NCLEX Antepartum Period

A nurse is teaching a pregnant client how to distinguish false labor contractions from true labor contractions. Which statement by the client indicates an understanding of this concept?

"False labor contractions are usually felt in the abdomen."

A 15-year-old client who is 26 weeks pregnant has been admitted to the labor and delivery unit with reports of abdominal pain. Her parents want to speak with a nurse about her condition. How should the nurse respond?

"I'll need a signed consent from your daughter to give you medical information."

A nurse is providing care for a pregnant 16-year-old. The client says that she is concerned she may gain too much weight and wants to start dieting. The nurse should respond by saying:

"Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems."

A nurse assesses a client for signs and symptoms of ectopic pregnancy. Which assessment finding should the nurse expect?

Abdominal pain

A client is 8 weeks pregnant. Which teaching topic is most appropriate at this time?

common discomforts of pregnancy

A pregnant client calls the nurse at 22 weeks gestation to report that she is experiencing some edema of her face and hands, with puffiness in her eyelids in the morning. What is the priority action by the nurse?

Refer the client to her physician.

A client at 38 weeks gestation with twins is placed on bed rest at home and has a home care nurse visit her on a regular basis. Which recommendation should the nurse suggest to her about her position in bed?

The client should lie on her left side as much as possible.

A client who is 32 weeks pregnant presents to the emergency department with bright red bleeding and no abdominal pain. A nurse should:

assess the fetal heart rate.

A 16-year-old unmarried client visiting the prenatal clinic at 32 weeks' gestation and currently weighing 140 lb (63.5 kg) is being closely monitored for early signs of preeclampsia. The client is 5 feet, 2 inch (158 cm) tall and weighed 120 lb (54.4 kg) before the pregnancy. Which factor would be most important to assess?

proteinuria

A client who's 4 weeks pregnant comes to the clinic for the first prenatal visit. When obtaining the health history, the nurse explores the client's use of drugs, alcohol, and cigarettes. Which client outcome identifies a safe level of alcohol intake for this client?

"The client consumes no alcohol."

A client is at risk for seizures due to pregnancy-induced hypertension. The healthcare provider orders 4 g magnesium sulfate in 250 ml D5W to be infused at 1 g/hour following a loading dose. What is the flow rate in milliliters per hour? Record your answer using a whole number.

63

The team on an antepartum unit consists of two registered nurses (RN), one licensed vocational nurse (LVN), and one nursing assistant. Which one of the following conditions would be appropriate to assign the LVN?

A client with gestational hypertension

A primigravid client at 16 weeks' gestation visits the clinic for a routine examination. The client tells the nurse that she knows someone whose baby was born with congenital toxoplasmosis. What should the nurse instruct the client to do to prevent transmission of the toxoplasmosis protozoan?

Cook all meats, such as beef and pork, thoroughly.

The nurse is performing a health history for a client in her first trimester of pregnancy who lives alone with two cats. What education should the nurse provide so that the client may protect herself from illness?

The client should wear disposable gloves to clean the litter box and wash hands with soap and warm water after cat litter exposure.

A client's membranes rupture during the 36th week of pregnancy. Eighteen hours later, the nurse measures the client's temperature at 101.8° F (38.8° C). After initiating ordered antibiotic therapy, the nurse should prepare the client for:

delivery.

A client, age 39, attends a regular prenatal check-up. She's 32 weeks pregnant. When assessing the client, the nurse should stay especially alert for signs and symptoms of:

gestational hypertension.

A nurse is caring for a client in the 13th week of pregnancy who develops hyperemesis gravidarum. The nurse is reviewing the client's laboratory report. Which finding indicates the need for intervention?

ketones in urine

A client and her partner, both 25 years old, are having trouble conceiving. Infertility in this couple is defined as:

the inability to conceive after 1 year of unprotected attempts.

In which maternal locations would the nurse place the ultrasound transducer of the external electronic fetal heart rate monitor if a fetus at 34 weeks' gestation is in the left occipitoanterior (LOA) position?

below the umbilicus on the left side

A client, 38 weeks pregnant, arrives in the emergency department complaining of contractions. To help confirm that she's in true labor, the nurse should assess for:

changes in cervical effacement and dilation after 1 to 2 hours.