Maternal-Newborn Prenatal Question

The nurse is explaining the pathophysiology that may cause the occurrence of pyrosis during pregnancy. Which statement is appropriate to​ include? 1. "Progesterone levels​ increase, which may contribute to​ heartburn." 2. "When you are​ upset, this occurs more​ frequently." 3. "Levels of the hormone hCG increase and cause​ this." 4. "Due to decreased​ peristalsis, your bowels become​ sluggish."

1. "Progesterone levels​ increase, which may contribute to​ heartburn." Decreased peristalsis occurs during pregnancy and may lead to constipation. Increased progesterone levels are a contributing factor to the occurrence of​ pyrosis, or​ heartburn, during pregnancy. Levels of hCG may be associated with the nausea and vomiting of pregnancy. Emotions may play a role in the occurrence of nausea and​ vomiting, not pyrosis.

Fetal heart tones may be audible with a Doppler as early as​ ______ weeks gestation. 1. 10 2. 12 3. 8 4. 14

1. 10 Fetal heart tones may be audible with a Doppler as early as 10 weeks gestation. At 8​ weeks, the nurse is not able to auscultate fetal heart tones. By weeks 12 and​ 14, the fetal heart tones should have already been assessed.

A pregnant client asks the nurse when the glucose tolerance test will be performed to screen for gestational diabetes. The nurse responds that this test is usually done between how many weeks​ gestation? 1. 24 and 28 weeks gestation 2. 16 and 20 weeks gestation 3. 20 and 24 weeks gestation 4. 12 and 16 weeks gestation

1. 24 and 28 weeks gestation The oral glucose tolerance test​ (OGTT) for gestational diabetes is performed between 24 and 28 weeks gestation.

What is the biggest challenge associated with a pregnant woman who is economically​ disadvantaged? 1. Access to prenatal care 2. Familial support 3. Child care 4. Adequate housing

1. Access to prenatal care Sometimes access to prenatal care can take a back seat to what is perceived to be more immediate needs like housing and child care. Familial support is important for every pregnant​ woman, regardless of her​ income, and it is not associated with the economically disadvantaged.

Which of the following hormones helps to prevent preterm labor and​ delivery? 1. Progesterone 2. Human placental lactogen 3. Human chorionic gonadotropin 4. Estrogen

1. Progesterone Progesterone is essential to maintaining a pregnancy by suppressing uterine contractility. This helps to prevent preterm labor and delivery. Estrogen is responsible for uterine​ development, maintaining a hospitable environment for the growing embryo and fetus. Human chorionic gonadotropin stimulates progesterone and estrogen secretion by the corpus luteum until the placenta is formed. Human placental lactogen increases insulin resistance in the maternal tissues.

What percentage of pregnancies is affected by cardiac​ disease? 1. 15% 2. 1% 3. 10% 4. 5%

2. 1% Cardiac disease is the​ fourth-ranked cause of maternal mortality and complicates about​ 1% of all pregnancies. Congenital heart defects and rheumatic heart disease are common causes of heart disease in pregnancy.

The nurse in a prenatal clinic is preparing educational material to distribute to pregnant clients throughout their pregnancy. Which of the following should be included in this ​teaching? Select all that apply. 1. A circumcision consent form 2. Childbirth education 3. Danger signs of pregnancy 4. Pediatric immunization schedule 5. Relief of pregnancy discomforts

2. Childbirth education 3. Danger signs of pregnancy 5. Relief of pregnancy discomforts Subsequent prenatal health maintenance assessments and education will include nutritional​ status, danger signs of​ pregnancy, childbirth​ education, subsequent lab​ evaluations, and relief of pregnancy discomforts. An immunization schedule will be provided by the pediatrician after delivery of the infant. Circumcision will be discussed with the client after delivery of the infant.

A client learns that she is pregnant. The nurse is aware that positive signs of pregnancy ​include: (Select all that apply) 1. Presence of linea nigra 2. Fetal movement detected by a practitioner 3. Presence of Goodell​'s sign. 4. Fetus observed on ultrasound 5. Detection of a fetal heartbeat

2. Fetal movement detected by a practitioner 4. Fetus observed on ultrasound 5. Detection of a fetal heartbeat Detection of a fetal​ heartbeat, fetal movement detected by a​ practitioner, and a fetus observed on ultrasound are all positive indicators of pregnancy. Presence of linea nigra and Goodell​'s sign are both probable indicators of pregnancy.

What is the primary cause of shortness of breath during​ pregnancy? 1. Dehydration 2. Pressure of the enlarging uterus on the diaphragm decreasing vital capacity 3. Anemia 4. Pressure applied to pelvic vasculature resulting in poor venous return

2. Pressure of the enlarging uterus on the diaphragm decreasing vital capacity As a woman gains weight during​ pregnancy, she may become short of breath while doing such everyday things as climbing stairs. This is due to the pressure of the uterus on the diaphragm. Neither dehydration nor anemia should cause shortness of breath. Pressure applied to the pelvic vasculature can cause​ varicosities, not shortness of breath.

What are the goals of care for the client who experiences bleeding in late ​pregnancy? Select all that apply. 1. Maintenance of stable blood glucose levels 2. Prevention of hemorrhage 3. Client understanding of condition 4. Delivery of a healthy baby 5. Delivery by cesarean section

2. Prevention of hemorrhage 3. Client understanding of condition 4. Delivery of a healthy baby Nursing care of the client experiencing bleeding in late pregnancy includes prevention of hemorrhage and delivery of a healthy baby. The nurse also ensures that the client has an understanding of her condition by providing education. Goals for this client would not include delivery by cesarean section or stabilization of blood glucose. The nurse would not anticipate that the client with late trimester bleeding would experience alterations in blood glucose levels.

The nurse is explaining the effects of the placental hormone relaxin to a pregnant client. Which statement is​ appropriate? 1. "Relaxin causes increased gastric acid and​ pyrosis." ​2. "Increased levels cause restless leg​ syndrome." 3. "It may cause your back to ache because your pelvic bones are​ relaxing." 4. "This is why you have increased amounts of​ saliva."

3. "It may cause your back to ache because your pelvic bones are​ relaxing." The hormone relaxin is not related to the development of restless leg syndrome during pregnancy. Relaxin does not lead to pyrosis during pregnancy. This​ hormone, produced by the​ placenta, causes relaxation of the pelvic bones. This may be a contributing factor to the occurrence of backache during pregnancy. Relaxin does not lead to increased amounts of saliva.

Which question will the nurse ask the client when calculating the estimated date of confinement​ (EDC) by Naegele​'s ​rule? 1. "How many months did you try to get ​pregnant?" 2. "What month did you stop using birth control ​pills?" 3. "When was the first day of your last menstrual ​period?" 4. "How long was your last menstrual ​period?"

3. "When was the first day of your last menstrual ​period?" To use Naegele​'s ​rule, the nurse questions the client about the first day of the last menstrual period. The nurse then subtracts 3 months and adds 7 days to that date to determine the EDC. Asking the client about cessation of birth control pills or the length of the last menstrual period does not provide accurate information about the EDC. The nurse does not take the length of time spent attempting to get pregnant into account when calculating the EDC.

During which period of gestation is screening for Group B Streptococcus​ completed? 1. 32-34 2. 28-30 3. 35-36 4. 38-40

3. 35-36 Screening for Group B Streptococcus is completed during gestational weeks 35dash-36. The screening may be​ cervical, anal,​ and/or urine culture. Waiting until weeks 38dash-40 may not allow time for accurate diagnosis of the condition. This may prevent the labor and delivery staff from providing proper treatment in the acute care​ setting, placing the newborn at risk for development of a serious infection. The current standard of care does not support screening for Group B Strep earlier than 35dash-36 weeks gestation.

