OB- Final Study
During routine preconception counseling, a client asks how early a pregnancy can be diagnosed. What is the nurse's best response?
"8 days after conception"
A client who's 32 weeks pregnant is hospitalized with preterm labor. After preterm labor is arrested, she's discharged with a prescription for oral terbutaline (Brethine). Which instruction should the nurse provide during discharge teaching?
"Abstain from sexual intercourse unless you use a condom."
Approximately how much time is required for the blastocyst to reach the uterus for implantation?
7 days
During a health-teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. Which answer should the nurse supply?
7 days after fertilization
A client who's 5 weeks pregnant reports nausea and vomiting. The nurse reassures the client that these symptoms probably will subside by:
9 to 12 weeks' gestation.
The nurse is caring for a 16-year-old pregnant client. The client is taking an iron supplement. What should this client drink to increase the absorption of iron?
A glass of orange juice
The nurse checks a client for signs and symptoms of ectopic pregnancy. What is the most common finding associated with this antepartum complication?
Abdominal pain
The nurse is collecting data on a client who is believed to be pregnant. Which signs or symptoms indicate a hydatidiform mole?
Abnormally high human chorionic gonadotropin (hCG) levels
On her second visit to the prenatal facility, a client states, "I guess I really am pregnant. I've missed two periods now." Based on this statement, the nurse determines that the client has accomplished which psychological task of pregnancy?
Accepting the biological fact of pregnancy
A client, 8 weeks pregnant, has a history of lactose intolerance. To prevent a nutritional deficiency as a result of lactose intolerance, the nurse teaches her about lactase replacement. Which teaching point is appropriate?
Add lactase replacement drops to milk at least 24 hours before drinking it.
A client is admitted for an amniocentesis. Initial data collection findings include the following: 16 weeks pregnant, vital signs within normal limits, hemoglobin 12.2 gm, hematocrit 35%, and type O-negative blood. Which action would be most important to include in the client's plan of care after the amniocentesis has been completed?
Administer RhoGAM.
Which of the following would the nurse expect to find as presumptive signs of pregnancy?
Amenorrhea and quickening
After developing severe hydramnios, a primigravid client exhibits dyspnea, along with edema of the legs and vulva. Which procedure should the nurse expect her to undergo and why?
Amniocentesis to temporarily relieve discomfort
A client is scheduled for amniocentesis. When preparing her for the procedure, the nurse should complete which of the following tasks?
Ask her to void.
During her first prenatal visit, a client expresses concern about gaining weight. Which of the following actions should be the nurse's next step?
Ask the client how she feels about gaining weight and provide instructions about expected weight gain and diet.
A client is scheduled for amniocentesis. What should the nurse do to prepare the client for the procedure?
Ask the client to void. Assess fetal heart rate. Monitor maternal vital signs.
When should a client who's Rh(D)-negative and D-negative and who hasn't already formed Rh antibodies receive Rh(D) human immunoglobulin (RhIg) to prevent isoimmunization?
At about 28 weeks' gestation and again within 72 hours after delivery
The nurse is caring for a 16-year-old pregnant client who is taking an iron supplement. Which instruction should the nurse include when teaching the adolescent about ferrous sulfate?
Avoid taking the supplement with milk. Avoid taking the supplement with antacids. Avoid chewing the extended-release form of the drug.
The nurse is developing a teaching plan for a client who's 2 months pregnant. The nurse should tell the client that she can expect to feel the fetus move at which time?
Between 16 and 22 weeks' gestation
When providing health teaching to a primigravid client, the nurse tells the client that she's likely to first experience Braxton Hicks contractions. When do these contractions typically begin?
Between 23 and 27 weeks' gestation
The nurse is checking the legs of a client who's 36 weeks pregnant. Which finding should the nurse expect?
Bilateral dependent edema
The nurse uses nitrazine paper to determine whether a pregnant client's membranes have ruptured. If the membranes have ruptured, the paper will turn which color?
Blue
Which statement accurately describes estrogen and progesterone levels during the 16th week of pregnancy?
Both estrogen and progesterone levels are rising.
A client who's pregnant with her second child comes to the clinic complaining of a pulling and tightening sensation over her pubic bone every 15 minutes. She reports no vaginal fluid leakage. Because she has just entered her 36th week of pregnancy, she's apprehensive about her symptoms. Vaginal examination discloses a closed, thick, posterior cervix. These findings suggest that the client is experiencing:
Braxton Hicks contractions.
