Maternity Exam 2
A pregnant client who is a lacto-vegetarian asks the nurse for assistance with her diet. What instruction should the nurse give? Select all that apply.
"A daily supplement of vitamin B12 is important."
A woman gave birth last week to a fetus at 18 weeks 'gestation after her first pregnancy. She is in the clinic for a follow-up and notices that her chart states she has had one abortion. The client is upset over the use of this word. How can the nurse best explain this terminology to the client?
"Abortion is the obstetric term for all pregnancies that end before 20 weeks."
The pregnant client and her partner are both 40 years old. The nurse is explaining the options of chorionic villus sampling (CVS) and amniocentesis for genetic testing. The nurse should correct the client if she makes which statement?
"Amniocentesis results are available sooner than CVS results are."
A client at 16 weeks gestation has a hematocrit of 35%. Her pre-pregnancy hematocrit was 40%. Which statement by the nurse best explains this change?
"Because your blood volume has increased, your hematocrit count is lower."
The nurse is preparing a prenatal class about infant feeding methods. The maternal nutritional requirements for breastfeeding and formula feeding will be discussed. What statement should the nurse include?
"Breastfeeding requires a continued high protein and calcium intake."
The nurse has completed a community presentation about the changes of pregnancy and knows that the lesson was successful when a community member states.
"Enlargement of the uterus."
A 38-year-old client in her second trimester wants to begin an exercise program to decrease fatigue. What is the most appropriate nursing response?
"Fatigue should resolve in the second trimester but walking daily might help."
The nurse is caring for a pregnant client. The client's husband has come to the prenatal visit. Which question is best for the nurse to assess the father's adaptation to the pregnancy?
"How are you feeling about becoming a father?
The nurse is providing care to a client entering the second trimester of pregnancy. Which client statement does the nurse anticipate when assessing this client?
"I am angry with my husband for not showing more interest in my pregnancy."
At 32 weeks' gestation, a woman is scheduled for a second nonstress test (following one she had at 28 weeks' gestation). Which statement by the client would indicate an adequate understanding of this procedure?
"I can't get up and walk around during the test."
Which statement, if made by a pregnant client, would indicate that she understands health promotion during pregnancy?
"I elevate my legs while sitting at my desk."
The nurse is preparing a client in her second trimester for a three-dimensional ultrasound examination. Which statement indicates that teaching has been effective?
"I might be able to see who the baby looks like with the ultrasound."
The nurse is preparing a client for amniocentesis. Which statement would indicate that the client clearly understands the risks of amniocentesis?
"I might go into labor early."
Which statement made by the pregnant adolescent would indicate to the nurse that she understood her increased risk of physiologic complications during pregnancy?
"I need to take good care of myself so my baby doesn't come early."
The nurse is explaining "quickening" to a pregnant client for the first time. Which client indicates the need for further education on this topic?
"It indicates that I am experiencing preterm labor."
Which statement is best to include when teaching a pregnant adolescent about her nutritional needs in pregnancy?
"It is important to eat iron-rich foods like meat every day."
The nurse is teaching an early pregnancy class for clients in the first trimester of pregnancy. Which statement by a client requires immediate intervention by the nurse?
"It is normal for my vaginal discharge to be green."
The primiparous client has told the nurse that she is afraid she will develop hemorrhoids during pregnancy because her mother did. Which statement would be best for the nurse to make?
"It is not unusual for women to develop hemorrhoids during pregnancy."
The nurse is explaining to a new prenatal client that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the client makes which statement about the reason for the exam.
"It will help us know how big a baby I can deliver vaginally."
The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she has not had a menstrual cycle for three months, and her breasts are getting bigger. What response by the nurse is best?
"Lack of menses can be caused by many things. We need to do a pregnancy test."
The pregnant client in her second trimester states, "I didn't know my breasts would become so large. How do I find a good bra?" The best answer for the nurse to give would be which of the following?