A pregnant client is 36 weeks gestation. How often will she return to her provider for prenatal​ visits? 1. Every day 2. Every 2 weeks 3. Weekly 4. Every 4 weeks

3. Weekly The prenatal client attends regularly scheduled clinic visits to ensure a healthy pregnancy outcome.​ Generally, the pregnant client will visit the provider once a month until she reaches 28 weeks. From 28 weeks to 36 weeks the client returns to the provider once every 2 weeks. After reaching 36​ weeks, the client will return to the office weekly until delivery. The client does not return to the office daily unless there is a problem with the pregnancy that requires intensive​ follow-up.

Which change of pregnancy involves a brownish discoloration of the​ forehead? 1. Striae gravidarum 2. Lordosis 3. Linea nigra 4. Cholasma

4. Chloasma Hyperpigmentation of the skin is primarily due to estrogen. The mask of​ pregnancy, or​ cholasma, is a​ blotchy, brownish discoloration of the skin over the​ forehead, cheeks, and bridge of the nose. The linea nigra refers to the darkened line over the midline of the abdomen extending from the umbilicus to the pubic area. Lordosis is not a skin​ change, but an abnormal curvature of the spine in relation to the pregnancy. Striae​ gravidarum, or stretch​ marks, are linear tears in the connective tissues of the​ abdomen, breasts,​ buttocks, or thighs.

HIV is transmissible from mother to baby in all of the following ways except which of the​ following? 1. During the birth process 2. Through breast milk 3. Across the placenta 4. Close contact

4. Close contact HIV is the virus that causes AIDS. It is not transmitted through close contact. Ways that an infected mother can transmit HIV to her child include the virus passing through the​ placenta, through contaminated blood during​ birth, and through breast milk.

Which of the following antenatal tests may help identify intrauterine growth restriction​ (IUGR)? 1. Percutaneous umbilical blood sample​ (PUBS) 2. Nuchal translucency test 3. Amniocentesis 4. Doppler flow study

4. Doppler flow study A Doppler flow study is used to detect or confirm IUGR​ and/or uteroplacental insufficiency. This is accomplished with ultrasound technology to assess blood flow. PUBS involves analysis of fetal cord blood to determine fetal​ acid-base status and genetic analysis. The NT test is used to screen for genetic anomalies. Amniocentesis provides genetic information about the fetus. The Doppler flow study is the only choice presented that can assess intrauterine fetal growth.

The nurse is providing anticipatory guidance to a pregnant client during the first trimester. Which of the following topics should the nurse​ discuss? 1. Collecting the obstetrical history 2. Urinalysis results 3. Cultural assessment 4. Physiological changes of pregnancy

4. Physiological changes of pregnancy During​ pregnancy, the woman and her family require lots of anticipatory guidance on the physical and psychological changes associated with pregnancy. The pregnant​ client's urine is tested frequently during pregnancy.​ However, discussing the results of the​ client's urinalysis is not considered anticipatory guidance for the client. The nurse should consider the​ client's cultural preferences when providing antenatal care.​ However, this is assessment and is not considered a part of teaching and providing anticipatory guidance. Completing an obstetrical history is a component of the assessment​ process, not providing anticipatory guidance.

A client reports a positive pregnancy test at home. This is considered which type of pregnancy​ indicator? 1. Presumptive 2. Possible 3. Positive 4. Probable

4. Probable Probable indicators of pregnancy are those objective​ signs/symptoms that a practitioner perceives. These signs may also be attributed to something other than a pregnancy. Probable signs include Chadwick​'s ​sign, Goodell​'s ​sign, Hegar​'s ​sign, abdominal​ enlargement, positive pregnancy​ test, ballottement, and skin pigmentation changes. Presumptive signs are subjective reports from the client. Positive signs are direct indicators of a pregnancy. The term possible is not used to describe pregnancy indicators.

The nurse is preparing to assess a pregnant client. The nurse reviews the client​'s clinical pelvimetry previously documented by the health care provider. The nurse knows that which of the following is the most important​ measurement? 1. The posterior sagittal diameter 2. The subrapubic angle 3. The true conjugate 4. The obstetric conjugate

4. The obstetric conjugate Pelvimetry utilizes a series of measurements to assess pelvic adequacy focusing on the pelvic​ inlet, mid-pelvis, and outlet. The​ anterior/posterior and transverse diameters are important in determining whether the pelvis has an adequate size and shape for a vaginal delivery. The obstetric conjugate is the smallest and most important​ measurement, equaling 1.5-2 cm less than the diagonal conjugate.

Which of the following lab tests would be included as part of an initial prenatal ​visit? Select all that apply. 1. HIV screening 2. Rubella titer 3. Hepatitis BsAg 4. Hemoglobin and hematocrit 5. ABO and Rh typing

All of the them! LOL The nurse will ensure that the prenatal client receives the proper antenatal lab testing. The initial lab testing includes​ hemoglobin, hematocrit, ABO and Rh​ typing, hepatitis​ BsAg, rubella​ titer, rapid plasma reagin​ (RPR), HIV​ screening, gonorrhea,​ chlamydia, urinalysis, Pap​ test, and TB skin test. The provider may order additional prenatal testing depending on the client​'s history and specific needs.

The developmental tasks of pregnancy for the adolescent include which of the ​following? Select all that apply. 1. Acceptance of pregnancy 2. Continuing her education 3. Modification of career and personal goals 4. Acceptance of changes in body image 5. Change in role identity

1. Acceptance of pregnancy 3. Modification of career and personal goals 4. Acceptance of changes in body image 5. Change in role identity The developmental tasks of pregnancy include the​ following: change in role identity to include​ motherhood, acceptance of changes in expected body image from puberty to pregnancy​ changes, modification of career and personal​ goals, and acceptance of the pregnancy. Many pregnant adolescents modify their educational goals to care for their newborn or drop out of school all together.

A client in her second trimester of pregnancy tells the nurse that her spouse is demonstrating signs of pregnancy as well. The nurse identifies this as Couvade Syndrome. Which symptom is the spouse most likely ​experiencing? Select all that apply. 1. Back pain 2. Breast tenderness 3. Fatigue 4. Nausea and vomiting 5. Increased appetite

1. Back pain 3. Fatigue 4. Nausea and vomiting 5. Increased appetite Fatigue, increased​ appetite, back​ pain, nausea, and vomiting are all symptoms that may be experienced with Couvade Syndrome. Breast tenderness is not commonly experienced.

The nurse in a prenatal clinic is preparing to see a client who is in the second trimester. Which of the following assessments should be completed during the second ​trimester? Select all that apply. 1. Maternal vital signs 2. Screening for Group B 3. Assessment of weight gain 4. Auscultation of the fetal heart rate 5. Fundal height assessment

1. Maternal vital signs 3. Assessment of weight gain 4. Auscultation of the fetal heart rate 5. Fundal height assessment Fundal height​ assessment, auscultation of the fetal heart​ rate, assessment of weight​ gain, and maternal vital signs should all be done throughout the​ pregnancy, including the second trimester. Screening for Group BStreptococcusis done in the third trimester.