The nurse is caring for a client in the first 4 weeks of pregnancy. The nurse should expect to collect which findings?
Breast sensitivity
Which of the following nutritional instructions should the nurse provide to a 32-year-old primigravida?
Caloric intake should be increased 300 cal/day. Protein intake should be increased by more than 30 g/day. Intake of all minerals, especially iron, should be increased. Intake of all minerals, especially iron, should be increased.
A client is 8 weeks pregnant. Which teaching topic is most appropriate at this time?
Common discomforts of pregnancy
The nurse is caring for a client who's on ritodrine (Yutopar) therapy to halt premature labor. What condition indicates an adverse reaction to ritodrine therapy?
Crackles
A pregnant client comes to the facility for her first prenatal visit. When providing teaching, the nurse should be sure to cover which topic?
Danger signs during pregnancy
A client in her 15th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this client?
Deficient fluid volume
What is the primary nursing diagnosis for a client with a ruptured ectopic pregnancy?
Deficient fluid volume
A client who's 24 weeks pregnant has sickle cell anemia. When preparing the plan of care, the nurse should identify which factor as a potential trigger for a sickle cell crisis during pregnancy?
Dehydration
The nurse has a client at 30 weeks' gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her baby?
Discourage breast-feeding because HIV can be transmitted through breast milk.
During a routine assessment, a pregnant client tells the nurse that she hasn't had a bowel movement for "close to a week." What should the nurse do to help this client?
Discuss the client's diet, focusing on her fiber and water intake.
A pregnant client is prescribed an iron supplement. Which point should the nurse include when teaching the client about taking the supplement?
Eat a diet rich in vitamin C to promote iron absorption.
During a routine prenatal visit, a pregnant client reports heartburn. To minimize her discomfort, the nurse should include which suggestion in the plan of care?
Eat small, frequent meals.
During the sixth month of pregnancy, a client reports intermittent earaches and a constant feeling of fullness in the ears. What is the likely cause of these symptoms?
Eustachian tube vascularization
During each prenatal checkup, the nurse obtains the client's weight and blood pressure and measures fundal height. What is another essential part of each prenatal checkup?
Evaluating the client for edema
During a home-care visit with a pregnant client, the nurse notices extension cords crossing between rooms. How should the nurse intervene?
Explain that extension cords can pose a danger to the client when she's walking.
A client, now 37 weeks pregnant, calls the clinic because she's concerned about being short of breath and is unable to sleep unless she places three pillows under her head. After listening to her concerns, the nurse should take which action?
Explain that these are expected problems for the latter stages of pregnancy.
A client who's 2 months pregnant complains of urinary frequency and says she gets up several times at night to go to the bathroom. She doesn't have other urinary symptoms. How should the nurse intervene?
Explain that urinary frequency is expected during the first trimester.
A pregnant client tells the nurse that she doesn't like milk and can't possibly drink three to four glasses per day as recommended by her physician. Which intervention by the nurse is best?
Explaining that other dairy products, such as cheese and yogurt, may be substituted for milk
At 15 weeks' gestation, a client is scheduled for a serum alpha-fetoprotein (AFP) test. Which maternal history finding would indicate a need for this test?
Family history of spina bifida in a sister
When determining maternal and fetal well-being, which of the following data collection findings is most important?
Fetal heart rate and activity
Which findings would be considered positive signs of pregnancy?
Fetal heartbeat and fetal movement on palpation
A nurse is obtaining a medication history from a client who suspects she's pregnant. At which week of gestation does placental transport of substances to and from the fetus begin?
Fifth week
After undergoing prenatal blood testing, a client learns that she tested positive for human immunodeficiency virus (HIV). What should the nurse do with this information?
Follow facility policy for documenting and communicating HIV status.
When evaluating a pregnant client's fundal height, the nurse should measure in which way?
From the symphysis pubis notch to the highest level of the fundus
The nurse is providing instruction to a woman who is 18 weeks pregnant. Which findings are expected at this time?
Fundal height of approximately 18 cm Quickening
When collecting data on a pregnant client with diabetes mellitus, the nurse stays alert for signs and symptoms of a vaginal or urinary tract infection (UTI). Which condition makes this client more susceptible to such infections?
Glycosuria
The nurse prepares a client who's 28 weeks pregnant for a nonstress test (NST). Which intervention is likely to stimulate fetal movements during this test?
