Chapter 11 fam exam

verify that desired outcomes for identified goals have been met.

30s The nursing instructor is explaining the nursing care that is given to a client during her pregnancy. The instructor determines the session is successful when the students correctly choose which method will be used to evaluate the effectiveness of the nursing care they will provide?

Offer to speak with the health care provider and then return her call.

A client at 32 weeks' gestation telephones the health care provider's office asking if omeprazole 20mg daily is safe to take as she is experiencing heartburn. When reviewing the over-the-counter medication, the nurse notes a Pregnancy category C listed. Which would be the nurse's first action?

G3P0020 ; FPAL (full, pre,abortion, living)

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

at the level of the umbilicus

A nurse at the health care facility assesses a client in the 20th week of gestation. The client is healthy and progressing well, without any sign of complications. Where should the nurse expect to measure the fundal height in this client?

"If my AFP level is high, it could mean there is a problem with my baby's spinal cord."

A nurse is educating a pregnant client about obtaining a blood sample for an alpha-fetoprotein (AFP) level. Which response by the client indicates that the health teaching was successful?

avoid sun bc it will make it darker

A nurse is educating a prenatal client at her second visit. The client is worried about "blotchy brown spots" on her forehead. The nurse reassures the client about this change by giving which appropriate response?

Individualized assessment Counseling Teaching

A nurse is providing care to a pregnant woman. To promote optimal outcomes, the nurse would engage in which activity? Select all that apply.

history of diabetes for 4 years

A nurse is taking a history during a client's first prenatal visit. Which assessment finding would alert the nurse to the need for further assessment?

10 to 12 weeks

A patient at 6 weeks' gestation asks if she can listen to the fetal heart sounds. The nurse informs the patient that fetal heart sounds cannot be heard with a Doppler until when?

fundal height of approx 18 cm quickening (between 18 and 30 wks, cm are approx same as weeks) (quickening is between 16-22 wks)

A pregnant client at 18 weeks' gestation has arrived for her routine prenatal visit. Which assessment findings should the nurse prepare to document at this time? Select all that apply.

G4P2 (dont forget to count current!)

A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse?

syphilis

A pregnant woman is undergoing testing on her first prenatal visit. A blood specimen is obtained for a rapid plasma reagin test. The nurse explains that this test will evaluate for which condition?

tubal pregnancy

A woman has a positive pregnancy test and comes to the nurse with left lower quadrant pain. Bimanual examination reveals a tender mass. Which of the following is suspected?

4 weeks

A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:

Secondary areolae develop Overall breast size increases Blue streaking of veins become prominent Colostrum expelled as early as the 16th week

A young patient comes to the clinic and reports feeling a fullness in her breasts. Upon further examination, the physician determines that the patient is pregnant. When teaching the patient about other expected changes in the breasts, which information would the nurse include? Select all that apply.

overall breast size increases montgomery tubercles become prominent areolae darken blue streaking of veins becomes prominent

As part of her physical examination of a pregnant client, the nurse examines the woman's breasts. Which are healthy breast changes that indicate pregnancy? Select all that apply.

Day history/social profile

As part of the assessment of a client's health history during the first prenatal visit, the nurse is having the client complete a 24-hour recall to establish what and how much the woman is eating. In which section of the health history should the nurse record this information?

clean catch urine

Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing?

alert the RN or primary care provider

Charlene McCoy, who has several children already, reports for a first prenatal visit. She seems preoccupied and withdrawn, and she makes consistently negative remarks about the pregnancy. Reviewing her records, you note that she is receiving a serotonin reuptake inhibitor. What should you do?

chadwicks sign

During the physical exam at the first prenatal visit a speculum exam is performed. What sign of pregnancy does the practitioner look for during the speculum exam?

false

Following her first prenatal visit, a woman will be scheduled for a sonogram to confirm pregnancy length and document healthy fetal growth at 3 to 5 weeks of pregnancy.

between 24 and 28 weeks' gestation

Gestational diabetes occurs around the 24th week of gestation. When should every woman be screened for gestational diabetes?

amniocentesis

RhoGAM

20 cm

The nurse assesses a 20-week gestational client at a routine prenatal visit. What will the nurse predict the fundal height to be on this client experiencing an uneventful pregnancy?

"At 36 weeks' gestation, the fundus is in the normal expected location."

The nurse is assessing a primipara's fundal height at 36 weeks' gestation and notes the fundus is now located at the xiphoid process of the sternum. The client asks if this is normal. Which response to the client would be best?

facial edema

Which of the following findings is most worrisome in Melissa, a woman in her 26th week of pregnancy?

soft systolic murmur

Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy?

once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth

he nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended for prenatal care?

breast

montgomery tubucles