Chapter 11: Antepartum Period (Test)

Which medication should the nurse have on hand when the client is receiving magnesium sulfate? 1. Hydralazine (Apresoline) 2. Oxytocin (Pitocin) 3. Methylergonovine (Methergine) 4. Calcium gluconate (Kalcinate)

4

Which method best promotes client comfort during the pelvic examination? 1. Have the client lift the head off the table. 2. Have the client press the back into the examination table. 3. Have the client tighten the buttocks. 4. Tell the client to let the knees fall outward.

4

Which nursing instruction given to the client complaining about shortness of breath is most appropriate? 1. "Contact your healthcare provider immediately." 2. "Decrease your activity level to conserve oxygen." 3. "Ask your physician for a mild sedative." 4. "Sleep with your upper body elevated on pillows."

4

A 28-year-old multipara client is admitted to the hospital for observation during the 10th week of pregnancy. The client has a history of spontaneous abortions and is spotting. Which findings reported by the client best suggests a potential for a spontaneous abortion? Select all that apply. 1. Cold, clammy skin 2. Severe headache 3. Persistent tachycardia 4. Abdominal cramping 5. Backache unresolved by positioning 6. Uterine contractions every 20 minutes

45

A 30-year-old multigravid client who is in the last trimester of pregnancy is diagnosed with abruptio placentae. Which assessment findings are considered predisposing factors for the development of abruptio placentae? Select all that apply. 1. Gestational diabetes 2. Hyperemesis gravidarum 3. Oligohydrarnnios 4. Pregnancy-induced hypertension 5. History of placenta previa 6. Reports of use of crack cocaine

456

One participant who is 5 months' pregnant complains of annoying backaches. Which advice can the nurse give to relieve the client's backache? Select all that apply. 1. Avoid tight-fitting clothing around the waist. 2. Sleep on a heating pad. 3. Take a nonopioid pain reliever regularly. 4. Wear low-heeled shoes. 5. Carry objects close to the body. 6. Squat when picking objects off the floor.

456

During a subsequent visit, the nurse notes that the client is eating a bag of potato chips and drinking a diet cola. The nurse revises the client's care plan accordingly. Which expected outcome should the nurse include based on the client's eating habits? 1. The client will eat three balanced meals and two snacks daily while pregnant. 2. The client will gain a total of 50 pounds .during the pregnancy. 3. The client will take two prenatal vitamins daily. 4. The client will report eating about 2,000 calories per day.

1

During the visit, the nurse also asks if the client has been taking the prescribed folic acid. When the client asks why folic acid is important, which response by the nurse is most accurate? 1. "Folic acid helps prevent neural tube defects such as spina bifida." 2. "Folic acid helps build strong bones for your baby." 3. "Folic acid helps your baby become resistant to infections." 4. "Folic acid prevents your baby from becoming anemic."

1

If the client develops a complete abruption, which nursing action is most appropriate? 1. Obtain a written consent for an immediate cesarean birth. 2. Give the client an enema and prep the abdomen . 3. Place the client in Trendelenburg' s position. 4. Prepare the client for a contraction stress test.

1

In a discussion about hormonal changes, the nurse informs the client that the placenta produces which hormone? 1. Estrogen 2. Testosterone 3. Oxytocin 4. Follicle-stimulating hormone

1

In the last trimester of pregnancy, the client's diabetes has been well controlled. The client tells the nurse about being excited but also scared that something could be wrong with the baby because of the diabetes. Which response by the nurse is most appropriate? 1. "Your baby may be large and initially will need blood glucose monitoring." 2. "Your baby may be small but otherwise healthy." 3. "Your baby will most likely be insulin dependent." 4. "Your baby will have difficulty eating."

1

Several people attending the prenatal class ask the nurse to discuss the causes of varicose veins and how to relieve the discomfort associated with them. The nurse explains that, in addition to increased blood volume, which other condition causes varicose veins during pregnancy? 1. Impaired venous return 2. Decreased cardiac output 3. Changes in the body's center of gravity 4. Impaired kidney function

1

The client asks the nurse if an ultrasound could confirm the pregnancy in the second month. Which statement by the nurse regarding an ultrasound is most accurate? 1. "Transvaginal ultrasound is used to diagnose pregnancy as early as 2 1/2 to 3 weeks." 2. "Ultrasounds aren't usually performed during the first trimester because of the risk to the baby." 3. "An X-ray is just as reliable as an ultrasound and poses less of a risk to the baby." 4. "Ultrasounds aren't used until the uterus ascends out of the pelvis into the abdomen."

