QUIZ 1

A nurse is caring for a client who is in the first trimester of pregnancy and asks how to manage heartburn. Which of the following responses should the nurse make? A. "Reduce the amount of food you eat during meals." B. "Sip carbonated beverages between meals." C. "Lie down and rest immediately after meals." D. "Drink iced tea with meals."

A. "Reduce the amount of food you eat during meals."

A nurse is teaching a client about squatting exercises during pregnancy. Which of the following statements should the nurse include? A. "These exercises should be done for 15 minutes each day to strengthen the perineal muscles." B. "Squatting exercises can tone your abdomen, helping you lose weight faster following delivery." C. "Practicing squatting exercises during pregnancy will reduce lower back pain during labor." D. "Doing squatting exercises 3 times per week will improve your overall fitness."

A. "These exercises should be done for 15 minutes each day to strengthen the perineal muscles." Rationale: Squatting exercises help stretch the perineum, allowing stretching during delivery and improving functional efficiency after delivery.

A nurse in a prenatal clinic is caring for a client who believes that she might be pregnant because she feels the baby moving. Which of the following statements should the nurse make? A. "This is a presumptive sign of pregnancy." B. "This is a probable sign of pregnancy." C. "This is a possible sign of pregnancy." D. "This is a positive sign of pregnancy."

A. "This is a presumptive sign of pregnancy."

A nurse is performing a routine prenatal examination of a client who is in the second trimester. The client reports backaches with no other symptoms and refuses medication. Which of the following responses should the nurse make? A. "Try pelvic tilt exercises." B. "Limit your physical activity." C. "Soak in a warm bubble bath." D. "Lie flat on your back for 1 hour."

A. "Try pelvic tilt exercises." Rationale: Backaches are common during the second trimester due to the relaxation of the joints that otherwise stabilize the pelvis and the shift in the client's center of gravity. Pelvic tilt exercises, resting, and sleeping on a firm mattress can help ease this pain.

A nurse is providing teaching about weight gain during pregnancy for a client who is a primigravida of normal pre-pregnancy weight. Which of the following statements should the nurse include? A. "You should plan to gain 25 to 35 pounds during your pregnancy." B. "You should plan to gain 11 to 20 pounds during your pregnancy." C. "Because you started pregnancy at a normal BMI and weight, your weight gain is not limited as long as you follow a healthy, balanced diet." D. "Because you are of normal weight prior to pregnancy, you are encouraged to gain 28 to 40 pounds during pregnancy."

A. "You should plan to gain 25 to 35 pounds during your pregnancy." Rationale: A client of normal prepregnancy weight should plan to gain 11.3 to 15.9 kg (25 to 35 lb) during pregnancy. Weight gain is primarily for maternal tissue growth during the first and second trimesters and fetal tissue growth during the third trimester.

A nurse is caring for a client at 12 weeks gestation who has a BMI of 45. Which of the following pieces of information should the nurse provide for the client regarding the recommended weight gain during her pregnancy? A. "You should plan to gain no more than 20 pounds during your pregnancy." B. "You should plan to gain between 25 and 35 pounds during your pregnancy." C. "You should not plan to gain any weight during your pregnancy because you are already well-nourished." D. "Since you have higher energy needs than an average-sized pregnant client, you should plan to gain 45 to 50 pounds."

A. "You should plan to gain no more than 20 pounds during your pregnancy." Rationale: Women who have a BMI above 30 should limit their weight gain to 11 to 20 pounds during pregnancy. Excessive weight and weight gain increase the risk of complications during and after pregnancy.

A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy, terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client's current status?

A. 4-0-1-2-2 This response correctly describes the client's current status: pregnant currently and had 3 prior pregnancies (G); no term births (T); one pregnancy resulted in the preterm birth (P) of twins; two pregnancies ended in abortion (A); and she has two living children (L).

A nurse is caring for a client during her first prenatal visit and notes that she is lactose-intolerant. Which of the following foods should the nurse include on a list of calcium sources for this client? A. Collard greens B. Cottage cheese C. Orange juice D. Broccoli

A. Collard greens Rationale: Collard greens are a good source of lactose-free calcium. One cup of collard greens provides approximately the same amount of calcium as the equivalent volume of 240 mL (8 oz) of milk. Collard greens also contain folic acid, which is a nutrient women should consume during pregnancy to prevent birth defects.