"Look for wide straps and cups big enough for all your breast tissue."
a client's partner at 16 weeks' gestation accompanies her to the clinic. The partner tells the nurse that the baby doesn't seem real to him and is having difficulty relating to his partner's fatigue and food aversions. Which statement would be best for the nurse to make?
"Many men feel this way. Feeling the baby move in a few weeks will help make it real to you."
The nurse teaches a pregnant 14-year-old client at ten weeks gestation about the expected body changes during pregnancy. Which client statement indicates that additional information is needed?
"My diet can stay the same even though I'm pregnant."
A client experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the client needs additional information?
"My last period was two months ago, which means I'm two months along."
A prenatal educator asks a partner about the regular psychologic adjustment of an expectant mother during the second trimester of pregnancy. Which answer by the partner would indicate a typical expectant mother's response to pregnancy?
"She daydreams about what kind of parent she will be."
The prenatal clinic nurse is explaining test results to a client who has had an assessment for fetal well-being. Which statement indicates that the client understands the test results?
"The normal Doppler velocimetry wave result indicates my placenta is getting enough blood to the baby."
The client with an abnormal quadruple screen is scheduled for an ultrasound. Which statement indicates that the client understands the need for this additional antepartal fetal surveillance?
"The ultrasound will show whether there are abnormalities with the baby's spine."
The pregnant client has asked the nurse what kinds of medications cause birth defects. Which statement would best answer this question?
"To be safe, don't take medication without talking to your doctor."
After telling a mother that her 13-year-old daughter is pregnant, the nurse would expect the mother to respond with which statement?
"We had such high hopes for you."
A 27-year-old married woman is 16 weeks pregnant and has an abnormally low maternal serum alpha-fetoprotein test. Which statement indicates that the couple understands the implications of this test result?
"We have decided to have an abortion if this baby has Down syndrome."
The nurse collects information during the health history assessment for the client profile during the initial prenatal visit. Which question is appropriate when assessing the current pregnancy?
"What was the date of your last menstrual period?"
The adolescent client reports to the clinic nurse that her period is late, but her home pregnancy test is negative. What should the nurse explain that these findings most likely indicate?
"You might be pregnant, but it might be too early for your home test to be accurate."
The nurse provides prenatal care to an obese client who asks, "How much weight should I gain during my pregnancy?" Which response by the nurse is appropriate?
"You should gain 11 to 20 pounds." (An obese client who becomes pregnant should gain 11 to 20 pounds during pregnancy.
A woman at 28 weeks' gestation is asked to keep a fetal activity record and to bring the results with her to her next clinic visit. One week later, she calls the clinic and anxiously tells the nurse that she has not felt the baby move for more than 30 minutes. Which of the following would be the nurse's most appropriate initial comment?
"Your baby might be asleep."
The primigravida at 22 weeks gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the client why she needs to be seen by a physician today?
"Your baby might not be growing enough."
The client at 14 weeks' gestation has undergone a transvaginal ultrasound to assess cervical length. The ultrasound revealed cervical funneling. How should the nurse explain these findings to the client?
"Your cervix has become cone-shaped and more open at the end near the baby."
The prenatal client in her third trimester tells the clinic nurse that she works 8 hours a day as a cashier and stands when at work. What response by the nurse is best?
"Your risk of poor pregnancy outcomes may be higher."
After teaching a pregnant client about the effects of smoking on pregnancy, the nurse knows that the client needs further education when she makes which statement?
) "I am at increased risk for preeclampsia."
The breastfeeding mother is concerned that her milk production has decreased. The nurse knows that further client teaching is needed based on which statement?
) "I have started cutting back on my protein intake."
The pregnant client at 14 weeks gestation is in the clinic for a regular prenatal visit. Her mother also is present. The grandmother-to-be states that she is quite uncertain about how to be a good grandmother to this baby because she works full-time. Her grandmother was retired and was always available when needed by a grandchild. What is the nurse's best response to this concern?
