yet to implant into the uterus." B. "The lung fields are finally completely formed." C. "The sex of the fetus can be clearly identified." D. "The eye lids are unfused and begin to open and close."

A. "The fertilized egg has yet to implant into the uterus."

When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of? A. Ambivalence B. Depression C. Anxiety D. Ecstasy.

A. Ambivalence

An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? Select all that apply. A. Amenorrhea B. Breast tenderness C. Quickening D. Frequent urination E. Uterine growth

A. Amenorrhea B. Breast tenderness C. Quickening D. Frequent urination

A nurse has identified the following nursing diagnosis for a prenatal client: Altered nutrition: less than body requirements related to poor folic acid intake. Which of the following foods should the nurse suggest the client consume? A. Potatoes and grapes B. Cranberries and squash C. Apples and corn D. Oranges and spinach

D. Oranges and spinach

A 37-week gravid client states that she noticed a "white liquid" leaking from her breasts during a recent shower. Which of the following nursing responses is appropriate at this time? A. Advise the woman that she may have a galactocele. B. Encourage the woman to pump her breasts to stimulate an adequate milk supply. C. Assess the liquid because a breast discharge is diagnostic of a mammary infection. D. Reassure the mother that this is normal in the third trimester

D. Reassure the mother that this is normal in the third trimester

The nurse asks a 31-week gestation client to lie on the examining table during a prenatal examination. In which of the following positions should the client be placed? A. Orthopneic B. Lateral-recumbent C. Sims' D. Semi-Fowler's.

D. Semi-Fowler's.

A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the pre procedure teaching? A. Fast for 12 hours before the test B. Bring a urine specimen to the laboratory on the day of the test C. Be prepared to have 4 blood specimens taken on the day of the test. D. The test should take one hour to complete

D. The test should take one hour to complete

A woman asks the nurse about consuming herbal supplements during pregnancy. Which of the following responses is appropriate? A. Herbals are natural substances, so they are safely ingested during pregnancy B. It is safe to take licorice and cat's claw, but no other herbs are safe C. A federal commission has established the safety of herbals during pregnancy D. The woman should discuss everything she eats with a health care practitioner.

D. The woman should discuss everything she eats with a health care practitioner.

A client is 35 weeks' gestation. Which of the following findings would the nurse expect to see? A. Nausea and vomiting B. Maternal ambivalence C. Fundal height 10 cm above the umbilicus D. Use of three pillows for sleep comfort.

D. Use of three pillows for sleep comfort.

A woman, G5P0401, is in the postanesthesia care unit (PACU) after a cervical cerclage procedure. During the immediate postprocedure period, what should the nurse carefully monitor this client for? A. Hyperthermia B. Hypotension C. Uterine contractions D. Fetal heart dysrhythmias.

C. Uterine contractions

A woman is 36-weeks' gestation. Which of the following tests will be done during her prenatal visit? A. Glucose challenge test B. Amniotic fluid volume assessment C. Vaginal and rectal cultures D. Karyotype analysis.

C. Vaginal and rectal cultures

Which finding would the nurse view as normal when evaluating the laboratory reports of a 34-week gestation client? A. Anemia B. Thrombocytopenia C. Polycythemia D. Hyperbilirubinemia

A. Anemia

A patient, 32 weeks pregnant with severe headache, is admitted to the hospital with preeclampsia. In addition to obtaining baseline vital signs and placing the client on bed rest, the physician ordered the following four items. Which of the orders should the nurse perform first? A. Assess deep tendon reflexes B. Obtain complete blood count C. Assess baseline weight D. Obtain routine urinalysis.

A. Assess deep tendon reflexes

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? A. Avoid eating greasy foods B. Drink orange juice before rising C. Drink 2 glasses of water with each meal D. Eat 3 large meals plus a bedtime snack.

A. Avoid eating greasy foods

Which of the following findings in an 8-week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? A. Body mass index of 17 B. Blood pressure of 100/60 C. Hematocrit of 36% D. Hemoglobin of 13.2.

A. Body mass index of 17

A nurse is discussing diet with a pregnant woman. Which of the following foods should the nurse advise the client to avoid consuming during her pregnancy? A. Bologna B. Cantaloupe C. Asparagus D. Popcorn.

A. Bologna

A hospitalized gravida's blood work is hematocrit 30% and hemoglobin 10 gm/dL. In light of the laboratory data, which of the following meal choices should the nurse recommend to this patient? A. Chicken livers, sliced tomatoes, and dried apricots B. Cheese sandwich, tossed salad, and rice pudding C. Veggie burger, cucumber salad, and wedge of cantaloupe D. Bagel with cream cheese, pear, and hearts of lettuce.

A. Chicken livers, sliced tomatoes, and dried apricots

A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant? A. Chorionic gonadotropin B. Oxytocin. C. Prolactin D. Luteinizing hormone.

A. Chorionic gonadotropin

Which of the following long-term goals is appropriate for a client, 10 weeks' gestation, who is diagnosed with gestational trophoblastic disease (hydatiform mole)? A. Client will be cancer-free 1 year from diagnosis B. Client will deliver her baby at full term without complications C. Client will be pain-free 3 months after diagnosis D. Client will have normal hemoglobin and hematocrit at delivery.

A. Client will be cancer-free 1 year from diagnosis

An insulin-dependent diabetic, G3P0200, 38 weeks' gestation, is being seen in the labor and delivery suite in metabolic dysequillibrium. The nurse knows that which of the following maternal blood values is most high risk to her unborn baby? A. Glucose 150 mg/dL B. pH 7.25 C. pCO2 34 mm Hg D. Hemoglobin A1c 10%.

