PN108 PrepU Chapter7
Why is the first prenatal visit usually the longest prenatal visit?
Baseline data is collected.
A pregnant woman is flying across the country to visit her family. After teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful?
"I'll get up and walk around the airplane about every 2 hours."
A nurse is educating a pregnant client about obtaining a blood sample for an alpha-fetoprotein (AFP) level. Which response by the client indicates that the health teaching was successful?
"If my AFP level is high, it could mean there is a problem with my baby's spinal cord."
At her 12-week prenatal visit, the primagravida states, "I haven't felt my baby move yet. What is wrong?" What is the best response to the client?
"The fetus kicks regularly, although the pregnant woman usually cannot feel the movements until approximately 16 to 20 weeks."
A client comes to the clinic for her usual prenatal check up. The nurse measures the fundal height at 24 cm. What is the estimated length of her gestation?
24 weeks
The nurse is measuring the fundal height of a woman who is at 28 weeks' gestation. Which measurement would the nurse expect?
28 cm
A pregnant woman comes to the clinic for a visit. This is her third pregnancy. She had a miscarriage at 12 weeks and gave birth to a son, now 3 years old, at 32 weeks. Using the GTPAL system, the nurse would document this woman's obstetric history as:
30111
A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:
4 weeks.
Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.
4, 1, 1, 1, 1
A client at 16 weeks' gestation is scheduled for prenatal testing. Which of the following would the nurse anticipate as the most likely screening test for congenital anomalies based on the current age of this pregnancy?
Amniocentesis.
What is the most appropriate nursing intervention when writing a care plan for a pregnant woman and using the nursing diagnosis "Readiness for enhanced family coping due to new role?"
Assess the structure, resources, and coping abilities of the family
As part of the assessment of a client's health history during the first prenatal visit, the nurse is having the client complete a 24-hour recall to establish what and how much the woman is eating. In which section of the health history should the nurse record this information?
Day history/social profile
What are the purposes for prenatal care? Select all that apply.
Establish a baseline of present health. Determine the gestational age of the fetus. Monitor for fetal development and maternal well-being. Identify women at risk for complications.
The client is 32 weeks pregnant and has been referred for biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective?
The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.
A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?
G3 P0020
Why is a Papanicolaou smear done at the first prenatal visit?
It identifies abnormal cervical cells.
A client's last menstrual period was April 11. Using Nagele's rule, her estimated date of birth (EDB) would be:
January 18.
During the initial prenatal visit, a client indicates that she frequently experiences stress incontinence. Which of the following should the nurse recommend to the client to help relieve this condition?
Perform Kegel exercises
The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client?
Primigravida
When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes which goal as the primary one?
Provide knowledge and skills to actively participate in birth and parenting.
A pregnant woman has come to the clinic for her first prenatal visit. The nurse informs the woman that the physician will do a pelvic examination at this time and that she should go empty her bladder. What is the primary reason the nurse instructs the patient to empty her bladder?
Urinating now will allow easier identification of organs.
A nurse is assessing a pregnant client. Which of the following would the nurse document as an abnormal finding in a pregnancy?
Visual changes
During pregnancy the cardinal rule regarding taking medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy?
asthma
A nurse at the health care facility assesses a client in the 20th week of gestation. The client is healthy and progressing well, without any sign of complications. Where should the nurse expect to measure the fundal height in this client?
at the level of the umbilicus
The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?
at the level of the umbilicus
A woman who is 26 weeks pregnant arrives for a follow-up visit. Which assessments, in addition to measuring fundal height and fetal heart rate, would the nurse expect to complete? Select all that apply.
blood pressure weight urine testing blood glucose level
Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing?
clean catch urine
Some women contract with other women to provide support during pregnancy and birth, to provide emotional support during labor and birth, and to aid in establishing breastfeeding. What is the name of the woman who is contracted?
doula
During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. The nurse would develop a plan of care identifying interventions to promote which area as the priority?
gas exchange
A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse?
gravida 4, para 2
A nurse is taking a history during a client's first prenatal visit. Which assessment finding would alert the nurse to the need for further assessment?
history of diabetes for 4 years
An adolescent who is 8 weeks' pregnant is at her first perinatal visit. During the health history interview, the nurse asks the client, "Are you afraid of anyone?" What is the nurse assessing with this question?
intimate partner abuse
By the time a woman is 36 weeks' gestation, where would the nurse expect to find the uterus?
near the bottom of the sternum
The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended for prenatal care?
once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth
A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which condition?
open spinal defects
At each prenatal visit, a client provides a urine sample to the health care provider. What is this urine sample tested for at each visit?
protein and glucose
Which two tests are generally performed on urine at a prenatal visit?
protein and glucose
During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as:
reactive pattern.
The nurse correctly identifies "gravida 3, para 2" as which definition?
two previous pregnancies, two children born at term, and currently pregnant