Ante/Intrapartum

A 26-year-old client comes to the clinic and asks for a pregnancy test because the client thinks they might be pregnant. The nurse assesses for which presumptive signs of pregnancy? Select all that apply. 1. Breast tenderness 2. Early morning nausea 3. Positive urine pregnancy test 4. Fetal heartbeat heard by Doppler 5. No menstruation for the last 8 weeks

1. breast tenderness 2. early morning nausea 5. No menstruation for the last 8 weeks

The nurse is providing emotional support to a client who experienced a spontaneous abortion. The nurse can best assist the client by planning care that focuses on which psychosocial issue? 1. The feelings of guilt that are often associated with grief 2. Grief and loss are usually resolved within 3 months. 3. The amount of pain and discomfort as a result of the abortion 4. The other children in the family and the ability to bear children in the future

1. The feelings of guilt that are often associated with grief

The nurse is caring for a pregnant client who was diagnosed with acquired immunodeficiency syndrome (AIDS). The client asks the nurse whether they will be able to breast-feed the infant after delivery. Which response by the nurse is appropriate? 1. Breast-feeding is contraindicated. 2. Breast-feeding is allowed as long as the parent is taking zidovudine (AZT). 3. Breast-feeding is allowed as long as the infant receives an immunization for HIV. 4. Breast-feeding is allowed as long as the infant is not showing signs of human immunodeficiency virus (HIV) infection."

1

The nurse working in a prenatal clinic receives a telephone call from a client at 22 weeks of gestation. The client reports some vaginal discharge and has started to experience menstrual-like cramps and diarrhea. Which responses by the nurse indicate an understanding of the implications of the client's signs and symptoms? Select all that apply. "1"Lie on your left side for an hour and try to drink some fluids. "2"It is important that you urinate frequently to keep your bladder empty. "3"This is probably an emergency. Have someone drive you to a hospital now. "4"Palpate for contractions and call back if there are more than four contractions in the next hour. "5"Can you identify what you ate and drank, what medications you took, and your activity during the past 24 hours?"

1.Lie on your left side for an hour and try to drink some fluids. 2.It is important that you urinate frequently to keep the bladder empty 4.Palpate for contractions and call back if there are more than four contractions in the next hour 5.Can you identify what you ate and drank, medications you took, and your activity during the past 24 hours?

A nulliparous client asks the nurse when they will feel fetal movements. The nurse responds by telling the client that the first recognition of fetal movement will occur at approximately which week of gestation? 1. 10 2. 12 3. 14 4. 18

18

A pregnant client in the second trimester of pregnancy is admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding would the nurse expect to note if this condition is present? 1. Soft uterus 2. Abdominal pain 3. Nontender uterus 4. Painless vaginal bleeding

2. Abdominal pain

A nurse is reinforcing instructions to a client in the first trimester of pregnancy about measures to help with morning sickness. Which would the nurse include in the instructions? Select all that apply. 1.Avoid milk. 2.Eat a low-fat diet. 3.Stop or decrease smoking. 4.Eat smaller, more frequent meals. 5.Consume adequate fluid between meals.

2. Eat a low-fat diet 3. stop or decrease smoking 4. eat smaller, more frequent meals 5. consume adequate fluid between meals

The nurse instructs the client to perform the procedure by taking which action? 1. Contracting and then consciously relaxing different muscle groups 2. Massaging the abdomen during contractions using both hands in a circular motion 3. Instructing the significant other to stroke or massage a tightened muscle by the use of touch 4. Contracting an area of the body such as an arm or leg and then concentrating on letting tension go from the rest of the body

2. Massaging the abdomen during contractions using both hands in a circular motion

The nurse is performing an assessment on a client who has just been told that a pregnancy test is positive. Which assessment finding indicates that the client is at risk for preterm labor? 1. The client is a 35-year-old primigravida. 2. The client has a history of cardiac disease. 3. The client's hemoglobin level is 13.5 g/dL. 4. The client is a 20-year-old primigravida of average weight and height.

2. The client has a history of cardiac disease.

The nurse is collecting data on a pregnant client in the 22nd week. The nurse prepares to use a fetoscope to auscultate the fetal heart rate. The nurse hears a fetal heart rate of 115 beats per minute. Which action would the nurse take? 1.Document the assessment. 2.Notify the physician. 3.Have another nurse check the fetal heart rate. 4.Compare the client's pulse rate with the fetal heart rate.

Document the assessment

The nurse is reviewing the health care record of a pregnant client at 24 weeks' gestation. The nurse would anticipate that the fundus would be located at which level? 1. 16 cm to 18 cm 2. 20 cm to 22 cm 3. 22 cm to 26 cm 4. 32 cm to 36 cm

3

A pregnant client visiting a health care clinic for the first prenatal visit hears the physician discuss the pre-embryonic period of development with the nurse. The client asks the nurse what this means. What information would the nurse share related to this stage of development? Select all that apply. 1.The pre-embryonic period is the period of time before conception. 2. The pre-embryonic period is the longest period of fetal development. 3. The pre-embryonic period is the first 2 weeks of fetal development following conception. 4. The pre-embryonic stage is the most critical time in the development of the organ systems and the main external features. 5. The pre-embryonic period is the fetal development period from the beginning of the third week through the eighth week after conception. 6. The pre-embryonic period includes initial development of the embryonic membranes and establishment of the primary germ layers.