B. pH 7.25

During a preconception counseling session, the nurse encourages a couple to prepare a birth plan. Which of the following is the most important goal for this action? A. Promote communication between the couple and health care professionals B. Enable the couple to learn about the types of medicine used in labor C. Provide the couple with a list of items that they should put in a bag for labor D. Give the high-risk couple a sense of control over having to have a cesarean.

A. Promote communication between the couple and health care professionals

A woman, G1P0000, is 40 weeks' gestation. Her Bishop score is 4. Which of the following complementary therapies do midwives frequently recommend to clients in similar situations? Select all that apply. A. Sexual intercourse B. Aromatherapy C. Breast stimulation D. Ingestion of castor oil E. Aerobic exercise.

A. Sexual intercourse C. Breast stimulation D. Ingestion of castor oil

A 38-week gestation client, Bishop score 1, is advised by her nurse midwife to take evening primrose daily. The office nurse advises the client to report which of the following side effects that has been attributed to the oil? A. Skin rash B. Pedal edema C. Blurred vision D. Tinnitus

A. Skin rash

A gravida's fundal height is noted to be at the xiphoid process. The nurse is aware that which of the following fetal changes is likely to be occurring at the same time in the pregnancy? A. Surfactant is formed in the fetal lungs B. Eyes begin to open and close C. Respiratory movements begin D. The spinal column is completely formed.

A. Surfactant is formed in the fetal lungs

Which of the following findings should the nurse expect when assessing a client, 8 weeks' gestation, with gestational trophoblastic disease (hydatiform mole)? A. Protracted pain B. Variable fetal heart decelerations C. Dark brown vaginal bleeding D. Suicidal ideations.

C. Dark brown vaginal bleeding

A woman who is seen in the prenatal clinic is found to be 8 weeks pregnant. She confides to the nurse that she is afraid her baby may be "permanently damaged because I had at least 5 beers the night I had sex." Which of the following responses by the nurse would be appropriate? A. "I would let the doctor know that if I were you." B. "It is unlikely that the baby was affected." C. "Abortions during the first trimester are very safe." D. "An ultrasound will tell you if the baby was affected."

B. "It is unlikely that the baby was affected."

A client, in her third trimester, is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy. How should the nurse respond? A. "Don't worry. You'll know the difference when the contractions start." B. "The contractions may feel just like a backache, but they will come and go." C. "Contractions are a lot worse than your pregnancy aches and pains." D. "I understand. You don't want to come to the hospital before you are in labor."

B. "The contractions may feel just like a backache, but they will come and go."

A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to make at this time? A. "Your period is probably just irregular." B. "We could do a blood test to check." C. "Home pregnancy test results are very accurate." D. "My recommendation would be to repeat the test in one week."

B. "We could do a blood test to check."

A 16-year-old, G1 P0000, is being seen at her 10-week gestation visit. She tells the nurse that she felt the baby move that morning. Which of the following responses by the nurse is appropriate? A. "That is very exciting. The baby must be very healthy." B. "Would you please describe what you felt for me?" C. "That is impossible. The baby is not big enough yet." D. "Would you please let me see if I can feel the baby?"

B. "Would you please describe what you felt for me?"

The nurse is evaluating the effectiveness of bed rest for a client with mild preeclampsia. Which of the following signs/symptoms would the nurse determine is a positive finding? A. Weight loss B. 2+ proteinuria C. Decrease in plasma protein D. 3+ patellar reflexes.

C. Decrease in plasma protein

The nurse is evaluating the 24-hour dairy intake of four gravid clients. Which of the following clients consumed the highest number of dairy servings during 1 day? The client who consumed: A. 4 oz whole milk, 2 oz hard cheese, 1 cup of pudding made with milk and 2 oz cream cheese. B. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 11⁄2 oz hard cheese. C. 1⁄2 cup cottage cheese, 8 oz whole milk, 1 cup of buttermilk, and 1⁄2 oz hard cheese. D. 1⁄2 cup frozen yogurt, 8 oz skim milk, 4 oz cream cheese, and 11⁄2 cup of cottage cheese.

B. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 11⁄2 oz hard cheese.

An 18-week gestation client telephones the obstetrician's office stating, "I'm really scared. I think I have breast cancer. My breasts are filled with tumors." The nurse should base the response on which of the following? A. Breast cancer is often triggered by pregnancy B. Nodular breast tissue is normal during pregnancy C. The woman is exhibiting signs of a psychotic break D. Anxiety attacks are especially common in the second trimester

B. Nodular breast tissue is normal during pregnancy

When analyzing the need for health teaching of a prenatal multigravida, the nurse should ask which of the following questions? A. "What are the ages of your children?" B. "What is your marital status?" C. "Do you ever drink alcohol?" D. "Do you have any allergies?"

C. "Do you ever drink alcohol?"

A 20-year-old client states that the at-home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time? A. "Congratulations, you and your family must be so happy." B. "Have you told the baby's father yet?" C. "How do you feel about the results?" D. "Please tell me when your last menstrual period was."

