Lippincott: Nursing Care During Pregnancy

A 40-year-old client who is quite anxious says that she would "rather die than be pregnant." Which response by the nurse is most helpful? "Try not to worry until after the pregnancy test." "You know, pregnancy is a normal event." "I see you're upset. Take some deep breaths to relax a little." "You're only 40 years old and not too old to have a baby."

"I see you're upset. Take some deep breaths to relax a little."

A pregnant client asks how she can best prepare her 3-year-old son for the upcoming birth of a sibling. The nurse should make which suggestion? "Reassure your son that nothing is going to change." "Reprimand your son if he displays immature behavior." "Tell your son about the childbirth about 1 month before your due date." "Involve your son in planning and preparing for a sibling."

"Involve your son in planning and preparing for a sibling."

A client who's 4 weeks pregnant comes to the clinic for the first prenatal visit. When obtaining the health history, the nurse explores the client's use of drugs, alcohol, and cigarettes. Which client outcome identifies a safe level of alcohol intake for this client? "The client consumes no more than 2 oz (60 mL) of alcohol daily." "The client consumes 2 to 6 oz (60 to 180 mL) of alcohol daily, depending on body weight." "The client consumes no alcohol." "The client consumes no more than 4 oz (120 mL) of alcohol daily."

"The client consumes no alcohol."

A client who is 37 weeks pregnant comes to the clinic for a prenatal checkup. Which question will the nurse ask to assess the client's preparation for parenting? "Have you begun prenatal classes?" "What changes have you made at home to get ready for the baby?" "Are you planning to have epidural anesthesia?" "Can you tell me about the meals you typically eat each day?"

"What changes have you made at home to get ready for the baby?"

A nurse is planning care for a 16-year-old adolescent in the prenatal clinic. Adolescents are prone to which complication during pregnancy? Nausea and vomiting Varicosities Gestational diabetes Iron-deficiency anemia

Iron-deficiency anemia

When caring for the pregnant client with hyperemesis gravidarum, the nurse would further assess the client for which problem? leaking amniotic fluid pinkish vaginal discharge abdominal pain dehydration

dehydration

A client who is 7 weeks pregnant comes to the clinic for her first prenatal visit. She reports smoking 20 to 25 cigarettes per day. When planning the client's care, the nurse anticipates informing her that if she doesn't stop smoking, her fetus may be at risk for: hydronephrosis. tetralogy of Fallot. spina bifida. low birth weight.

low birth weight.

A client who's planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. What is the nurse's best response? "You practice good health habits; just follow them and you'll be fine." "There is nothing you can do to have a healthy pregnancy; it's all up to nature." "Folic acid, 400 mcg, improves pregnancy outcomes by preventing certain complications." "Pregnancy is a human process; you don't have to worry."

"Folic acid, 400 mcg, improves pregnancy outcomes by preventing certain complications."

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 of the following recommendations by the nurse would be best? "Limit the time you spend in the car to a maximum of 4 to 5 hours." "Avoid wearing your seat belt in the car to prevent injury to the fetus." "Taking the trip is okay if you stop every 1 to 2 hours and walk." "Try to avoid traveling anywhere in the car during your third trimester."

"Taking the trip is okay if you stop every 1 to 2 hours and walk."

At a preconception visit a 24-year-old client is found to have malformation of the uterus. The nurse uses the accompanying figure to explain which type of uterine malformation? septate uterus double uterus uterus didelphys bicornate uterus

bicornate uterus

A client is 8 weeks pregnant. Which teaching topic is most appropriate at this time? breathing techniques during labor neonatal nutrition common discomforts of pregnancy infant care responsibilities

common discomforts of pregnancy

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? enjoying the role of nurturer preparing for the reality of parenthood experiencing ambivalence about pregnancy differentiating the self from the fetus

experiencing ambivalence about pregnancy

When evaluating a pregnant client's fundal height, the nurse should measure in which way? from the symphysis pubis notch to the highest level of the fundus from the symphysis pubis notch to the umbilicus with a pelvimeter designed to measure fundal height across the abdomen laterally

from the symphysis pubis notch to the highest level of the fundus

Which statements made by a pregnant woman in the first trimester are consistent with this stage of pregnancy? Select all that apply. "We went to the mall yesterday to buy a crib and dressing table." "I can't wait to see my baby. Do you think it will have my blond hair and blue eyes?" "I wonder how it will feel to buy maternity clothes and be fat." "I used a princess theme for decorating the room." "My husband told his friends we'll have to give up the convertible for a minivan." "Oh my, how did this happen? I don't need this now."

"I wonder how it will feel to buy maternity clothes and be fat." "My husband told his friends we'll have to give up the convertible for a minivan." "Oh my, how did this happen? I don't need this now."

During her fourth clinic visit, a client who's 5 months pregnant tells the nurse she was exposed to rubella during the past week and asks whether she can be immunized now. How should the nurse respond? "No because the vaccine can be given only during the first trimester." "Yes and you should consider pregnancy termination because rubella has teratogenic effects." "No because the live viral vaccine is contraindicated during pregnancy." "Yes, but immunization against rubella requires a physician's order."

"No because the live viral vaccine is contraindicated during pregnancy."

A primigravida at 36 weeks' gestation is having discomfort during a pelvic examination. What should the nurse tell the client to do to help her relax during the exam? Visualize the examination being completed. Hold on tightly to the nurse with both hands. Breathe in and out with slow deep breaths. Hold her breath until the speculum is inserted.