A nurse is discussing contraceptive choices with a client who has a history of thrombophlebitis. Which of the following methods of contraception should the nurse recommend? A. Copper intrauterine device B. Combination pill C. Vaginal ring D. Medroxyprogesterone injection

A. Copper intrauterine device Rationale: A history of thrombophlebitis is a contraindication for the use of hormonal contraceptive methods such as oral combinations of estrogen and progesterone in pill form, vaginal inserts that release hormones continuously, and injectable progestins. A copper intrauterine device that does not contain hormones is a safer choice for this client. Other options for this client include barrier methods and spermicides.

A nurse is teaching a client who is at 12 weeks gestation about manifestations of potential complications that she should report to her provider. Which of the following pieces of information should the nurse include in the teaching? A. Facial swelling B. Urinary frequency C. White vaginal discharge D. Intermittent nausea

A. Facial swelling Rationale: The nurse should instruct the client to report facial swelling because this can indicate a hypertensive disorder or preeclampsia.

A nurse is providing nutritional counseling for a client who is pregnant. Which of the following nutrients should the nurse instruct the client to increase in her daily diet? A. Iron B. Calcium C. Vitamin E D. Vitamin K

A. Iron Rationale: Iron supplements are recommended during pregnancy to promote adequate transfer of iron to the fetus and to support the expansion of the maternal RBC mass.

A nurse on the antepartum unit is caring for a client who is at 28 weeks gestation and reports dizziness when lying on her back. Into which of the following positions should the nurse assist the client? A. Lateral B. Lithotomy C. Trendelenburg D. Prone

A. Lateral Rationale: A lateral or side-lying position promotes uteroplacental blood flow and helps relieve the symptoms of supine hypotension, including faintness, dizziness, and breathlessness.

A nurse is assessing a client who reports that she might be pregnant. Which of the following findings should the nurse identify as a presumptive sign of pregnancy? A. Nausea in the morning B. Positive home pregnancy test C. Increased sensitivity of the cervix noted upon examination D. Gestational sac observed by transvaginal ultrasound

A. Nausea in the morning Rationale: Nausea is a presumptive sign of pregnancy—that is, a subjective symptom reported by the mother that could have a cause other than pregnancy.

A nurse is caring for a client who believes she may be pregnant. Which of the following findings should the nurse identify as a positive sign of pregnancy? A. Palpable fetal movement B. Chadwick's sign C. Positive pregnancy test D. Amenorrhea

A. Palpable fetal movement Rationale: Palpable fetal movements are a positive sign of pregnancy. Quickening, the client's report of fetal movement, is a presumptive sign of pregnancy

A nurse is reviewing the medical record of a client who is at 20 weeks of gestation. Which of the following findings should the nurse identify as a presumptive indication of pregnancy? A. Report of fetal movement by the client B. Auscultation of the fetal heart rate with Doppler ultrasound C. Presence of Chadwick's sign on pelvic examination D. Report of Braxton-Hicks contractions by the client

A. Report of fetal movement by the client

A nurse in a clinic is caring for a client who is pregnant and reports a last menstrual period (LMP) that began on December 7. Which of the following dates would be the client's estimated date of birth (EDB)? A. September 14 B. September 7 C. March 14 D. March 7

A. September 14

A nurse is assessing a client at 27 weeks of gestation. The client has placenta previa and reports vaginal bleeding. Which of the following additional manifestations should the nurse expect? A. The fundal height measures greater than gestational age. B. A rigid abdomen is noted on palpation. C. The client reports a pain level of 8 on a 0-to-10 pain scale. D. A urine drug screen is positive for cocaine

A. The fundal height measures greater than gestational age. Rationale: Clients with placenta previa often measure slightly larger than expected because the fetus remains higher in the uterus.

