Maternity Exam 5-9

During a prenatal visit, a nurse is explaining dietary management to a client with pre-existing diabetes mellitus. The nurse determines that teaching has been effective if the client makes which statement?

"Diet and insulin needs change during pregnancy."

A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement by the client indicates a need for further teaching?

"I cannot exercise because of the negative effects on insulin production."

The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching?

"I should avoid exercise because of the negative effects on insulin production."

A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement made by the client indicates a need for further instruction?

"I will maintain strict bed rest throughout the remainder of the pregnancy."

A home care nurse is monitoring a 16-year-old primigravida who is at 36 weeks' gestation and has gestational hypertension. Her blood pressure during the past 3 weeks has been averaging in the 130/90 mm Hg range. She has had some swelling in the lower extremities and has had mild proteinuria. Which statement by the woman should alert the nurse to the worsening of gestational hypertension?

"My vision the past 2 days has been really fuzzy."

The nurse in an obstetrical clinic is reviewing current prenatal laboratory results of a pregnant client who is being seen for a routine prenatal visit. The nurse discovers the client's 1-hour oral glucose tolerance test (OGTT) result to be 163 mg/dL. Which would be the nurse's best response to the client?

"The OGTT is a screening tool for gestational diabetes, and you will need further testing to confirm a diagnosis owing to your results being elevated."

The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that further teaching is needed if the client makes which statement?

1. "I will need to increase my insulin dosage during the first 3 months of pregnancy."

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data, if noted on the client's record, would alert the nurse that the client is at risk for a spontaneous abortion?

2. History of syphilis

The clinic nurse is performing a prenatal assessment on a pregnant client. The nurse should plan to implement teaching related to the risk of abruptio placentae if which information is obtained on assessment?

3. The client has a history of hypertension.

A nurse is caring for a pregnant woman who has herpes genitalis. The nurse provides instructions to the woman about treatment modalities that may be necessary for this condition. Which statement made by the woman indicates an understanding of these treatment measures?

"It may be necessary to have a cesarean section for delivery."

A woman in the third trimester of pregnancy with a diagnosis of mild preeclampsia is being monitored at home. The home care nurse teaches the woman about the signs that need to be reported to the health care provider. The nurse should tell the woman to call the health care provider if which occurs?

Weight increases by more than 1 pound in a week.

A pregnant woman has a positive history of genital herpes but has not had lesions during this pregnancy. What should the nurse should plan to tell the client?

"You will be evaluated at the time of delivery for herpetic genital tract lesions, and if any are present, a cesarean delivery will be needed."

The nurse is providing instructions to a pregnant client with genital herpes about the measures that are needed to protect the fetus. Which instruction should the nurse provide to the client?

A cesarean section will be necessary if vaginal lesions are present at the time of labor.

The clinic nurse is reviewing the medical record of a woman scheduled for her weekly prenatal appointment. The nurse notes that the woman has been diagnosed with mild preeclampsia. Of the following interventions, which should the nurse list as having the lowest priority in planning nursing care for this client?

Discuss the need for hospitalization.

A maternity unit nurse is developing a plan of care for a client with severe preeclampsia who will be admitted to the nursing unit. The nurse should include which nursing intervention in the plan?

Reduce external stimuli.

A primigravida is receiving magnesium sulfate for the treatment of gestational hypertension. The nurse who is caring for the client is performing assessments every 30 minutes. Which finding would be of most concern to the nurse?

Respiratory rate of 10 breaths per minute

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data if noted on the client's record would alert the nurse that the client is at risk for developing gestational diabetes during this pregnancy?

1. The client's last baby weighed 10 pounds at birth.

The nurse is providing instructions to a maternity client with a history of cardiac disease regarding appropriate dietary measures. Which statement, if made by the client, indicates an understanding of the information provided by the nurse?

4. "I should drink adequate fluids and increase my intake of high-fiber foods."

The nurse is performing an assessment on a pregnant client with a diagnosis of severe preeclampsia. The nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis?

4. Evidence of bleeding, such as in the gums, petechiae, and purpura

A pregnant client reports to a health care clinic, complaining of loss of appetite, weight loss, and fatigue. After assessment of the client, tuberculosis is suspected. A sputum culture is obtained and identifies Mycobacterium tuberculosis. Which instruction should the nurse include in the client's teaching plan?

4. Isoniazid plus rifampin (Rifadin) will be required for 9 months.

A client with severe preeclampsia is admitted to the maternity department. Which room assignment would be most appropriate for this client?

A private room two doors away from the nurses' station

A nurse is assessing a woman in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding would the nurse expect to note if abruptio placentae is present?

Abdominal pain

A nurse is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. The nurse determines that the client understands dietary and insulin needs if the client states that which may be required during the second half of pregnancy?

Increased insulin

The nurse is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. The nurse determines that the client understands dietary and insulin needs if the client states that the second half of pregnancy may require which treatment?

Increased insulin

A home care nurse is visiting a pregnant client with a diagnosis of mild preeclampsia. What is the priority nursing intervention during the home visit?

Monitor for fetal movement.

The nurse is preparing to care for a client who is being admitted to the hospital with a possible diagnosis of ectopic pregnancy. The nurse develops a plan of care for the client and determines that which nursing action is the priority?

Monitoring the apical pulse

A nurse is caring for a client with a diagnosis of placenta previa. The nurse collects data knowing that which is a characteristic of placenta previa?

Painless, bright red vaginal bleeding

The home care nurse visits a pregnant client who has a diagnosis of mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the health care provider?

The client complains of a headache and blurred vision.

A nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data should alert the nurse that the client is at risk for developing gestational diabetes during this pregnancy?

The client's last baby weighed 10 lb at birth.

A 25-year-old woman arrives on the maternity unit on February 2. She states that her estimated date of delivery (EDD) is March 22. She is verbalizing complaints of dull lower back pain, pelvic heaviness, and diarrhea for the past few days. On admission for observation, the client's blood pressure is 128/80 mm Hg, pulse is 100 beats/minute, respirations are 16 breaths per minute, and temperature is 99° F. The nurse plans care based on which interpretation?

The woman requires further evaluation for preterm labor.

The clinic nurse has provided home care instructions to a client with a history of cardiac disease who has just been told that she is pregnant. Which statement, if made by the client, indicates a need for further instructions?

"During the pregnancy, I need to avoid contact with other individuals as much as possible to prevent infection."

The nurse is caring for a client with preeclampsia. The client is receiving an intravenous (IV) infusion of magnesium sulfate. When gathering items to be available for the client, which highest priority item should the nurse obtain?

-Calcium gluconate injection

The nurse is counseling a pregnant woman diagnosed with gestational diabetes at 29 weeks of gestation. Which information should the nurse discuss with the client? Select all that apply.

-Plan for weekly non-stress test at 32 weeks. -Obtain nutritional counseling with a dietitian.

The home care nurse is monitoring a pregnant client with gestational hypertension who is at risk for preeclampsia. At each home care visit, the nurse assesses the client for which classic signs of preeclampsia? Select all that apply.

-Proteinuria -Hypertension -Generalized edema

A 35-week-gestation pregnant woman is transferred to the maternity unit from the emergency department, where she was treated for minor injuries sustained in a motor vehicle crash. The maternal nurse's priority will be to assess for which complication?

Abruptio placentae

The nurse is assessing a client with a diagnosis of gestational trophoblastic disease (hydatidiform mole). The nurse understands that which findings are associated with this condition? Select all that apply.

-Vaginal bleeding -Excessive nausea and vomiting -Larger-than-normal uterus for gestational age -Elevated levels of human chorionic gonadotropin (hCG)