1

In order to best enhance absorption of the iron supplement, which foods should the nurse recommend the client increase in her diet? Select all that apply. 1. Oranges 2. Cantaloupe 3. Bananas 4. Broccoli 5. Whole milk 6. Carrots

124

A 17-year-old primigravid client is seen at the health clinic for the first time. The nurse assesses the teenager's nutritional status and provides nutritional guidance. Which dietary adjustment is most appropriate for a pregnant teenager? 1. Increase caloric intake to 2,500 calories per day. 2. Drink presweetened beverages instead of carbonated ones. 3. Eat foods that are low in carbohydrates and fats. 4. Choose nonspicy, easy to digest foods.

1

A 21-year-old multigravid client who is 8 months' pregnant is admitted to the obstetric unit for observation. The admission diagnosis is partial placenta previa. The client's partner asks the nurse, "What is placenta previa?" Which response by the nurse provides the best explanation regarding placenta previa? 1. ''The placenta is implanted over or close to the internal cervical opening." 2. "The placenta isn't producing the hormones needed to maintain the pregnancy." 3. "The placenta is invaded by polyps that cause premature uterine contractions." 4. ''The placenta is producing antibodies that are destroying the baby's red blood cells."

1

A 30-year-old women and her spouse attend an infertility clinic. They have no children and have had several appointments with the physician regarding their infertility problems. After receiving information about reproduction, the client asks the nurse where fertilization takes place. The nurse correctly explains that fertilization usually takes place in which structure? 1. Outer third of the fallopian tube 2. Ovary 3. Fundus of the uterus 4. Vagina

1

A client in the class reports having intermittent episodes of nausea, especially in the morning. The nurse advises the class about ways to minimize the occurrence of heartburn and nausea. Which statement made by a participant regarding remedies for heartburn and nausea indicates that teaching has been effective? 1. "I should eat frequent, small meals." 2. "I should take an antacid after eating." 3. "I should eat my largest meal in the evening." 4. "I should drink extra water with my meals."

1

Another participant informs the nurse about smoking about a pack of cigarettes a day. The nurse correctly informs the participants that women who smoke during pregnancy have a greater risk of which problem? 1. Having a premature delivery 2. Having a cesarean birth 3. Having a large overweight baby 4. Developing a prenatal infection

1

At a subsequent prenatal visit, the client complains of edema in the lower extremities. After gathering further information about the edema, the nurse advises the client to limit the intake of which substance? 1. Sodium 2. Potassium 3. Vitamin C 4. Magnesium

1

During a discussion regarding menstruation, the client asks the nurse, "Where does the blood flow come from when a woman has her monthly period?" The nurse correctly explains that the bleeding is the result of sloughing of which structure? 1. Endometrium 2. Perimetrium 3. Myometrium 4. Epimetrium

1

The client comments to the nurse, "This is like a recurring nightmare. This same thing happened last year. I don't want to lose another baby. " Which response by the nurse is most appropriate at this time? 1. "I know this is painful for you. Would you like to talk about how you are feeling?" 2. "Be positive. It's too early to know whether or not you will lose your baby." 3. "I know you are scared, but you must try to stay calm. Stress makes the situation worse." 4. " Trust me: everything will work out for the best in the end."

1

The client informs the nurse about some spotting during the first week of pregnancy. The client asks if it should be reported to the physician. The nurse correctly explains that the spotting the client experienced is probably normal and the result of what occurrence? 1. The embryo implanting in the lining of the uterus 2. Increased blood circulation to the vaginal area 3. Hormonal changes that occur during pregnancy 4. The cervical opening enlarging and thinning out

1

The nurse frequently assesses the client and finds that the pregnancy-induced hypertension (PIH) has progressed to eclampsia. The nurse notifies the physician immediately when the client has which assessment finding? 1. Seizures 2. Long periods of sleep 3. Fetal heart rate greater than 100 beats/minute 4. Vomiting

1

The nurse leads a discussion with the group about distinguishing between danger signs and common discomforts of pregnancy. The nurse considers prenatal teaching successful when the class correctly identifies which of the following as a danger sign of pregnancy? 1. Headache and swelling of the face and fingers 2. Constipation and flatulence 3. Lower extremity muscle cramping and varicosities 4. Large amounts of odorless, colorless vaginal secretions

1

The nurse should also include which information about the side effects of iron supplementation? 1. "You may notice that your stools will be black." 2. "Your teeth will become stained." 3. "Vomiting is likely to occur." 4. "You may have diarrhea several times per day."