Which of the following affect the ability of the pregnant woman to adapt to ​pregnancy? Select all that apply. 1. Socioeconomic support 2. Maternal age 3. Cultural beliefs 4. Gender of the fetus 5. Psychosocial support

1. Socioeconomic support 2. Maternal age 3. Cultural beliefs 5. Psychosocial support The ability of the woman to psychologically adapt to pregnancy depends on a variety of factors. These include maternal​ age, psychosocial​ support, socioeconomic​ status, and cultural beliefs. Developmental age affects the ability to adapt to​ pregnancy; an adolescent may have difficulty with this task. Adequate support is needed to experience the role transitions of pregnancy. Poverty and unemployment may negatively affect pregnancy outcomes. Cultural beliefs affect health care practices during pregnancy. The gender of the fetus should not affect the woman​'s ability to adapt to pregnancy.

A pregnant client has two living children one delivered at 41 weeks and the other at 39 weeks​ gestation, and has had two spontaneous abortions. How would the nurse describe her pregnancy history using the acronym​ GTPAL? 1. G5 T1 P1 A2 L3 2. G5 T2 P0 A2 L2 3. G4 T2 P2 A0 L2 4. G3 T2 P0 A2 L2

2. G5 T2 P0 A2 L2 Gravida​ (G) refers to any​ pregnancy, including the present pregnancy. Term​ (T) refers to any delivery occurring after 37 completed weeks gestation. Preterm​ (P) refers to any delivery occurring after 20 weeks gestation but before 37 completed weeks gestation. Abortion​ (A) is the number of pregnancies ending in either a spontaneous​ (miscarriage) abortion or therapeutic​ (elective) abortion. Living​ (L) is the number of currently living children.

According to Reva​ Rubin, what is the last developmental stage of​ pregnancy? 1. Accepting the pregnancy 2. Giving of self to others 3. Seeking safe passage 4. Seeking acceptance of others

2. Giving of self to others According to Reva​ Rubin, a nurse​ theorist, there are four developmental tasks of pregnancy. The mother must first seek safe​ passage, which involves seeking competent health care.​ Secondly, the mother seeks acceptance of the pregnancy by others. This helps to maintain current relationships. The mother must also then begin to recognize the pregnancy is real.​ Lastly, the mother learns to give to others ahead of​ herself, focusing on her child.

What is the cervical softening of pregnancy​ called? 1. Chadwick​'s sign 2. Goodell​'s sign 3. Hegar​'s sign 4. Montgomery​'s sign

2. Goodell​'s sign The cervical softening associated with pregnancy is referred to as Goodell​'s sign. Chadwick​'s sign is indicated by the increased vascularity and bluish coloration of the endocervical canal during pregnancy. Softening of the lower uterine segment is known as Hegar​'s sign. There is no change associated with pregnancy that is referred to as Montgomery​'s sign.

If a pregnant woman is planning to travel by​ plane, what would you advise her to​ do? Select all that apply. 1. Travel by car​ instead; flying while pregnant is unsafe. 2. Stay hydrated. 3. Stand as long as possible. 4. Take time to move around the cabin. 5. Check with the airline to see if they have any specific travel restrictions.

2. Stay hydrated. 4. Take time to move around the cabin. 5. Check with the airline to see if they have any specific travel restrictions. As long as a woman does not have any medical​ conditions, flying during pregnancy is safe. Some airlines have their own​ restrictions, so she should check with the airline. She should also stay hydrated and move around the cabin to prevent​ phlebitis, but standing for long periods is not a good idea while pregnant.

Which of the following is not considered a positive sign of​ pregnancy? 1. Visualization of fetus by ultrasound 2. Auscultation of fetal heart tones with Doppler 3. Abdominal enlargement 4. Palpable fetal movement

3. Abdominal enlargement Abdominal enlargement is considered a probable sign of​ pregnancy; this is because it could be due to something other than pregnancy. Positive signs of pregnancy are diagnostic indicators that cannot be attributed to anything other than pregnancy. These include visualization of fetus by​ ultrasound, auscultation of fetal heart tones with​ Doppler, and palpable fetal movement by the practitioner.

Which of the following nursing interventions should be included in the care plan for a pregnant client preparing for fetal antenatal​ testing? 1. Ensuring the acceptance of all testing recommended 2. Counseling regarding clinic appointment schedule 3. Allowing the client to express concerns about testing 4. Discussing healthy weight gain during pregnancy

3. Allowing the client to express concerns about testing The nurse provides emotional support through the processes of fetal antenatal testing. This includes allowing the client to express fears or concerns about the testing or the anticipated results. Discussion regarding the clinic schedule and healthy weight gain is appropriate prenatal​ education; however, this is not specifically related to antenatal testing. The​ nurse's role does not include ensuring that the clients accept all testing that is recommended. The client has the right to refuse testing. The nurse can provide education so the client can make an informed decision.

A client presents to the prenatal clinic and tells the nurse that she thinks she is pregnant. Which symptoms described by the client would be considered presumptive indicators of ​pregnancy? Select all that apply. 1. Fetal heartbeat detected with a Doppler 2. Enlargement of the abdomen 3. Amenorrhea 4. Breast tenderness 5. A positive home pregnancy test

3. Amenorrhea 4. Breast tenderness Amenorrhea is a presumptive indicator of pregnancy. It is described by the​ client, but may be attributed to something other than pregnancy. Breast tenderness is a presumptive indicator of pregnancy. It is described by the​ client, but may be attributed to something other than pregnancy. A positive home pregnancy test is a probable indicator of​ pregnancy; it can be assessed by a practitioner but may also be attributed to something other than pregnancy. Abdominal enlargement is a probable indicator of​ pregnancy, it can be assessed by a practitioner but may also be attributed to something other than pregnancy. Fetal heartbeat detected with a Doppler is a positive sign of pregnancy.

A client tells the nurse she wants to have​ "natural childbirth" and wants her husband to be as active as possible in the birth. Which of the various childbirth preparation methods would be most suitable to incorporate into this client​'s plan of​ care? 1. Lamaze method 2. Odent method 3. Bradley method 4. LeBoyer method

3. Bradley method The goal of the Bradley method is to have a natural childbirth with the active participation of the husband as a coach. The LeBoyer method involves delivering the infant in a dimly​ lit, quiet room. The focus is on the infant and does not identify a specific role for the partner. The Lamaze method focuses on maternal control using breathing​ techniques; it does not identify a specific role for a partner in the process. The Odent method of delivery involves giving birth in a bathtub or pool full of warm water. It does not identify a specific role for a partner in the process.

An expecting father experiences weight gain and nausea. Which of the following is this referred to​ as? 1. Focusing phase 2. Pseudopregnancy 3. Couvade syndrome 4. Moratorium phase

3. Couvade syndrome Couvade syndrome is a phenomenon that occurs with some men of certain cultural groups. It refers to the development of physical symptoms of pregnancy such as​ fatigue, weight​ gain, and nausea. The moratorium phase occurs during the second trimester of pregnancy. It involves the formation of a bond with the unborn child. The father does not experience pseudopregnancy. The focusing phase occurs during the third​ trimester, when the parents become involved in preparing for the pregnancy.

What would you suggest as a treatment for restless leg​ syndrome? 1. Pelvic tilt exercises 2. There are no relief measures for this discomfort. 3. Iron supplements 4. Hydration

3. Iron supplements Restless leg syndrome could be associated with iron deficiency​ anemia, so an appropriate treatment may be iron supplements. Pelvic tilt exercises can be helpful in relieving back​ pain, and staying hydrated is important for all pregnant women but can also specifically be helpful for avoiding constipation.