Having the client drink orange juice
The nurse obtains the antepartum history of a client who's 6 weeks pregnant. Which finding should the nurse discuss with the client first?
Her consumption of six to eight cans of beer on weekends
A client calls to schedule a pregnancy test. The nurse knows that most pregnancy tests measure which hormone?
Human chorionic gonadotropin (hCG)
During the first 3 months, which hormone is responsible for maintaining pregnancy?
Human chorionic gonadotropin (hCG)
A nurse in a prenatal clinic is assessing a 28-year-old who's 24 weeks pregnant. Which findings would lead this nurse to suspect that the client has mild preeclampsia?
Hypertension, edema, proteinuria
During her first prenatal visit, a pregnant client admits to the nurse that she uses cocaine at least once per day. Which nursing diagnosis is most appropriate for this client?
Imbalanced nutrition: Less than body requirements related to limited food intake
"As long as you wish, if the pregnancy is normal"
Increased plasma volume
A famous pregnant client comes to the physician's office for a routine prenatal examination. While the client is in the office, the media arrives asking for information about the client. What should the nurse do?
Inform the media that you can't comment about whether the person is being seen in the office.
A client comes to her prenatal examination complaining of increasing episodes of leg cramping. Which intervention by the nurse is most appropriate?
Instructing the client to gently stretch her legs to relieve the cramping
Deficient fluid volume
Insulin
A pregnant client who's diabetic is at risk for having a large-for-gestational-age infant because of which of the following?
Insulin acting as a growth hormone on the fetus
The nurse is assisting in planning care for a 16-year-old client in the prenatal clinic. Adolescents are prone to which complication during pregnancy?
Iron deficiency anemia
A pregnant client's last menstrual period began on October 12. The nurse calculates the estimated date of delivery (EDD) as:
July 19.
A client in the 13th week of pregnancy develops hyperemesis gravidarum. Which laboratory finding indicates the need for intervention?
Ketones in urine
When questioned, a pregnant client admits she sometimes has several glasses of wine with dinner. Her alcohol consumption puts her fetus at risk for which condition?
Learning disability
A client is in the 8th month of pregnancy. To enhance cardiac output and renal function, the nurse should advise her to use which body position?
Left lateral
While caring for pregnant adolescents, the nurse should develop a plan of care that incorporates which health concern?
Level of emotional maturity
A client comes to the clinic for a routine prenatal examination. The nurse notices that the client is disheveled and unkempt. The client explains, "I have no energy to take care of myself and I really don't care." How should the nurse intervene?
Offer to assist the client with basic care needs while waiting for the physician.
The nurse is caring for a client with hyperemesis gravidarum who will need close monitoring at home. When should the nurse begin discharge planning?
On admission to the facility
What key psychosocial tasks must a woman accomplish during the third trimester?
Overcoming fears she may have about the unknown, loss of control, and death
The nurse is teaching a pregnant client about exercises that may be helpful during pregnancy. Which points should the nurse include in her instruction?
Pelvic rocking may help relieve lower back pain. Abdominal breathing lifts the abdominal wall off of the uterus. Kegel exercises help improve vaginal contractility and bladder control.
Which drug will the physician probably order to treat a pregnant client who is experiencing morning sickness?
Phosphorated carbohydrate solution (Emetrol)
A client, 7 months pregnant, is admitted to the unit with abdominal pain and bright red vaginal bleeding. Which action should the nurse take?
Place the client on her left side and start supplemental oxygen, as ordered, to maximize fetal oxygenation.
Which of the following functions would the nurse expect to be unrelated to the placenta?
Production of maternal antibodies
A client who is 14 weeks pregnant mentions that she has been having difficulty moving her bowels since she became pregnant. Which hormones are responsible for this common discomfort during pregnancy?
Progesterone
The nurse is developing a plan of care for a client in her 34th week of gestation who's experiencing preterm labor. What nonpharmacologic intervention should the plan include to halt premature labor?
Promoting adequate hydration
A client with pregnancy-induced hypertension (PIH) probably exhibits which of the following symptoms?
Proteinuria, headaches, and double vision
A pregnant client in her second trimester reveals that she feels very anxious because of a lack of knowledge about giving birth. Which intervention by the nurse is most appropriate for this client?
Provide her with the information and teach her the skills she'll need to understand and cope during birth.
As a client progresses through pregnancy, she develops constipation. What is the primary cause of this problem during pregnancy?