1

The physician asks the nurse to prepare the client for a pelvic examination. The nurse correctly assists the client into which position? 1. Lithotomy 2. Prone 3. Sims' 4. Trendelenburg' s

1

The physician examines the client and determines that the cervix is dilated but the fetus and placenta are still in the uterus. Which nursing intervention is most appropriate when a spontaneous abortion is inevitable? 1. Prepare the client for dilation and curettage (D&C). 2. Place the client in Trendelenburg' s position. 3. Prepare the client for placement of a purse-string stitch. 4. Place the client in the side-lying position

1

When reviewing the client' s medical record, the nurse notes that the physician documented the presence of ballottement. On the basis of this finding, the nurse can assume that the client is at least how many months pregnant? 1. 5 months 2. 6 months 3. 7 months 4. 8 months

1

Which fetal heart rate must the nurse report immediately to the physician? 1. 100 beats/minute 2. 120 beats/minute 3. 140 beats/minute 4. 160 beats/minute

1

Which response by the nurse is most relevant when another participant talks about having recurrent mood swings? 1. "Try to avoid fatigue and decrease your stress." 2. "Avoid interactions with people who upset you." 3. "You need to be assessed for a possible mood disorder." 4. "Are you ambivalent about the pregnancy?"

1

Which statement made by a participant indicates the need for additional teaching regarding management of urinary frequency? 1. "Limiting fluid intake will help control this problem." 2. "I should report a burning sensation during urination ." 3. "Urinating before going to bed may help control the problem." 4. "Avoiding caffeinated beverages may help control the problem."

1

In a discussion regarding fetal development, the nurse informs the client that as growth increases, the amount of amniotic fluid increases. The client asks the nurse to explain the purpose of the amniotic fluid. Which response given by the nurse is most appropriate regarding the purpose of amniotic fluid? 1. It provides the fetus with antibodies from the mother. 2. It helps protect the fetus from external injury. 3. It provides oxygen for the fetus. 4. It helps lower the mother's body temperature.

2

A 30-year -old client comes to the clinic complaining of severe nausea and frequent vomiting. The nurse learns that the client has had these symptoms for the last 7 days.The physician determines that the client has hyperemesis gravidarum and is moderately dehydrated. Which of the following should the nurse plan to have available to provide care for this client? Select all that apply. 1. I.V. start kit 2. An intake and output record 3. Oxygen and face mask 4. Cardiac monitor 5. A consent for a blood transfusion 6. A suction machine

12

The client also asks the nurse whether it is safe to continue to exercise routinely throughout the pregnancy. Which nursing instructions concerning exercise during pregnancy are accurate? Select all that apply. 1. Avoid exercising during hot, humid weather. 2. Avoid any jerking, bouncing, or jumping movements. 3. Drink plenty of fluids before and after exercising. 4. Limit strenuous activity to no more than 60 minutes a session. 5. Perform exercises only in the supine position. 6. Limit exercising to once per week.

123

A nurse conducts a nutrition class at a local public health department for a group of clients who are newly pregnant. During the class, the nurse collects information about each person's nutritional status and assesses the group for nutritional risk factors during pregnancy. Which of the following clients are at risk for nutritional problems during pregnancy? Select all that apply. 1. A 17-year-old primigravid client who works part time 2. A 25-year-old client who weighs 250 pounds at conception 3. A 19-year-old client who admits that she smokes cigarettes and drinks alcohol 4. A 30-year-old client who is unemployed and uses food stamps 5. A 25-year-old client whose prepregnancy hemoglobin level is 13 g/100 rnL 6. A 30-year-old client who drinks four glasses of milk per day

1234

Which of the following beverages should be included in the list of unhealthy drinks to avoid? Select all that apply 1. Alcohol 2. Coffee 3. Tea 4. Cola beverages 5. Sports drinks 6. Orange juice

12345

It is confirmed that a nurse who works in a busy doctor's office is 12 weeks pregnant. The nurse has been working long hours and is experiencing fatigue . If this nurse is similar to other women experiencing normal pregnancies, which guidelines for pregnant working women should be implemented? Select all that apply. 1. Use break and lunch periods for resting. 2. Void every 2 hours. 3. Eat foods high in carbohydrates. 4. Schedule work days close together. 5. Refrain from working overtime. 6. Get at least 12 hours of sleep per night.