What exercise would you recommend to a pregnant woman to strengthen her perineal​ muscles? 1. Swimming 2. Partial​ sit-ups 3. Kegel exercises 4. Pelvic tilt exercises

3. Kegel exercises Kegel exercises strengthen the perineal muscles and can help prevent​ cystocele, rectocele, uterine​ prolapse, and stress incontinence later in life. Pelvic tilt exercises are useful for relieving back​ pain, partial​ sit-ups can strengthen the abdominal​ muscles, and swimming is a good form of general exercise while pregnant.

Which approach to the birth process includes controlled breathing in attempt to control​ pain? 1. Odent method 2. Bradley method 3. Lamaze 4. LeBoyer

3. Lamaze Lamaze is a birth philosophy that views the process as normal and healthy. The focus is on control for the woman. Breathing is controlled in an attempt to control pain. The Bradley method encourages the use of midwives versus more technically oriented doctors. This includes a​ take-your-time approach to labor. LeBoyer includes birthing in a dim environment and with quiet voices. The Odent method involves water births.

To provide culturally competent prenatal​ care, what must the initial action of the nurse​ be? 1. Consider who the family decision maker is. 2. Determine food preferences during the prenatal period. 3. Ask for assistance from an interpreter. 4. Develop​ self-awareness of own culture and values.

4. Develop​ self-awareness of own culture and values. In order to be culturally​ competent, the nurse must start with a​ self-assessment of​ his/her own values and beliefs. The nurse must also recognize how these beliefs may affect the provision of nursing care to those of another culture. Once the nurse accomplishes​ this, he/she is better prepared to provide culturally competent care. The nurse works with families during the prenatal period to provide care that meets their cultural needs. This may include inquiring about food​ preferences, using an​ interpreter, and assessing the role structure of the family.

What is the​ nurse's initial role in assessing the​ client's understanding of antenatal​ testing? 1. Assessing understanding of the procedure 2. Providing emotional support after results are given 3. Ensuring understanding of test results 4. Forming a therapeutic relationship

4. Forming a therapeutic relationship The​ nurse's role should start with forming a therapeutic relationship with the client. This will help ensure that the nurse is then able to assess the​ client's understanding of the procedure or testing being performed. The nurse may discuss test results initially with the client or assist the provider in ensuring that the client understands the test results. Once test results are​ provided, the nurse provides emotional support for the couple through their​ decision-making process

Which of the following results would be concerning when you are performing a contraction stress test on a pregnant​ client? 1. Fetal movement 2. Accelerations 3. Contractions 4. Late decelerations

4. Late decelerations A contraction stress test is used to observe the fetal response to the stress of uterine contractions. The fetus who has late decelerations with uterine contraction may have less than adequate oxygenation. Accelerations and fetal movements are not a cause for​ concern; these show healthy fetal status. Contractions are a desired component of contraction stress testing.

Which assessment finding would the nurse expect in a client with placenta​ previa? 1. Elevated blood glucose levels 2. Low levels of iron 3. Severe lower abdominal pain 4. Painless, bright red vaginal bleeding

4. Painless, bright red vaginal bleeding Placenta previa is an abnormally implanted placenta in the lower uterine segment near or over the cervical os. Manifestations include a sudden onset of painless​ bright, red bleeding that may be scant or profuse. The client does not present with abdominal pain.​ Generally, the client would not present with alterations in blood glucose or​ iron, unless other prenatal conditions were present.

Which of the following is considered an advantage of chorionic villi​ sampling? 1. Noninvasive testing procedure 2. Lack of risk to developing fetus 3. Occurs prior to 8 weeks gestation 4. Time in which results become available

4. Time in which results become available Advantages of chorionic villi sampling include results becoming available within 24 hours and the diagnosis of​ anomalies, if​ present, can be as early as 10 weeks gestation. Chorionic villi sampling is performed between 9 and 12 weeks​ gestation; testing any earlier increases the risk of fetal complications. This is an invasive testing procedure that involves sampling of the chorionic villi of the placenta. Fetal risks include limb​ reduction, rupture of​ membranes, spontaneous​ abortion, and Rh sensitization in​ Rh-negative women.

The acronym GTPAL is used when completing an obstetric history. What does the open double quote"Pclose double quote" in this acronym​ represent? 1. Total number of term deliveries 2. Total number of pregnancies regardless of outcome 3. Total number of living children 4. Total number of preterm deliveries

4. Total number of preterm deliveries The acronym GTPAL stands for​ gravida, term,​ para, abortion, and living. The "P" represents the total number of preterm deliveries after 20 weeks and prior to 37 weeks. "G" or gravida refers to the total number of​ pregnancies, regardless of the outcome. "T" or term refers to the total number of term deliveries after 37 weeks gestation. "L" or living refers to the total number of living children.

Risk factors for teenage pregnancy include which of the​ following? Select all that apply. 1. Multiple sex partners 2. Late entry into prenatal care 3. Poor​ self-esteem 4. Sexual activity without the use of contraceptives 5. Low socioeconomic status

All of them! LOL The facts that teens tend to be inconsistent in their use of contraceptives and have multiple partners are risk factors for teenage pregnancy. Teens in the lower socioeconomic levels tend to maintain their pregnancies. Up to​ 80-85% of births to unmarried teens happen in the economic levels below middle class. A teen with poor​ self-esteem may see the pregnancy as proof that she is loved by someone. Late entry into prenatal care is not only a pregnancy​ risk, it also increases the risk for a poor pregnancy outcome. It is not a risk factor for pregnancy.

You are explaining maternal serum​ alpha-fetal protein​ (msAFP) screening to a client. During which period of gestation would you recommend the​ testing? ​1. 14-22 weeks 2. 24 weeks 3. 28 weeks 4. 9-13 weeks

​1. 14-22 weeks Maternal serum assays such as the msAFP and triple screen are performed during certain time periods to increase the accuracy of the screening. The msAFP is performed during weeks​ 14-22 of gestation. The test is not accurate if performed any earlier or any later than this time.​ Therefore, weeks​ 9-13, 24, and 28 would not be appropriate times for this screening.

Which of the following are clinical manifestations of ectopic ​pregnancy? Select all that apply. 1. Abdominal or pelvic pain 2. Vaginal spotting 3. Leaking amniotic fluid 4. Expulsion of fetal parts 5. Missed period

1. Abdominal or pelvic pain 2. Vaginal spotting 5. Missed period An ectopic pregnancy refers to the implantation of a fertilized ovum in an area outside of the uterus. Early manifestations of ectopic pregnancy include a missed​ menses, abdominal or pelvic pain that may be severe in nature or​ mild, and vaginal spotting or bleeding. If the fallopian tube​ ruptures, the client may experience severe abdominal​ pain, profuse​ hemorrhage, and hypovolemic shock. The client with an ectopic pregnancy does not expel products of conception or leak amniotic fluid because the pregnancy has not occurred normally in the uterus.

The nurse is reviewing the history of a client at 20 weeks gestation who is in the office for a prenatal visit. The nurse would be concerned if which of the following elements have not been previously​ assessed? 1. Cultural assessment 2. Testing for Group B 3. Screening for gestational diabetes 4. Labor and delivery plans

1. Cultural assessment Cultural preferences should be​ considered, as specific beliefs and values will influence health care practices during pregnancy. These factors should be assessed earlier than 20 weeks gestation. The nurse will discuss plans for labor and delivery later in the pregnancy. The nurse would not expect testing for Group B Streptococcus to occur at 20 weeks​ gestation; this happens later in pregnancy. Screening for gestational diabetes occurs later in pregnancy and is not expected at 20 weeks gestation.

