Assessment of Pregnancy Practice Questions
A 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 which question? "Have you recently had a rubeola vaccination?" "Have you ever had osteomyelitis?" "Do you have any cats at home?" "Do you have any birds at home?"
"Do you have any cats at home?"
A nurse is assessing a client who's 29 weeks pregnant. What is the most cost-effective method for assessing fetal well-being? nonstress test ultrasonography maternal fetal activity count chorionic villi sampling
maternal fetal activity count
When teaching a primigravid client about the diagnostic tests used in pregnancy, the nurse should include which information? A fetal biophysical profile involves assessments of breathing movements, body movements, tone, amniotic fluid volume, and fetal heart rate reactivity. Percutaneous umbilical blood sampling uses a needle inserted through the vagina to obtain a sample. Contraction stress testing, performed on most pregnant women, can be initiated as early as 16 weeks' gestation. Fetal heart rate increases during a nonstress test is an ominous sign and requires further evaluation with fetal echocardiography.
A fetal biophysical profile involves assessments of breathing movements, body movements, tone, amniotic fluid volume, and fetal heart rate reactivity.
A 24-year-old nulligravid client with a history of irregular menstrual cycles visits the clinic because she suspects that she is "about 6 weeks pregnant." An ultrasound is scheduled in 2 weeks. What should the nurse tell the client that the primary purpose of the test is? Determine a multifetal pregnancy. Discover fetal malformation. Assess gestational age. Identify the gender of the fetus.
Assess gestational age.
A client who is 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 is apprehensive about her symptoms. Vaginal examination discloses a closed, thick, posterior cervix. These findings suggest that the client is experiencing: back labor. fetal distress. true labor contractions. Braxton Hicks contractions.
Braxton Hicks contractions.
A nurse is providing teaching to a client who's being discharged after delivering a hydatidiform mole. Which expected outcome takes highest priority for this client? Client will schedule her first follow-up Papanicolaou (Pap) test and gynecologic examination for 6 months after discharge. Client will state that she won't attempt another pregnancy until her human chorionic gonadotropin (hCG) level rises. Client will use a reliable contraceptive method until her follow-up care is complete in 1 year and her hCG level is negative. Client will state that she may attempt another pregnancy after 3 months of follow-up care.
Client will use a reliable contraceptive method until her follow-up care is complete in 1 year and her hCG level is negative.
A 40-year-old primigravid client with AB-positive blood visits the outpatient clinic for an amniocentesis at 16 weeks' gestation. The nurse determines that the most likely reason for the client's amniocentesis is to determine if the fetus has which problem? erythroblastosis fetalis ABO incompatibility Down syndrome cri-du-chat syndrome
Down syndrome
A nulligravid client with gestational diabetes tells the nurse that she had a reactive nonstress test 3 days ago and asks, "What does that mean?" The nurse explains that a reactive nonstress test indicates which of the following about the fetus? Evidence of some compromise that will require birth soon. No accelerations demonstrated within a 20-minute period. Evidence of late decelerations occurring during the test. Fetal well-being at this point in the pregnancy.
Fetal well-being at this point in the pregnancy.
A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of the fetus. The client's BPP score is 8. What does this score indicate? The client should repeat the test in 1 week. The fetus should be delivered within 24 hours. The client should repeat the test in 24 hours. The fetus isn't in distress at this time.
The fetus isn't in distress at this time.
When performing Leopold's maneuvers, which action would the nurse ask the client to perform to ensure optimal comfort and accuracy? drinking a full glass of water emptying her bladder lying on her left side breathing deeply for 1 minute
emptying her bladder
Following an eclamptic seizure, the nurse should assess the client for which complication? uterine contractions hypotension polyuria facial flushing
uterine contractions
A client at 36 weeks' gestation is scheduled for a routine ultrasound prior to an amniocentesis. After teaching the client about the purpose of the ultrasound, which client statement would indicate to the nurse that the client needs further instruction? "The ultrasound identifies blood flow through the umbilical cord." "The ultrasound will determine where to insert the needle." "The ultrasound locates a pool of amniotic fluid." "The ultrasound will help to locate the placenta."
"The ultrasound identifies blood flow through the umbilical cord."
During routine prenatal screening, a nurse tells a client that her blood sample will be used for alpha fetoprotein (AFP) testing. Which statement best describes what AFP testing indicates? "This screening indicates if your baby's lungs are mature." "To provide accurate results, this screening must be performed exactly at 25 weeks' gestation." "This test will show if you have gestational diabetes." "This test will screen for spina bifida, Down syndrome, or other genetic defects."
"This test will screen for spina bifida, Down syndrome, or other genetic defects."
An obstetric ultrasound reveals that the client's fetus has spina bifida. The mother is concerned about raising a child with a congenital abnormality and she starts to cry. Which response by the nurse is best? Discuss the risk of dystocia with vaginal births. Recommend a pediatrician because the baby will be sick. Recommend elective termination of the pregnancy. Sit at her bedside and allow the client to express her feelings.
Sit at her bedside and allow the client to express her feelings.