Reduced intestinal motility
A client treated with terbutaline (Brethine) for preterm labor is ready for discharge. Which instruction should the nurse include in the discharge teaching plan?
Report a heart rate greater than 120 beats/minute to the physician.
A client admitted with preterm labor is prescribed magnesium sulfate to halt contractions. The nurse should monitor the client for which adverse reactions to the drug?
Respiratory rate less than 12 breaths/minute Extreme muscle weakness Palpitations Hot flashes
A client is in the 38th week of her first pregnancy. She calls the prenatal facility to report occasional tightening sensations in the lower abdomen and pressure on the bladder from the fetus, which she says seems lower than usual. The nurse should take which action?
Review premonitory signs of labor with the client.
An adolescent in her first trimester of pregnancy continues to smoke cigarettes. The client tells the nurse that she'd like to quit but she doesn't want to gain any more weight. What should the nurse do for this client?
Review the hazards of smoking with the client and suggest a smoking-cessation class.
A client who's 12 weeks pregnant is complaining of severe left lower quadrant pain and vaginal spotting. She's admitted for treatment of an ectopic pregnancy. Of the following nursing diagnoses, the nurse should give the highest priority to:
Risk for deficient fluid volume.
During a prenatal screening of a client with diabetes, the nurse should keep in mind that the client is at increased risk for which complications?
Still birth Pregnancy-induced hypertension Spontaneous abortion
A client is 2 months pregnant. Which factor should the nurse anticipate as most likely to affect her psychosocial transition during pregnancy?
Support from her partner
A client with hyperemesis gravidarum is on a clear liquid diet. Which foods would be appropriate for the nurse to serve?
Tea and gelatin Ginger ale and apple juice Cranberry juice and chicken broth
A client who's 7 months pregnant reports severe leg cramps at night. Which nursing action would be most effective in helping her cope with these cramps?
Teaching her to dorsiflex her foot during the cramp
A client who's 4 weeks pregnant comes to the clinic for her first prenatal visit. When obtaining her health history, the nurse explores her use of drugs, alcohol, and cigarettes. Which client behavior identifies a safe level of alcohol intake for this client?
The client consumes no alcohol.
The nurse is reviewing a client's prenatal history. Which finding indicates a genetic risk factor?
The client has a child with cystic fibrosis.
A client, 2 months pregnant, has hyperemesis gravidarum. Which expected outcome is most appropriate for her?
The client will exhibit uterine growth within the expected norms for gestational age.
After an amniotomy, which client goal should take the highest priority?
The client will maintain adequate fetal tissue perfusion.
A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. Her BPP score is 8. What does this score indicate?
The fetus isn't in distress at this time.
The labor and delivery unit has 10 clients in varying stages of labor. Staffing for the upcoming shift consists of four registered nurses (RNs) and one licensed practical nurse (LPN). Which client care assignment is best?
The stable clients in the early stages of labor should be assigned to the LPN.
The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?
They're usually felt in the abdomen.
The nurse is discussing posture with a client who's 18 weeks pregnant. Why should the nurse caution her to avoid the supine position?
This position impedes blood flow to the fetus.
A pregnant client in her third trimester asks why she needs to urinate frequently, as she did during the first trimester. What should the nurse tell her?
This symptom is normal and results from the fetus exerting pressure on the bladder.
After determining that a pregnant client is Rh-negative, the physician orders an indirect Coombs' test. What is the purpose of performing this test in a pregnant client?
To detect maternal antibodies against fetal Rh-positive factor
A client with pregnancy-induced hypertension (PIH) receives magnesium sulfate, 4 g in 50% solution I.V. over 20 minutes. What is the purpose of administering magnesium sulfate to this client?
To prevent seizures
A pregnant client arrives in the emergency department and states, "My baby is coming." The nurse sees a portion of the umbilical cord protruding from the vagina. Why should the nurse apply manual pressure to the baby's head?
To relieve pressure on the umbilical cord
During a physical examination, a client who's 32 weeks pregnant becomes pale, dizzy, and light-headed while supine. Which action should the nurse immediately take?
Turn the client on her left side.
A client in the first trimester of pregnancy joins a childbirth education class. During this trimester, the class is most likely to cover which physiologic aspect of pregnancy?
Warning signs of complications
A client is admitted to the facility with a suspected ectopic pregnancy. When reviewing the client's health history for risk factors for this abnormal condition, the nurse expects to find:
a history of pelvic inflammatory disease.