) "What are your thoughts on what your role as grandmother will include?"
Which of the following is common in many non-Western cultures and is increasing in the United States?
) Co-sleeping
The nurse is conducting an initial prenatal appointment for a client who believes she is pregnant. Which is considered a positive sign of pregnancy?
) Fetal heartbeat (positive)
The nurse is assessing a pregnant client during a scheduled prenatal visit in the second trimester of pregnancy. Which questions are appropriate during the assessment process? Select all that apply.
1. "Do you feel bloated?" 2. "Do you have hemorrhoids?" 3. "Are you experiencing heartburn?" 4. "Are you experiencing constipation?"
The nurse is planning an early pregnancy class session on nutrition. Which information should the nurse include? Select all that apply.
1. A) Protein is essential for fetal development. 2. B) Iron helps both mother and baby maintain the oxygen-carrying capacity of the blood. 4. D) Zinc facilitates the synthesis of RNA and DNA. 5. E) Vitamin A promotes the development of the baby's eyes.
The nurse learns that a patient who is eight weeks pregnant continues smoking ten cigarettes daily. In which order should the nurse provide a 5-to-15-minute intervention about smoking with this patient?
1. Ask about tobacco use 2. Advise to quit smoking 3Arrange for follow-up care 4Assess willingness to quit 5.Assist in attempt to quit
The nurse is preparing material to present to patients in the second trimester of their pregnancies. Which topics should the nurse include in this presentation? Select all that apply.
1. Clothing 2. Infant feeding3. Fetal movement4. 5. Skin and breast care
A pregnant patient's healthcare provider is using the Hadlock method to determine gestational age and growth of the fetus. Which measurements will be used to make this fetal determination?
1. Femurlength 2. Biparietaldiameter 3. Headcircumference 4. Abdominalcircumference
A pregnant patient in the early stages of labor asks for assistance to sit in the whirlpool tub. What are the advantages of using this intervention for the laboring patient Select all that apply?
1. Increases relaxation2. Increases pain threshold 5. Reduces the need for pain medication
The community nurse is preparing to visit the home of an adolescent who is 18 weeks pregnant. Which health problems should the nurse focus on when assessing this patient? Select all that apply.
1. Preeclampsia 2. Preterm birth 3. Low-birth-weight 5. Iron deficiency anemia
A patient asks if seafood is permitted during pregnancy. Which foods should the nurse encourage the patient to consume during this time? Select all that apply.
1. Shrimp 2. Catfish3. Salmon5. Canned light tuna
A patient in the first trimester of pregnancy is experiencing ptyalism. What should the nurse suggest to help this patient? Select all that apply.
1. Use chewing gum2. Suck on hard candy4. Use an astringent mouthwash
The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected findings?
12 weeks gestation, with fetal heart tones heard by Doppler fetoscope
When preparing nutritional instruction, which pregnant client would the nurse consider the highest priority?
15-year-old nulligravida
Several adolescent female students are waiting to be seen by the school sexual health clinic nurse. Which student should the nurse see first?
16-year-old who had chlamydia treated 2 weeks ago
A pregnant adolescent is scheduled for her first prenatal visit. For which sexually transmitted infections (STIs) should the nurse anticipate testing will occur? Select all that apply.
2. Candida 3. Gonorrhea 4. Chlamydia 5. Trichomonas
The nurse is instructing a pregnant patient on the importance of increasing her dietary intake of vitamin E. Which foods should the nurse recommend to meet this dietary need? Select all that apply.
2. Eggs3. . Green salads5. Wholegrain bread
he nurse is preparing to conduct a nonstress test with a pregnant patient. In which order should the nurse complete the steps of the procedure?
2. Place the patient in the semi-Fowler's position 5.Place the ultrasound transducer from the external fetal monitor over the FHR 3. Place the pressure transducer over the uterine fundus 1. Obtain baseline measurement for 20 minutes 4.Give the patient a handheld marker to indicate when fetal movement is felt
Screening for gestational diabetes mellitus (GDM) is typically completed between which of the following weeks of gestation?
