Lippincott Antepartal care
A primigravid client at 15 weeks gestation has received teaching about concerning signs and symptoms to report following an amniocentesis. Which statement indicates that the client needs further teaching?
"If my baby does not move, i need to call my health care provider."
The nurse is discussing dietary concerns with pregnant teens. Which choices are convenient for teens yet nutritious for both the mother and fetus? Select all the 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 primigravid client at 36 weeks gestation tells the nurse that she has been experiencing insomnia for the past 2 weeks. Which suggestion would be most helpful?
Practice relaxation techniques before bedtime.
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 trimester states, "Ive been having strange dreams about the baby. Last week i dreamed he was covered with hair." What should the nurse tell the mother?
"It is not uncommon to have dreams about the baby, particularly in the third trimester."
A 39-year-old multigravid client asks the nurse for information about female sterilization with tubal ligation. Which client statement indicates effective teaching?
"My fallopian tubes will be tied off through a small abdominal incision."
The nurse teaches a client about using medroxyprogesterone as a birth control method. Which client statement indicates effectiveness teaching?
"One possible adverse effect is absence of a menstrual period."
A primigravid client in a preparation for parenting class asks how much blood is lost during an uncomplicated vaginal birth. What should the nurse tell the client?
"The maximum blood loss considered within normal limits is 500 ml."
A 40 year old client at 8 weeks' gestation has a 3 year old child with down syndrome. The nurse is discussing amniocentesis and chorionic villus sampling as genetic screening methods for the expected baby. The nurse is confident that the teaching has been understood when the client makes which statement?
"Chorionic villus sampling can be performed earlier in pregnancy."
Which statement by a primigravid client about the amniotic fluid and sac indicates the need for further teaching?
"Fetal nutrients are provided by the amniotic fluid."
On entering the room of a client who has undergone a dilatation and curettage (D&C) for a spontaneous abortion, the nurse finds the client crying. Which comment by the nurse would be most appropriate?
"I am truly sorry you lost your baby."
Which statement best identifies 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
The nurse is caring for a 24 year old primigravid client scheduled for emergency surgery because of a probable ectopic pregnancy. What is the most important thing for the nurse to do?
Prepare to witness an informed consent for surgery
A 23-year-old nulliparous client visiting the clinic for a routine examination tells the nurse that she desires to use the basal body temperature method for family planning. What instructions should the nurse give the client?
Take her temperature at the same time every morning before getting out of bed.
After instructing primigravid client about the functions of the placenta, the nurse determines that the client needs additional teaching when she says that which hormone is produced by the placenta?
Testosterone
After instructing a primigravid client about desired weight gain during pregnancy, the nurse determines that the teaching has been successful when the client makes which statement?
"Although it varies, a gain of 25 to 35 lb (11.4 to 14.5 kg) is about average."
A couple is inquiring about vasectomy as a permanent method of contraception. Which teaching statement would the nurse include in the teaching plan?
"Another method of contraception is needed until the sperm count is 0"
A woman with asthma controlled through the consistent use of medication is now pregnant for the first time. Which client statement concerning asthma during pregnancy indicated the need for further instruction?
"Bronchodilators should be used only when necessary because of the risk they present to the fetus."
A primigravid client at 32 weeks gestation is enrolled in a breastfeeding class. Which statements indicate that the client understands the breastfeeding education? Select all that apply
"I can hold my baby several different ways during feedings." "If i breastfeed, my uterus will return to pre-pregnancy size more quickly." "I need to feed my baby when i see feeding cues and not wait until she is crying."
An antenatal client is discussing her anemia with the nurse in the prenatal clinic. After a discussion about sources of iron to be incorporated into her daily meals, the nurse knows the client needs further instruction when she responds with which statement?
"I can meet two goals when i drink milk: lots of iron and meeting my calcium needs at the same time."
A client has obtained levonorgestrel as emergency contraception. After unprotected intercourse, the client calls the clinic to ask questions about taking the contraceptives. The nurse realizes the client needs further explanation when she makes which statement?
"I can wait up to 4 days after intercourse to start taking these to prevent pregnancy."
The nurse is teaching a new prenatal client about her iron deficiency 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 client statement indicated a need for additional teaching about self-care during pregnancy?
"I should sit in a hot tub for 20 minutes to relax after working."
After being examined and fitted for a diaphragm, a 24-year-old receives instructions about its use. Which client statement indicates a need for further teaching?
"If i gain or lose 20 lb (9kg), i can still use the same diaphragm."
A primiparous client at 10 weeks gestation questions the nurse about the need for an ultrasound. She states "I feel fine, 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
"The test helps us view the gross anatomy of the fetus." "We need to determine gestational age."
Which statement 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 birth."
