Antepartum

A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? Select all that apply. 1. Pap smear. 2. Mammogram. 3. Glucose challenge test. 4. Biophysical profile. 5. Complete blood count.

1 and 5 are correct. 1. The client will have a Pap smear done. 2. A mammogram will not be performed. 3. A glucose challenge test will likely be performed at the end of the second trimester. 4. A biophysical profile may be done, but not until the third trimester. 5. A complete blood count will be performed.

An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? Select all that apply. 1. Amenorrhea. 2. Breast tenderness. 3. Quickening. 4. Frequent urination. 5. Uterine growth.

1. 1, 2, 3, and 4 are correct. 1. Amenorrhea is a presumptive sign of pregnancy. 2. Breast tenderness is a presumptive sign of pregnancy. 3. Quickening is a presumptive sign of pregnancy. 4. Frequent urination is a presumptive sign of pregnancy. 5. Uterine growth is a probable sign of pregnancy. TEST-TAKING TIP: There are three classifications of signs of pregnancy: presumptive, probable, and positive. Signs that are totally subjective, or presumptive, include amenorrhea, breast tenderness, quickening, and frequent urination. Signs that are objective, but not totally absolute, are termed probable and include alterations in uterine shape and size and softening of the cervix. Signs that are absolute, or positive, include hearing the fetal heartbeat, detecting fetal movement, and seeing ultrasound images of the fetal outline.

The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above prepregnancy levels? Select all that apply. 1. Glucose. 2. Fibrinogen. 3. Hematocrit. 4. Bilirubin. 5. White blood cells.

2 and 5 are correct. 1. Glucose levels should be within normal limits. 2. Fibrinogen levels will be elevated slightly in a 40-week-pregnant woman because coagulation factors like fibrinogen increase to help prevent excessive blood loss during delivery. 3. Hematocrit levels are usually slightly lower. 4. Bilirubin levels should be within normal limits. 5. A 40-week-pregnant woman's white blood cell count will be elevated above normal as a means of protecting her body from infection. TEST-TAKING TIP: During the latter part of the third trimester, coagulation factors increase in preparation for delivery. It is the body's means of protecting itself against a large loss of blood at delivery. In addition, the white blood cell count rises as a means of protecting the body from infection.

A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to make at this time? 1. "Your period is probably just irregular." 2. "We could do a blood test to check." 3. "Home pregnancy test results are very accurate." 4. "My recommendation would be to repeat the test in one week."

2. This response is correct. Serum pregnancy tests are more sensitive than urine tests are.

When analyzing the need for health teaching of a prenatal multigravida, the nurse should ask which of the following questions? 1. "What are the ages of your children?" 2. "What is your marital status?" 3. "Do you ever drink alcohol?" 4. "Do you have any allergies?"

3. This question is important to ask to determine a prenatal client's health teaching needs.

A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time? 1. "We expect you to gain about 1 lb per week, so your weight is a little low at this time." 2. "Most women gain no weight during the first trimester, so I would suggest you eat fewer desserts for the next few weeks." 3. "You entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need." 4. "Your weight gain is exactly what we would expect it to be at this time."

4. The weight gain is within normal for the first trimester. TEST-TAKING TIP: One of the assessments that aids health care practitioners in assessing the health and well-being of antenatal clients and their babies is weight gain. For women who enter the pregnancy with a normal weight for height, the expected weight gain is 3 to 5 lb for the entire first trimester and approximately 0.8 to 1 lb per week from weeks 13 to 40. Women with a normal BMI, therefore, should gain between 25 and 35 lb during the entire pregnancy (see http://www.iom.edu/~/media/Files/ Report%20Files/2009/Weight-Gain-During- Pregnancy-Reexamining-the-Guidelines/ Report%20Brief%20-%20Weight%20 Gain%20During%20Pregnancy.pdf).

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? 1. Avoid eating greasy foods. 2. Drink orange juice before rising. 3. Consume 1 teaspoon of nutmeg each morning. 4. Eat 3 large meals plus a bedtime snack.

5. 1. Greasy foods should be avoided.