C. "How do you feel about the results?"

A woman, 26-weeks' gestation, calls the triage nurse stating, "I'm really scared. I tried not to but I had an orgasm when we were making love. I just know that I will go into preterm labor now." Which of the following responses by the nurse is appropriate? A. "Lie down and drink a quart of water. If you feel any back pressure at all call me back right away." B. "Although oxytocin was responsible for your orgasm, it is very unlikely that it will stimulate preterm labor." C. "I will inform the doctor for you. What I want you to do is to come to the hospital right now to be checked." D. "The best thing for you to do right now is to take a warm shower, and then do a fetal kick count assessment."

C. "I will inform the doctor for you. What I want you to do is to come to the hospital right now to be checked."

A client asks the nurse what was meant when the physician told her she had a positive Chadwick's sign. Which of the following information about the finding would be appropriate for the nurse to convey at this time? A. "It is a purplish stretch mark on your abdomen." B. "It means that you are having heart palpitations." C. "It is a bluish coloration of your cervix and vagina." D. "It means the doctor heard abnormal sounds when you breathed in."

C. "It is a bluish coloration of your cervix and vagina."

A client makes the following statement after finding out that her pregnancy test is positive, "This is not a good time. I am in college and the baby will be due during final exams!" Which of the following responses by the nurse would be most appropriate at this time? A. "I'm absolutely positive that everything will turn out all right." B. "I suggest that you e-mail your professors to set up an alternate plan." C. "It sounds like you're feeling a little overwhelmed right now." D. "You and the baby's father will find a way to get through the pregnancy."

C. "It sounds like you're feeling a little overwhelmed right now."

A client is admitted to the hospital with severe preeclampsia. The nurse is assessing for clonus. Which of the following actions should the nurse perform? A. Strike the woman's patellar tendon B. Palpate the woman's ankle C. Dorsiflex the woman's foot D. Position the woman's feet flat on the floor.

C. Dorsiflex the woman's foot

When counseling a preeclamptic client about her diet, what should the nurse encourage the woman to do? A. Restrict sodium intake B. Increase intake of fluids C. Eat a well-balanced diet D. Avoid simple sugars.

C. Eat a well-balanced diet

A woman is to receive RhoGAM at 28 weeks' gestation. What action must the nurse take before giving the injection? A. Validate that the baby is Rh negative B. Assess that the direct Coombs' test is positive C. Verify the identity of the woman D. Reconstitute the globulin with sterile water.

C. Verify the identity of the woman

During a prenatal interview, a client tells the nurse, "My mother told me she had toxemia during her pregnancy and almost died!" Which of the following questions should the nurse ask in response to this statement? A. "Does your mother have a cardiac condition?" B. "Did your mother tell you what she was toxic from?" C. "Does your mother have diabetes now?" D. "Did your mother say whether she had a seizure or not?"

D. "Did your mother say whether she had a seizure or not?"

The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that she might experience in the coming weeks. Which of the following comments by the client indicates that further teaching is needed? A. "During the third trimester I may experience frequent urination." B. "During the third trimester I may experience heartburn." C. "During the third trimester I may experience back pain." D. "During the third trimester I may experience persistent headache."

D. "During the third trimester I may experience persistent headache."

Which of the following nursing diagnoses would be most appropriate for a 15-year-old woman who is in her first trimester of pregnancy? A. Sleep pattern disturbance related to discomforts of pregnancy B. Knowledge deficit related to care of infants C. Anxiety related to fear of labor and delivery D. Ineffective individual coping related to developmental level.

D. Ineffective individual coping related to developmental level.

A client who was seen in the prenatal clinic at 20 weeks' gestation weighed 128 lb at that time. Approximately how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks' gestation? A. 129 lb B. 130 lb C. 131 lb D. 132 lb

D. 132 lb

A woman, G4P0210 and 12 weeks' gestation, has been admitted to the labor and delivery suite for a cerclage procedure. Which of the following long-term outcomes is appropriate for this client? A. The client will gain less than 25 pounds during the pregnancy B. The client will deliver after 37 weeks' gestation C. The client will have a normal blood glucose throughout the pregnancy D. The client will deliver a baby that is appropriate for gestational age.

B. The client will deliver after 37 weeks' gestation

At 28 weeks' gestation, an Rh-negative woman receives RhoGAM. Which of the following would indicate that the medication is effective? A. The baby's Rh status changes to Rh negative B. The mother produces no Rh antibodies C. The baby produces no Rh antibodies D. The mother's Rh status changes to Rh positive.

B. The mother produces no Rh antibodies

The nurse midwife tells a client that the baby is growing and that ballottement was evident during the vaginal examination. How should the nurse explain what the nurse midwife means by ballottement? A. The nurse midwife saw that the mucus plug was intact B. The nurse midwife felt the baby rebound after being pushed C. The nurse midwife palpated the fetal parts through the uterine wall D. The nurse midwife assessed that the baby is head down

B. The nurse midwife felt the baby rebound after being pushed

A client is being taught fetal kick counting. Which of the following should be included in the patient teaching? A. The woman should choose a time when her baby is least active B. The woman should lie on her side with her head elevated about 30o C. The woman should report fetal kick counts of greater than 10 in an hour D. The woman should refrain from eating immediately before counting.

B. The woman should lie on her side with her head elevated about 30o

An ultrasound has identified that a client's pregnancy is complicated by hydramnios. The nurse would expect that an ultrasound may show that the baby has which of the following structural defects? A. Pulmonic stenosis B. Tracheoesophageal fistula C. Ventriculoseptal defect D. Developmental hip dysplasia.