125

The client informs the nurse about planning a vacation next month before the pregnancy is too "far along." The client asks if there are any special instructions regarding traveling. Which response by the nurse regarding travel is most appropriate? Select all that apply. 1. "Carry a copy of your medical record with you when traveling ." 2. "Refrain from traveling until after the baby is born." 3. "Pack a scale and weigh yourself every day." 4. "Avoid using a seatbelt for extended periods of time." 5. "Eat foods that you are normally accustomed to eating." 6. "If you travel to a foreign country, make sure to get vaccinated."

14

Which clients are most likely to be identified as being at high risk for pregnancy complications? Select all that apply. 1. A client who is pregnant for the fifth time 2. A client who has gained 30 pounds during the pregnancy 3. A client who has a history of twins in the family 4. A client who has primary hypertensive disease 5. A client who works 40 hours a week in a factory 6. A client who reports spotting in the first trimester

14

Which findings are most indicative of abruptio placentae that should be reported to the physician immediately? Select all that apply. 1. Rigid, boardlike, tender abdomen 2. Severe nausea and vomiting 3. Fetal heart rate of 160 beats/minute 4. Painless vaginal bleeding 5. Dark red vaginal bleeding 6. A seizure lasting several seconds

15

A 26-year-old primigravid client visits the obstetrician for the first prenatal visit. The physician confirms that the client is in the ninth week of pregnancy. The nurse and client discuss general health needs during pregnancy. Which client statement regarding bathing indicates a need for additional teaching? 1. "I should avoid taking tub baths if my membranes rupture." 2. "I should avoid taking tub baths during my pregnancy." 3. "I shouldn't sit in a hot tub because the heat could affect my baby." 4. "I should use warm water when I bathe."

2

A 32-year-old multigravid client visits the prenatal clinic for the first time during this pregnancy and states to the nurse, "I know I'm pregnant; I've already felt the baby move." On the basis of the client's statement, what can the nurse conclude? 1. The client is having twins. 2. The client is between 14 and 18 weeks' gestation. 3. The client is in the first trimester. 4. The client's due date will be difficult to calculate.

2

A 40-year-old participant, a gravida V para I in the 10th week of pregnancy, tells the nurse of concerns about her age that may affect the health of the baby. The participant asks the nurse if there is a test that can identify any genetic disorders that the baby may have. At this point in the client's pregnancy, which test is typically used to detect genetic disorders? 1. Amniocentesis 2. Chorionic villi sampling 3. Rapid plasma reagin 4. Ultrasound

2

A physician recommends amniocentesis for a pregnant woman whose first child has Down syndrome. The nurse advises the client that this test is typically performed at which time during the pregnancy? 1. Just after the pregnancy is confirmed 2. Early in the second trimester 3. In the transition phase of labor 4. Just after the first fetal movements

2

After a short observation period, the client with placenta previa is sent home. One week later, the client reports to the hospital with complications. On the basis of the client's earlier diagnosis, the admitting nurse would expect the client to report which finding? 1. Sudden, sharp abdominal pain 2. Painless bleeding from the vagina 3. Persistent frontal headache 4. Continuous, painless contractions

2

After interviewing the client, the nurse determines that the client is not getting an adequate intake of calcium. The nurse correctly instructs the client to drink how many glasses of milk per day to meet calcium requirements? 1. 1 to 2 2. 3 to 4 3. 5 to 6 4. 7 to 8

2

At 24 weeks' gestation, the nurse prepares the client for which routine test? 1. Coombs' test 2. Glucose tolerance test 3. Papanicolaou (Pap) smear 4. Rubella titer

2

At the clinic, an 18-year-old primigravid client is seen for the first time. The physician determines that the client is 3 months' pregnant and diagnoses chlamydia, a sexually transmitted disease. Which assessment finding best indicates the presence of this condition? 1. Painful blisters on the labia 2. Heavy, grayish white discharge 3. Milky white discharge that smells like fish 4. Thick, white, curdlike vaginal discharge

2

Before the pelvic examination, which intervention by the nurse is most appropriate? 1. Give the client an enema. 2. Instruct the client to urinate. 3. Shave the client's perineum. 4. Give the client a mild sedative.