24 and 28 weeks
The nurse measures the fundal height of a patient who is at 28 weeks gestation using the following method. What would be considered a normal finding?
28 cm
An adolescent in the third trimester of pregnancy comes into the clinic for a routine examination. What should the nurse assess to determine if the patient is working through this trimester's developmental tasks? Select all that apply.
3. Supplies purchased for the baby 4. Presence of heartburn or constipation 5. Place in the home identified for the baby
Each of the following pregnant women is scheduled for a 14-week antepartal visit. In planning care, the nurse would give priority teaching on amniotic fluid alpha- fetoprotein (AFP) screening to which client?
35-year-old with a child with spina bifida
A patient weighing 80 kg with a body mass index of 29.8 is six weeks pregnant. What should be this patient's maximum weight at the time of delivery?
89 kg Explanation: Women who are obese are advised to limit weight gain to 5 to 9 kg (11 to 20 lb.). Since the patient weighs 80 kg at six weeks pregnant, the maximum amount she should weigh would be 80 kg + 9 kg = 89 kg.
The clinic nurse is compiling data for a yearly report. Which client would be classified as a primigravida?
A client at 15 weeks gestation who has never been pregnant before
The nurse is responding to phone calls. Whose call should the nurse return first?
A client at 37 weeks' gestation reports no fetal movement for 24 hours.
Of all the clients who have been scheduled to have a biophysical profile, the nurse should check with the physician to clarify the order for which client?
A gravida with mild hypotension of pregnancy
During a nonstress test, the nurse notes that the fetal heart rate decelerates about 15 beats during a period of fetal movement. The decelerations occur twice during the test, and last 20 seconds each. The nurse realizes these results will be interpreted as which of the following?
A nonreactive test
Which third-trimester client would the nurse suspect might be having difficulty with psychological adjustments to her pregnancy?
A woman who has not investigated the kind of clothing or feeding methods the baby will need
The client and her partner are carriers of sickle cell disease. They are considering prenatal diagnosis with either amniocentesis or chorionic villus sampling (CVS). Which statements indicate that further teaching is needed on these two diagnostic procedures?
A) "Chorionic villus sampling carries a lower risk of miscarriage." B) "Amniocentesis can be done earlier in my pregnancy than CVS. "E) "Amniocentesis is more accurate in diagnosis than the CVS."
The pregnant teen prescribed prenatal vitamins at her initial prenatal visit states that she dislikes taking them. How should the nurse respond? Select all that apply.
A) "Folic acid is essential for minimizing the risk of neural tube defects." E) "You need the supplements because your dietary intake may not be adequate for fetal development."
The pregnant client states she does not want "to take all these supplements." What recommendations could the nurse make for the client? Select all that apply.
A) "Folic acid is essential for minimizing the risk of neural tube defects." C) "Most women do not have an adequate intake of iron pre-pregnancy, and iron needs increase with pregnancy."
While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts, "Why are you asking me all these questions? What difference does it make?" Which statement would best answer the client's questions?
A) "We ask these questions to detect anything that happened in your past that might affect the pregnancy."
Which serum markers are assessed when conducting a quadruple screen? Select all that apply.
A) Alpha-fetoprotein (AFP) B) Human chorionic gonadotropin (hCG) C) Unconjugated estriol (UE) D) Inhibin-A
What self-care measures would a nurse recommend for a client in her first trimester to reduce the discomfort of nausea and vomiting? Select all that apply.
A) Avoid odors or causative factors.B) Have small but frequent meals.C) Drink carbonated beverages.
The prenatal period should expose prospective parents to up-to-date, evidence-based information about which of the following topics? Select all that apply.
A) BreastfeedingB) Pain reliefC) Obstetric complications and procedures
The nurse is conducting an initial prenatal assessment for a pregnant client. Which screenings should the nurse prepare the client for during this visit? Select all that apply.