A nurse is providing teaching to a client who is planning on becoming pregnant about the changes she should expect. Identify the sequence of maternal changes. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)- Quickening- Lightening- Goodell's sign- Amenorrhea

Amenorrhea, Goodell's sign, Quickening, Lightening Rationale: Amenorrhea, a presumptive sign of pregnancy, is one of the first physiological indications of pregnancy that occurs by 4 weeks of gestation. Goodell's sign, a probable sign of pregnancy, is the next of physiological indications to occur. Goodell's sign is the softening of the cervix that typically occurs at 5 to 6 weeks of gestation. Quickening, the mother's perception of the first fetal movement, is a presumptive sign of pregnancy that typically occurs between 16 and 20 weeks of gestation. Lightening is the last of these physiological signs of pregnancy to occur. As the fetus descends into the pelvic cavity the fundal height decreases, which typically occurs between 38 and 40 weeks of gestation.

A nurse in a prenatal clinic is caring for a client who is pregnant and asks the nurse for her estimated date of birth (EDB). The client's last menstrual period began on July 27. What is the client's EDB? (State the date in MMDD. For example, July 27 is 0727).

Answer: 0504. Using Nägele's rule, the nurse subtracts three months from the date of the last menstrual period, then adds 7 days. July minus 3 months equals April. There are 30 days in April, so 27 + 7 = May 4. The client's EDB is May 4, which would be written as 0504 in the MMDD format.

A nurse is caring for a client who is in her first trimester of pregnancy and asks the nurse if she can continue to exercise during pregnancy. Which of the following responses by the nurse is appropriate? A. "Exercising during pregnancy is not recommended. B. "Daily jogging for up to 30 minutes is fine throughout the pregnancy." C. "Activities that raise the body temperature, such as saunas and hot tubs, are safe until the third trimester." D. "It is recommended that pregnant clients limit their exercise routine to stretching activities on a mat several times a week."

B. "Daily jogging for up to 30 minutes is fine throughout the pregnancy."

A nurse is assessing a client who is at 20 weeks gestation and reports frequent episodes of indigestion and heartburn. Which of the following instructions should the nurse give to the client? A. "Limit your intake of food to twice per day." B. "Decrease your intake of spicy foods." C. "Rest in a supine position for a few minutes after eating." D. "Increase your intake of water and carbonated beverages."

B. "Decrease your intake of spicy foods." Rationale: Spicy foods cause gastric irritation, which may increase during pregnancy as a result of various physiological changes.

A nurse is providing education for a pregnant client about symptoms that should be reported immediately to the provider. Which of the following client responses indicates an understanding of the teaching? A. "I should call my provider if I develop melasma." B. "If I notice that my eyes are puffy, I should call my provider." C. "I should call my provider if I notice that my feet and ankles are swollen." D. "If I notice periodic numbness and tingling in my fingers, I should call my provider."

B. "If I notice that my eyes are puffy, I should call my provider." Rationale: Puffy eyes are associated with facial edema, which is a sign of pregnancy-induced hypertension. This should be reported immediately.

A nurse is caring for a client at the first prenatal visit who has a BMI of 26.5. The client asks how much weight she should gain during pregnancy. Which of the following responses should the nurse make? A. "It would be best if you gained about 11 to 20 pounds." B. "The recommendation for you is about 15 to 25 pounds." C. "A gain of about 25 to 35 pounds is recommended for you." D. "A gain of about 1 pound per week is the best pattern for you."

B. "The recommendation for you is about 15 to 25 pounds." Rationale: Clients who are overweight, having a BMI of 25 to 29.9, should be advised that the recommended weight gain is 7 to 11.5 kg (15 to 25 lb). The pattern of weight gain is also important, with minimal gain in the first trimester.

A nurse is caring for several clients. Which of the following clients should the nurse identify as a candidate for oral contraceptives? A. A client who smokes 2 packs of cigarettes per week B. A client who is breastfeeding a 7-month-old infant C. A client who is taking an anticonvulsant medication D. A client who is taking anti-HIV protease inhibitors

B. A client who is breastfeeding a 7-month-old infant Rationale: A nurse is caring for several clients. Which of the following clients should the nurse identify as a candidate for oral contraceptives?