2

During a routine prenatal visit, the physician determines that a client in the fourth month of pregnancy is not eating an appropriate diet and asks whether she has been taking the prenatal vitamins, Jolie acid, and iron supplements that were previously prescribed. The physician asks the nurse to instruct the client about nutritional needs during pregnancy. Before teaching the client about the nutritional needs during pregnancy, which nursing intervention is most appropriate? 1. Determine if the client needs to gain or lose weight. 2. Assess the client's current eating pattern and preferences. 3. Determine if the client knows how to accurately count calories. 4. Develop a sample menu that includes the required nutrients.

2

If the client reports the following signs and symptoms, which one represents a probable sign of pregnancy? 1. Absence of monthly periods 2. Abdominal enlargement 3. Nausea and vomiting 4. Frequent urination

2

One of the participants in the prenatal class tells the nurse, "My skin itches so much. What can I do about it?" Which nursing instruction is most appropriate regarding the relief of itchy skin during pregnancy? 1. Take a hot bath daily. 2. Increase fluid intake. 3. Add a daily vitamin C tablet to the diet. 4. Take diphenhydramine (Benadryl) twice per day.

2

One participant tells the nurse about drinking a beer every night before going to bed. The participant asks the nurse if occasional alcohol consumption will harm the unborn baby. Which response by the nurse is best? 1. "Any alcohol consumption during pregnancy will cause the child to have complications later in life." 2. "The minimal safe amount of alcohol consumption during pregnancy has not yet been determined." 3. "Alcohol consumption has a harmful effect on the baby only if consumed during the first trimester of pregnancy." 4. "Occasional intake of a small amount of alcohol during pregnancy will not adversely affect the unborn baby."

2

The client 's condition worsens and requires admission to the hospital. The physician orders magnesium sulfate. While the client is receiving magnesium sulfate, the nurse routinely assesses the client's vital signs and what else? 1. Urine for glucose 2. Deep tendon reflexes 3. Stool for blood 4. Pupils for constriction

2

The client also asks the nurse what kinds of diabetes-related complications can be expected during pregnancy. The nurse correctly informs the client that diabetics are at risk for developing which condition? 1. Hyperemesis gravidarum 2. Pregnancy-induced hypertension 3. Placenta previa 4. Toxoplasmosis

2

The client asks the nurse when it will be possible to feel the baby move. In the primigravid client, when is fetal movement typically felt for the first time? 1. Between 10 and 14 weeks 2. Between 16 and 20 weeks 3. Between 22 and 26 weeks 4. Between 28 and 32 weeks

2

The client tells the nurse that despite desperately wanting to have a baby, the client is concerned about a vaginal birth because of small hips. Which response by the nurse is most appropriate when addressing the client's concerns? 1. "Your hips are measured to make an accurate determination of whether or not the baby can be delivered vaginally." 2. "The size of your true pelvis, not the size of your hips, determines whether or not you can deliver a baby vaginally." 3. "It doesn't really matter whether you deliver vaginally or by cesarean birth because the risk for both types of delivery is the same." 4. "The size of the baby's head is the only factor that determines whether the infant can be delivered vaginally."

2

The obstetrician sees a 31-year-old multipara client in the firs t trimester of pregnancy. When sharing a health history, the client tells the nurse that the last pregnancy ended in a spontaneous abortion because of an incompetent cervix. The client asks the nurse to clarify what is meant by an incompetent cervix. Which statement by the nurse best explains what occurs with an incompetent cervix? 1. The cervix is not large enough for passage of the fetus. 2. The cervix cannot support the weight of the fetus. 3. The cervix has an external opening but not an internal opening. 4. The cervix has an internal opening but not an external opening.

2

The physician determines that the client is in the 15th week of pregnancy. The client asks if it is too early to hear the baby's heartbeat. How early in a pregnancy can the nurse expect to hear the fetal heartbeat using a Doppler device? 1. 4 to 6 weeks 2. 8 to 10 weeks 3. 12 to 14 weeks 4. 16 to 18 weeks

2

The physician informs the client that the pregnancy test is positive and tells the client that during the pelvic examination Chadwick's sign was positive. After the physician leaves, the client asks the nurse to explain the significance of a positive Chadwick's sign. Which response by the nurse about Chadwick's sign is most accurate? 1. "It's the spontaneous occurrence of intermittent painless contractions that begin early in pregnancy and continue throughout the entire period of gestation." 2. "It's a bluish discoloration of the cervix, vagina, and vulva that occurs as a result of the presence of an increased number of blood vessels." 3. "It's a softening of the cervix that occurs because of an increased amount of blood flowing to the reproductive organs." 4. "It's a dark brown line extending from the umbilicus to the symphysis pubis that occurs as a result of hormonal changes."