3. The pre-embryonic period is the first 2 weeks of fetal development following conception. 6. The pre-embryonic period includes initial development of the embryonic membranes and establishment of the primary germ layers.

The nurse is reinforcing instructions to a pregnant client regarding measures that will strengthen the perineal floor muscles. Which would the nurse include in the instructions? 1. Drink 8 ounces of fluid 6 times per day. 2. Wipe the perineal area anterior to posterior after toileting. 3Perform Kegel exercises in 10 repetitions, three times per day. 4Perform pelvic tilt exercises in 10 repetitions, three times per day.

4

The nurse is assessing a client who is at 32 weeks of gestation. It has been 4 weeks since the client's last visit. Which assessment needs to be reported to the physician? 1.Fundal height, 38 cm 2.Weight gain, 3 pounds 3.Blood pressure, 118/70 mm Hg 4.Fetal heart tones, 144 beats/minute

Fundal height, 38 cm

The nurse in a prenatal clinic is explaining to a group of pregnant clients about anemia and foods high in iron. Which foods are high in iron content? Select all that apply. PB Fresh Fruit Salad whole grain bread Omelet with Cheese Chocolate Milkshake

PB, omelet with cheese

A client presents at the physician's office 10 weeks pregnant with their first pregnancy. Which are presumptive signs of pregnancy that the client might be expected to have? Select all that apply. 1.Fatigue 2Breast changes 3Chadwick's sign 4Nausea and vomiting 5Pigmentation changes of the face6A bluish discoloration of the vagina and cervix

1, 2, 4

The clinic nurse is assisting to perform a psychosocial assessment of a client who has been told that they are pregnant. Which assessment findings indicate to the nurse that the client is at risk for contracting human immunodeficiency virus (HIV)? Select all that apply. 1.The client has a history of intravenous drug use. 2.The client has a significant other who is heterosexual. 3.The client has a history of sexually transmitted infections. 4.The client has had one sexual partner for the past 10 years. 5.The client has a previous history of gestational diabetes mellitus.

1. The client has a history of intravenous drug use 3. The client has a history of sexually transmitted infections

A pregnant client in the second trimester of pregnancy complains of constipation and describes the home care measures they are taking to relieve the problem. Which would the nurse determine is a harmful measure in preventing constipation? 1. Drinking eight to 10 glasses of water daily 2. Daily activity such as walking or swimming 3. Increasing whole grains and fresh vegetables in the diet 4. Adding 1 tablespoon of mineral oil to a bowl of cereal daily

4. Adding 1 tablespoon of mineral oil to a bowl of cereal daily

A client in their 24th week of pregnancy is admitted to the hospital in preterm labor. The client asks the nurse if the baby will live if the labor cannot be stopped. Which diagnostic test would the nurse expect the physician to prescribe? 1. Biophysical profile 2. Chorionic villus sampling 3. Ultrasound for amniotic fluid volume 4. Amniocentesis for fetal surfactant level

4. Amniocentesis for fetal surfactant level

During an office visit, a prenatal client with mitral stenosis states that they have been under a lot of stress lately. During data collection, the client questions everything the nurse does and behaves in an anxious manner. Which is the appropriate nursing response or action at this time? 1. Tell the client not to worry. 2. Refer the client to a counselor. 3. Ignore the client's unfounded concerns and continue. 4. Explain the purpose of the nurse's actions and answer all questions.

4. Explain the purpose of the nurse's actions and answer all questions

The nurse is reinforcing instructions to a pregnant client regarding the need to consume folic acid in the diet. The nurse determines that the client understands the instructions when the client states that it is necessary to include which food item in the diet? 1. Rice 2. Cheese 3. Chicken 4. Green, leafy vegetables

4. Green, leafy vegetables

The nurse is reviewing the health record of a pregnant client at 16 weeks' gestation. The nurse would expect documentation to show that the fundus of the uterus is located at which area? 1. At the umbilicus 2. Just above the symphysis pubis 3. At the level of the xiphoid process 4. Midway between the symphysis pubis and the umbilicus

4. Midway between the symphysis pubis and the umbilicus

Which history places a maternity client at risk for uterine rupture? 1.Preterm labor 2.Placenta previa 3.Abruptio placentae 4.Cesarean section birth

Cesarean section birth

The nurse is performing an assessment on a pregnant client who has had a severe asthma attack. The nurse asks the client about prescription and herbal medications being taken, and the client tells the nurse about taking the herb chamomile. Which statement made by the client demonstrates correct information about this herbal intervention? -Chamomile is a known stimulant. -Chamomile is always safe during pregnancy, and I can drink as much as I want. -Chamomile has no side effects or interactions with other medications. -Chamomile should be avoided while I am pregnant and because I have asthma.

Chamomile should be avoided while I am pregnant and because I have asthma.

The nurse is providing education to a client with gestational diabetes who was recently placed on insulin therapy. Which information would the nurse tell the client about insulin needs during the second and third trimesters of pregnancy? 1.The insulin needs will increase 2.The insulin needs will decrease. 3.The insulin needs will remain unchanged. 4.The client will require both short- and long-term insulin therapy.

the insulin needs will increase