A nurse is assessing a pregnant client at 26 weeks of gestation who reports an episode of dizziness after lying on her back on the couch. Which of the following actions should the nurse take? A. Request a prescription for preeclampsia laboratory studies B. Advise the client to lie on her side C. Request an ultrasound to evaluate fetal wellbeing D. Advise the client to add a calcium supplement to her diet

B. Advise the client to lie on her side Rationale: Dizziness after a pregnant client lies flat on her back is a sign of supine hypotension, which is caused by compression of the vena cava from the weight of the pregnant uterus. Pregnant women should be advised to avoid lying in a supine position.

A nurse is reviewing recent laboratory values during a prenatal visit for a client who is pregnant. The nurse notes a hemoglobin level of 10 g/dL. Which of the following actions should the nurse take? A. Review the medical record for a history of gastric bypass surgery B. Advise the client to start iron and vitamin C supplementation C. Review the medication list to determine if the client is taking an anticonvulsant D. Request an order for sickle cell anemia screening

B. Advise the client to start iron and vitamin C supplementation Rationale: Anemia during pregnancy is defined by hemoglobin levels less than 10.5 to 11 g/dL, depending on the client's gestational age. Iron-deficiency anemia is characteristically microcytic. It is treated with iron supplementation with added vitamin C to aid in iron absorption.

A nurse is providing discharge instructions for a client who had a cesarean birth 4 days ago. The client's hemoglobin level is 9.2 g/dL, and the provider has prescribed an iron supplement. Which of the following foods should the nurse recommend to help increase the client's iron intake? A. Spinach B. Citrus fruit C. Milk D. Whole-grain bread

B. Citrus fruit Rationale: Foods that have a high vitamin C content help increase the absorption of iron. These foods include citrus fruits, strawberries, melons, and tomatoes.

A nurse is assessing a client who is at 36 weeks of gestation. Which of the following manifestations should the nurse recognize as a potential prenatal complication and report to the provider? A. Varicose veins B. Double vision C. Leukorrhea D. Flatulence

B. Double vision Rationale: Double vision, blurred vision, or visual disturbances are signs of potential complications associated with preeclampsia. The nurse should report this finding to the provider.

A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the client that smoking places the client's newborn at risk for which of the following complications? A. Hearing loss B. Intrauterine growth restriction C. Type 1 diabetes mellitus D. Congenital heart defects

B. Intrauterine growth restriction Rationale: Clients who smoke place their newborns and themselves at risk for diverse complications, including fetal intrauterine growth restriction, placental abruption, placenta previa, preterm delivery, and fetal death

A nurse is caring for a client who requests an intrauterine device (IUD) for contraception. Which of the following findings is a contraindication for this device? A. Hypertension B. Menorrhagia C. History of multiple gestations D. History of thromboembolic disease

B. Menorrhagia Rationale: An IUD is a small plastic or copper device placed inside the uterus that changes the uterine environment to prevent pregnancy. An IUD is contraindicated for women who have menorrhagia, severe dysmenorrhea, or a history of ectopic pregnancy.

A nurse is reviewing the laboratory values of a client who is pregnant and has a low progesterone level. Which of the following complications should the nurse expect? A. Gestational diabetes B. Preterm labor C. Inadequate milk supply D. Inadequate uterine growth

B. Preterm labor Rationale: Progesterone maintains the lining of the uterus, which maintains the pregnancy. It also reduces uterine contractility. A client who has a low progesterone level is at risk for preterm labor.

A nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation. At which location should the nurse expect to palpate the fundus? A. 5 cm above the umbilicus B. Slightly above the umbilicus C. Slightly below the umbilicus D. 3 cm below the umbilicus

B. Slightly above the umbilicus Rationale: The distance in centimeters from the symphysis pubis to the top of the fundus is a gross estimate of the weeks of gestation.

A nurse is discussing diaphragm use with a client. Which of the following statements by the client indicates an understanding of the teaching? A. "I should clean my diaphragm with alcohol each time I use it." B. "I should leave the diaphragm in place for 4 hours after intercourse." C. "I should replace my diaphragm every 2 years." D. "I should use a vaginal lubricant to insert my diaphragm."

C. "I should replace my diaphragm every 2 years." Rationale: A diaphragm is a flexible rubber cup that is filled with spermicide and inserted over the cervix prior to intercourse. The diaphragm is a prescribed device fitted by a provider and should be replaced every 2 years.