A client, 11 weeks pregnant, is admitted to the facility with hyperemesis gravidarum. She tells the nurse she has never known anyone who had such severe morning sickness. The nurse understands that hyperemesis gravidarum results from:
an unknown cause.
The nurse is collecting data on a pregnant woman in the clinic. In the course of the data collection, the nurse learns that this woman smokes one pack of cigarettes per day. The first step the nurse should take to help the woman stop smoking is to:
assess the client's readiness to stop.
The nurse is providing care for a pregnant client in her second trimester. Glucose tolerance test results show a blood glucose level of 160 mg/dl. The nurse should anticipate that the client will need to:
be taught about diet.
A client is in the last trimester of pregnancy. The nurse should instruct her to notify her obstetrician immediately if she notices:
blurred vision.
The nurse is reviewing a pregnant client's nutritional status. To determine whether she has an adequate intake of vitamin A, the nurse should check her diet for consumption of:
dairy products.
A client with hyperemesis gravidarum is on a clear liquid diet. The nurse should serve this client:
decaffeinated coffee and scrambled eggs.
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 prescribed antibiotic therapy, the nurse should prepare the client for:
delivery.
After receiving large doses of an ovulatory stimulant such as menotropins (Pergonal), a client comes in for her office visit. Data collection reveals the following findings: Weight gain of 6 lb (3 kg), ascites, and pedal edema. These findings indicate that the client is:
demonstrating signs of hyperstimulation syndrome.
During a prenatal visit, a pregnant client with cardiac disease and slight functional limitations reports increased fatigue. To help combat this problem, the nurse should advise her to:
divide daily food intake into five or six meals.
At 32 weeks' gestation, a client is admitted to the facility with a diagnosis of pregnancy-induced hypertension (PIH). Based on this diagnosis, the nurse expects assessment to reveal:
edema.
A low-risk client who's 6 weeks pregnant comes to the clinic for her first prenatal visit. At this time, the nurse should assign highest priority to:
establishing a schedule of prenatal visits.
A client makes a routine visit to the prenatal clinic. Although she believes that she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. The physician diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal:
grapelike clusters.
A client who's 12 weeks pregnant attends a class on fetal development as part of a childbirth education program. The nurse says that at 16 weeks' gestation, the client's fetus will likely:
have audible heart sounds.
When teaching a group of pregnant adolescents about reproduction and conception, the nurse is correct when stating that fertilization occurs:
in the first third of the fallopian tube.
A client who's 7 weeks pregnant comes to the clinic for her first prenatal visit. She reports smoking 20 to 25 cigarettes per day. When planning the client's care, the nurse anticipates informing her that if she doesn't stop smoking, her fetus will develop:
intrauterine growth retardation.
The nurse is caring for a client whose membranes ruptured prematurely 12 hours ago. When collecting data on this client, the nurse's highest priority is to evaluate:
maternal vital signs and fetal heart rate (FHR).
A client at 28 weeks' gestation is complaining of contractions. Following admission and hydration, the physician writes an order for the nurse to give 12 mg of betamethasone I.M. This medication is given to:
promote fetal lung maturity.
A client, 7 months pregnant, is receiving the tocolytic agent terbutaline (Bricanyl), 17.5 mcg/minute I.V., to halt uterine contractions. She also takes prednisone (Orasone), 5 mg by mouth twice per day, to control asthma. To detect an adverse interaction between these drugs, the nurse should monitor the client for:
pulmonary edema.
A woman who's 10 weeks pregnant tells the nurse that she's worried about her fatigue and frequent urination. The nurse should:
recognize these as normal early pregnancy signs and symptoms.
An 18-year-old pregnant woman tells the nurse that she's concerned that she may not be able to take care of herself during her pregnancy. She states that prenatal care is expensive and her job doesn't provide insurance. The nurse should recognize that the client:
should be referred to community resources available for pregnant women.
The nurse is providing dietary teaching to a pregnant client. To help meet the client's iron needs, the nurse should advise her to eat:
spinach and beef.
A newly pregnant woman tells the nurse that she hasn't been taking her prenatal vitamins because they make her nauseous. In addition to telling the client how important taking the vitamins are, the nurse should advise her to:
take the vitamin on a full stomach.
A 20-year-old female's pregnancy is confirmed at a clinic. She says her husband will be excited, but she is concerned because she herself isn't excited. She fears this may mean she'll be a bad mother. The nurse should respond by:
telling her such feelings are normal in the beginning of pregnancy.
