PNU 133 PassPoint PrepU Antepartum Period
The community nurse works with the family to answer any questions on baby care. The nurse would like to maintain therapeutic boundaries within the therapeutic relationship. Which of the following is the best way to maintain boundaries?
The nurse does not disclose her home address or accept the invitation to stay for lunch.
As part of a prenatal nutritional education program for a 17-year-old pregnant client who is concerned about weight gain, a nurse is reinforcing the information. Which statement by the nurse would be most appropriate?
"During pregnancy, you need to gain weight to help make sure your baby is healthy."
A client arrives at the clinic for a scheduled amniocentesis. Which question should the nurse ask?
"Have you emptied your bladder?"
During a routine prenatal visit, a pregnant client reports constipation, and the nurse teaches her how to relieve it. Which client statement indicates an accurate understanding of the nurse's instructions?
"I'll increase my intake of unrefined grains."
A client in the first trimester of pregnancy reports constant fatigue. Which response by the nurse is best?
"Needs for rest and sleep typically increase during the first trimester of pregnancy."
A pregnant client asks the nurse whether she can take castor oil for her constipation. How should the nurse respond?
"No, it can initiate premature uterine contractions."
The nurse is providing care for a pregnant 16-year-old client. The client says that she's concerned she may gain too much weight and wants to start dieting. The nurse should respond by saying:
"Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems."
A primigravida client in her 10th week of pregnancy calls the clinic to report that she's experiencing slight vaginal bleeding. Which responses by the nurse would be best? Select all that apply.
"Save any perineal pads, clots, and tissue." "Come into the clinic as soon as possible."
A pregnant client being seen in the clinic reports increasing leg cramps. Which response by the nurse is most appropriate?
"Sometimes gently stretching the legs helps relieve leg cramps."
An adolescent who is 14 weeks pregnant comes to the clinic for a prenatal examination. During the examination, the client says to the nurse, "I'm still not sure if I want to keep my baby." Which response by the nurse is best?
"Tell me more about how you are feeling about the baby."
The nurse is discussing posture with a client who's 18 weeks pregnant. The clients asks why should she avoid the supine position. How does the nurse respond?
"This position impedes blood flow to the fetus."
A nurse is providing care for a pregnant client who asks how she can best deal with her fatigue. Which instruction would the nurse most likely reinforce with the client?
"Try to get more rest by going to bed earlier."
A client in the seventh month of pregnancy reports back pain and wants to know what can be done to relieve it. After consulting with the supervising nurse about the client's report, which instruction would the nurse most likely reinforce?
"Try using pelvic tilt exercises while avoiding lifting heavy objects."
A client who's 4 months pregnant asks the nurse how much and what type of exercise she should get during pregnancy. How should the nurse counsel her?
"Walk briskly for 10 to 15 minutes daily, and gradually increase this time."
A client who's 37 weeks pregnant comes to the clinic for a prenatal checkup. To evaluate the client's preparation for parenting, the nurse might ask which question?
"What changes have you made at home to get ready for the baby?"
A nurse is discussing nutrition with a primigravida client. The nurse is informed that the client knows that calcium is important during pregnancy but that client and the client's family do not consume many milk or dairy products. What advice should the nurse give?
"You should consume other nondairy foods that are high in calcium."
A client with preeclampsia is prescribed magnesium sulfate to prevent seizure activity. The nurse is reviewing the results of the client's serum magnesium level and determines that the client's level is therapeutic based on which result?
6.8 mEq/L (3.4 mmol/L)
During a health-teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. Which timeframe should the nurse appropriately supply?
7 days after fertilization
During her first prenatal visit, a client expresses concern about gaining weight. Which action should be the nurse's next step?
Ask the client how she feels about gaining weight and provide instructions about expected weight gain and diet.
A client in the third trimester of pregnancy is having contractions 5 minutes apart that began suddenly. The nurse identifies that it is the client's seventh month. The client is admitted directly to the obstetrics department. Which intervention has priority?
Check fetal heart tones.
A client who's 24 weeks pregnant has sickle cell anemia. When preparing the plan of care, the nurse should identify which factor as a potential trigger for a sickle cell crisis during pregnancy?
Dehydration
When collecting data on a pregnant client with diabetes mellitus, the nurse stays alert for signs and symptoms of a vaginal or urinary tract infection (UTI). The nurse recognizes which condition makes this client more susceptible to such infections?
Glycosuria
A client who is 12 weeks pregnant attends a class on fetal development as part of a childbirth education program. The nurse provide which information that at 16 weeks' gestation the client's fetus will most likely present?