A nurse is providing teaching to a client who has come to the family-planning clinic requesting an intrauterine device (IUD). Which of the following pieces of information should the nurse provide the client? A. "If you lose weight, you will need to have your IUD refitted." B. "An IUD provides protection from certain sexually transmitted infections." C. "Your risk for ectopic pregnancy increases with an IUD." D. "You shouldn't use an IUD if you want to have children later."

C. "Your risk for ectopic pregnancy increases with an IUD." Rationale: An IUD is a contraceptive device the provider inserts through the cervix into the uterus. The IUD works by changing the lining of the uterus and fallopian tubes, making fertilization in the uterus more difficult. Consequently, an IUD increases the risk of ectopic pregnancy.

A nurse is caring for a client who states, "I think I am pregnant." Which of the following findings should the nurse identify as a positive sign of pregnancy? A. Positive serum pregnancy test B. Amenorrhea C. Fetal heart tones auscultated by Doppler D. Chadwick sign

C. Fetal heart tones auscultated by Doppler Rationale: Fetal heart tones heard by Doppler are a positive sign of pregnancy. The only possible explanation for hearing fetal heart tones is the presence of a fetus

A nurse is assessing a pregnant client who is at 38 weeks gestation. The client reports that her breathing has become easier but notes an increased frequency of urination. The nurse should document this occurrence as which of the following? A. Effacement B. Dilation C. Lightening D. Quickening

C. Lightening Rationale: Lightening describes the engagement of the fetal head into the pelvis. When this occurs, breathing becomes easier, but urination is more frequent.

A nurse is calculating a pregnant client's estimated date of delivery using Naegele's rule. The client's last menstrual period started on January 20. Which of the following is the client's expected date of delivery? A. October 13 B. November 13 C. October 27 D. November 27

C. October 27

A nurse is caring for a client who is at 18 weeks of gestation. The client tells the nurse that she felt fluttering movements in her abdomen 3 days ago. The nurse should interpret this finding as which of the following? A. Ballottement B. Lightening C. Quickening D. Chloasma

C. Quickening Rationale: Clients describe quickening as a fluttering sensation, which can be felt as early as the 14th week of gestation although is most typically felt between 16-20 weeks gestation (closer to 16 for multipara and closer to 20 for primipara patients). It reflects fetal movement.

A nurse is teaching a client who is at 30 weeks gestation about warning signs of complications that she should report to her provider. Which of the following findings should the nurse include in the teaching? A. Mild constipation B. Nasal congestion C. Vaginal bleeding D. 10 fetal movements per hour

C. Vaginal bleeding Rationale: Vaginal bleeding can be an abnormal finding during pregnancy indicating a complication such as placental abruption, placenta previa, or preterm labor.

A nurse is caring for a client who has a BMI of 22.6 and expresses concern about weight gain during pregnancy. Which of the following responses should the nurse make? A. "You're eating for 2, so you should double your caloric intake." B. "You'll lose weight easily after the birth of your baby." C. "Plan to gain a total of 15 to 20 pounds during pregnancy." D. "Gaining weight will promote a healthy pregnancy."

D. "Gaining weight will promote a healthy pregnancy."

A nurse is providing nutritional teaching for a pregnant client who had a prepregnancy body mass index (BMI) of 38. Which of the following statements by the client demonstrate an understanding of the teaching about her recommended weight gain during pregnancy? A. "I should plan to gain 12.7 to 18.1 kg during my pregnancy." B. "I should plan to gain 11.3 to 15.9 kg during my pregnancy." C. "I should plan to gain 6.8 to 11.3 kg during my pregnancy." D. "I should plan to gain 5 to 9.1 kg during my pregnancy."

D. "I should plan to gain 5 to 9.1 kg during my pregnancy." Rationale: Clients with a prepregnancy BMI of greater than 30 are considered to be obese and should plan to limit their weight gain to 5 to 9.1 kg (11 to 20 lb) during pregnancy.

A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make? A. "It's a minor inconvenience, which you should ignore." B. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone." C. "There is no way to predict how long it will last in each individual client." D. "It occurs during the first trimester and near the end of the pregnancy."