Which of the following would be included in the teaching for a client with preeclampsia whose provider is practicing expectant ​management? Select all that apply. 1. Daily weights 2. Checking blood glucose daily 3. Eating foods high in protein 4. Self-assessment of blood pressure 5. Performing fetal kick counts

1. Daily weights 3. Eating foods high in protein 4. Self-assessment of blood pressure 5. Performing fetal kick counts Expectant management of clients diagnosed with preeclampsia may lead to positive health outcomes. This approach to management may include educating the client to assess her blood pressure and weight​ daily, maintain a diet high in​ protein, and perform fetal kick counts daily. Bed rest may be​ recommended, but there are varying opinions about that. It is not necessary for the client with preeclampsia to check blood glucose levels daily.

Which of the following are considered presumptive indicators of ​pregnancy? Select all that apply. 1. Fatigue 2. Positive pregnancy test 3. Breast tenderness 4. Amenorrhea 5. Urinary frequency

1. Fatigue 3. Breast tenderness 4. Amenorrhea 5. Urinary frequency Presumptive indicators of pregnancy are those subjective​ signs/symptoms that a pregnant woman reports. These signs may be attributed to something other than the pregnancy. They include​ amenorrhea, breast​ tenderness, nausea and​ vomiting, fatigue, and urinary frequency. A positive pregnancy test is not a presumptive indicator of pregnancy. This is considered to be a probable indicator of pregnancy.

Which of the following fetal factors are assessed as part of a biophysical ​profile? Select all that apply. 1. Fetal heart rate 2. Fetal tone 3. Fetal gender 4. Fetal movement 5. Fetal breathing

1. Fetal heart rate 2. Fetal tone 4. Fetal movement 5. Fetal breathing A biophysical profile involves electronic fetal monitoring and ultrasound to assess fetal​ well-being. Fetal measures assessed include​ tone, gross​ movement, breathing, and heart rate. Each component is given a score of 2 if present and 0 if absent. The total best score is 10 out of 10. Determination of the gender of the fetus is not a component of a biophysical profile.

What are risks associated with pregnancy over the age of ​35? Select all that apply. 1. Having a child diagnosed with autism 2. Having a child with spina bifida 3. Giving birth to a child with Down syndrome 4. Having a child diagnosed with attention​ deficit/hyperactivity disorder​ (ADHD) 5. Fetal death

1. Having a child diagnosed with autism 3. Giving birth to a child with Down syndrome 5. Fetal death When a woman is pregnant over the age of​ 35, her risks of having a child with Down syndrome or autism are both increased. She is also more likely to experience fetal death. Having a child with attention​ deficit/hyperactivity disorder​ (ADHD) or spina​ bifida, which is a neural tube​ defect, is not associated with advanced maternal age.

The nurse anticipates the need for IV hydration in the client with hyperemesis gravidarum when electrolyte imbalance and what other condition is​ present? 1. Hemoconcentration 2. Hypertension 3. Hematuria 4. Anemia

1. Hemoconcentration When the client with hyperemesis gravidarum begins to exhibit signs of dehydration including electrolyte imbalance and​ hemoconcentration, hospitalization is needed. Inpatient care includes IV​ hydration, electrolyte​ replacement, possible total parenteral nutrition​ (TPN), and stabilization of weight loss. The nurse would not anticipate the occurrence of​ hematuria, anemia, or hypertension in the client with hyperemesis gravidarum.

The reaction of the teen​'s partner to the pregnancy and his involvement depends upon which of the​ following? Select all that apply. 1. His exposure to certain cultural and social norms 2. His ability to help make health care decisions 3. His maturity level 4. How meaningful the relationship is to him 5. The acceptance of his involvement by the pregnant teen

1. His exposure to certain cultural and social norms 3. His maturity level 4. How meaningful the relationship is to him 5. The acceptance of his involvement by the pregnant teen How the​ teen's partner reacts when he learns she is pregnant depends on his maturity level and on how meaningful he perceives the relationship to be. The cultural and social norms to which he has been exposed will also guide his reaction to the pregnancy. It is appropriate for the​ father-to-be to be involved in his​ partner's prenatal​ care, attend prenatal​ classes, and be present during labor and birth. This kind of participation provides support to the pregnant adolescent. The pregnant teen must welcome his involvement. It is the pregnant teen​'s mom who is most involved in the teen​'s health care decisions.

Which of the following are characteristics of ​preeclampsia? Select all that apply. 1. Hypertension 2. Proteinuria 3. Urinary tract infections 4. Onset after 20 weeks gestation 5. Liver damage

1. Hypertension 2. Proteinuria 4. Onset after 20 weeks gestation Preeclampsia is characterized by persistent​ proteinuria, elevated blood​ pressure, and an onset at greater than 20 weeks gestation. The client with preeclampsia is not prone to liver​ damage; however, HELLP syndrome may be a complication that involves elevated liver enzymes. Urinary tract infections are not generally associated with preeclampsia in the pregnant client.

Which of the following are considered purposes of childbirth education ​classes? Select all that apply 1. Improving coping mechanisms during the birth 2. Teaching about the process of childbirth 3. Sharing feelings about pregnancy and birth 4. Providing information about pregnancy 5. Ensuring a painless labor and delivery

1. Improving coping mechanisms during the birth 2. Teaching about the process of childbirth 3. Sharing feelings about pregnancy and birth 4. Providing information about pregnancy Childbirth classes are taught by certified childbirth educators. The classes are designed to provide the childbearing couple with information about​ pregnancy, childbirth, and coping mechanisms to help with the labor and delivery process. Childbirth education does not ensure a painless labor and delivery.

Which of the following would be avoided for an​ HIV-positive client who is in​ labor? 1. Internal fetal monitoring 2. IV fluids 3. Pain medication 4. Foley catheter

1. Internal fetal monitoring Invasive​ procedures, such as​ amniotomy, episiotomy, and internal fetal​ monitoring, should be avoided during labor for the​ HIV-positive client. This is due to the increased risk of exposure to the fetus. There is no contraindication for the administration of pain medication. It is important to assess pain and provide nursing care to manage this. Intravenous fluids fluids may be administered. Although this is​ invasive, there is no risk of exposing the fetus to maternal blood. Foley catheter administration may be used during labor without problems.

The nurse is caring for a client who is experiencing nausea and vomiting. The nurse believes the client could be pregnant. Which subjective change should the nurse assess in this​ client? 1. Last menstrual period 2. A pregnancy test 3. Abdominal enlargement 4. Presence of Chadwick​'s sign

1. Last menstrual period The absence of menses is the earliest subjective symptom of pregnancy. A positive pregnancy​ test, abdominal​ enlargement, and the presence of Chadwick​'s sign are all objective changes with pregnancy.

A nurse is teaching a pregnant client about hygiene and bathing during pregnancy. Which of the following are important topics to ​include? Select all that apply. 1. Leukorrhea may occur during pregnancy. 2. A​ well-balanced diet is needed for proper weight gain. 3. Balance may be off due to the enlarging abdomen. 4. Good dental hygiene is important due to ptyalism. 5. Bath water should not be too warm.

