OB First Half

A pregnant client in her third trimester asks why she needs to urinate frequently, getting up multiple times at night. The client asks the nurse, "Why am I urinating so much?" How would the nurse respond? "It sounds like you may have a bladder infection. Are you able to provide a sample today?" "Frequency results from the fetus exerting pressure on the bladder. This is normal." "Women often retain fluids at this stage. Elevating your feet during the day should help." "Besides having to urinate often, are there any other symptoms you are experiencing?"

"Besides having to urinate often, are there any other symptoms you are experiencing?"

A client who is 2 months pregnant has hyperemesis gravidarum. Which expected outcome will the nurse set as a goal for this client? "Client will accept the pregnancy, and vomiting will decrease within one week." "Client will vomit less than 3 times per day for the duration of pregnancy." "Client will exhibit uterine growth within the expected norms for gestational age." "Client will maintain hydration status with balanced intake and output levels."

"Client will exhibit uterine growth within the expected norms for gestational age."

A client in her 15th week of pregnancy has presented with abdominal cramping and bright red vaginal bleeding for the past 2 hours. She has passed several clots. What is the priority nursing care? Prepare for surgery. Assess the fetal heart rate. Assess the maternal vital signs. Obtain hemoglobin and hematocrit.

Assess the maternal vital signs.

The nurse is caring for a client in the first trimester of pregnancy with a threatened miscarriage. The client is ordered to bed rest with bathroom privileges. The client is experiencing muscle cramps and pain in her legs while on bed rest. What is an appropriate recommendation from the nurse? Select all that apply. Have support persons do passive ROM exercises. Do mild stretching exercises. Frequently walking around the room. Do gentle exercises of the legs. Roll side to side in bed a few times an hour.

Do mild stretching exercises. Do gentle exercises of the legs. Roll side to side in bed a few times an hour.

A 19-year-old primigravid client is being discharged home after hospitalization for hyperemesis gravidarum and is being referred to home health care. The nurse should develop a discharge plan that includes which interventions? Select all that apply. Ensure that the client has a prescription for an antiemetic. Ask the health care provider for an anxiolytic prescription. Discuss plan of care and discharge instructions with client. Refer client to a nutritionist for the following day. Coordinate follow-up appointment with provider in 6 weeks. Encourage return to normal routine when client feels ready.

Ensure that the client has a prescription for an antiemetic. Discuss plan of care and discharge instructions with client. Refer client to a nutritionist for the following day. Encourage return to normal routine when client feels ready.

A nurse is caring for a client who is 32 weeks gestation and being monitored in the antepartum unit for pre-eclampsia. The client suddenly reports continuous abdominal pain and vaginal bleeding. Which nursing interventions are priorities? Select all that apply. Evaluate maternal vital signs. Auscultate fetal heart tones. Monitor intake and output. Reassure the client that she will be able to continue the pregnancy. Monitor the amount of vaginal bleeding. Prepare for vaginal birth.

Evaluate maternal vital signs. Auscultate fetal heart tones. Monitor intake and output. Monitor the amount of vaginal bleeding.

A multigravid client at 36 weeks' gestation who is visiting the clinic for a routine visit begins to sob and tells the nurse, "My boyfriend has been beating me up once in a while since I became pregnant, but I can't bring myself to leave him because I don't have a job and I don't know how I would take care of my other children." What is the priority action by the nurse at this time? Help the client make concrete plans for the safety of herself and her children. Contact a social worker for assistance and family counseling. Provide the client with brochures on the statistics about violence against women. Tell the client that she should not allow anyone to hit her or her children.

Help the client make concrete plans for the safety of herself and her children.

A client at 28 weeks' gestation presents to the emergency department with a "splitting headache." What action(s) would be indicated by the nurse at this time? Select all that apply. Determine if the client has a documented ultrasound for this pregnancy. Obtain a nonstress test. Assess the client for vision changes or epigastric pain. Assess for the presence of urine ketones. Assess the client's reflexes and presence of clonus.

Obtain a nonstress test. Assess the client for vision changes or epigastric pain. Assess the client's reflexes and presence of clonus.