D. "It occurs during the first trimester and near the end of the pregnancy." Rationale: Urinary frequency is due to increased bladder sensitivity during the first trimester and recurs near the end of the pregnancy as the enlarging uterus places pressure on the bladder.

A nurse is caring for an adolescent who is in the second trimester of pregnancy. The client states, "I've gotten used to the idea of this pregnancy. It will be fun to have a little baby around the house." Which of the following is the appropriate response by the nurse? A. "Babies are not fun. They're a lot of work." B. "I'm so glad to see you're happy about the baby." C. "How are your parents reacting to the pregnancy?" D. "Tell me how you think your life will be after the baby is born."

D. "Tell me how you think your life will be after the baby is born." Rationale: Open-ended questions allow the client to provide additional assessment data for the nurse about her reaction to pregnancy.

A nurse is providing teaching about exercise to a client who is pregnant. Which of the following pieces of information should the nurse include? A. "You can continue participating in whatever sports or activities you did prior to becoming pregnant." B. "Intermittent exercise is a great way to stay healthy during pregnancy." C. "You should limit your exercise to walking if you did not exercise prior to becoming pregnant." D. "Vigorous exercises should be limited and should not be performed in hot, humid weather."

D. "Vigorous exercises should be limited and should not be performed in hot, humid weather." Rationale: Vigorous or strenuous activities should be limited to no longer than 20 minutes. Hot, humid weather and vigorous exercise can prompt dehydration or cause the fetus to develop hyperthermia

A nurse is providing teaching about nutrition to a client at her first prenatal visit. Which of the following statements by the nurse should be included in the teaching? A. "You will need to increase your calcium intake during breast feeding." B. "Prenatal vitamins will meet your need for increased vitamin D during pregnancy." C. "Vitamin E requirements decline during pregnancy due to the increase in body fat." D. "You will need to double your intake of iron during pregnancy."

D. "You will need to double your intake of iron during pregnancy."

A nurse is assessing a female client 24 hr after delivery and notes the fundus is 2 cm above the umbilicus. Which of the following actions should the nurse take? A. Administer a tocolytic medication B. Apply a heating pad to the mid-abdominal area C. Reassess the fundus in 2 hr D. Ambulate the client to the bathroom

D. Ambulate the client to the bathroom Rationale: An increased fundal height in the postpartum period is a sign of a non-contracted uterus, which increases the risk for hemorrhage. The most common postpartum cause of an elevated fundal height is an over-distended bladder.

A nurse is caring for a client whose last menstrual period (LMP) began on July 8. Using Naegele's rule, what is the client's estimated date of birth (EDB)? A. October 1 B. April 1 C. October 15 D. April 15

D. April 15

A nurse is assessing a client who missed 2 menstrual cycles and reports that she might be pregnant. Which of the following findings is a positive sign of pregnancy? A. Quickening B. Breast tenderness C. Uterine enlargement D. Auscultation of a fetal heart rate

D. Auscultation of a fetal heart rate Rationale: The auscultation of a fetal heart rate is a conclusive sign of pregnancy.

A nurse is counseling a female client who expresses a desire to conceive in the near future. Which of the following dietary recommendations should the nurse make to prevent neural tube defects? A. Take a multivitamin every day B. Decrease consumption of mercury-containing fish C. Increase consumption of dairy products D. Begin taking a folic acid supplement

D. Begin taking a folic acid supplement Rationale: Adequate amounts of folic acid are necessary for fetal neural tube development. All women of child-bearing age and intention should take a folic acid supplement of 0.4 mg.

A nurse in a prenatal clinic is caring for a client who is at 12 weeks gestation. The client asks about the cause of her heartburn. Which of the following responses should the nurse make? A. Retained bile in the liver results in delayed digestion. B. Increased estrogen production causes increased secretion of hydrochloric acid. C. Pressure from the growing uterus displaces the stomach. D. Increased progesterone production causes decreased motility of smooth muscle.

D. Increased progesterone production causes decreased motility of smooth muscle. Rationale: Increased progesterone production causes a relaxation of the cardiac sphincter of the stomach and delayed gastric emptying, which can result in heartburn.