"Folic acid supplements improve pregnancy outcomes by preventing certain complications."
terbutaline (Brethine).
Infertility in a 25-year-old couple is defined as:
the couple's inability to conceive after 1 year of unprotected attempts.
The nurse is providing care for a pregnant client with gestational diabetes. The client asks the nurse if her gestational diabetes will affect her delivery. The nurse should know that:
the delivery may need to be induced early.
The nurse is providing care for a pregnant woman. The woman asks the nurse how she can effectively deal with her fatigue. The nurse should instruct her to:
try to get more rest by going to bed earlier.
The nurse is caring for a client after evacuation of a hydatidiform mole. The nurse should tell the client to:
use birth control for at least 1 year.
A client asks how long she and her husband can safely continue sexual activity during pregnancy. How should the nurse respond?
"As long as you wish, if the pregnancy is normal"
A client is receiving terbutaline (Brethine) to stop preterm labor. The physician plans to discharge the client in the morning with a terbutaline infusion pump. Which instruction should the nurse include when teaching the client about the drug?
"Assess the insertion site for signs of infection."
A client has come to the clinic for her first prenatal visit. The nurse should include which statement about using drugs safely during pregnancy in her teaching?
"Consult with your health care provider before taking any medications."
The nurse is obtaining a prenatal history from a client who's 8 weeks pregnant. To help determine whether the client is at risk for a TORCH infection, the nurse should ask:
"Do you have any cats at home?"
A client is expecting her second child in 6 months. During the psychosocial assessment, she says, "I've been through this before. Why are you asking me these questions?" What is an appropriate response by the nurse?
"Each pregnancy has a unique psychosocial meaning."
A client who's planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. Which of the following would be the nurse's best response?
"Folic acid supplements improve pregnancy outcomes by preventing certain complications."
An adolescent who's 14 weeks pregnant comes to the clinic for a prenatal examination. During the examination, the client says to the nurse, "I'm still not sure whether I want to keep my baby." Which response by the nurse is best?
"Have you and your physician discussed your options?"
A pregnant client tells the nurse that she dreads coming for her prenatal examinations. She states, "When I see the physician, he constantly reminds me that so many women keep weight on after having children; it really depresses me." How should the nurse respond?
"Have you asked the physician why he feels it's important for him to say that to you?"
The nurse is caring for a client in her 34th week of pregnancy who wears an external monitor. Which statement by the client indicates an understanding of the nurse's teaching?
"I can lie in any comfortable position, but I should stay off my back."
A client has just expelled a hydatidiform mole. She's visibly upset over the loss and wants to know when she can try to become pregnant again. Which of the following would be the nurse's best response?
"I can see that you're upset; however, you must wait at least 1 year before becoming pregnant again."
The nurse is teaching a client who's 28 weeks pregnant and has gestational diabetes how to control her blood glucose levels. Diet therapy alone has been unsuccessful in controlling this client's blood glucose levels, so she has started insulin therapy. The nurse should consider the teaching effective when the client says:
"I need to use insulin each day."
When collecting data on a client during her first prenatal visit, the nurse discovers that the client had a reduction mammoplasty. The mother indicates she wants to breast-feed. What information should the nurse give to this mother regarding breast-feeding success?
"I support your commitment; however, you may have to supplement each feeding with formula."
A pregnant client concerned about gaining weight during pregnancy questions the nurse about dietary intake. Which response by the nurse is best?
"I'll ask the dietitian to speak with you about normal weight gain during pregnancy."
During a routine prenatal visit, a pregnant client reports constipation, and the nurse teaches her how to relieve it. Which client statement indicates an accurate understanding of the nurse's instructions?
"I'll increase my intake of unrefined grains."
When evaluating a client's knowledge of symptoms to report during her pregnancy, which statement would indicate to the nurse that the client understands the information given to her?
"If I have blurred or double vision, I should call the clinic immediately."
A client with type 1 diabetes mellitus has just learned she's pregnant. The nurse is teaching her about insulin requirements during pregnancy. Which guideline should the nurse provide?
"Insulin requirements usually decrease during the first trimester."
A pregnant client asks how she can best prepare her 3-year-old son for the upcoming birth of a sibling. The nurse should make which suggestion?
"Involve your son in planning and preparing for a sibling."