A client who is 7 weeks' pregnant comes to the clinic for her first prenatal visit. She reports smoking 20 to 25 cigarettes per day. The nurse should include what priority implementation in this client's plan of care? Implement a smoking cessation program. Have the client switch to vaping. Reduce the number of cigarettes smoked. Measure the fundal height.

Reduce the number of cigarettes smoked.

After an amniotomy, which client goal should take the highest priority? The client will report relief of pain. The client will display no signs of infection. The client will maintain adequate fetal tissue perfusion. The client will express increased knowledge about amniotomy.

The client will maintain adequate fetal tissue perfusion.

A 30-year-old multigravid client at 8 weeks' gestation has a history of insulin-dependent diabetes since age 20. When explaining about the importance of blood glucose control during pregnancy, the nurse should tell the client that what will occur regarding the client's insulin needs during the first trimester? They often double. They typically increase slightly. They may decrease. They will remain constant.

They may decrease.

Which of the following situations does the nurse recognize as having the greatest risk for the fetus? a fetal heart rate of 170 bpm with fetal movements a breech lie a fundal height of 27 cm at 32 weeks gestation a gestational age of 37 weeks

a fundal height of 27 cm at 32 weeks gestation

The health care provider (HCP) prescribes an amnioinfusion for a primigravid client at term who is diagnosed with oligohydramnios. What does the nurse explain is the primary purpose of the procedure? raises the amniotic fluid index to more than 15 cm minimizes the possibility of fetal metabolic alkalosis increases the fetal heart rate accelerations during a contraction decreases the frequency and severity of variable decelerations

decreases the frequency and severity of variable decelerations

The nurse is administering intravenous magnesium sulfate as prescribed for a client at 34 weeks' gestation with severe preeclampsia. Which outcome(s) of this therapy would be desired? Select all that apply. deep tendon reflexes 2+ absence of seizures blood pressure of less than 140/90 mm Hg urinary output less than 30 mL per hour temperature, 98° F (36.7° C); pulse, 72 bpm; respiratory rate, 14 breaths/min fetal heart rate with late decelerations

deep tendon reflexes 2+ absence of seizures temperature, 98° F (36.7° C); pulse, 72 bpm; respiratory rate, 14 breaths/min

A 16-year-old primigravid client at 37 weeks' gestation with severe preeclampsia is in early active labor. The client's blood pressure is 164/110 mm Hg. Which finding would alert the nurse that the client may be about to experience a seizure? decreased temperature epigastric pain decreased contraction intensity hyporeflexia

epigastric pain

The nurse develops the collaborative plan of care with the health care pterm-8rovider (HCP) for a multigravid client at 10 weeks' gestation being treated with digitalis for a history of cardiac disease. Based on the understanding of renal function in pregnancy, the nurse anticipates which modification will be needed to the client's drug therapy regimen? switching to a different medication addition of a diuretic to the regimen need for weekly drug level monitoring possible need for an increased dosage

possible need for an increased dosage

During prenatal screening of a client with diabetes, the nurse should keep in mind that the client is at increased risk for which complications? Select all that apply. pregnancy-induced hypertension placenta previa Rh incompatibility spontaneous abortion stillbirth

pregnancy-induced hypertension spontaneous abortion stillbirth

A multigravid client diagnosed with a probable ruptured ectopic pregnancy is scheduled for emergency surgery. In addition to monitoring the client's blood pressure before surgery, which factor is most important for the nurse to assess? abdominal distention uterine cramping hemoglobin and hematocrit pulse rate

pulse rate

A client who's 12 weeks pregnant is complaining of severe left lower quadrant pain and vaginal spotting. She is admitted for treatment of an ectopic pregnancy. The nurse should give the highest priority to which nursing diagnosis? anxiety risk for deficient fluid volume acute pain impaired gas exchange

risk for deficient fluid volume

A client at 32 weeks of gestation has mild preeclampsia. She is discharged home with instructions to remain in bed rest. She is also instructed to call her healthcare provider if she experiences which of the following symptoms? Select all that apply. severe nausea and vomiting difficulty sleeping headache increased urine output blurred vision epigastric pain

severe nausea and vomiting headache blurred vision epigastric pain