A) Complete blood count (CBC) B) Glucose tolerance test (GTT) C) ABO and Rh typing D) HIV screening E) Urinalysis labor."
Postpartum nutritional status is determined primarily by assessing which of the following? Select all that apply.
A) Dietary history C) Mother's weight D) Hemoglobin levels
The nurse is teaching the pregnant client about the symptoms of preeclampsia. Which clinical manifestations will the nurse include in the teaching session?
A) Dizziness B) Blurred vision
The nurse's goals for prenatal classes may include which of the following? Select all that apply.
A) Increasing self-esteem D) Providing anticipatory guidance about pregnancy E) Helping participants develop more adaptive coping skills
Remedies for back pain in pregnancy supported by research evidence and may safely be taught to any pregnant woman by the nurse include which of the following? Select all that apply.
A) Pelvic tilt B) Water aerobics D) Proper body mechanics E) Good posture is essential because it allows more room for the stomach to function
The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected? Select all that apply
A) The client's chest circumference has increased by 6 cm during the pregnancy. C) The client is using thoracic breathing. D) The client may have epistaxis. (Nose bleeds, (may occur and are primarily the result of estrogen-induced edema and vascular congestion of the nasal mucosa).
The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected? Select all that apply.
A) The client's chest circumference has increased by 6 cm during the pregnancy. C) The client is using thoracic breathing. D) The client may have epistaxis. (Nose bleeds, (may occur and are primarily the result of estrogen-induced edema and vascular congestion of the nasal mucosa).
The nurse understands that a client's pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks gestation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) The pelvis joints have relaxed, causing a waddling gait. C) The uterus vasculature contains one-sixth of the total maternal blood volume. D) Gastric emptying time is delayed, and the client complains of constipation and bloating. E) Supine hypotension occurs when the client lies on her back.
The nurse is assessing a newly pregnant client. Which finding does the nurse note as a regular psychosocial adjustment in this client's first trimester?
Ambivalence about the pregnancy
The nurse provides the following diagram to a patient in the 3rd trimester of pregnancy. For which diagnostic test is the nurse preparing this patient?
Amniocentesis Explanation:B) For an amniocentesis the patient is usually scanned by ultrasound to determine the placental site and to locate a pocket of fluid. As the needle is inserted, three levels of resistance are felt when the needle penetrates the skin, fascia, and uterine wall. When the needle is placed within the amniotic cavity, amniotic fluid is withdrawn. A needle is not injected into the amniotic sac for an ultrasound, biophysical profile, or contraction stress test.
A pregnant patient's first day of her last menstrual period was 6/14. What would be this patient's estimated date of birth?
Answer: 3/21
The nurse is preparing to assess the pregnant client's fundal height during a routine prenatal visit. Which nursing action is appropriate in this situation?
Asking the client to empty her bladder before the procedure
A Chinese woman who is 12 weeks pregnant reports to the nurse that ginseng and bamboo leaves help reduce her anxiety. How should the nurse respond to this client?
B) Advise the client to discuss all herbal remedies with the provider.
What signs indicate a pregnant client's urinalysis culture was abnormal? Select all that apply.
B) Alkaline urine C) Cloudy appearance E) Hemoglobinuria lab results
A patient at 28 weeks gestation asks the nurse why she has backaches. To help explain the changes, the nurse shows her a picture of the shape of her back. Which picture should the nurse use?
B) In the 28th week of gestation, the baby is becoming large enough that it is increasingly causing lordosis of the lumbosacral spine.
The nurse is assessing a primiparous client who indicates that her religion is Judaism. Why is this information pertinent for the nurse to assess?
B) It provides a baseline to ask questions about the client's religious and cultural background.
The nurse receives a phone call from a client who claims she is pregnant. The client reports that she has regular menses that occur every 28 days and last five days. The first day of her last menses was April 10. What would the client's estimated delivery date (EDD) be if she is pregnant?
