Antepartal Care: The Pregnant Client Receiving Prenatal Care

After instructing a primigravid client about desired weight gain during pregnancy, the nurse determines that the teaching has been successful when the client states which of the following?

"Although it varies, a gain of 25 to 35 lb (11.4 to 14.5 kg) is about average."

An antenatal client is discussing her anemia with the nurse in the prenatal clinic. After a discus- sion about sources of iron to be incorporated into her daily meals, the nurse knows the client needs further instruction when she responds with which of the following?

"I can meet two goals when I drink milk, lots of iron and meeting my calcium needs at the same time."

The nurse is teaching a new prenatal client about her iron defi ciency anemia during pregnancy. Which statement indicates that the client needs further instruction about her anemia?

"I may have anemia because my family is of Asian descent."

Which of the following client statements indicates a need for additional teaching about self- care during pregnancy?

"I should sit in a hot tub for 20 minutes to relax after working."

An antenatal client receives education concerning medications that are safe to use during pregnancy. The nurse evaluates the client's understanding of the instructions and determines that she needs further information when she states which of the following?

"If I need to have a bowel movement, Ex-Lax is preferred."

A primagravid client at 16 weeks' gestation has had an amniocentesis and has received teaching concerning signs and symptoms to report. Which statement indicates that the client needs further teaching?

"If my baby does not move, I need to call my health care provider."

During a routine clinic visit, a 25-year-old multigravid client who initiated prenatal care at 10 weeks' gestation and is now in her third trimes- ter states, "I've been having strange dreams about the baby. Last week I dreamed he was covered with hair." The nurse should tell the mother:

"It's not uncommon to have dreams about the baby, particularly in the third trimester."

A primigravid client at 28 weeks' gestation tells the nurse that she and her husband wish to drive to visit relatives who live several hundred miles away. Which of the following recommenda- tions by the nurse would be best?

"Taking the trip is okay if you stop every 1 to 2 hours and walk."

Which of the following statements by a prim- igravid client scheduled for chorionic villi sampling indicates effective teaching about the procedure?

"The procedure involves the insertion of a thin catheter into my uterus."

Which of the following statements by the nurse would be most appropriate when responding to a primigravid client who asks, "What should I do about this brown discoloration across my nose and cheeks?"

"This usually disappears after delivery."

A primiparous client at 10 weeks' gestation questions the nurse about the need for an ultra- sound. She states "I don't have health insurance and I can't afford it. I feel fi ne, so why should I have the test?" The nurse should incorporate which statements as the underlying reason for performing the ultrasound now? Select all that apply.

"We must view the gross anatomy of the fetus." "We need to determine gestational age."

A 20-year-old married client with a positive pregnancy test states, "Is it really true? I can't believe I'm going to have a baby!" Which of the following responses by the nurse would be most appropriate at this time?

"Yes it is true. How does that make you feel?"

A primigravid client asks the nurse if she can continue to have a glass of wine with dinner during her pregnancy. Which of the following would be the nurse's best response?

"You should abstain from drinking alcoholic beverages."

A primigravid client at 32 weeks' gestation is enrolled in a breast-feeding class. Which of the fol- lowing statements indicate that the client understands the breast-feeding education? Select all that apply.

2. "I can hold my baby several different ways during feedings." 4. "If I breast-feed, my uterus will return to prepregnancy size more quickly." 6. "I need to feed my baby when I see feeding cues and not wait until she is crying."

When teaching a primigravid client at 24 weeks' gestation about the diagnostic tests to determine fetal well-being, which of the following should the nurse include?

A fetal biophysical profi le involves assessments of breathing movements, body movements, tone, amniotic fl uid volume, and fetal heart rate reactivity.

The nurse assesses a woman at 24 weeks' gestation and is unable to find the fetal heart beat. The fetal heart beat was heard at the cli- ent's last visit 4 weeks ago. According to priority, the nurse should do the following tasks in which order?

Ask client if baby is or has been moving. Obtain different equipment and recheck. Explain that the fetal heart beat could not be found at this time. Call the health care provider.

When measuring the fundal height of a primigravid client at 20 weeks' gestation, the nurse will locate the fundal height at which of the follow- ing points?

At about the level of the client's umbilicus.

When caring for a primigravid client at 9 weeks' gestation who immigrated to the United States from Vietnam 1 year ago, the nurse would assess the client's diet for a defi ciency of which of the following?

Calcium.

When planning a class for primigravid clients about the common discomforts of pregnancy, which of the following physiologic changes of pregnancy

Cardiac output increases by 25% to 50% during pregnancy.

Which of the following would be included in the teaching plan about pregnancy-related breast changes for a primigravid client?

Colostrum is usually secreted by about the 16th week of gestation.

During a visit to the prenatal clinic, a preg- nant client at 32 weeks' gestation complains of heartburn. The client needs further instruction when she says she must do what?

Consume liquids only between meals.

Examination of a primigravid client com- plaining of increased vaginal secretions since becoming pregnant reveals clear, highly acidic vaginal secretions. The client denies any perineal itching or burning. The nurse interprets these findings as a response related to which of the following?

Control of the growth of pathologic bacteria.

A client, approximately 11 weeks pregnant, and her husband are seen in the antepartal clinic. The client's husband tells the nurse that he has been experiencing nausea and vomiting and fatigue along with his wife. The nurse interprets these findings as suggesting that the client's husband is experiencing which of the following?

Couvade syndrome.

When performing Leopold's maneuvers on a primigravid client at 22 weeks' gestation, the nurse performs the first maneuver to do which of the following?