2

When the client asks the nurse about the viability of the ovum after ovulation, the nurse correctly explains that after ovulation, the ovum remains alive for how many hours? 1. 2 hours 2. 24 hours 3. 48 hours 4. 72 hours

2

Which assessment finding best indicates the presence of magnesium sulfate toxicity? 1. Brisk deep tendon reflexes 2. Respiratory rate less than 14 breaths/minute 3. Protein in the urine 4. Magnesium blood level of 5 mg/dL

2

Which statement by the client indicates a need for additional teaching regarding chlamydial infection? 1. "My sex partner should be treated also." 2. "I will have to have a cesarean birth to protect my baby." 3. "The physician will probably give me some antibiotics." 4. "My Pap smear results may show abnormal cells."

2

When teaching the class about varicose veins, which symptom should the clients be instructed to report immediately? 1. The appearance of additional varicose veins 2. Varicose veins that are purple in color 3. Legs that begin to ache and feel heavy 4. Calves that become red, tender, and warm

4

To improve sperm production, the nurse should instruct the client's husband to avoid which activities? Select all that apply. 1. Swimming in chlorinated water 2. Sitting in hot tubs 3. Wearing boxer shorts 4. Wearing colored underwear 5. Avoiding smoking 6. Refraining from strenuous exercise

236

The nurse conducts a prenatal class on common discomforts of pregnancy. One person attending the class states, "I've been having trouble with constipation. " Which responses by the nurse regarding prevention of constipation are most appropriate? Select all that apply. 1. "Resting helps to relieve constipation." 2. "Exercising can help relieve constipation." 3. "A low-fat diet helps to relieve constipation." 4. "Prenatal vitamins help to relieve constipation." 5. "Drink 8 glasses of water per day to add moisture to stool." 6. "Take an over-the-counter laxative to maintain bowel elimination."

25

On the basis of the client's clinical presentation, which information should the nurse obtain first? Select all that apply. 1. Height and weight 2. Blood pressure and pulse rate 3. Pregnancy and prior delivery history 4. General health and drug history 5. Urinalysis and beta streptococcal test results 6. Phone number of the client's obstetrician

26

A 22-year-old gravida I, para 0, has insulin-dependent diabetes mellitus and is being seen by the obstetrician for thefirst time. The client was diagnosed with diabetes at age 6. The diabetes has been well controlled since the initial diagnosis. While waiting to see the physician, the client asks the nurse if the pregnancy will increase the need for insulin. Which explanation by the nurse is correct concerning the client's need for insulin during pregnancy? 1. Insulin level will most likely increase. 2. Insulin level will most likely decrease. 3. Insulin level will most likely fluctuate. 4. Insulin level will most likely not change.

3

After interviewing the client, the nurse determines that the client lives with her boyfriend and works several hours per week. She frequently skips meals or eats at fast food restaurants. The client drinks beer or wine when with friends and is constantly concerned about weight gain and appearance. How many factors in this scenario place the client at risk for nutritional deficiencies and the need for dietary guidance and counseling? 1. Three 2. Four 3. Five 4. Six

3

Before leaving the clinic, the client asks the nurse about the schedule for the next few perinatal visits. The nurse responds that, for clients with uncomplicated pregnancies, it is usually best to plan monthly visits for the first 28 weeks and then more frequent visits following which schedule? 1. Weekly for the remainder of the pregnancy 2. Every 2 weeks for the remainder of the pregnancy 3. Every 2 weeks up to 36 weeks, then weekly for the last month 4. Weekly up to 36 weeks, then twice weekly for the last month

3

Before leaving the clinic, the nurse teaches the client about danger signs that should be reported immediately to the physician . The nurse correctly instructs the client to contact the physician immediately under which circumstance? 1. When the first fetal movement is felt 2. If the breasts become tender 3. If vaginal bleeding occurs 4. When experiencing frequent urination

3

On the basis of the health history data, how should the nurse record the client's pregnancy status on the prenatal records? 1. Multipara 2. Primipara 3. Primigravida 4. Multigravida

3

One participant who is in the third trimester says, "I've started to experience shortness of breath and I'm concerned about the baby. " Which information about shortness of breath during pregnancy is correct? 1. It is not common during pregnancy and may indicate a blood clot in the lungs. 2. It is probably the result of anxiety about the baby's impending delivery. 3. It is probably caused by the enlarged uterus pressing against the diaphragm. 4. It is probably caused by decreased oxygen secondary to slow venous circulation.