The nurse observes many cuts and bruises on the back, arms, and legs of a pregnant client. The client tells the nurse, "I was cleaning and a box of supplies fell on me." Which response by the nurse is most appropriate?
"It's our responsibility to maintain client confidentiality and to make sure our clients are safe. I'd be glad to listen if there's anything you want to talk about."
A client in her first trimester of pregnancy complains that she's always tired. Which response by the nurse is best?
"Needs for rest and sleep typically increase during the first trimester of pregnancy."
During her fourth clinic visit, a client who's 5 months pregnant tells the nurse she was exposed to rubella during the past week and asks whether she can be immunized now. How should the nurse respond?
"No, because the live viral vaccine is contraindicated during pregnancy."
A pregnant client asks the nurse whether she can take castor oil for her constipation. How should the nurse respond?
"No, it can initiate premature uterine contractions."
The nurse is providing care for a pregnant 16-year-old client. The client says that she's 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."
The nurse determines that a client is in false labor. After obtaining discharge orders from the nurse-midwife, the nurse provides discharge teaching to the client. Which instruction is appropriate at this time?
"Return to the facility if your contractions become more intense."
A client who's 24 weeks pregnant and diagnosed with preeclampsia is sent home with orders for bed rest and a referral for home health visits by a community health nurse. Which comment made by the client should indicate to the nurse that the client understands the purpose of home health visits?
"The community health nurse will check me and my baby and talk with my physician."
A client in her second trimester of pregnancy has been diagnosed with gestational diabetes. While instructing the client about home glucose monitoring the client states, "Why should I use this if the diabetes is going to resolve after I have my baby anyway?" Which response by the nurse is best?
"The monitor helps you see how your blood sugar is being controlled during your pregnancy to help prevent complications."
A pregnant client is brought to the emergency department after being an unrestrained driver in a motor vehicle accident. When questioned about seatbelt use, the client states that she thought a seatbelt would harm her baby. Which response by the nurse is best?
"The only way to safely secure yourself in a car is to use a seatbelt."
A 30-year-old primiparous client at 34 weeks' gestation comes to the prenatal facility concerned about the reddish streaks she has increasingly developed on her breasts and abdomen. She asks what these skin changes are and whether they're permanent. What should the nurse tell her?
"These streaks are called striae gravidarum, or stretch marks; they'll grow lighter after delivery."
A client who's 4 months pregnant asks the nurse how much and what type of exercise she should get during pregnancy. How should the nurse counsel her?
"Walk briskly for 10 to 15 minutes daily, and gradually increase this time."
A client who's 37 weeks pregnant comes to the clinic for a prenatal checkup. To evaluate the client's preparation for parenting, the nurse might ask which question?
"What changes have you made at home to get ready for the baby?"
A pregnant client asks questions about labor and delivery. During the nurse's explanations, the client states, "Is it true that a lot of other people are going to be in the room while I'm giving birth? I was expecting privacy." Which response would be appropriate for the nurse to make to this client?
"What did the physician tell you about the delivery room?"
A client is at her ideal weight when she conceives. During a prenatal visit 2 months later, she asks the nurse how much weight she should gain during pregnancy. What is the nurse's best response?
"You should gain 24 to 32 lb."
A pregnant client comes to the clinic after missing several scheduled prenatal appointments. During the initial assessment, the client states, "I haven't been coming to some of my appointments because I go to a homeopathic specialist who takes great care of me." Which response by the nurse is best?
"You should mention the homeopathic specialist to your physician so he can help devise the best care plan for you."
A client in the first trimester of pregnancy comes to the facility for a routine prenatal visit. She tells the nurse she doesn't know whether she's ready to have a baby, even though this was a planned pregnancy. Which response should the nurse offer?
"You're feeling ambivalent, which is normal during the first trimester."
A pregnant client in her second trimester visits the health care practitioner for a regular prenatal checkup. The nurse weighs the client. She then compares the client's current and previous weights. During the second trimester, how much weight should the client gain per week?
1 lb (0.45 kg)
A pregnant client asks the nurse about the percentage of congenital anomalies caused by drug exposure. How should the nurse respond?
1%
At what gestational age would a primigravida expect to feel quickening?
18 to 22 weeks
During a prenatal visit, the nurse measures a client's fundal height at 19 cm. This measurement indicates that the fetus has reached approximately which gestational age?
19 weeks
The caloric requirements for a client of normal weight increase by how much during pregnancy?
300 kcal