During a preparation for parenting class, one of the participants asks the nurse, "How will i know if i am really in labor?" What should the nurse tell the participant about true labor contractions?
"True labor contractions are felt first in the lower back, then the abdomen"
The prenatal client wants to know why the nurse is asking about her use of herbal supplements. What is the nurse best response?
"Understanding the full picture of what herbal supplements you use to manage your health will help us better provide coordinated and safe care."
A 20-year-old primigravid client tells the nurse that her mother had a friend who died from hemorrhage about 10 years ago during a vaginal birth. Which response would be most helpful?
"What is it that concerns you about pregnancy, labor, or childbirth?"
A 20-year-old married client with a positive pregnancy test states, "is it really true i cannot believe i am going to have a baby!" Which response 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 statement would be the nurses best response?
"You should abstain from drinking alcoholic beverages."
The nurse performs a routine prenatal assessment on a woman at 35 weeks' gestation and finds vital signs: b/p 138/88 mm Hg, pulse 82/min, respirations 18/min, temperature 99.1 degree. Which statement is most appropriate for the nurse to make at this time?
"Your blood pressure is slightly high. I will check it again before you leave."
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.
The nurse assess a woman at 24 weeks' gestation and is unable to find the fetal heartbeat. The fetal heartbeat was heard at the clients last visit 4 weeks ago. According to priority, the nurse should do the tasks in which orde?
Ask the client if the baby is or has been moving Obtain different equipment and recheck Explain that the fetal heartbeat could not be found at this time Call the health care provider
At a preconception visit, a 24-year-old client is found to have malformation of the uterus. The nurse uses the figure below to explain which typer of uterine malformation?
Bicornuate uterus
When providing care to the client who has undergone a dilatation and curettage (D&C) after a spontaneous abortion, the nurse administers hydroxyzine as prescribed. What is an expected outcome?
Absence of nausea
A 19-year-old nulligravid client visiting the clinic for a routine examination asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which information would the nurse expect to include in the clients teaching plan?
As ovulation approaches, cervical mucus is abundant and clear.
An antenatal G2, T1, P0, A0, L1 client is discussing her postpartum plans for birth control with her HCP. In analyzing the available choices, which factor has the greatest impact on her birth control options?
Breast- or bottle-feeding plan
When planning a class for primigravid clients about the common physiologic changes of pregnancy, the nurse should include which information in the teaching plan?
Cardiac output increases by 25% to 50% during pregnancy.
Which information would the nurse include in a teaching plan about treatments or sexually transmitted infections?
Ceftriaxone may be used to treat Niesseria gonorrhoeae infections
During a 2 hour birth preparation class focusing on the labor and birth process for primigravid clients, the nurse is describing the maneuvers that the fetus goes through during the labor process when the head is the presenting part. In which order do these maneuvers occur?
Engagement, descent, flexion, internal rotation
When developing a series of parent classes on fetal development, the nurse should include which feature as being developed by the end of the 3rd month (9 to 12 weeks)?
External genitalia
Using Naegeles rulle for a client whose last normal menstrual period began on May 10th, the nurse determines that the clients estimated date of birth is what date?
February 17
After the nurse reviews the primary health care providers explanation of amniocentesis with a multigravid client, which complication, if stated by the client, indicates that see needs more teaching about the procedure?
Fetal organ malformations
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for which signs and symptoms?
Hypertension
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?
Increased levels of alpha fetoprotein are associated with neural tube defects
The topic of physiologic changes that occur during pregnancy is to be included in a parenting class for primigravid clients who are in their first half of pregnancy. Which topic would be important for the nurse to include in the teaching plan?
Increased risk for urinary tract infections
A 17-year-old gravid client presents for her regularly scheduled 26-week prenatal visit. She appears disheveled, is wearing ill-fitting clothes, and does not make eye contact with the nurse. Which items should the nurse discuss with the client? Select all that apply
Intimate partner violence, substance abuse, depression, blood glucose screening
A multigravid client at 32 weeks' gestation has experienced hemolytic disease of the newborn in a previous pregnancy. The nurse should prepare the client for frequent antibody titer evaluations obtained from which source?
Maternal blood
A 34-year-old multiparious cliet at 16 weeks gestation who recieved regular prenatal care for all of her previous pregnancies tells the nurse that she has already felt the baby move. How does the nurse interpret this finding?
Normal because multiparous clients can experience quickening between 14 and 20 weeks gestation
After instructing a 20-year-old nulligravid client about adverse effects of oral contraceptives, the nurse determines that further instruction is needed when the client states which as an adverse effect?
Ovarian cancer
Which information would be important to include in the teaching plan for the client who wants more information on ovulation and fertility management?
Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle
During a birth preparation class, a primigravid client a 36 weeks gestation tells the nurse, "My lower back has really been bothering me lately." Which exercises would be most helpful?