3

Several participants in the prenatal class complain of frequent urination. The nurse explains to the group that frequent urination during early pregnancy usually subsides when what occurs? 1. The placenta is fully developed. 2. Fetal kidneys begin to function. 3. The uterus rises into the abdominal cavity. 4. The hormonal balance is reestablished.

3

The client informs the nurse that twins "run" in the family. The client asks the nurse why some women have identical twins and others have twins who do not look alike. Which explanation by the nurse correctly describes the occurrence of identical twins? 1. Two separate ova are fertilized by identical sperm. 2. The mother releases two identical ova. 3. One fertilized ovum divides into two identical halves. 4. Two identical ova are fertilized by two identical sperm.

3

The client returns for follow-up visits on a regular basis, following the prearranged schedule. According to the most recent examination, the client is estimated to be at 20 weeks' gestation. Where can the nurse expect to palpate the fundus at this time? 1. Just above the symphysis pubis 2. Just below the xiphoid process 3. Near the level of the umbilicus 4. Just below the symphysis pubis

3

The client tells the nurse that a cousin 's baby was born with spina bifida. The client asks if it is possible to detect the presence of this condition during her pregnancy. Which response by the nurse is most accurate? 1. Fluorescent treponemal antibody absorption (FTA-ABS) test can detect this type of defect. 2. Hepatitis B surface antigen (HBsAg) test can detect this type of defect. 3. Maternal serum alpha-fetoprotein (MSAFP) test can detect this type of defect. 4. Venereal Disease Research Laboratory (VDRL) test can detect this type of defect.

3

The client tells the nurse that it is hard to get the required amount of calcium because of a dislike for milk. Which food provides the best alternative source of calcium? 1. Organ meats 2. White bread 3. Leafy green vegetables 4. Dark turkey meat

3

The client's partner verbalizes concern about how placenta previa is treated. The nurse correctly states that the physician is most likely to do which of the following if the client's condition remains stable? 1. Induce labor prematurely. 2. Perform an emergency cesarean birth. 3. Place the client on bed rest until full term. 4. Start the client on ritodrine (Yutopar).

3

The nurse asks whether the client is taking the daily iron supplement. The client states, "I have not been taking the iron routinely because it causes constipation. " When providing information about iron supplements, which instruction by the nurse is most appropriate? 1. "Take the supplement with meals." 2. "Be aware that iron can cause abdominal pain." 3. "Make sure you drink plenty of fluids." 4. "You can substitute dietary sources of iron for this medication."

3

The nurse correctly explains to the group that the most probable cause of frequent urination late in pregnancy is related to what factor? 1. Loss of bladder tone in the mother 2. The presence of a urinary tract infection 3. The enlarging uterus exerting pressure on the bladder 4. The growing fetus excreting increased amounts of waste

3

The physician decides that the client can manage her pregnancy-induced hyptertension (PIH) at home and requests that the nurse provide instructions for home care. Which instruction regarding the home care of PIH is most appropriate? 1. Decrease fluid intake. 2. Return for bimonthly checkups. 3. Eat high-protein foods. 4. Limit activity to light housework.

3

The physician examines the client and orders a pregnancy test. The nurse correctly sends a requisition and specimen for which laboratory test? 1. Alpha-fetoprotein (AFP) 2. Corticotropin-releasing hormone (CRH) 3. Human chorionic gonadotropin (HCG) 4. Follicle-stimulating hormone (FSH)

3

When one participant asks the nurse what can be done to relieve leg cramps while working, which instruction by the nurse is correct? 1. Increase protein intake to five to six servings per day. 2. Wear elastic stockings when at work 3. Point the toes frequently toward the head. 4. Massage the leg when a cramp occurs.