B. Tracheoesophageal fistula

The partner of a gravida accompanies her to her prenatal appointment. The nurse notes that the father of the baby has gained weight since she last saw him. Which of the following comments is most appropriate for the nurse to make to the father? A. "I see that you are gaining weight right along with your partner." B. "You and your partner will be able to go on a diet together after the baby is born." C. "I can see that you are a bad influence on your partner's eating habits." D. "I am so glad to see that you are taking so much interest in your partner's pregnancy."

D. "I am so glad to see that you are taking so much interest in your partner's pregnancy."

A client is having an ultrasound assessment done at her prenatal appointment at 8 weeks' gestation. She asks the nurse, "Can you tell what sex my baby is yet?" Which of the following responses would be appropriate for the nurse to make at this time? A. "The technician did tell me the sex, but I will have to let the doctor tell you what it is." B. "The organs are completely formed and present, but the baby is too small for any to be seen." C. "The technician says that the baby has a penis. It looks like you are having a boy." D. "I am sorry. It will not be possible to see which sex the baby is for another month or so."

D. "I am sorry. It will not be possible to see which sex the baby is for another month or so."

A 12-week gestation client tells the nurse that she and her husband eat sushi at least once per week. She states, "I know that fish is good for me, so I make sure we eat it regularly." Which of the following responses by the nurse is appropriate? A. "You are correct. Fish is very healthy for you." B. "You can eat fish, but sushi is too salty to eat during pregnancy." C. "Sushi is raw. Raw fish is especially high in mercury." D. "It is recommended that fish be cooked to destroy harmful bacteria."

D. "It is recommended that fish be cooked to destroy harmful bacteria."

The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor? A. "My first child has cerebral palsy." B. "My first child has hypertension." C. "My first child has asthma." D. "My first child has cystic fibrosis."

D. "My first child has cystic fibrosis."

A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? A. Pap smear B. Mammogram C. Glucose challenge test D. Biophysical profile.

A. Pap smear

A nurse is advising a pregnant woman about the danger signs of pregnancy.The nurse should teach the mother that she should notify the physician immediately if she experiences which of the following signs/symptoms? Select all that apply. A. Convulsions B. Double vision C. Epigastric pain D. Persistent vomiting E. Polyuria.

A. Convulsions B. Double vision C. Epigastric pain D. Persistent vomiting

A father experiencing couvade syndrome is likely to exhibit which of the following symptoms/behaviors? A. Heartburn B. Promiscuity C. Hypertension D. Indifference

A. Heartburn

A nurse is discussing the serving sizes in the grain food group with a new prenatal client. Which of the following foods equals 1 serving size from the grain group? Select all that apply. A. 1 bagel B. 1 slice of bread C. 1 cup cooked pasta D. 1 tortilla E. 1 cup dry cereal

B. 1 slice of bread D. 1 tortilla E. 1 cup dry cereal

A client's 32-week clinic assessment was: BP 90/60; TPR 98.6oF, P 92, R 20; weight 145 lb; and urine negative for protein. Which of the following findings at the 34-week appointment should the nurse highlight for the certified nurse midwife? A. BP 110/70; TPR 99.2oF, 88, 20 B. Weight 155 lb; urine protein +2. C. Urine protein trace; BP 88/56 D. Weight 147 lb; TPR 99.0oF, 76, 18.

B. Weight 155 lb; urine protein +2.

A woman is carrying dizygotic twins. She asks the nurse about the babies. Which of the following explanations is accurate? A. During a period of rapid growth, the fertilized egg divided completely B. When the woman ovulated, she expelled two mature ova C. The babies share one placenta and a common chorion D. The babies will definitely be the same sex and have the same blood type.

B. When the woman ovulated, she expelled two mature ova

A 34-week gestation woman calls the obstetric office stating, "Since last night I have had three nosebleeds." Which of the following responses by the nurse is appropriate? A. "You should see the doctor to make sure you are not becoming severely anemic." B. "Do you have a temperature?" C. "One of the hormones of pregnancy makes the nasal passages prone to bleeds." D. "Do you use any inhaled drugs?"

C. "One of the hormones of pregnancy makes the nasal passages prone to bleeds."

A client, 37 weeks' gestation, has been advised that she is positive for group B streptococci. Which of the following comments by the nurse is appropriate at this time? A. "The doctor will prescribe intravenous antibiotics for you. A visiting nurse will administer them to you in your home." B. "You are very high risk for an intrauterine infection. It is very important for you to check your temperature every day." C. "The bacteria are living in your vagina. They will not hurt you but we will give you medicine in labor to protect your baby from getting sick." D. "This bacteria causes scarlet fever. If you notice that your tongue becomes very red and that you feel feverish you should call the doctor immediately."

C. "The bacteria are living in your vagina. They will not hurt you but we will give you medicine in labor to protect your baby from getting sick."

It is discovered that a 28-week-gestation gravid is leaking amniotic fluid. Before the client is sent home on bed rest, the nurse teaches her which of the following? A. Perform a nitrazine test every morning upon awakening B. Immediately report any breast tenderness to the primary health care practitioner C. Abstain from engaging in vaginal intercourse for the rest of the pregnancy D. Carefully weigh all of her saturated peripads.

C. Abstain from engaging in vaginal intercourse for the rest of the pregnancy

A 14-year-old woman is seeking obstetric care. Which of the following vital signs must be monitored very carefully during this woman's pregnancy? A. Heart rate B. Respiratory rate C. Blood pressure D. Temperature.

