Lippincott - Normal Pregnancy
A primigravid client in a preparation for parenting class asks how much blood is lost during an uncomplicated birth. The nurse should tell the woman:
"The maximum blood loss considered within normal limits is 500 mL."
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 client's last visit 4 weeks ago. According to the priority, the nurse should do the following tasks in which order?
(1). Ask the client if the baby is or has been moving. (2). Obtain different equipment and recheck. (3). Explain that the fetal heart beat could not be found at this time. (4). Call the health care provider.
The nurse is developing a teaching plan for a client entering the third trimester of her pregnancy. The nurse should include which of the following in the plan? Select all that apply.
(1). Experimenting with mothering roles. (2). Realignment of roles and tasks (3). Trying various caregiver roles (4) Concern with labor and delivery
A 17-year-old gravid client presents for her regularly scheduled 26-week prenatal visit. She appears dishelved, 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.
(1). Intimate partner violence (2). Substance abuse (3). Depression (4). Glucose Tolerance Screening
Which diagnostic test would be the most important to have for a primigravid client in the second trimester of her pregnancy?
Alpha-fetoprotein (AFP) testing *AFP testing is usually performed between the 15th and 18th weeks of gestation.
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.
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 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 primigravid client at 8 weeks' gestation tells the nurse that since having had sexual relaxations with a new partner 2 weeks ago, she has noticed flulike symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to a primary health care provider because the nurse suspects which of the following sexually transmitted diseases?
Herpes genitalis
After instructing a female client about the radioimmunoassay pregnancy test, the nurse determines 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)
The nurse instructs a primigravid client to increase her intake of feeds high in magnesium because of its role with which of the following?
Synthesis of proteins, nucleic acids, and fat
Which of the following statements by a primigravid client scheduled for chorionic villi sampling indicates effective teaching about the procedure?
The procedure involves insertion of a thin catheter into my uterus
During a 2-hour childbirth preparation course focusing on the labor and birth process for primi-gravid clients, the nurse is describing the maneuver that the fetus goes through during the labor process when the head is in the presenting part. In which order does these manuevers occur?
(1) Engagement (2) Descent (3) Flexion (4) Internal Rotation
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 of the following? Select all that apply.
(1) Hepatitis B immune globulin at birth (2) Series of three hepatitis B vaccinations per recommended schedule (3) Universal precautions for mother and infant
A primigravid client at 32 weeks' gestation is enrolled in a breast-feeding class. Which of the following statements indicate that the client understands the breast-feeding education? Select all that apply.1
(1). "I can hold my baby several different ways during feedings." (2). "If I breast-feed, my uterus will return to pre-pregnancy size more quickly." (3). "I need to feed my baby when I see feeding cues and not wait until she is crying."
A nurse is assigned to the obstetrical triage area. When beginning the assignment, the nurse is given a report about four clients waiting to be seen. Place the clients in the order in which the nurse should see them.
(1). A single mother at 4 months postpartum fearful of shaking her baby when he cries (2). An antenatal client at 16 weeks' gestation who has occasional sharp pain on her left side radiating from her symphysis to her fundus (3). A primigravid client at 10 weeks' gestation stating that she is not feeling well with nausea and vomiting, urinary frequency, and fatigue. (4). A multiparous client at 32 weeks' gestations asking for assistance with finding a new primary healthcare provider.
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 the fetus? Select all that apply.
(1). Milkshake or yogurt with fresh fruit or granola bar. (2). Cheese pizza with spinach and mushroom topping. (3). Peanut butter with crackers and a juice drink.
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.
(1). Walk in the hospital room. (2). Use slow chest breathing. (3) Lightly massage her abdomen.
The nurse is teaching a new prenatal client about her iron deficiency anemia during pregnancy. Which statement indicate that the client needs further instruction about her anemia?
"I may have anemia because of my family is of Asian descent." *Other thalassemias and sickle cell anemia, rather than iron deficiency anemia, can be associated with ethnicity but occur primarily in clients of African or Mediterranean descent.
When performing Leopold's maneuver 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.
Rho (D) immune globulin (RhoGAM) is prescribed for a client before she is discharged after a spontaneous abortion. The nurse instructs the client that this drug is used to prevent which of the following?
Development of Rh-positive antibodies
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 rate tones are found. While evaluating this client, the nurse identifies her as being the highest risk for developing which problem?
Disseminated intravascular coagulation (DIC)
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 of the following topics would be important for the nurse to include in the teaching plan?
Increased risk for urinary tract infections.
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
After instructing participants in a childbirth 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 of the following?
Pelvic tilt exercises
When teaching a primigravid client how to do Kegel exercises, the nurse explains that the expected outcomes of these exercises.
Strengthen the perineal muscles.