1. Leukorrhea may occur during pregnancy. 3. Balance may be off due to the enlarging abdomen. 4. Good dental hygiene is important due to ptyalism. 5. Bath water should not be too warm. The pregnant client may experience increased vaginal discharge and sweating during pregnancy. It is important to provide education about proper hygiene. The pregnant client should be counseled about her changing center of gravity. She may be at increased risk for falls when getting in and out of a tub bath. Tub baths should not be too warm. There is an increased risk of fainting and spontaneous abortion associated with hyperthermia from bath water that is too hot. It is important for the pregnant woman to maintain good oral hygiene during pregnancy due to​ ptyalism, tender​ gums, and the nausea and vomiting associated with pregnancy. While it is true that a​ well-balanced diet is needed for proper weight​ gain, this is not related to hygiene practices.

Which of the following may be seen in the prenatal client who has diabetes ​mellitus? Select all that apply. 1. Maternal preeclampsia 2. Neonatal macrosomia 3. Congenital abnormalities 4. HELLP syndrome 5. Cesarean section birth

1. Maternal preeclampsia 2. Neonatal macrosomia 3. Congenital abnormalities 5. Cesarean section birth Pre-existing medical conditions can lead to adverse effects on the outcome of pregnancy. Diabetes mellitus can lead to abnormally large newborns or neonatal macrosomia. Infants of diabetic mothers are at an increased risk of congenital abnormalities. These mothers may be at increased risk for the development of preeclampsia as well. Due to the occurrence of fetal macrosomia there is an increased incidence of cesarean section births in mothers who are diabetic. HELLP syndrome is associated with chronic​ pre-existing maternal​ hypertension, not diabetes mellitus.

What should be included in the nursing care of a pregnant client who has just had an​ amniocentesis? Select all that apply. 1. Monitoring fetal status 2. Administering IV pain medication 3. Assessing maternal vital signs 4. Noting uterine contraction pattern 5. Monitoring insertion site for bleeding

1. Monitoring fetal status 3. Assessing maternal vital signs 4. Noting uterine contraction pattern 5. Monitoring insertion site for bleeding The nurse may assist the provider with amniocentesis. Nursing responsibilities postprocedure include monitoring the insertion site for bleeding or leakage of​ fluid, monitoring maternal and fetal​ status, and noting uterine contraction pattern. The client should not require administration of IV pain medication as part of postprocedure care.

Which of the following would you include in the teaching plan for a client preparing for a nuchal translucency​ (NT) ​test? Select all that apply. 1. NT is a noninvasive test. 2. NT is performed between 18 and 20 weeks gestation. 3. An amniocentesis may be needed after the NT. 4. There may be false positive results. 5. NT is a screening​ test, not a diagnostic tool.

1. NT is a noninvasive test. 3. An amniocentesis may be needed after the NT. 4. There may be false positive results. 5. NT is a screening​ test, not a diagnostic tool. Nuchal translucency​ (NT) testing is a screening tool to assess the accumulation of fluid between the fetal cervical spine and skin overlying the neck. If the skin folds measure greater than 3​ mm, there is an increased risk for Down syndrome. To diagnose an​ anomaly, an amniocentesis will be required after the NT testing. Because this is a screening​ tool, there is the possibility of false positive results. This information should be provided to the mother prior to testing to help her decide about whether to have the testing or not. NT is performed during a specific window of​ time, weeks 11dash-13 of pregnancy

Which of the following describes Class I cardiac disease in​ pregnancy? 1. No activity​ limitations, no signs of cardiac insufficiency 2. Slight limitations in​ activity, comfortable at rest 3. Comfortable at​ rest, marked intolerance of activity 4. Cardiac insufficiency at​ rest, no activity tolerated

1. No activity​ limitations, no signs of cardiac insufficiency Cardiac disease in pregnancy is diagnosed through history and physical along with diagnostic testing. The severity of the mother​'s disease is determined by her tolerance for physical activity and is classified accordingly. Class I involves no activity restrictions and no signs of cardiac insufficiency. Class II clients have slight limitations in activity with fatigue. They are comfortable at rest. Class III disease includes being comfortable at​ rest, but having marked intolerance of activity. Class IV disease involves intolerance of any activity and signs of cardiac insufficiency at rest.

Which of the following tests may be performed during the second trimester of ​pregnancy? Select all that apply. 1. Oral glucose tolerance test 2. Urine dip for protein 3. Hemoglobin 4. Fundal height 5. Triple screen for chromosomal abnormalities

1. Oral glucose tolerance test 2. Urine dip for protein 4. Fundal height 5. Triple screen for chromosomal abnormalities Prenatal assessment during the second trimester includes assessment done earlier such as vital signs and urine dip for protein. Additional testing may include a triple or quad screen for chromosomal abnormalities. During 24dash-28 weeks of​ gestation, prenatal clients are screened for gestational diabetes with an oral glucose tolerance test. If the client is Rh​ negative, an indirect Coomb​'s test is completed at 28 weeks gestation. Routine measurements at each prenatal visit include fetal heart tones and fundal heights. The pregnant client​'s urine is tested at each visit for protein and signs of infection. If​ present, these may indicate preeclampsia or a risk for preterm labor. A hemoglobin level is often monitored during the first trimester but it is not commonly monitored during the second trimester.

Which of the following are potential complications associated with maternal smoking during ​pregnancy? Select all that apply. 1. Placenta previa 2. Poor nutrition 3. Abruptio placentae 4. Decreased placental perfusion 5. Hypotension

1. Placenta previa 2. Poor nutrition 3. Abruptio placentae 4. Decreased placental perfusion Many factors may influence the outcomes of pregnancy. Smoking may cause serious effects in the mother as well as the developing fetus. There may be decreased placental perfusion associated with maternal smoking. The mother may develop placental abnormalities such as abruptio placentae or placenta previa. Smoking is associated with poor nutritional intake as well. Smoking does not cause​ hypotension; on the​ contrary, the nicotine in cigarettes is a vasoconstrictor and increases blood pressure.

Which of the following nursing interventions are appropriate for the client with hyperemesis ​gravidarum? Select all that apply. 1. Providing education about the disease process 2. Giving emotional support to the mother 3. Recommending avoidance of offensive odors 4. Encouraging three large meals per day 5. Administering antiemetics as prescribed

1. Providing education about the disease process 2. Giving emotional support to the mother 3. Recommending avoidance of offensive odors 5. Administering antiemetics as prescribed The nurse provides care to the client with hyperemesis gravidarum to improve her pregnancy outcomes. Nursing interventions include measures to reduce the incidence of nausea and vomiting such as eating​ small, frequent meals and avoiding offensive odors. The nurse provides emotional support to the client and education about the disease condition.

Which of the following are psychosocial developmental tasks of early​ adolescence? Select all that apply. 1. Struggling with becoming comfortable with body image 2. Thinking in concrete terms 3. Acting in a​ self-centered way 4. The ability to think abstractly and anticipate consequences 5. Development of secondary sexual characteristics

1. Struggling with becoming comfortable with body image 2. Thinking in concrete terms 3. Acting in a​ self-centered way Psychosocial development of early adolescence includes the adolescent becoming comfortable with her developing body​ (body image) and acting in​ self-centered ways as she is preoccupied with her physical changes. Early adolescence thinking is​ concrete, as the ability to think abstractly and anticipate consequences happens in​ middle-to-late adolescence. Development of secondary sexual characteristics is a​ physiological, not​ psychosocial, task.

The nurse is completing an assessment on a woman that is 10 weeks gestation. The nurse is aware that which anatomic and physiologic changes occur in ​pregnancy? Select all that apply. 1. Superficial veins on the breasts become more​ prominent, and Montgomery​'s tubercles more pronounced. 2. The corpus luteum secretes progesterone that supports the pregnancy. 3. Vaginal tissue firms with a decrease in vascularity and also becomes less acidic. 4. There is uterine enlargement with an increase in uterine muscle fibers. 5. Progesterone triggers the cervix to produce thick​ mucus, which creates a plug creating a barrier between the vagina and the uterus.