C. Blood pressure

A 14-year-old woman is seeking obstetric care. Which of the following is an appropriate nursing care goal for this young woman? A. Bring her partner to all prenatal visits B. Terminate the pregnancy C. Continue her education D. Undergo prenatal chromosomal analysis.

C. Continue her education

A woman is recovering at the gynecologist's office following a late first-trimester spontaneous abortion. At this time, it is essential for the nurse to check which of the following? A. Maternal rubella titer B. Past obstetric history C. Maternal blood type D. Cervical patency.

C. Maternal blood type

Which of the following skin changes should the nurse highlight for a pregnant woman's health care practitioner? A. Linea nigra B. Melasma C. Petechiae D. Spider nevi.

C. Petechiae

A nurse is performing an assessment on four 22-week-pregnant clients. The nurse reports to the obstetrician that which of the clients may be carrying twins? A. The client who states that she feels huge B. The client with a weight gain of 13 pounds C. The client whose fundal height measurement is 26 cm D. The client whose alpha-fetoprotein level is one-half normal.

C. The client whose fundal height measurement is 26 cm

A gravid client, G6P5005, 24 weeks' gestation, has been admitted to the hospital for placenta previa. Which of the following is an appropriate long-term goal for this client? A. The client will state an understanding of need for complete bedrest B. The client will have a reactive nonstress test on day 2 of hospitalization C. The client will be symptom-free until at least 37 weeks' gestation D. The client will call her children shortly after admission

C. The client will be symptom-free until at least 37 weeks' gestation

The nurse discusses sexual intimacy with a pregnant couple. Which of the following should be included in the teaching plan? A. Vaginal intercourse should cease by the beginning of the third trimester B. Breast fondling should be discouraged because of the potential for preterm labor C. The couple may find it necessary to experiment with alternate positions D. Vaginal lubricant should be used sparingly throughout the pregnancy.

C. The couple may find it necessary to experiment with alternate positions

A client asks the nurse, "Could you explain how the baby's blood and my blood separate at delivery?" Which of the following responses is appropriate for the nurse to make? A. "When the placenta is born, the circulatory systems separate." B. "When the doctor clamps the cord, the blood stops mixing." C. "The separation happens after the baby takes the first breath. The baby's oxygen no longer has to come from you." D. "The blood actually never mixes. Your blood supply and the baby's blood supply are completely separate."

D. "The blood actually never mixes. Your blood supply and the baby's blood supply are completely separate."

A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse's best response? A. "Because the organ systems in the baby are developing right now, it is risky to take medicine." B. "You can take any of the over-the-counter medications because they are all safe in pregnancy." C. "The physician will prescribe a category "X" medication for you." D. "You can take acetaminophen because it is a category "B" medicine."

D. "You can take acetaminophen because it is a category "B" medicine."

A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time? A. "We expect you to gain 1 lb per week, so your weight is a little low at this time." B. "Most women gain no weight during the first trimester, so I would suggest you eat fewer desserts for the next few weeks." C. "You entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need." D. "Your weight gain is exactly what we would expect it to be at this time."

D. "Your weight gain is exactly what we would expect it to be at this time."

A vegan is being counseled regarding vitamin intake. It is essential that this woman supplement which of the following B vitamins? A. B1 (thiamine) B. B2 (niacin) C. B6 (pyridoxine) D. B12 (cobalamin).

D. B12 (cobalamin).

A nurse, who is providing nutrition counseling to a new gravid client, advises the woman that a serving of meat is approximately equal in size to which of the following items? A. Deck of cards B. VCR tape C. CD case D. Video camera

A. Deck of cards

A nurse is about to inject RhoGAM into an Rh-negative mother. Which of the following is the preferred site for the injection? A. Deltoid B. Dorsogluteal C. Vastus lateralis D. Ventrogluteal.

A. Deltoid

A woman states that she frequently awakens with "painful leg cramps" during the night. Which of the following assessments should the nurse make? A. Dietary evaluation B. Goodell's sign C. Hegar's sign D. Posture evaluation

A. Dietary evaluation

An ultrasound has identified that a client's pregnancy is complicated by oligohydramnios. The nurse would expect that an ultrasound may show that the baby has which of the following structural defects? A. Dysplastic kidneys B. Coarctation of the aorta C. Hydrocephalus D. Hepatic cirrhosis.

A. Dysplastic kidneys

During a prenatal visit, a gravid client is complaining of ptyalism. Which of the following nursing interventions is appropriate? A. Encourage the woman to brush her teeth carefully B. Advise the woman to have her blood pressure checked regularly. C. Encourage the woman to wear supportive hosiery D. Advise the woman to avoid eating rare meat.

A. Encourage the woman to brush her teeth carefully

The nurse notes each of the following findings in a 12-week gestation client. Which of the findings would enable the nurse to tell the client that she is positively pregnant? A. Fetal heart rate via Doppler B. Positive pregnancy test C. Positive Chadwick's sign D. Montgomery gland enlargements.

A. Fetal heart rate via Doppler

Which of the following clients is at highest risk for developing a hypertensive illness of pregnancy? A. G1P0000, age 44 with history of diabetes mellitus B. G2P0101, age 27 with history of rheumatic fever C. G3P1102, age 25 with history of scoliosis D. G3P1011, age 20 with history of celiac disease.

A. G1P0000, age 44 with history of diabetes mellitus

A mother is experiencing nausea and vomiting every afternoon. The ingestion of which of the following spices has been shown to be a safe complementary therapy for this complaint? A. Ginger B. Sage C. Cloves D. Nutmeg.