Breathe in and out with slow deep breaths.

Which instruction should a nurse give to a client who's 26 weeks pregnant and complains of constipation? Tell her to ask her caregiver for a mild laxative. Tell her to go to the evaluation unit because constipation may cause contractions. Encourage her to increase her intake of roughage and to drink at least six glasses of water per day. Suggest the use of an over-the-counter stool softener.

Encourage her to increase her intake of roughage and to drink at least six glasses of water per day.

A client, now 37 weeks pregnant, calls the clinic because she is concerned about being short of breath and is unable to sleep unless she places three pillows under her head. After listening to the client's concerns, the nurse should take which action? Explain that these are expected problems for the latter stages of pregnancy. Arrange for the client to be admitted to the birth center and prepare for birth. Make an appointment because the client needs to be evaluated. Tell the client to go to the hospital; she may be experiencing signs of heart failure.

Explain that these are expected problems for the latter stages of pregnancy.

A client who is 18 weeks pregnant is losing weight. She tells a nurse that she's out of work and, after paying bills, has no money to buy healthy food. The nurse should offer the client information about: Healthy Mothers, Healthy Babies. Women, Infants, and Children (WIC). Medicaid. Women in Distress.

Women, Infants, and Children (WIC).

A primigravid client visits the clinic for a routine examination at 35 weeks' gestation. The client's blood pressure is near the baseline of 120/74 mm Hg with no proteinuria or evidence of facial edema. The client asks the nurse, "What should I take if I get an occasional headache after looking at my computer at work all day?" Which over-the-counter medicine does the nurse consider to be safest for occasional use by a pregnant client with no known risks? ibuprofen acetaminophen naproxen aspirin

acetaminophen

A 30-year-old multiparous client has been prescribed oral contraceptives as a method of birth control. The nurse instructs the client that decreased effectiveness may occur if the client is prescribed which drug? amitriptyline indomethacin ampicillin omeprazole

ampicillin

A nurse is doing an assessment of a pregnant client who states that she smokes one pack of cigarettes each day. The nurse should: inform the client of the risks to the fetus and ask if she'd like a referral to a smoking cessation support group. insist that the client stop smoking immediately for the health of her baby. do nothing; smoking is a personal decision. ask the client to cut down to half a pack a day.

inform the client of the risks to the fetus and ask if she'd like a referral to a smoking cessation support group.

An 18-year-old pregnant client tells the nurse that she is concerned that she may not be able to take care of herself during her pregnancy. She states that she is not sure what prenatal care is available, or if she should access it. The nurse should recognize that the client: should be referred to community resources available for pregnant women. needs to find a second job. may not take care of herself. may not be fit to take care of a child.

should be referred to community resources available for pregnant women.

A client has come to the clinic for her first prenatal visit. The nurse should include which statement about using drugs safely during pregnancy in client teaching? "Medications that are available over the counter are safe for you to use, even early on." "During the first 3 months, avoid all medications except ones ordered by your health care provider." "Consult with your health care provider before taking any medications." "All medications are safe after you've reached the 5th month of pregnancy."

"Consult with your health care provider before taking any medications."

A client asks the nurse why taking folic acid is so important before and during pregnancy. What should the nurse tell the client? "Folic acid is needed to promote blood clotting and collagen formation in the newborn." "Folic acid is important in preventing neural tube defects in newborns and preventing anemia in mothers." "Folic acid consumption helps with the absorption of iron during pregnancy." "Eating foods with moderate amounts of folic acid helps regulate blood glucose levels."

"Folic acid is important in preventing neural tube defects in newborns and preventing anemia in mothers."

During her first prenatal visit, a client expresses concern about gaining weight. What is the nurse's first action? Ask her to come back to the clinic every 2 weeks for a weight check. Be alert for a possible eating problem and do a further in-depth assessment. Report the client's concerns to her caregiver. Ask the client how she feels about gaining weight and provide instructions about expected weight gain and diet.

Ask the client how she feels about gaining weight and provide instructions about expected weight gain and diet.

A primigravid client at 16 weeks' gestation visits the clinic for a routine examination. The client tells the nurse that she knows someone whose baby was born with congenital toxoplasmosis. What should the nurse instruct the client to do to prevent transmission of the toxoplasmosis protozoan? Avoid contact with anyone diagnosed with this disease. Cook all meats, such as beef and pork, thoroughly. Consider a course of prophylactic penicillin as prevention. Plan to be vaccinated for this condition at the next visit.

Cook all meats, such as beef and pork, thoroughly.

A client, approximately 11 weeks pregnant, and her husband are seen in the antepartal clinic. The client's 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 client's husband is experiencing which complication? pica ptyalism Couvade syndrome mittelschmerz

Couvade syndrome

A client is 2 months pregnant. Which factor should the nurse anticipate as most likely to affect the client's psychosocial transition during pregnancy? the due date month readiness at home for the baby support from a partner previous health promotion activities

support from a partner

A nurse obtains the antepartum history of a client who is 6 weeks pregnant. Which finding is a concern? the client's consumption of six to eight cans of beer on weekends the client's participation in low-impact aerobics three times per week the client's consumption of four to six small meals daily the client's practice of taking a multivitamin supplement daily

the client's consumption of six to eight cans of beer on weekends