During a nonstress test (NST), a nurse notes three fetal heart rate (FHR) increases of 20 beats/minute, each lasting 20 seconds. These increases occur only with fetal movement. What does this finding suggest? The test is inconclusive and must be repeated. The client should undergo an oxytocin challenge test. The fetus is not in distress at this time. The fetus is nonreactive and hypoxic.
The fetus is not in distress at this time.
A client is scheduled for amniocentesis. When preparing the client for the procedure, the nurse should: place the client on the left side. ask the client to void. instruct the client to drink 1 L of fluid. prepare the client for I.V. anesthesia.
ask the client to void.
A multigravid client at 38 weeks' gestation is scheduled to undergo a contraction stress test. What should the nurse include in the explanation as the purpose of this test? assessment of fetal ability to tolerate labor evaluation of fetal lung maturity determination of the fetal biophysical profile determination of fetal response during movements
assessment of fetal ability to tolerate labor
During a nonstress test (NST), the electronic tracing displays a relatively flat line for fetal movement, making it difficult to evaluate the fetal heart rate (FHR). To mark the strip, a nurse should instruct the client to push the control button at which time? after every three fetal movements at the end of fetal movement at the beginning of each fetal movement at the beginning of each contraction
at the beginning of each fetal movement
The fetus of a multigravid client at 38 weeks' gestation is determined to be in a frank breech presentation. The nurse describes this presentation to the client as which fetal part coming in contact with the cervix? both feet buttocks shoulder head
buttocks
A nurse is caring for a post-term client at 41 weeks of gestation who is about to undergo a biophysical profile (BPP) to evaluate her fetus's well-being. The client asks, "What will be able to be determined from this test?" The nurse is correct to answer which? Select all that apply. crown-rump length biparietal diameter fetal tone femur length amniotic fluid volume fetal breathing movements
fetal tone fetal breathing movements amniotic fluid volume
The nurse is assessing fetal presentation in a multiparous client. The figure here indicates which presentation? vertex complete breech footling breech frank breech
footling breech
A client at 36 weeks' gestation with type 1 diabetes is scheduled for a contraction stress test. After explaining the purpose of the test, the nurse determines that the client understands the instruction when she states that the test is done to detect which problem? amniotic fluid volume cardiac anomalies kidney anomalies uteroplacental sufficiency
uteroplacental sufficiency
After teaching a pregnant client about potential complications of amniocentesis that must be reported immediately, the nurse determines that the client understands the instruction when she says that she will report which problem? nausea irregular, painless uterine tightness urinary frequency vaginal bleeding
vaginal bleeding
A 27-year-old primigravid client with insulin-dependent diabetes at 34 weeks' gestation undergoes a nonstress test, the results of which are documented as reactive. What should the nurse tell the client that the test results indicate? A contraction stress test is necessary. Chorionic villus sampling is necessary. The nonstress test should be repeated. There is evidence of fetal well-being.
There is evidence of fetal well-being.
The health care provider prescribes a maternal blood test for alpha fetoprotein for a nulligravid client at 16 weeks' gestation. When developing the teaching plan, the nurse bases the explanations on the understanding that this test is used to detect which condition? Rh incompatibilities inborn errors of metabolism Lecithin-sphingomyelin ratio neural tube defects
neural tube defects
A primigravid adolescent client at approximately 15 weeks' gestation is visiting the prenatal clinic to undergo maternal quad screening. What information should the nurse include in the teaching plan for this client? Ultrasonography usually accompanies maternal quad screen testing. Increased levels of alpha fetoprotein are associated with neural tube defects. A clean-catch midstream urine specimen is needed. Results are usually very accurate until 20 weeks' gestation.
Increased levels of alpha fetoprotein are associated with neural tube defects.
A client is told that she needs to have a nonstress test to determine fetal well-being. After 20 minutes of monitoring, the nurse reviews the strip and finds two 15-beat accelerations that lasted for 15 seconds. What should the nurse do next? Notify the physician and transfer the mother to labor and delivery for imminent birth. Ask the mother to eat something and return for a repeat test; the results are inconclusive. Continue to monitor the baby for fetal distress. Inform the physician and prepare for discharge; this client has a normal strip.
Inform the physician and prepare for discharge; this client has a normal strip.
A client has her first prenatal visit at 15 weeks' gestation. The client weighs 144 lb (65.5kg) and states this is a 4-pound weight gain. Which assessment finding requires further investigation? weight of 144 lb (65 kg) urine negative for protein blood pressure of 124/72 mmHg fundal height of 18 cm
fundal height of 18 cm
A primigravid client with diabetes at 38 weeks' gestation asks the nurse why she had a fetal acoustic stimulation during her last nonstress test. Which should the nurse include as the rationale for this test? to confirm amniotic fluid amount to startle and awaken the fetus to listen to the fetal heart rate to stimulate mild contractions
to startle and awaken the fetus
A multigravid client visits the clinic because she suspects that she is pregnant but is unable to tell the nurse when her last menstrual period began. The client has a history of preterm birth. The nurse instructs the client that the gestational age of the fetus can be estimated by which procedure? ultrasonography alpha-fetoprotein level amniocentesis percutaneous umbilical blood sampling
ultrasonography