A. Ginger

A gravid woman has sickle cell anemia. Which of the following situations could precipitate a vasoocclusive crisis in this woman? A. Hypoxia B. Alkalosis C. Fluid overload D. Hyperglycemia.

A. Hypoxia

A gravid woman who recently emigrated from mainland China is being seen at her first prenatal visit. She was never vaccinated in her home country. An injection to prevent which of the following communicable diseases should be administered to the woman during her pregnancy? A. Influenza B. Mumps C. Rubella D. Varicella

A. Influenza

A nurse is working in the prenatal clinic. Which of the following findings seen in third-trimester pregnant women would the nurse consider to be within normal limits? Select all that apply. A. Leg cramps B. Varicose veins C. Hemorrhoids D. Fainting spells E. Lordosis

A. Leg cramps B. Varicose veins C. Hemorrhoids E. Lordosis

Why is it essential that women of childbearing age be counseled to plan their pregnancies? A. Much of the organogenesis occurs before the missed menstrual period. B. Insurance companies must pre approve many prenatal care expenditures. C. It is recommended that women be pregnant no more than 3 times during their lifetime. D. The cardiovascular system is stressed when pregnancies are less than 2 years apart.

A. Much of the organogenesis occurs before the missed menstrual period.

A woman is to receive methotrexate IM for an ectopic pregnancy. The nurse should teach the woman about which of the following common side effects of the therapy? Select all that apply. A. Nausea and vomiting B. Abdominal pain C. Fatigue D. Lightheadedness. E. Breast tenderness.

A. Nausea and vomiting B. Abdominal pain C. Fatigue D. Lightheadedness.

A type 1 diabetic is being seen for preconception counseling. The nurse should emphasize that during the first trimester the woman may experience which of the following? A. Need for less insulin than she normally injects B. An increased risk for hyperglycemic episodes C. Signs and symptoms of hydramnios D. A need to be hospitalized for fetal testing.

A. Need for less insulin than she normally injects

A client has just done a fetal kick count assessment. She noted 6 movements during the last hour. If taught correctly, what should be her next action? A. Nothing because further action is not warranted B. Call the doctor to set up a non-stress test C. Redo the test during the next one-half hour D. Drink a glass of orange juice and redo the test.

A. Nothing because further action is not warranted

A child has been diagnosed with rubella. What must the pediatric nurse teach the child's parents to do? A. Notify any exposed pregnant friends B. Give penicillin po every 6 hours for 10 full days C. Observe the child for signs of respiratory distress D. Administer diphenhydramine every 4 hours as needed.

A. Notify any exposed pregnant friends

Which of the following vital sign changes should the nurse highlight for a pregnant woman's obstetrician? A. Pre-pregnancy blood pressure (BP) 100/60 and third trimester BP 140/90 B. Pre-pregnancy respiratory rate (RR) 16 rpm and third trimester RR 22 rpm C. Pre-pregnancy heart rate (HR) 76 bpm and third trimester HR 88 bpm D. Pre-pregnancy temperature (T) 98.6oF and third trimester T 99.2oF.

A. Pre-pregnancy blood pressure (BP) 100/60 and third trimester BP 140/90

A woman is planning to become pregnant. Which of the following actions should she be counseled to take before stopping birth control? Select all that apply. A. Take a daily multivitamin B. See a medical doctor C. Drink beer instead of vodka D. Stop all over-the-counter medications E. Stop smoking cigarettes.

A. Take a daily multivitamin B. See a medical doctor E. Stop smoking cigarettes.

A nurse is interviewing a prenatal client. Which of the following factors in the client's history should the nurse highlight for the health care practitioner? A. That she is eighteen years old B. That she owns a cat and a dog C. That she eats peanut butter every day D. That she works as an airline pilot.

A. That she is eighteen years old

The laboratory reported the L/S ratio results from an amniocentesis as 1:1. How should the nurse interpret the result? A. The baby is premature B. The mother is high risk for hemorrhage C. The infant has kernicterus D. The mother is high risk for eclampsia.

A. The baby is premature

A woman asks the nurse about the function of amniotic fluid. Which of the following statements by the woman indicates that additional teaching is needed? A. The fluid provides fetal nutrition B. The fluid cushions the fetus from injury C. The fluid enables the fetus to grow D. The fluid provides a stable thermal environment.

A. The fluid provides fetal nutrition

The nurse has taken a health history on four primigravida clients at their first prenatal visits. It is high priority that which of the clients receives nutrition counseling? A. The woman diagnosed with phenylketonuria B. The woman who has Graves' disease C. The woman with Cushing's syndrome D. The woman diagnosed with myasthenia gravis

A. The woman diagnosed with phenylketonuria

The nurse is caring for a pregnant client who is a vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods? A. Tofu, legumes, broccoli B. Corn, yams, green beans C. Potatoes, parsnips, turnips D. Cheese, yogurt, fish.

A. Tofu, legumes, broccoli

A pregnant client is lactose intolerant. Which of the following alternative calcium- rich foods could this woman consume? A. Turnip greens B. Green beans C. Cantaloupe D. Nectarines

A. Turnip greens

A 32-week-gestation client was last seen in the prenatal client at 28 weeks' gestation. Which of the following changes should the nurse bring to the attention of the certified nurse midwife? A. Weight change from 128 pounds to 138 pounds B. Pulse rate change from 88 bpm to 92 bpm C. Blood pressure change from 120/80 to 118/78 D. Respiratory rate change from 16 rpm to 20 rpm

A. Weight change from 128 pounds to 138 pounds

The nurse is assisting a couple to develop decisions for their birth plan. Which of the following decisions should be considered nonnegotiable by the parents? A. Whether or not the father will be present during labor B. Whether or not the woman will have an episiotomy C. Whether or not the woman will be able to have an epidural D. Whether or not the father will be able to take pictures of the delivery.