Pelvic rocking
After instructing participants in a birth education class about methods for coping with discomforts in the first stage of labor, the nurse determines that one of the pregnant clients needs further instruction when she says that she has been practicing which technique?
Pelvic tilt exercises
When instructing a client about the proper use of condoms for pregnancy prevention, the nurse should include which instruction to ensure maximum effectiveness?
Place the condom over the erect penis before coitus
The nurse is caring for a client who is 12 weeks pregnant and speaks Spanish only. Which interventions should the nurse include in the plan of car at the clients initial visit? Select all that apply.
Provide brochures in the clients native language Arrange for an interpreter for her appointments Review nutritional preferences
Which diagnostic test would be the most important for a 40-year-old primigravid client to have in the second trimester of her pregnancy?
Quad screen
A woman at 22 weeks' gestation has right upper quadrant pain radiating to her back. She rates the pain as 9 on a scale of 1 to 10 and says that it has occurred 2 times in the last week for about 4 hours at a time. She does not associate the pain with food. Which nursing measure is the highest priority for this client?
Refer the client to her health care provider (HCP) for evaluation and treatment of the pain.
The nurse is reviewing a pregnant client immunization record. Which immunization are contraindicated during pregnancy and are not updated at this time? Select all that apply
Rubella, mumps, chickenpox, live attenuated influenza vaccine
After a preparation for parenting class session, a pregnant client tells the nurse that she has had some yellow-gray frothy vaginal discharge and local itching. What is the best advice for the nurse to give the client?
Schedule an appointment at the clinic for an examination
Which instruction should the nurse include in the teaching plan for a 30-year-old multiparous client who will be using an intrauterine device for family planning?
Severe cramping may occur when the IUD is inserted
When developing a teaching plan for a client who is at 8 week pregnant, the nurse would suggest what foods to meet the clients need for increased folic acid?
Spinach, beans
Which recommendation would be most helpful to suggest to a primigravid client at 37 weeks gestation who has leg cramps?
Straighten the knee and flex the toes toward the chin.
The nurse teaches a primigravid client how to do kegel exercises. What does the nurse explain is the expected outcome of these exercises?
Strengthening the perineal muscles
The nurse instructs a primigravid client to increase her intake of foods high in magnesium because of its role in which process?
Synthesis of proteins, nucleic acids, and fats
Which instructions about activities during menstruation would the nurse include when counseling an adolescent who has just begun to menstruate?
Take a mild analgesic if needed for menstrual pain
The nurse is caring for a client who has a history of gastric bypass surgery and is now being seen for her first prenatal visit. Which interventions should be included in the plan of carer? Select all that apply
Take a prenatal vitamin with 400 mcg of folic acid. Refer the client to a registered dietician Check urine at each visit for protein and glucose
A multigravid client who stands for long periods while working in a factory visits the prenatal clinic at 35 weeks gestation, stating, "The varicose veins in my legs have really been bothering me lately." Which instruction would be most helpful?
Take frequent rest periods with the legs elevated above the hips
A new antenatal G6 , T4, P0, A1, L4 client attends her first prenatal visit with her partner. The nurse is assessing the couples psychological response to the pregnancy. Which finding requires the most immediate follow-up?
The father of the baby is irritated that the mother is not like she was before pregnancy.
A 30-year-old multigravid client has missed three periods and now visits the prenatal clinic because she assumes she is pregnant. She is experiencing enlargement of her abdomen, a positive pregnancy test, and changes in the pigmentation on her face and abdomen. These assessment findings reflect this woman is experiencing a cluster of which signs of pregnancy?
probable
A couple is visiting the clinic because they have been unable to conceive a baby after 3 years of frequent coitus. The nurse determines that the couple needs further instruction when they identify which factor as a cause of male infertility?
seminal fluid with an alkaline pH
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. Why does the nurse need to assess the clients fundal height?
to estimate the fetal growth
Which information 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.
After conducting a presentation to a group of adolescent parents on the topic of adolescent pregnancy, the nurse determines that one of the parents needs further instruction when the parent says that adolescents are a greater risk for which complication?
Congenital anomalies
During a visit to the prenatal clinic, a pregnant client at 32 weeks' gestation has heartburn. The client needs further instruction when she says she must do what to manage her heartburn?
Consume liquids only between meals
A dilatation and curettage (D&C) is scheduled for a primigravid client admitted to the hospital at 10 weeks' gestation with abdominal cramping, bright red vaginal spotting, and passage of some of the products of conception. The nurse should assess the client further for the expression of which feeling?