1. Superficial veins on the breasts become more​ prominent, and Montgomery​'s tubercles more pronounced. 2. The corpus luteum secretes progesterone that supports the pregnancy. 4. There is uterine enlargement with an increase in uterine muscle fibers. Reproductive system changes during pregnancy include uterine enlargement with an increase in uterine muscle​ fibers, secretion of progesterone from the corpus​ luteum, and prominent superficial veins and pronounced Montgomery​'s tubercles on the breasts. Vaginal tissue softens and vascularity​ increases, resulting in Chadwick​'s ​sign; pH becomes acidic. Estrogen triggers the formation of the mucus plug sealing the endocervical canal.

The nurse anticipates monitoring of which of the following lab tests for the client who is diagnosed with gestational trophoblastic​ disease? 1. hCG 2. Hematocrit 3. Iron 4. Urinalysis

1. hCG Gestational trophoblastic disease causes abnormal elevations in levels of hCG. The nurse should anticipate the need for hCG monitoring in the client diagnosed with gestational trophoblastic disease. Following evacuation of the​ mole, hCG levels will be monitored every 1dash-2 weeks until they return to​ normal, then every 1dash-2 months for 1 year. Hematocrit​ levels, urinalysis, and iron are not routinely assessed in the client diagnosed with gestational trophoblastic disease

Which condition occurs in the initial newborn period due to maternal​ diabetes? 1. Spontaneous abortion 2. Hypoglycemia 3. Hypertension 4. Hypobilirubinemia

2. Hypoglycemia Hypoglycemia can occur in the newborn once the umbilical cord is cut. This leaves the newborn with a diminishing supply of glucose but an excessive supply of circulating insulin. Hyperbilirubinemia may occur as the result of the neonate​'s immature liver being unable to metabolize bilirubin. Since it occurs after 20 weeks​ gestation, gestational diabetes is not associated with spontaneous abortion. Hypertension is not an effect seen in the newborn whose mother had gestational diabetes.

The nurse is completing an initial assessment on a pregnant client who is​ single, has a high school​ diploma, and works for minimum wage. Which of the following outcomes would most likely be related to her socioeconomic​ status? 1. Development of gestational diabetes 2. Infant with low birth weight 3. Increased risk of chromosomal abnormalities 4. Anemia in the infant

2. Infant with low birth weight A low socioeconomic status places pregnant women at greater risk for premature​ labor/delivery, low-birth-weight​ infants, and intrauterine growth restriction​ (IUGR). An increased risk of chromosomal​ abnormalities, development of gestational​ diabetes, and anemia in the infant are not associated with a low socioeconomic status.

You are discussing birth plans with Mrs.​ Chavis, who is being admitted in early labor. She shares with you that she is interested in using special breathing techniques to control pain and having a water birth. You understand this involves which approaches to​ childbirth? 1. Odent and Bradley 2. Lamaze and Odent 3. Bradley and Lamaze 4. LeBoyer and Bradley

2. Lamaze and Odent The Lamaze method of childbirth involves breathing to control pain. The Odent approach involves the use of water births. The Bradley method encourages the use of midwives and a​ take-your-time approach. The LeBoyer method involves dim​ lighting, low​ voices, and light handling of newborns. The methods that would be applicable to this client are Lamaze and Odent.

A client with a normal​ pre-pregnancy weight asks why she has been told that she should gain 25dash-30 pounds during her​ pregnancy, but her underweight friend was told to gain more weight. The nurse should tell the client that recommended weight gain during pregnancy should​ be: 1. More than 25-30 pounds for an overweight client 2. More than 25-30 pounds for an underweight woman. 3. The same for a​ normal-weight woman as for an overweight woman. 4. 25-30 ​pounds, regardless of a​ client's pre-pregnant weight

2. More than 25-30 pounds for an underweight woman. Pre-pregnant weight determines the recommended weight gain during pregnancy. Women of normal weight should gain 25-30 pounds during pregnancy for optimal fetal outcome. Overweight women should gain 15-25 pounds during pregnancy. Underweight women are encouraged to gain the amount of weight needed to bring them to normal body weight plus 25-30 pounds.

Which of the following laboring clients may request herbal tea to help stimulate uterine​ contractions? 1. Hispanic client 2. Native American client 3. Asian client 4. African American client

2. Native American client Pregnancy is considered a normal process for Native American​ women, according to their cultural beliefs. The birth is usually attended by the whole​ family, and herbal teas may be used for uterine stimulation. Tea is not generally used by​ Hispanic, Asian, and African American cultural groups.

Which of the following are clinical manifestations associated with abruptio ​placentae? Select all that apply. 1. Nausea and vomiting 2. Painful vaginal bleeding 3. Maternal hypovolemic shock 4. Uterine hyperactivity 5. Abnormal fetal heart tracings

2. Painful vaginal bleeding 3. Maternal hypovolemic shock 4. Uterine hyperactivity 5. Abnormal fetal heart tracings Placental abruption is the premature separation of the placenta from the endometrium. The manifestations include the classic sign of painful vaginal​ bleeding, uterine hyperactivity or a​ board-like, rigid​ abdomen, abnormal fetal heart​ tracings, and maternal hypovolemic shock. The client is not generally affected by nausea and vomiting.

What are contraindications to sexual activity during ​pregnancy? Select all that apply. 1. Nausea 2. Placenta previa 3. There are no contraindications. 4. Premature rupture of membranes 5. Signs of preterm labor

2. Placenta previa 4. Premature rupture of membranes 5. Signs of preterm labor As long as the woman has no complications or risk factors the couple may continue to engage in sexual activity during her pregnancy. Complications such as premature rupture of​ membranes, placenta​ previa, and signs of preterm​ labor, are all contraindications to sexual activity. While nausea may make a woman disinterested in sexual​ activity, it is not a contraindication.

Which of the following are risk factors for gestational ​diabetes? Select all that apply. 1. Maternal age younger than 25 2. Previous gestational diabetes 3. Chronic hypertension 4. Underweight for height 5. Family history of diabetes

2. Previous gestational diabetes 3. Chronic hypertension 5. Family history of diabetes Gestational diabetes occurs during pregnancy. There are several known risk​ factors, including​ obesity, chronic​ hypertension, family history of​ diabetes, Maternal age older than​ 25, previous infant birth weight greater than​ 4,000 grams, and gestational diabetes in a previous pregnancy. Maternal age younger than 25 is not considered a risk factor. Nutrition and weight are important during​ pregnancy; being underweight is not a risk factor for gestational diabetes.

What are the effects on the client diagnosed with hyperemesis ​gravidarum? Select all that apply. 1. Hypertension 2. Starvation 3. Electrolyte imbalance 4. Dehydration 5. Weight loss

2. Starvation 3. Electrolyte imbalance 4. Dehydration 5. Weight loss Hyperemesis gravidarum refers to​ persistent, uncontrollable vomiting that begins in the first weeks of pregnancy and may continue throughout pregnancy. The effects on the client include weight​ loss, dehydration, electrolyte​ imbalances, and starvation. The exact etiology is unknown. Clients diagnosed with this condition do not generally experience hypertension. The nurse should not anticipate seeing this in a client with hyperemesis gravidarum.

