20 prep u
After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful?
"I will be sure to avoid getting pregnant for at least 1 year."
A pregnant woman has been admitted to the hospital due to preeclampsia with severe features. Which measure will be important for the nurse to include in the care plan?
Institute and maintain seizure precautions.
The nurse is comforting and listening to a young couple who just suffered a spontaneous abortion (miscarriage). When asked why this happened, which reason should the nurse share as a common cause?
Chromosomal abnormality
A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate?
fetal distress related to hypoxia
A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements?
gestational hypertension
A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy?
use of IUD for contraception
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 with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate? "I have a toddler and preschooler at home who need my attention." "I realize the importance of following the instructions for my care." "I know to call my health care provider right away if I start to bleed again." "My mother lives next door and can drive me here if necessary."
"I have a toddler and preschooler at home who need my attention."
A client with a history of cervical insufficiency is seen for reports of pink-tinged discharge and pelvic pressure. The primary care provider decides to perform a cervical cerclage. The nurse teaches the client about the procedure. Which client response indicates that the teaching has been effective? "Staples are put in the cervix to prevent it from dilating." "Purse-string sutures are placed in the cervix to prevent it from dilating." "The cervix is glued shut so no amniotic fluid can escape." "A cervical cap is placed so no amniotic fluid can escape."
"Purse-string sutures are placed in the cervix to prevent it from dilating."
A patient is admitted with a diagnosis of ectopic pregnancy. For what should the nurse anticipate preparing the patient?
Immediate surgery
A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth?
The viral load
The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity?
Reflexes
A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome?
congenital anomalies
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."
Upon entering the room of a client who has had a spontaneous abortion (miscarriage), the nurse observes the client crying. Which response by the nurse would be most appropriate?
"I'm sorry you lost your baby."
The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame?
24 to 28 weeks
A client with preeclampsia is receiving magnesium sulfate to suppress or control seizures. Which nursing intervention should a nurse perform to determine the effectiveness of therapy?
Assess deep tendon reflexes.
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 patient having an examination to check the placement of an intrauterine device (IUD) is diagnosed as being pregnant. For which action should the nurse prepare the patient at this time?
Removal of the IUD
A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV?
Respiratory rate
A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate? "Wait until after the infant is born, and then something can be done." "Antibodies cross the placenta and provide immunity to the newborn." "Antiretroviral medications are available to help reduce the risk of transmission." "You'll probably have a cesarean birth to prevent exposing your newborn."
"Antiretroviral medications are available to help reduce the risk of transmission."
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. The nurse determines that the drug is at a therapeutic level based on which result?
4-7 mEq/L
A pregnant woman with type 2 diabetes is scheduled for a laboratory test of glycosylated hemoglobin (HbA1C). What does the nurse tell the client is a normal level for this test?
5.7-6.4
The nurse is caring for a pregnant woman who is struggling with controlling her gestational diabetes mellitus. What effect does the nurse predict this situation may have on the fetus?
Grow to an unusually large size
A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection?
Safety of antiviral therapy during pregnancy has not been established
A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP?
elevated lipoproteins
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 nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find?
gestational diabetes
While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios. Which information would the nurse use to support this suspicion? Select all that apply. identifiable fetal parts on abdominal palpation fundal height below that for expected gestational age reports of shortness of breath difficulty obtaining fetal heart rate history of diabetes
history of diabetes reports of shortness of breath difficulty obtaining fetal heart rate
A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as:
hydatidiform mole.
Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy?
methotrexate
A patient in her third trimester comes in for a routine prenatal visit. The nurse places her in a comfortable position and attaches the tocodynamometer and ultrasound monitor to the patient's abdomen. What is the purpose of this test?
Assesses fetal well-being
An infant was born at term but has intrauterine growth restriction (IUGR). What findings in the infant's history would contribute to this problem? Select all that apply. Daily maternal exercise Maternal smoking Maternal heartburn Parents small in stature Intrauterine infection of the fetus
Maternal smoking Intrauterine infection of the fetus
The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client?
Monitor the client's vital signs and bleeding.
The nurse is caring for a client who has a multifetal pregnancy. What topic should the nurse prioritize during health education?
Signs of preterm labor
The nurse is monitoring a pregnant patient 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 patient 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 is diagnosed with gestational hypertension and is receiving magnesium sulfate. The nurse determines that the medication is at a therapeutic level based on which finding?
deep tendons reflexes 2+
A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints?
ectopic pregnancy
A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions?
fetal genetic abnormalities
A nurse is assessing a pregnant woman with gestational hypertension. Which finding would lead the nurse to suspect that the client has developed severe preeclampsia?
hyperreflexia
A pregnant woman has just found out that she is having twin girls. She asks the nurse the difference between fraternal and identical twins. The nurse explains that with one set of twins there is fertilization of two ova, and with the other set one fertilized ovum splits. What type of twins result from the split ovum?
identical
A woman with gestational hypertension develops eclampsia and experiences a seizure. Which intervention would the nurse identify as the priority?
oxygenation
A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion?
strong abdominal cramping
A nurse is performing an assessment on a new client. The woman estimates that she is approximately 16 weeks pregnant. While assessing her, the nurse asks her about apparent scratch marks on her hands, and she tells the nurse that she has three cats at home. What screening would be prescribed for this woman?
toxoplasmosis
A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilation (dilatation) to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point?
Bed rest to maintain pregnancy as long as possible
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 40-year-old female client with a chronic pelvic infection expresses her desire to conceive post-treatment. When discussing this with the client the nurse keeps in mind that the client is at increased risk for which of the following?
Ectopic pregnancy
A female patient is complaining of vaginal spotting and sharp colicky pain. She informs the nurse that her period is 2 weeks late. The patient should be investigated for which of the following?
Ectopic pregnancy
After delivery, a patient is diagnosed with postpartal gestational hypertension. What care will the nurse provide to this patient?Select all that apply. Maintain on bed rest. Instruct on the purpose of a fluid restriction Administer magnesium sulfate as prescribed. Monitor urine output. Administer antihypertensive medication as prescribed
Maintain on bed rest. Monitor urine output. Administer magnesium sulfate as prescribed. Administer antihypertensive medication as prescribed.
The health care provider prescribes PGE2 for a woman to help evacuate the uterus following a spontaneous abortion. Which action would be most important for the nurse to do?
Maintain the client supine for 30 minutes after administration
The nutritional needs of an adolescent pregnant patient are unique because
Owing to typical food choices, an adolescent is often lacking calcium, iron, and folic acid in the diet
A client in her third trimester is scheduled for a nonstress test. What is the purpose of the nonstress test for the client?
To determine the well-being of the fetus
A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available?
calcium gluconate
A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?
cytomegalovirus
A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client?
diminished reflexes
A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding?
elevated liver enzymes
A 44-year-old client has lost several pregnancies over the last 10 years. For the past 3 months, she has had fatigue, nausea, and vomiting. She visits the clinic and takes a pregnancy test; the results are positive. Physical examination confirms a uterus enlarged to 13 weeks' gestation; fetal heart tones are heard. Ultrasound reveals that the client is experiencing some bleeding. Considering the client's prenatal history and age, what does the nurse recognize as the greatest risk for the client at this time?
spontaneous abortion (miscarriage)
A nurse is assessing the following antenatal clients. Which client is at highest risk for having a multiple gestation? the 41-year-old client who conceived by in vitro fertilization the 19-year-old client diagnosed with polycystic ovarian syndrome the 38-year-old client whose spouse is a triplet the 27-year-old client who gave birth to twins two years ago
the 41-year-old client who conceived by in vitro fertilization