A. Whether or not the father will be present during labor

A woman has just completed her first trimester. Which of the following fetal structures can the nurse tell the women are well formed at this time? select all that apply A. genitals B. heart C. fingers D. alveoli E. kidneys

A. genitals B. heart C. fingers E. kidneys

A woman delivers a fetal demise that has lanugo covering the entire body, nails that are present on the fingers and toes, but eyes that are still fused. Prior to the death, the mother stated that she had felt quickening. Based on this information, the nurse knows that the baby is about how many weeks' gestation? A. 15 weeks B. 22 weeks C. 29 weeks D. 36 weeks.

B. 22 weeks

Which of the following choices can the nurse teach a prenatal client is equivalent to one 2-oz meat serving? A. 4 tbsp peanut butter B. 2 eggs C. 1 cup cooked lima beans D. 2 ounces mixed nuts

B. 2 eggs

The nurse working in an outpatient obstetric office assesses four primigravida clients. Which of the client findings would the nurse highlight for the physician? A. 17 weeks' gestation; denies feeling fetal movement B. 24 weeks' gestation; fundal height at the umbilicus C. 27 weeks' gestation; complains of excess salivation D. 34 weeks' gestation; complains of hemorrhoidal pain.

B. 24 weeks' gestation; fundal height at the umbilicus

A woman, 6 weeks pregnant, is having a vaginal examination. Which of the following would the practitioner expect to find? A. Thin cervical muscle B. An enlarged ovary C. Thick cervical mucus D. Pale pink vaginal wall

B. An enlarged ovary

A third-trimester client is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the visit? Select all that apply. A. Blood glucose B. Blood pressure C. Fetal heart rate D. Urine protein E. Pelvic ultrasound

B. Blood pressure C. Fetal heart rate D. Urine protein

A couple is preparing to interview obstetric primary care providers in order to determine who they will go to for care during their pregnancy and delivery. In order to make the best choice, which of the following actions should the couple perform first? A. Take a tour of hospital delivery areas B. Develop a preliminary birth plan C. Make appointments with three or four obstetric care providers D. Search the internet for the malpractice histories of the providers.

B. Develop a preliminary birth plan

A 36-week gestation gravid lies flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe? A. Hypertension B. Dizziness C. Rales D. Chloasma

B. Dizziness

The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above pre pregnancy levels? A. Glucose B. Fibrinogen C. Hematocrit D. Bilirubin.

B. Fibrinogen

A 36-week gestation gravid client is complaining of dyspnea when lying flat. Which of the following is the likely clinical reason for this complaint? A. Maternal hypertension B. Fundal height C. Hydramnios D. Congestive heart failure

B. Fundal height

The nurse is caring for a prenatal client who states she is prone to developing anemia. Which of the following foods should the nurse advise the gravida is the best source of iron? A. Raisins B. Hamburger C. Broccoli D. Molasses

B. Hamburger

It is discovered that a pregnant woman practices pica. Which of the following complications is most often associated with this behavior? A. Hypothyroidism B. Iron deficiency anemia C. Hypercalcemia D. Overexposure to zinc.

B. Iron deficiency anemia

A mother has just experienced quickening. Which of the following developmental changes would the nurse expect to occur at the same time in the woman's pregnancy? A. Fetal heart begins to beat B. Lanugo covers the fetal body C. Kidneys secrete urine D. Fingernails begin to form.

B. Lanugo covers the fetal body

A Chinese immigrant is being seen in the prenatal clinic. When providing nutrition counseling, which of the following factors should the nurse keep in mind? A. Many Chinese eat very little protein B. Many Chinese believe pregnant women should eat cold foods C. Many Chinese are prone to anemia D. Many Chinese believe strawberries can cause birth defects.

B. Many Chinese believe pregnant women should eat cold foods

A 10-week gravid client is being seen in the prenatal clinic. For the nurse caring for this patient, providing anticipatory guidance for which of the following should be a priority? A. Pain management during labor B. Methods to relieve backaches C. Breastfeeding positions D. Characteristics of the newborn.

B. Methods to relieve backaches

Which of the following exercises should be taught to a pregnant woman who complains of backaches? A. Kegeling B. Pelvic tilting C. Leg lifting D. Crunching

B. Pelvic tilting

A gravid client is admitted with a diagnosis of third-trimester bleeding. The nurse must carefully monitor for a change in which of the following vital signs? A. Temperature B. Pulse C. Respirations D. Blood pressure.

B. Pulse

A woman in her third trimester advises the nurse that she wishes to breastfeed her baby, "but I don't think my nipples are right." Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time? A. Advise the client that it is unlikely that she will be able to breastfeed. B. Refer the client to a lactation consultant for advice. C. Call the labor room and notify them that a client with inverted nipples will be admitted. D. Teach the woman exercises in order to evert her nipples.