Determine what is in the fundus.

Which of the following recommendations would be the most appropriate preventive measure to suggest to a primigravid client at 30 weeks' gestation who is experiencing occasional heartburn?

Eat smaller and more frequent meals during the day.

The nurse instructs a primigravid client about the importance of suffi cient vitamin A in her diet. The nurse knows that the instructions have been effective when the client indicates that she should include which of the following in her diet?

Egg yolks and squash.

When performing Leopold's maneuvers, which of the following would the nurse ask the client to do to ensure optimal comfort and accuracy?

Empty her bladder.

A 36-year-old primigravid client at 22 weeks' gestation without any complications to date is being seen in the clinic for a routine visit. The nurse should assess the client's fundal height to:

Estimate the fetal gestational age.

Following a positive pregnancy test, a client begins discussing the changes that will occur in the next several months with the nurse. The nurse should include which of the following information about changes the client can anticipate in the fi rst trimester?

Experiencing ambivalence about pregnancy.

Using Nägele's rule for a client whose last normal menstrual period began on May 10, the nurse determines that the client's estimated date of delivery would be which of the following?

February 17

An antenatal primagravid client has just been informed that she is carrying twins. The plan of care includes educating the client concerning factors that put her at risk for problems during the pregnancy. The nurse realizes the client needs further instruc- tion when she indicates carrying twins puts her at risk for which of the following?

Group B Streptococcus.

After instructing a female client about the radioimmunoassay pregnancy test, the nurse deter- mines that the client understands the instructions when the client states that which of the following hormones is evaluated by this test?

Human chorionic gonadotropin (hCG).

A primigravid adolescent client at approxi- mately 15 weeks' gestation who is visiting the prenatal clinic with her mother is to undergo alphafetoprotein (AFP) screening. When developing the teaching plan for this client, the nurse should include which of the following?

Increased levels of AFP are associated with neural tube defects.

When preparing a 20-year-old client who reports missing one menstrual period and suspects that she is pregnant for a radioimmunoassay preg- nancy test, the nurse should tell the client which of the following about this test?

It has a high degree of accuracy within 1 week after ovulation.

The nurse is assessing fetal position for a 32-year-old client in her eighth month of pregnancy. As shown below, the fetal position can be described as which of the following?

Left occipital transverse.

The nurse is discussing dietary concerns with pregnant teens. Which of the following choices are convenient for teens yet nutritious for both the mother and fetus? Select all that apply.

Milkshake or yogurt with fresh fruit or granola bar. Cheese pizza with spinach and mushroom topping. Peanut butter with crackers and a juice drink.

A newly diagnosed pregnant client tells the nurse, "If I'm going to have all of these discomforts, I'm not sure I want to be pregnant!" The nurse inter- prets the client's statement as an indication of which of the following?

Normal ambivalence.

A 34-year-old multiparous client at 16 weeks' gestation who received regular prenatal care for all of her previous pregnancies tells the nurse that she has already felt the baby move. The nurse interprets this as which of the following?

Normal because multiparous clients can experience quickening between 14 and 20 weeks' gestation.

After the nurse reviews the physician's explanation of amniocentesis with a multigravid cli- ent, which of the following indicates that the client understands a serious risk of the procedure.?

Possible premature labor.

A primigravid client at 36 weeks' gesta- tion tells the nurse that she has been experiencing insomnia for the past 2 weeks. Which of the follow- ing suggestions would be most helpful?

Practice relaxation techniques before bedtime.

Which of the following statements best identifi es the rationale for why the nurse reinforces the need for continued prenatal care throughout the pregnancy with an adolescent primigravid client?

Pregnant adolescents are at high risk for pregnancy-induced hypertension.

A 30-year-old multigravid client has missed three periods and now visits the prenatal clinic because she assumes she is pregnant. She is experi- encing enlargement of her abdomen, a positive preg- nancy test, and changes in the pigmentation on her face and abdomen. These assessment fi ndings refl ect this woman is experiencing a cluster of which signs of pregnancy?

Probable.

When developing a teaching plan for a client who is 8 weeks pregnant, which of the following foods would the nurse suggest to meet the client's need for increased folic acid?

Spinach.

Which of the following recommendations would be most helpful to suggest to a primigravid client at 37 weeks' gestation who is complaining of leg cramps?

Straighten the knee and flex the toes toward the chin.

When teaching a primigravid client how to do Kegel exercises, the nurse explains that the expected outcome of these exercises is to:

Strengthen the perineal muscles.

To obtain the obstetric conjugate measurement, the nurse would do which of the following?

Subtract 1.5 to 2 cm from the diagonal conjugate.

The nurse instructs a primigravid client to increase her intake of foods high in magnesium because of its role with which of the following?

Synthesis of proteins, nucleic acids, and fats.

After instructing a primigravid client about the functions of the placenta, the nurse determines that the client needs additional teaching when she says that which of the following hormones is produced by the placenta?

Testosterone.

A primigravida at 8 weeks' gestation tells the nurse that she wants an amniocentesis because there is a history of Hemophilia A in her family. The nurse informs the client that she will need to wait until she is 15 weeks gestation for the amniocentesis. Which of the following provides the most appropriate rationale for the nurse's statement regarding amniocentesis at 15 weeks' gestation?

The volume of amniotic fluid needed for testing will be available by 15 weeks.

Which diagnostic test would be the most important to have for a primigravid client in the second trimester of her pregnancy?

α-fetoprotein (AFP) testing.