OB Ch. 17 Questions

A client at 11 weeks' gestation experiences pregnancy loss. The client asks the nurse if the bleeding and cramping that occurred during the miscarriage were caused by working long hours in a stressful environment. What is the most appropriate response from the nurse?

"I can understand your need to find an answer to what caused this. Let's talk about this further."

A pregnant women calls the clinic to report a small amount of painless vaginal bleeding. What response by the nurse is best?

"Please come in now for an evaluation by your health care provider."

A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage (D&C). The client looks frightened and confused and states that she does not believe in induced abortion (medical abortion). Which statement by the nurse is best?

"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."

A client is at 26 weeks gestation with twins. What teaching is most important regarding this client's food intake?

"You should eat foods that are high in iron."

A 17-year-old client comes to the clinic because of irregular menstrual bleeding and facial acne. The client is overweight, despite exercising daily, and has excessive hair growth on the chin and abdomen. The nurse explains to the client that blood will be drawn for which purposes? Select all that apply.

-to screen for insulin resistance -to obtain fasting cholesterol levels -to measure androgen level

A student nurse asks the instructor what percentage of clinically recognized pregnancies end in miscarriages during the first trimester. Which response from the nurse is the most accurate?

15% to 20%

A client with a molar pregnancy is scheduled for a dilatation and curettage (D&C). The nurse is educating that client about postoperative care. The nurse will instruct the client that she will have the first serum hCG level drawn at how many hours after the D&C?

48

A nurse is monitoring the serum drug level of a pregnant client with preeclampsia who is receiving a continuous infusion of magnesium sulfate. For which level would the nurse continue the infusion?

6.8 mg/100 ml

A nurse is caring for a client who just experienced a spontaneous abortion (miscarriage) in the first trimester. When asked by the client why this happened, which is the best response from the nurse?

Abnormal fetal development

A nurse in the maternity triage unit is caring for a client with a suspected ectopic pregnancy. Which nursing intervention should the nurse perform first?

Assess the client's vital signs.

A woman in her 20s has experienced a spontaneous abortion (miscarriage) at 10 weeks' gestation and asks the nurse at the hospital what went wrong. She is concerned that she did something that caused her to lose her baby. The nurse can reassure the woman by explaining that the most common cause of miscarriage in the first trimester is related to which factor?

Chromosomal defects in the fetus

A pregnant client with preeclampsia is being treated with intravenous magnesium sulfate. The nurse assesses the client's deep tendon reflexes and grades them as 4+. The nurse notifies the health care provider about this finding, describing them using which term to ensure accurate communication?

Clonus

A client has been admitted to the hospital with a diagnosis of preeclampsia with severe features. Which nursing intervention is the priority?

Confine the client to bed rest in a darkened room.

An 18-year-old pregnant client is hospitalized as she recovers from hyperemesis gravidarum. The client reveals she wanted to have an abortion (elective termination of pregnancy) but her cultural background forbids it. She is very unhappy about being pregnant and even expresses a wish for a spontaneous abortion (miscarriage). Which action by the nurse is most appropriate?

Contact the health care provider to report the client's feelings.

A pregnant client late in the second trimester comes to the emergency department with a report of painless, bright red vaginal bleeding. The client states, "It started all of a sudden and now it seems to have stopped." Placenta previa is suspected. Which action should the nurse implement immediately for this

Determine fetal heart sounds using an external monitor.

A woman at 10 weeks' gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize?

Fundal height measurement of 18 cm

A client tells that nurse in the doctor's office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia?

Have her blood pressure checked at every prenatal visit.

A pregnant client at 8 weeks' gestation comes to the facility for vaginal bleeding. Assessment reveals that the client has experienced an incomplete spontaneous abortion (miscarriage) for which suction curettage is planned. While preparing the client for the procedure, the nurse would closely monitor for which possible complication?

Hemorrage

The nurse is identifying nursing diagnoses for a client with gestational hypertension. Which diagnosis would be the most appropriate for this client?

Ineffective tissue perfusion related to vasoconstriction of blood vessels

A client recovering from an uneventful vaginal delivery is prescribed Rho(D) immune globulin. What should the nurse explain to the client regarding the purpose of this medication?

It prevents maternal D antibody formation.

A pregnant client is diagnosed with preeclampsia and is to receive medication therapy to prevent eclampsia. Which medication does the nurse anticipate being prescribed?

Magnesium sulfate

A pregnant client diagnosed with hyperemesis gravidarum is prescribed intravenous fluids for rehydration. When preparing to administer this therapy, which solution would the nurse anticipate being prescribed initially?

Normal saline

A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next?

Palpate the fundus and check fetal heart rate.

A client at 33 weeks' gestation comes to the emergency department with vaginal bleeding. Assessment reveals the following: • Onset of slight vaginal bleeding at 29 weeks with spontaneous cessation • Recent onset of bright red vaginal bleeding, more than with previous episode • No uterine contractions at present • Fetal heart rate within normal range • Uterus soft and nontender Based on the assessment findings, which condition would the nurse likely suspect?

Placenta previa

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between placental abruption (abruptio placenta) and placenta previa. Which statement will the nurse include in the teaching?

Placenta previa is an abnormally implanted placenta that is too close to the cervix.

A nurse is reviewing a client's history and physical examination findings. Which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy?

Recurrent pelvic infections

A client who is 16 weeks' pregnant is passing pieces of body tissue along with blood clots and dark red blood from the vagina. What should the nurse direct the client to do at this time?

Seek immediate medical attention and bring the expressed vaginal material.

The nurse is monitoring a pregnant client who is receiving intravenous magnesium sulfate for eclampsia. During the last assessment, the nurse was unable to elicit a patellar reflex. What should the nurse do?

Stop the current infusion.

A pregnant client with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful?

The client delivers a full-term fetus at 39 weeks' gestation.

A client at 32 weeks' gestation is admitted with acute abdominal pain. She is diagnosed with placental abruption (abruptio placenta). The nurse documents the above assessment. Which intervention is the priority in the management of this client?

Transfusion of blood

A client reporting she recently had a positive pregnancy test has reported to the emergency department stating one-sided lower abdominal pain. The health care provider has prescribed a series of tests. Which test will provide the most definitive confirmation of an ectopic pregnancy?

abdominal ultrasound

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission?

assessing fetal heart tones by use of an external monitor

A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect?

ensures passage of all the products of conception

A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements?

gestational hypertension

The nurse is assessing a client at 12 weeks' gestation at a routine prenatal visit who reports something doesn't feel right. Which assessment findings should the nurse prioritize?

gestational hypertension, hyperemesis gravidarum, absence of FHR

What would be the physiologic basis for a placenta previa?

low placental implantation

A client with hyperemesis gravidarum is admitted to the facility after being cared for at home without success. What would the nurse expect to include in the client's plan of care?

nothing by mouth

The nurse is appraising the medical record of a pregnant client who is resting in a darkened room and receiving betamethasone and magnesium sulfate. The nurse recognizes the client is being treated for which condition?

severe preeclampsia

The nurse is caring for a woman at 32 weeks' gestation with severe preeclampsia. Which assessment finding should the nurse prioritize after the administration of hydralazine to this client?

tachycardia

The obstetric nurse is caring for a pregnant client who has been diagnosed with a hydatidiform mole. What assessment should the nurse prioritize?

vaginal bleeding