Chapter 12

During pregnancy the cardinal rule regarding taking medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy?

Asthma

A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which of the following symptoms is an indicator of true labor?

Contractions beginning in the back and sweeping forward across the abdomen

A 28-year-old client who has just conceived arrives at a health care facility for her first prenatal visit to undergo a physical examination. Which intervention should the nurse perform to prepare the client for the physical examination?

Instruct the client to empty her bladder

Why is a Papanicolaou smear done at the first prenatal visit?

It identifies abnormal cervical cells.

A woman reports constant redness and itching of her palms early in her pregnancy. She fears that she is suffering an allergic reaction and asks the nurse whether this is normal. What explanation should the nurse mention?

It is caused by increased estrogen levels and should disappear in time

A client in her second trimester of pregnancy visits a healthcare facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which of the following precautions should the nurse instruct the pregnant client to take when practicing aerobic exercises?

Maintain tolerable intensity of exercise

A nurse counsels a pregnant woman regarding her recommended daily allowance of calories. She advises her to obtain her carbohydrate calories from complex carbohydrates rather than simple carbohydrates. What is the best rationale for this guidance?

More consistent regulation of glucose and insulin

The hormone responsible for the initiation of lactation is what?

Prolactin

The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence?

Quickening

A nurse is caring for a client in her second trimester of pregnancy. During a regular follow-up visit, the client reports varicosities of the legs. Which instruction should the nurse provide to help the client alleviate varicosities of the legs?

Refrain from crossing legs when sitting for long periods

A patient, 31 years old, at 28 weeks gestation with her second pregnancy is in the clinic for a prenatal check-up. She informs you of frequent low back pain and ankle edema by the end of the day. What interventions should you suggest to relieve these discomforts?

Rest when possible with feet elevated at or above the heart.

A 24-year-old pregnant woman complains of excessive vaginal discharge. The discharge is not associated with a strong odor, itching, or irritation but she finds it messy and unpleasant. What do you advise her to do?

Use sanitary pads

The doula primarily focuses on providing continuous labor support.

G3, P2

A pregnant woman enjoys exercising at a local health spa once a week. Which of the following comments would lead you to believe she needs additional health teaching?

"Nothing feels nicer than a hot sauna after exercise."

Mrs. Kelly comes to the clinic for her usual prenatal check-up. The nurse measures the fundal height at 24 cm. What is the estimated length of her gestation?

24 weeks

A pregnant woman comes to the clinic for a visit. This is her third pregnancy. She had a miscarriage at 12 weeks and gave birth to a son, now 3 years old, at 32 weeks. Using the GTPAL system, the nurse would document this woman's obstetric history as:

30111

A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:

4 weeks

What advice should the nurse provide to a pregnant patient who admits to continuing to drink alcohol 1 to 2 times a week?

Alcohol should not be consumed during pregnancy

A client in the third trimester of pregnancy has to travel a long distance by car. The client is anxious about the effect the travel may have on her pregnancy. Which instruction should the nurse provide to promote easy and safe travel for the client?

Always wear a three-point seat belt

You meet a family at the prenatal clinic. What is the most effective way to assess the woman's usual food intake during her pregnancy?

Ask her to describe her intake for the last 24 hours.

A woman in her third trimester complains to the nurse of significant back pain. The nurse questions the client carefully and records a detailed account of her back symptoms. What is the best rationale for the nurse evaluating the client's back symptoms with such care?

Back pain could be a sign of bladder or kidney infection

Why is the first prenatal visit usually the longest prenatal visit?

Baseline data is collected

Which of the following nursing interventions is appropriate when preparing a woman for an amniocentesis?

Be certain she knows that there is are risks of complication, such as premature labor, from amniocentesis

A woman has come to the clinic for her first prenatal visit. Which of the following would be the most effective way to initiate data gathering for a health history?

Conduct an interview in a private room to obtain her health history.

A client in her second trimester of pregnancy has developed varicose veins and experiences leg cramps. Which of the following suggestions would be most appropriate?

Elevate legs while sitting

A woman comes to the clinic for an exam and says that she is considering trying to become pregnant in the next few months. Which of the following would the nurse encourage the client to begin taking now?

Folic acid

Martha is pregnant and arrives for her second prenatal appointment. Her previous pregnancy ended at 19 weeks and she has 3-year-old twins born at 30 weeks gestation. How will you document her "G" and "L" for her records?

G3 L2

A client has been confirmed to be pregnant. She gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history?

G3, P2

Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing?

Obtain a clean catch urine

When discussing rest and sleep with a pregnant woman, which of the following positions would you suggest that she use for napping?

On her side with the weight of the uterus on the bed

The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which of the following is the recommended schedule for prenatal care?

Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth.

A client in her third trimester of pregnancy wishes to use the method of feeding formula to her baby. What instruction should the nurse provide?

Serve the formula at room temperature

At a prenatal appointment, a woman who is 3 months pregnant confides to you that she ingests starch because of a craving she has had since adolescence. She is now 26 years old. What would be your most appropriate response?

Suggest she have a hemoglobin assessment done because of the association between pica and iron-deficiency anemia

When describing the role of a doula to a group of pregnant women, which of the following would the nurse include?

The doula primarily focuses on providing continuous labor support.

A non-stress test is performed on a pregnant woman. The nurse informs the client the test was reactive. Which of the following statements by the patient indicates understanding of the test results?

The fetal heart rate increases with activity and indicates fetal well-being

Body joints become more relaxed with pregnancy because of relaxin, a hormone produce by the placenta.

True

The nurse correctly identifies "gravida 3, para 2" to mean which of the following?

Two previous pregnancies, two children born at term, and currently pregnant

A nurse is caring for a pregnant client in her second trimester of pregnancy. The nurse educates the client to look for which danger sign of pregnancy needing immediate attention by the physician?

Vaginal bleeding

A client in her second trimester of pregnancy arrives at a health care facility complaining of heartburn. What instructions should the nurse offer to help the client deal with heartburn? Select all that apply

• Sleep in a semi-Fowler's position • Limit consumption of food before bedtime • Avoid overeating