Have audible heart sounds
A nurse in a prenatal clinic is assessing a 28-year-old who's 24 weeks pregnant. Which findings would lead this nurse to suspect that the client has mild preeclampsia?
Hypertension, edema, proteinuria
Which medication is considered safe during pregnancy?
Insulin
A nurse is preparing a presentation for a pregnant client with diabetes. Which information would the nurse include to explain why a pregnant diabetic client is at risk for having a large-for-gestational-age infant?
Insulin acting as a growth hormone on the fetus
A pregnant client's last menstrual period began on October 12. The nurse calculates the estimated date of delivery (EDD) as:
July 19.
A client is in the 8th month of pregnancy. Which body position does the nurse advise the client to assume to enhance cardiac output and renal function when laying down?
Left lateral
The nurse is caring for a pregnant client in the third trimester of pregnancy. The client is concerned about being dizzy when lying down on her back. The nurse would suggest which intervention to eliminate the dizziness?
Lie on the left side when lying down.
The nurse is assessing a client whose membranes ruptured prematurely 12 hours ago. Which is the nurse's highest priority to evaluate when collecting data on this client?
Maternal vital signs and fetal heart rate (FHR)
A client comes to the clinic for a routine prenatal examination. The nurse notices that the client is disheveled and unkempt. The client explains, "I have no energy to take care of myself and I really don't care." How should the nurse intervene?
Offer to assist the client with basic care needs while waiting for the health care provider.
A client treated with terbutaline for preterm labor is ready for discharge. Which instruction should the nurse include in the discharge teaching plan?
Report a heart rate greater than 120 beats/minute to the health care provider.
A client who's 12 weeks pregnant is reporting severe left lower quadrant pain and vaginal spotting. She's admitted for treatment of an ectopic pregnancy. Which nursing diagnosis should the nurse should give the highest priority to?
Risk for deficient fluid volume.
A client's prenatal history shows the client to be a 23-year-old gravida 4, para 2. The nurse has correctly interpreted this information when making which statement?
The client has been pregnant four times and delivered two live-born children.
A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. Her BPP score is 8. How does the nurse correctly interpret this finding?
The fetus isn't in distress at this time.
During a physical examination, a client who's 32 weeks pregnant becomes pale, dizzy, and light-headed while supine. Which action should the nurse immediately take?
Turn the client on her left side.
During an examination, a pregnant client at 32 weeks' gestation becomes dizzy, light-headed, and pale while supine. Which action would the nurse do first?
Turn the client to the left side.
A pregnant client at 26 weeks' gestation undergoes a glucose tolerance test. The nurse identifies the need for further action based on which results?
a 1-hour glucose level of 160 mg/dL (8.88 mmol/L) during a 3-hour glucose tolerance test
A pregnant client is screened for tuberculosis during at the first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. The nurse determines that the result is positive based on which finding?
an indurated wheal larger than 10 mm in diameter appearing in 48 to 72 hours
A client, 11 weeks pregnant, is admitted to the facility with hyperemesis gravidarum. She tells the nurse she has never known anyone who had such severe morning sickness. The nurse understands that hyperemesis gravidarum results from:
an unknown cause.
An adolescent prenatal client asks about getting fat while pregnant. To prevent which condition, the nurse says, "Because of your age, you need to gain enough weight to be in the upper portions of your recommended weight"?
birth of a low-birth-weight neonate
At 32 weeks' gestation, a client is admitted to the facility with a diagnosis of pregnancy-induced hypertension (PIH). What signs and symptoms will the nurse expect? Select all that apply.
edema proteinuria
When determining maternal and fetal well-being, which data collection finding is most important?
fetal heart rate and activity
A client with preeclampsia is scheduled to undergo a nonstress test (NST) and asks the nurse why this test is being performed. When responding to the client, which condition would the nurse most likely include as the reason?
fetal well-being
The nurse obtains the antepartum history of a client who's 6 weeks pregnant. Which finding should the nurse discuss with the client first?
her consumption of six to eight cans of beer on weekends
The nurse is providing care to a pregnant client with preeclampsia. Magnesium sulfate has been ordered. The nurse understands that this drug is being given to prevent which condition?
seizures
A nurse receives the result of a pregnant client's human immunodeficiency virus (HIV) testing. When the nurse attempts to notify the client of the results, the client can't be located. The nurse should:
send a registered letter asking the client to contact the clinic.
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.
A primigravida client in the fifth month of pregnancy has been receiving regular prenatal care since week 8. During a routine visit, the client reports feeling dizzy, breathless, and clammy when arising from bed in the morning. The nurse should obtain data relevant to which condition?
supine hypotension