A pregnant client reports having leg cramps at night. Which of the following actions could the nurse suggest to relieve the ​cramps? Select all that apply. 1. Performing pelvic tilt exercises 2. Stretching the calf muscle 3. Applying heat to the affected area 4. Taking iron supplements 4. Placing the foot flat on the floor

2. Stretching the calf muscle 3. Applying heat to the affected area 4. Placing the foot flat on the floor Discomforts of the musculoskeletal system during pregnancy include leg cramps. These may be relieved by placing the foot flat on the floor. Stretching the calf muscle helps to relieve leg cramps. Heat may help ease the discomfort of leg cramps. Iron supplementation may help prevent the occurrence of restless leg​ syndrome, not leg cramps. Pelvic tilt exercises may help​ backaches; however, they do not prevent or relieve leg cramps.

What suggestion could you make that would be most helpful in ensuring that a father feels included in the birth​ process? 1. Have him watch a live birth. 2. Take a childbirth class together. 3. Eat meals together. 4. Suggest that he read a book on pregnancy to make sure his partner is doing everything she should.

2. Take a childbirth class together. Having both partners attend a birth class together is an excellent way to include the father in the pregnancy. Eating meals together may be beneficial to the​ relationship, but may not have much effect on a​ father's feeling connected to the birth. Watching a birth or reading a book would be more educational than inclusive.

Which of the following are reasons ultrasound is used during the first trimester of ​pregnancy? Select all that apply. 1. Determining sex of the fetus 2. Verifying location of the pregnancy 3. Performing amniocentesis 4. Confirming pregnancy viability 5. Estimating amniotic fluid volume

2. Verifying location of the pregnancy 3. Performing amniocentesis 4. Confirming pregnancy viability Ultrasound is widely used in pregnancy due to the fact that it is readily​ available, safe, and noninvasive. Uses for ultrasound during the first trimester include confirmation of​ pregnancy, verification of location of​ pregnancy, determination of gestation​ age, confirmation of viability of​ pregnancy, and assisting with amniocentesis. During the second​ trimester, ultrasound may be used to determine the sex of the fetus and estimate amniotic fluid volume.

What discomforts could you tell a woman she might expect to experience during her ​pregnancy? Select all that apply. 1. Dry mouth 2. Excessive energy 3. Leg cramps 4. Round ligament pain 5. Heartburn

3. Leg cramps 4. Round ligament pain 5. Heartburn It may be helpful for you to provide anticipatory guidance as to the discomforts a woman might expect during her pregnancy. Among them are leg​ cramps, heartburn, and round ligament pain. Most pregnant women do not experience excessive energy or dry mouth

What is the most common cause of first trimester​ bleeding? 1. Urinary tract infection 2. Chlamydia 3. Spontaneous abortion 4.Cervical engorgement

3. Spontaneous abortion The most common cause of first trimester bleeding is spontaneous abortion​ (SAB). This is a loss of the pregnancy that occurs at less than 20 weeks gestation. It is commonly called a miscarriage. Urinary tract​ infection, chlamydia, and cervical engorgement are not common causes of bleeding in pregnancy. The nurse would not anticipate these problems in the client who presents with first trimester bleeding without taking a more detailed history and performing an assessment

The nurse is interviewing a pregnant client and her partner during an office visit. Which of the following statements by the nurse can assist in involving the ​partner? Select all that apply. ​1. "I have information about childbirth classes for you to take home​ today." 2 "Backrubs can help relieve lower back discomfort associated with​ pregnancy." ​3. "You will not understand many of her​ complaints." ​4. "Having crackers by the bedside helps with morning​ nausea." ​5. "How do you feel about participating in the childbirth​ process?"

​1. "I have information about childbirth classes for you to take home​ today." 2 "Backrubs can help relieve lower back discomfort associated with​ pregnancy." ​4. "Having crackers by the bedside helps with morning​ nausea." ​5. "How do you feel about participating in the childbirth​ process?" Nurses caring for pregnant women need to consider the needs of the​ woman's family. The nurse can assess the​ father's plans for participating in the childbirth experience. The nurse encourages participation of the father by providing information about childbirth education classes. The nurse offers information to the father that may help him be aware of the common discomforts of pregnancy. In​ addition, the nurse should provide information to help the father feel that he can assist the pregnant client in managing these discomforts. The nurse should educate the father on what to expect and how to support the woman through pregnancy. Encouraging the father to provide crackers in the morning for the pregnant client helps involve him in the pregnancy. The nurse should not tell the father that he may not understand the pregnant​ client's complaints or experiences. This distances the father from the pregnancy.

The nurse is explaining some of the common discomforts of pregnancy to a couple. Which of the following statements should the nurse ​include? Select all that apply. ​1. "Some women experience heartburn during​ pregnancy." ​ 2. "Having an increased amount of clear vaginal discharge is​ normal." ​ 3. "You may experience leg cramps while you are​ pregnant." ​ 4. "It is not uncommon to have some tenderness in your​ breasts." ​5. "Most women lose about 10 lbs during their​ pregnancy."

​1. "Some women experience heartburn during​ pregnancy." 2. "Having an increased amount of clear vaginal discharge is​ normal." 3. "You may experience leg cramps while you are​ pregnant." 4. "It is not uncommon to have some tenderness in your​ breasts." One of the subtle changes in pregnancy is enlargement of the breasts. There may also be tenderness associated with this physiological change. Pregnant women may notice an increase in the amount of vaginal discharge. This is considered normal as long as the discharge is clear and without any signs of infection such as odor or vaginal itching. Heartburn is considered a common occurrence during pregnancy. The nurse provides education about management of this during pregnancy. Other common discomforts of pregnancy include leg cramps and round ligament pain. A weight loss of 10 lbs during pregnancy is not considered a common occurrence. The nurse would not include this in education about the common discomforts of pregnancy.

A client expresses concern that she is an older mother and wonders how she will be able to care for her child as the child gets older. What is an appropriate response by the​ nurse? ​1. "I will let the doctor know your​ concerns." ​2. "I understand you are​ concerned, but you are doing all you can right now to have a healthy​ baby." ​3. "Do you have family members to care for this child when you are​ gone?" ​4. "This is something that needed to be considered prior to getting​ pregnant."

​2. "I understand you are​ concerned, but you are doing all you can right now to have a healthy​ baby." The nurse provides opportunities for older parents to express their concerns about raising a child. They also provide reassurance that the parents are doing all the right things for their child right now. The nurse is not providing reassurance to the older pregnant client by asking her about plans for her child after her death. This is not an appropriate response by the nurse. The nurse provides an insensitive comment by telling the client she should have considered this prior to becoming pregnant. This is not an appropriate or helpful comment in addressing the​ client's concerns. The nurse is not responding to the​ client's needs by referring this to the provider.

A pregnant client tells the nurse that her culture demands that she not eat certain foods during pregnancy. Which of the following responses by the nurse would be​ inappropriate? 1. "Let​'s have you see a dietician to ensure that your diet is adequate without the foods you want to​ avoid." 2. "I respect your nutritional​ preferences, and we can work within those​ guidelines." ​3. "Let​'s talk about other foods that you can eat to ensure nutrition that will support the health of you and your​ baby." ​4. "You need to eat a​ good, nutritious diet. You should not follow such rules​ now."

​4. "You need to eat a​ good, nutritious diet. You should not follow such rules​ now." It is important to respect the woman​'s cultural​ preferences, help her plan an adequate prenatal diet within the framework of her​ preferences, and refer her to a dietitian if necessary. It would not be therapeutic to tell her not to follow cultural rules.