B) Jan. 17 (April 10 +7days-3 months)
Absolute contraindications to exercise while pregnant include which of the following? Select all that apply.
B) Placenta previa after 26 weeks gestation C) Preeclampsia-eclampsiaD) Cervical insufficiency (cerclage)
The nurse is preparing a brochure for couples considering pregnancy after the age of 35. Which statements should be included? Select all that apply.
B) Preexisting medical conditions can complicate pregnancy. C) Preterm births are more common. D) Amniocentesis can be performed to detect genetic anomalies.
A client in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice?
B) Reddish streaks called striae on her abdomen
A pregnant patient is having pelvic measurements made. Which approach should the examiner use to determine this patient's estimated length of the pubic ramus?
B- length of the pubic
The nurse assesses an obese pregnant client during a routine prenatal visit. Which is the priority assessment for this client?
Blood pressure
The nurse has given a community presentation on adolescent pregnancy. Which statements indicate that further teaching is necessary? Select all that apply.
C) "When a teen plans to attend college, abortion is less likely." D) "In the United States, the adolescent birth rate is higher among white teens." E) "Teens from low-income households are less likely to become pregnant."
The client is at six weeks gestation and is spotting. The client had an ectopic pregnancy one year ago, so the nurse anticipates that the physician will order which intervention.
C) An antiserum pregnancy test (β-Subunit radioimmunoassay (RIA) uses an antiserum with specificity for the β-subunit of hCG in blood plasma. This test may detect both pregnancy and an ectopic pregnancy or trophoblastic disease.
When assisting with a transabdominal ultrasound sampling, which of the following would the nurse do?
C) Assist the woman into a supine position on the examining table.
A standard ultrasound examination is performed during the second or third trimester and includes an evaluation of which of the following?
C) Determine fetal presentation. D) Assess amniotic fluid volume. E) Determine fetal number.
What is the increased vascularization causing the softening known as?
C) Goodell sign (Increased vascularization causes softening of the cervix)
The nurse in a prenatal clinic finds that four clients have called with complaints related to their pregnancies. Which call should the nurse return first?
C) Pregnant woman at 15 weeks gestation with nausea and vomiting and a 15-pound weight loss
It is one week before a pregnant client's due date. The nurse notes on the chart that the client's pulse rate was 74-80 before pregnancy. Today, the client's pulse rate at rest is 90. What action should the nurse take?
C) Prepare the client for an EKG (This pulse rate in a near-term client does not indicate a need for emergency measures or treatment.)
The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take?
C) Schedule an appointment with her physician that same day. (Fetal movement can occur from 18-20 weeks, in multigravidas, it can occur 16 weeks)
Which drugs and drug categories can cause multiple fetal central nervous system (CNS), facial, and cardiovascular anomalies?
Category X: Isotretinoin
If a woman has the pre-existing condition of diabetes, the nurse knows that she would be prone to what high-risk factor when pregnant?
Cerebrovascular accident (CVA)
The nurse at the prenatal clinic has four calls to return. Which call should the nurse return first?
Client, at 32 weeks, reports headache and blurred vision.
A pregnant client who swims 3-5 times weekly asks the nurse whether she should stop this activity. What is the appropriate nursing response?
Continuing your exercise program would be beneficial."
The client at 24 weeks' gestation is experiencing painless vaginal bleeding after intercourse. The physician has ordered a transvaginal ultrasound examination. Which statements by the client indicate an understanding of why this exam has been requested?
D) "This ultrasound can determine the location of my placenta."E) "This ultrasound might detect whether the placenta is detaching prematurely."
The nurse is returning phone calls from clients. Which client does the nurse anticipate would not require a serum beta hCG?
D) A client with a previous history of twins
The nurse is evaluating the fundal height of a patient who is 20 weeks pregnant. Which height should the nurse expect to assess in this patient?
D) At 20 weeks gestation, the fundal height should be at the level of the patient's umbilicus.
