Maternity PrepU Chapter 11

A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a bloody mucus discharge noted in the toilet after an OB office visit several hours earlier. What is the bestresponse from the triage nurse?

"A one time discharge of bloody mucus in the toilet might have been your mucus plug."

During a visit to the clinic, a client in the first trimester tells the nurse, "My nose is so stuffy, lately. Could I have a cold?" Which response by the nurse is appropriate?

"A stuffy nose is common in pregnancy because of high estrogen levels."

The nurse is caring for a client at 8 weeks' gestation who states, "I did not plan for this right now and I am not happy or excited about this pregnancy. I am not sure what to do." Which response by the nurse is best?

"Many women feel this way during the first trimester."

A client is about 16 weeks' pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to this client's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer?

"You will experience quickening, and you will actually feel the baby."

The nurse is assessing a pregnant client at 20 weeks' gestation and obtains a hemoglobin level. Which result would be a cause for concern?

10.6 g/dl

A urinalysis is done on a client in her third trimester. Which result would be considered abnormal?

2+ Protein in urine

The nursing instructor is pointing out to a group of nursing students the various findings which are expected during a normal assessment of a pregnant client. The instructor determines the session is successful when the students correctly provide which gestational week that the examiner should be able to feel fetal movement?

22

A mother comes in with her 17-year-old daughter to find out why she has not had a menstrual cycle for a few months. Examination confirms the daughter is pregnant with a fundal height of approximately 24 cm. The nurse interprets this finding as indicating that the daughter is approximately how many weeks pregnant?

24

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her?

Arrange for prenatal care if the test is positive.

A pregnant client in her third trimester, lying supine on the examination table, suddenly grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize?

Blood is trapped in the vena cava in a supine position.

During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings?

Both findings are normal at this point of the pregnancy.

Which information provided by a client would be considered a presumptive sign of pregnancy?

Breast tenderness

The nurse cares for a pregnant client at the first prenatal visit and reviews expected changes that will occur during pregnancy. Which information will the nurse include in the education?

During pregnancy blood volume can increase by at least 40%.

What physiological changes would be noted in a pregnant woman? Select all that apply.

Enlarged pituitary gland Lordosis Delayed gastric emptying and decreased peristalsis

A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy?

FSH and LH

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely?

Fundal height has dropped since the last recording.

The nurse is appraising the laboratory results of a pregnant client who is in her second trimester and notes the following: thyroid stimulating hormone (TSH) slightly elevated, glucose in the urine, complete blood count (CBC) low normal, and normal electrolytes. The nurse prioritizes further testing to rule out which condition?

Gestational diabetes

A 22-year-old client comes to the walk-in clinic complaining of fatigue, breast heaviness and extreme tenderness, and a clear vaginal discharge. What question would the nurse ask this client?

Have you been sexually active in the past 2 months?

A pregnant woman's husband does not voice concerns at prenatal visits. You would believe he is emotionally involved in the pregnancy by observing which of the following actions?

He walks around furniture as if his abdomen is enlarged.

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem?

Hemorrhoids

A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next?

Inform the client this is a normal response to pregnancy that many women experience.

In preparing for a prenatal class to discuss the hormonal changes during pregnancy, which information would the nurse most likely include?

Over-the-counter antacids can be used to treat acid reflux with the health care provider's

A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition?

Place the client in the left lateral position.

During a routine prenatal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse take next?

Tell the woman that this is entirely normal.

You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a probable sign of pregnancy?

a positive pregnancy test

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply.

breast changes amenorrhea morning sickness

What is the major concern for a lactose intolerant woman who is pregnant?

calcium deficiency

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to:

detect fetal heart sounds with a Doppler.

A woman is 10 weeks' pregnant and tells the nurse that this pregnancy was unplanned and she has no real family support. The nurse's most therapeutic response would be to:

encourage her to identify someone that she can talk to and share the pregnancy experience.

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy?

fetal movement felt by examiner

Which of the following is a positive sign of pregnancy?

fetal movement felt by examiner

After teaching a class of newly pregnant women about the many changes the female body undergoes during pregnancy, the nurse determines that the teaching was successful when the class identifies which hormones as being secreted by the placenta? Select all that apply.

hCG relaxin estrogen

A nurse assessing the laboratory results of a pregnant client in the second trimester notes that the client has a hemoglobin level of 11 gm/dl. What will the nurse interpret this finding to most likely indicate?

hemodilution of pregnancy

A nurse who has been caring for a pregnant client understands that the client has pica and has been regularly consuming soil. For which condition should the nurse monitor the client?

iron-deficiency anemia

What would the nurse recommend to a pregnant client at 35 weeks' gestation who reports irregular contractions and lower backache?

lie down and rest and see if the contractions stop and pain subsides.

A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth?

oxytocin

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response?

physical symptoms similar to the mother

On a routine hematocrit screen during a prenatal visit, the nurse notices that the client is mildly anemic. When discussing this with the couple, the husband hints that she might be eating unusual things. The nurse recognizes the need for the woman to be evaluated for which condition?

pica

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

At what point in pregnancy does the average woman switch from accepting she is pregnant to accepting she is having a child?

when quickening occurs