Guilt
A client asks why she feels so much variability in fetal activity each day. The nurse explains that fetal movement is affected by which factors? Select all that apply
Fetal sleep, blood glucose, time of day, cigarette smoking
A primigravid client at 28 weeks gestation tells the nurse that she and her husband wish to drive to visit relatives who live several hours away. Which recommendation by the nurse would be best?
"Taking the trip is okay if you stop every 1 to 2 hours and walk."
A primigravid client has completed her first prenatal visit and blood work. Her laboratory test for the hepatitis B surface antigen (HBsAg) is positive. The nurse can advise the client that the plan of care for this newborn will include which interventions? Select all that apply
Hepatitis B immune globulin at birth Series of three hepatitis B vaccinations per recommended schedule Universal precautions for mother and infant
When performing leopolds maneuvers, which action would the nurse ask the client to perform to ensure optimal comfort and accuracy?
Emptying her bladder
A 20-year-old nulligravid client expresses a desire to learn more about the symptothermal method of family planning. Which information would the nurse include in the teaching plan?
Cervical mucus is carefully monitored for changes
A client with a past medical history of ventricular septal defect repaired in infancy is seen at the prenatal clinic. She has dyspnea with exertion and is very tired. Her vital signs are oxygen saturation 98, pulse 80, respirations 20, bp 116/72 mm Hg. She has +2 pedal edema and clear breath sounds. The nurse determines that clients symptoms indicate which cardiac functional classification?
Class II
A client, approximately 11 weeks pregnant, and her husband are seen in the antepartal clinic. The clients 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 clients husband is experiencing which complication?
Couvade syndrome
A couple visiting the infertility clinic for the first time states that they have been trying to conceive for the past 2 years without success. After a history and physical examination of both partners, what would be the most appropriate outcome for the couple to accomplish by the end of this visit?
Describe each of the potential causes and possible treatment modalities.
Which information would the nurse include in the teaching plan for a 32-year-old female client requesting information about using a diaphragm for family planning?
Diaphragms should not be used if the client develops acute cervicitis
A client in the triage area who is at 19 weeks' gestation states that she has not felt her baby move in the past week, and no fetal heart tones are found. While evaluating this client, the nurse identifies her as being at the highest risk for developing which problem?
Disseminated intravascular coagulation
A prenatal client wants to begin a yoga-based exercise class to keep her healthy during pregnancy. What information should the nurse include in the plan of care? Select all that apply
Drink plenty of water before, during, and after a workout Take precaution to prevent overheating Avoid jerky, high-impact motions Modify any positions that put strain on the abdomen
The nurse instructs a primigravid client about the importance of sufficient vitamin A in her diet. The nurse knows that the instructions have been effective when the client indicates that she should indicates that she should include which foods in her diet?
Egg yolks and squash
A client is experiencing pain during the first stage of labor. What should the nurse instruct the client to do to manage her pain? Select all that apply
Walk in the hospital room Use slow chest breathing Lightly massage the abdomen
When measuring the fundal height of a primigravid client at 20 weeks gestation, the nurse will locate the fundal height at which point?
at about the level of the client's umbilicus
Examination of primigravid client having 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 factor?
control of the growth of pathologic bacteria
When performing leopolds maneuvers on a primigravid client at 22 weeks gestation, the nurse performs the first maneuver to accomplish which action?
determine what is in the fundus
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 information about a change the client can anticipate in the first trimester?
experiencing ambivalence about pregnancy
A newly diagnosed pregnant client tells the nurse, "If i am going to have all of these discomforts, i am not sure i want to be pregnant!" The nurse interprets the clients statement as an indication of which perception?
normal ambivalence
An antenatal primigravid 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 instruction when she indicates carrying twins puts her at risk for which complication?
Group B Streptococcus
When preparing a 20-year-old client for a serum pregnancy test, the nurse should include what information?
The test has a high degree of accuracy within 1 week after ovulation
When preparing a prenatal class about endocrine changes that normally occur during pregnancy, the nurse should include information about which subject?
The thyroid enlarges with an increase in basal metabolic rate
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 at 15 weeks gestation for the amniocentesis. Which is the most appropriate rationale for the nurses statement regarding amniocentesis at 15 weeks gestation?
The volume of amniotic fluid needed for testing will be available by 15 weeks.
After conducting a class for female adolescents about human reproduction, the nurse concludes teaching has been effective when a student makes which statement?
Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in pregnancy
A primigravid client at 8 weeks gestation tells the nurse that since having had sexual relations with a new partner 2 weeks ago, she has noticed flu like symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to a primary health care provider (HCP) because the nurse suspects which sexually transmitted infection?
Herpes genitalis
After instructing a female client about the radioimmunoassay pregnancy test, the nurse determines that the client understands that instructions when the client states that which hormone is evaluated by this test?
Human chorionic gonadotropin (hCG)