A client in her third trimester of pregnancy reports frequent leg cramps. What strategy would be most appropriate for the nurse to suggest?
D) Flex the foot to stretch the calf
Recommendations for parents to help their teens avoid pregnancy include which of the following?
D) Parents should be clear about their sexual attitudes and values.
The client is upset at 30 weeks gestation with her first child. She tells the prenatal clinic nurse she is excited to become a mother and has been thinking about what kind of parent she will be. But her mother has told her that she doesn't want to be a grandmother because she doesn't feel old enough, while her husband has said that the pregnancy doesn't feel natural to him yet, and he will become excited when the baby is here. What is the most likely explanation for what is happening within this family?
D) The family members adjust to the role change at their own pace.
The nurse provides the following diagram to a patient who is 10 weeks pregnant and scheduled for a sonogram. Why is this test being used?
Determine gestational age
The nurse developing a care plan for a pregnant teen knows what plan is best suited to pregnant teens
Determine whether there are substance abuse issues.
A 16-year-old is making her first prenatal visit to the clinic in her fourth month of pregnancy. What is the nurse's first responsibility?
Develop a trusting relationship.
The nurse is preparing for a postpartum home visit. The client has been home for a week, is breastfeeding, and experienced a third-degree perineal tear after vaginal delivery. The nurse should assess the client for which of the following?
Dietary intake of fiber and fluids
The prenatal clinic nurse is designing a new prenatal intake information form for pregnant clients. Which question is best to include on this form?
Do genetic diseases run in the baby's father's family?
The client delivered her first child at 37 weeks. The nurse would describe this to the client as what type of delivery?
Early term (37-38)
The nurse assessing a pregnant African American woman in the first trimester understands that a cultural practice is which of the following?
Eating clay to supply dietary minerals
The pregnant client cannot tolerate milk or meat. What would the nurse recommend to the client to assist in meeting protein needs?
Eggs and tofu
Which of the following is essential for developing the fetus's central nervous system?
Essential fatty acids
The nurse knows that a lecithin/sphingomyelin (L/S) ratio finding of 2:1 in amniotic fluid means which of the following?
Fetal lungs are mature.
What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing?
Fundal height measurement
The nurse is working in an outpatient clinic. Which client's indications most warrant fetal monitoring in the third trimester?
Gravida 2, para 1, 36 weeks, with a history of preterm labor or cervical insufficiency
The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings?
Have the physician see the client today.
The nurse listens to the fetal heart tone sofa client at 37 weeks gestation while the client is supine. The client states, "I'm getting lightheaded and dizzy." What is the nurse's best action?
Help the client turn onto her left side.
During the initial prenatal visit, the pregnant teenager states that she does not know how she got pregnant. The nurse can help to educate her regarding anatomy by doing what?
Including anatomic models and drawings in the teaching session
A nurse examining a prenatal client recognizes that a lag in the progression of fundal height measurements from week to week and month to month could signal what condition
Intrauterine growth restriction
During a pelvic examination of a pregnant patient, the following area is identified as being softened. How should the nurse document this finding?
Ladin sign (softened middle uterus) is a soft spot anteriorly in the middle of the uterus near
During a routine assessment of a pregnant patient, the nurse observes the following on the patient's abdomen. How should the nurse document this finding?
Linea nigra
The nurse is caring for a pregnant client experiencing a high white, thick, and "cottage cheese-like" vaginal discharge. Based on this data, which diagnosis does the nurse anticipate for this client?
Moniliasis
During a routine health visit, the nurse notes that a ten-week pregnant patient is wearing the following items. On what should the nurse focus when assessing the patient?
Nausea and vomiting
A client at 37 weeks' gestation has a mildly elevated blood pressure. Her antenatal testing demonstrates three contractions in 10 minutes, no decelerations, and accelerations four times in 1 hour. What would this test be considered?
Negative contraction stress test
Which of the following tests has become a widely accepted method of evaluating fetal status?