B. Refer the client to a lactation consultant for advice.

The blood of a pregnant client was initially assessed at 10 weeks' gestation and re-assessed at 38 weeks' gestation. Which of the following results would the nurse expect to see? A. Rise in hematocrit from 34% to 38% B. Rise in white blood cells from 5,000 cells/mm3 to 15,000 cells/mm3 C. Rise in potassium from 3.9 mEq/ L to 5.2 mEq/ L D. Rise in sodium from 137 mEq/ L to 150 mEq/ L.

B. Rise in white blood cells from 5,000 cells/mm3 to 15,000 cells/mm3

A pregnant woman, 24 weeks' gestation, who has been diagnosed with gallstones is scheduled for surgery. In order to provide high-quality care, what should the nurse be aware of? A. That preterm delivery of the baby must precede the cholescystectomy surgery. B. That decreased gastric motility of pregnancy increases her risk of postoperative vomiting. C. That physiological anemia of pregnancy increases her risk of perioperative hemorrhage. D. That antiembolic stockings are contraindicated for the pregnant woman after surgery.

B. That decreased gastric motility of pregnancy increases her risk of postoperative vomiting.

A client states that she is a strong believer in vitamin supplements to maintain her health. The nurse advises the woman that it is recommended to refrain from consuming excess quantities of which of the following vitamins during pregnancy? A. Vitamin C B. Vitamin D C. Vitamin B2 (niacin) D. Vitamin B12 (cobalamin)

B. Vitamin D

Prenatal teaching for a pregnant woman should include instructions to do which of the following? A. Refrain from touching her pet bird B. Wear gloves when gardening C. Cook pork until medium well D. Avoid sleeping with the dog.

B. Wear gloves when gardening

When assessing the fruit intake of a pregnant client, the nurse notes that the client usually eats 1 piece of fruit per day and drinks 7 to 8 servings of fruit juice per day. Which of the following is the most important communication for the nurse to make? A. "You are effectively meeting your daily fruit requirements." B. "Fruit juices are excellent sources of folic acid." C. "It would be even better if you were to consume more whole fruits and less fruit juice." D. "Your fruit intake far exceeds the recommended daily fruit intake."

C. "It would be even better if you were to consume more whole fruits and less fruit juice."

A client, 8 weeks pregnant, has been diagnosed with a bicoruate uterus. Which of the following signs should the nurse teach the client to carefully monitor for? A. Hyperthermia B. Palpitations C. Cramping D. Oliguria.

C. Cramping

A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? A. Backache B. Dyspnea C. Fatigue D. Diarrhea

C. Fatigue

A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks' gestation; delivered a daughter, now 5 years old, at39 weeks' gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman's gravidity and parity? A. G4 P2121 B. G4 P1212 C. G5 P1122. D. G5 P2211

C. G5 P1122.

A nurse is providing diet counseling to a new prenatal client. Which of the following dairy products should the client be advised to avoid eating during the pregnancy? A. Vanilla yogurt B. Parmesan cheese C. Gorgonzola cheese D. Chocolate milk.

C. Gorgonzola cheese

The following four changes occur during pregnancy. Which of them usually increases the father's interest and involvement in the pregnancy? A. Learning the results of the pregnancy test B. Attending childbirth education classes C. Hearing the fetal heartbeat D. Meeting the obstetrician or midwife

C. Hearing the fetal heartbeat

The glucose challenge screening test is performed at or after 24 weeks' gestation to assess for the maternal physiological response to which of the following pregnancy hormones? A. Estrogen B. Progesterone C. Human placental lactogen D. Human chorionic gonadotropin

C. Human placental lactogen

A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2006. Using Nagele's rule, the nurse calculates the client's estimated date of delivery as: A. May 30, 2007 B. June 20, 2007 C. June 27, 2007 D. July 3, 2007.

C. June 27, 2007

Which of the following developmental features would the nurse expect to be absent in a 41-week gestation fetus? A. Fingernails B. Eye lashes C. Lanugo D. Milia.

C. Lanugo

An ultrasound of a fetus' heart shows that normal fetal circulation is occurring. Which of the following statements should the nurse interpret as correct in relation to the fetal circulation? A. The foramen ovale is a hole between the ventricles B. The umbilical vein contains oxygen-poor blood C. The right atrium contains both oxygen-rich and oxygen-poor blood D. The ductus venous lies between the aorta and pulmonary artery.

C. The right atrium contains both oxygen-rich and oxygen-poor blood

After nutrition counseling, a woman, G3 P1101, proclaims that she certainly can't eat any strawberries during her pregnancy. Which of the following is the likely reason for this statement? A. The woman is allergic to strawberries B. Strawberries have been shown to cause birth defects C. The woman believes in old wives' tales D. The premature baby died because the woman ate strawberries

C. The woman believes in old wives' tales

Which of the following would indicate that a nipple stimulation test is creating the desired effect? A. The woman's inverted nipples become erect B. The woman's nipple and breast tissue hypertrophy C. The woman's uterus contracts 3 times in 10 minutes D. The woman's cervix dilates 2 centimeters in 3 hours.

C. The woman's uterus contracts 3 times in 10 minutes

A gravid woman, who is 42 weeks' gestation, has just had a 20-minute nonstress test (NST). Which of the following results would the nurse interpret as a reactive test? A. Moderate fetal heart baseline variability B. Maternal heart rate accelerations to 140 bpm lasting at least 20 seconds C. Two fetal heart accelerations of 15 bpm lasting at least 15 seconds D. Absence of maternal premature ventricular contractions.

C. Two fetal heart accelerations of 15 bpm lasting at least 15 seconds