3

Which assessment finding is most indicative of mild PIH? 1. A 15 mm Hg rise in the baseline systolic blood pressure 2. A weight gain of 1 pounds per week in the second trimester 3. A +1 protein reading on the urine reagent test strip 4. The presence of frequent ankle edema

3

While discussing pre-pregnancy eating habits with the nurse, the client asks, "What's the normal weight gain during pregnancy?" Which explanation by the nurse accurately identifies the recommended weight gain for a pregnant client who has a normal pre-pregnancy weight? 1. Less than 15 pounds (6.8 kg) 2. 15 to 20 pounds (6.8 to 9 kg) 3. 25 to 35 pounds (11 to 15.8 kg) 4. No more than 40 pounds (18 kg)

3

Which action by the nurse best ensures that an accurate fetal heart rate is obtained? 1. Assess the fetal heart rate when the client is lying on her right side. 2. Assess the fetal heart rate when the client reports fetal movement. 3. Assess the fetal heart rate between Braxton Hicks contractions. 4. Assess the maternal pulse and fetal heart rate, and compare the two.

4

A 29-year-old primigravid client is in the 22nd week of pregnancy. The physician determines that the client has pregnancy-induced hypertension (PIH ). When assessing a client with a history of PIH, the nurse should thoroughly explore which finding at each visit? 1. A decrease in urine protein level 2. An increase in urine output 3. A decrease in pulse rate 4. An unexpected weight gain

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A nurse discusses high-risk complications with a group of women at a prenatal clinic. Which client would the nurse identify as being at highest risk for developing complications during pregnancy? 1. A 25-year-old gravida I client 2. A client with the placenta implanted on the fundus of the uterus 3. A client who has nausea and vomiting during the first trimester 4. A 35-year-old gravida V client

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After discussing various options regarding the correction of their infertility problems, there is a question regarding when the gender of the baby is determined. The nurse accurately explains that the gender of a baby is determined at which point? 1. During maturation of the ovum in the ovaries 2. During maturation of the sperm in the epididymis 3. When the fertilized ovum implants in the uterine lining 4. When the sperm fertilizes the ovum in the fallopian tube

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At 9 weeks' gestation, the client asks the nurse, "What does my baby look like now?" The nurse explains that between 8 and 12 weeks' gestation, what characteristics have developed? 1. The zygote looks like a bumpy ball. 2. The embryo has a well-defined bead. 3. The embryo's sex is distinguishable. 4. The fetus has fully developed arms and legs.

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At the end of the first trimester, the physician puts a cerclage in the client' s cervix. The client asks the nurse how long the cerclage will remain in place. The nurse correctly explains to the client that the physician will probably leave the cerclage in place until what occurs? 1. The client goes into labor. 2. The client's baby is delivered. 3. The second trimester ends. 4. The client is near term.

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During the interview, the client informs the nurse, "I have a son and twin daughters, no abortions, or stillbirths. " According to the TPAL method, which of the following accurately records the client's obstetric history? 1. T-III, P-0, A-0, L-III 2. T-III, P-III, A-0, L-0 3. T-III, P-II, A-0, L-II 4. T-II, P-0, A-0, L-III

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During the visit, the client expresses concern that an increased weight gain over the last month is causing unwanted obesity. Which response by the nurse is most appropriate? 1. "A weight gain of about 10 pounds is recommended during pregnancy." 2. "Your weight gain depends on the amount of food that you eat." 3. "It's normal for adolescent girls to be worried about weight gain." 4. "The average weight gain during pregnancy is between 25 and 35 pounds."

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The client asks the nurse if sexual intercourse is safe during pregnancy. The nurse correctly explains that sexual intercourse should be avoided at what time? 1. Throughout pregnancy . 2. Until the baby is fully developed 3. Once the abdomen starts to enlarge 4. Once the membranes rupture

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The client has progressed to the last month of pregnancy. The physician orders a nonstress test. When planning for this test, the nurse should have which of the following available? 1. The emergency crash cart 2. A cardiac monitor 3. I.V. oxytocin (Pitocin) 4. A fetal monitor

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The client informs the nurse that her last menstrual period began on March 13 and then asks the nurse when the baby is due. Using Nagele's rule, the nurse can assume the client's expected delivery date to be approximately which date? 1. November 13 2. November 23 3. December 3 4. December 20

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The nurse correctly explains to the group that the discomfort associated with varicose veins is relieved by which activity? 1. Resting with the feet in a dependent position 2. Sitting when possible 3. Putting on calf-length, elastic-top hose 4. Moving around when standing in one position

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The physician also documented that the client had a positive sign of pregnancy. Which assessment finding best represents a positive sign of pregnancy? 1. Palpable fetal outline 2. Blotchy tan facial skin 3. Positive pregnancy test 4. Fetal heartbeat

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