Nonstress test (NST)
Nurses interacting with expectant families from a different culture or ethnic group can provide more effective, culturally sensitive nursing care by doing what?
Obtaining a medical interpreter of the language the client speaks.
Intercourse is contraindicated if the pregnancy is vulnerable because of which diagnosis?
Placenta previa
Which of the following is the most prevalent medical complication of pregnant adolescents?
Preeclampsia-eclampsia
The nurse cares for a pregnant client diagnosed with a urinary tract infection (UTI) during a routine prenatal visit. What will the nurse educate the client about based on this data?
Preterm labor
Carbohydrates provide the body's primary source of energy as well as fiber necessary for proper bowel functioning. If the carbohydrate intake is not adequate, the body will use which of the following for energy?
Protein
The nurse begins a prenatal assessment on a 25-year-old primigravida at 20 weeks gestation and immediately contacts the healthcare provider because of which finding?
Respirations 30/minute
A 25-year-old primigravida is at 20 weeks gestation. Because of this finding, the nurse immediately takes her vital signs and notifies the healthcare provider.
Rhonchi in both bases
The nurse is preparing a class for expectant fathers. Which information should the nurse include?
Sexual activity is safe for normal pregnancy.
The nurse is presenting a preconception counseling class. The nurse instructs the participants to increase niacin intake during pregnancy to promote metabolic coenzyme activity. The nurse will know that teaching has been effective if a client suggests which food is a source of niacin.
Shellfish
Introducing a new baby into the family is often the beginning of which of the following?
Sibling Rivalry
Which of the following tests provides information about the fetal number?
Standard second-trimester sonogram
the nurse notes purplish stretch marks on the pregnant client's breasts during the physical assessment. Which term will the nurse use when documenting this finding in the medical record?
Striae
The nurse anticipates that the physician will most likely order a cervicovaginal fetal fibronectin test for which client?
The client at 32 weeks' gestation with regular uterine contractions
A Navajo client who is 36 weeks pregnant meets with a traditional healer and her physician. What does the nurse understand this to mean?
The client is seeking spiritual direction.
A woman calls the clinic and tells a nurse she might be pregnant. She wants to use a home pregnancy test before going to the clinic and asks the nurse how to use it correctly. What information should the nurse give?
The client should follow up with a healthcare provider after taking the home pregnancy test.
The nurse is reviewing amniocentesis results. Which of the following would indicate that client care was appropriate?
The client was monitored for 30 minutes after completion of the test.
A 28-year-old woman has been an insulin-dependent diabetic for 10 years. At 36 weeks' gestation, she has an amniocentesis. A lecithin/sphingomyelin (L/S) ratio test is performed on the sample of her amniotic fluid. Because she is a diabetic, what would an obtained 2:1 ratio indicate for the fetus?
The fetus may or may not have immature lungs.
During her first months of pregnancy, a client tells the nurse, "It seems like I have to go to the bathroom every 5 minutes." The nurse explains to the client that this is because of which of the following?
The growing uterus puts pressure on the bladder.
The nurse presents a class of important "dos and don'ts" during pregnancy, including travel considerations. What method of travel does the nurse recommend as most appropriate for a client in her 25th week of pregnancy?
Train
While examining a pregnant patient for 24 weeks, the healthcare provider performs the maneuver in the diagram below. What is being measured on this patient?
Transverse diameter
1. A client with an average pre-pregnancy weight asks why she has been told to gain 25- 35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client about the recommended weight gain during pregnancy?
Up to 40 pounds for an underweight woman
A pregnant patient is lying in bed in the following position. Which health problem is this patient prone to developing?
Vena Cava Syndrome
A pregnant teenage client is diagnosed with iron-deficiency anemia. Which nutrient should the nurse encourage her to take to increase iron absorption?
Vitamin C
The nurse teaches a pregnant client the clinical manifestations of preterm labor. Which client statement indicates the need for further education?
Vomiting is a sign of preterm