A nurse is caring for a client who is pregnant and whose last menstrual period (LMP) began on April 8. Using Naegele's rule, which of the following dates would be the client's estimated date of birth (EDB)? A. July 15 B. July 11 C. January 11 D. January 15

D. January 15

A nurse is using Naegele's rule to determine the estimated date of birth (EDB) for a client whose first day of her last menstrual period was February 2, 2018. The nurse should identify which of the following as the client's EDB? A. November 16, 2018 B. October 19, 2018 C. October 26, 2018 D. November 9, 2018

D. November 9, 2018

A nurse is providing care for a pregnant adolescent who is at 12 weeks gestation and verbalizes a fear of gaining weight during pregnancy. Which of the following actions should the nurse take? A. Have the client watch a video on fetal growth and development during pregnancy. B. Supply pamphlets that discuss the importance of nutrition during pregnancy. C. Explain how poor nutrition can prevent the baby from growing properly. D. Provide examples of how eating well will help maintain a healthy weight during pregnancy.

D. Provide examples of how eating well will help maintain a healthy weight during pregnancy. Rationale: Adolescents are typically preoccupied with self and lack the ability to understand outcomes that will occur in the future. Effective teaching for this age group should mainly focus on benefits to the client and positive outcomes that will occur in the near future.

Signs and symptoms that a woman should report immediately to her health care provider include (Select all that apply): a. Vaginal bleeding. b. Rupture of membranes. c. Heartburn accompanied by severe headache. d. Decreased libido. e. Urinary frequency.

a. Vaginal bleeding. b. Rupture of membranes. c. Heartburn accompanied by severe headache. Rationale: a. Vaginal bleeding. b. Rupture of membranes. c. Heartburn accompanied by severe headache. Vaginal bleeding, rupture of membranes, and severe headaches all are signs of potential complications in pregnancy. Clients should be advised to report these signs to the health care provider.

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have: a. amenorrhea b. positive pregnancy test c. chadwicks sign d. hegars sign

a. amenorrhea Rationale: Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are felt by the woman.

During the first trimester, a woman can expect which of the following changes in her sexual desire? a. An increase, because of enlarging breasts b. A decrease, because of nausea and fatigue c. No change d. An increase, because of increased levels of female hormones

b. A decrease, because of nausea and fatigue Rationale: A decrease, because of nausea and fatigue Maternal physiologic changes such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses may affect sexuality and sexual expression. Libido may be depressed in the first trimester but often increases during the second and third trimesters

To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that: a. A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear. b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term. c. Palpitations are twice as likely to occur in twin gestations. d. All of the above changes likely will occur.

b. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term. Rationale: Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term. Auscultatory changes should be discernible after 20 weeks of gestation.

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? a. Less audible heart sounds (S1, S2) b. Increased pulse rate c. Increased blood pressure d. Decreased red blood cell (RBC) production

b. Increased pulse rate Rationale: Increased pulse rate Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term. Splitting of S1 and S2 is more audible

To reassure and educate pregnant clients about changes in the uterus, nurses should be aware that: a. Lightening occurs near the end of the second trimester as the uterus rises into a different position. b. The womans increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softening. c. Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise. d. The uterine souffle is the movement of the fetus.

b. The womans increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softening. Rationale: The womans increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softening (The softening of the lower uterine segment is called Hegars sign)

Which minerals and vitamins usually are recommended to supplement a pregnant womans diet? a. Fat-soluble vitamins A and D b. Water-soluble vitamins C and B6 c. Iron and folate d. Calcium and zinc

c. Iron and folate Rationale: Iron and folate Iron generally should be supplemented, and folic acid supplements often are needed because folate is so important.

To reassure and educate pregnant clients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that: a. Because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are much easier to evaluate. b. Quickening is a technique of palpating the fetus to engage it in passive movement. c. The deepening color of the vaginal mucosa and cervix (Chadwicks sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor. d. Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.

d. Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester. Rationale: Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester. Increased sensitivity and an increased interest in sex sometimes go together. This frequently occurs during the second trimester.

A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She can expect the following advice: a. Discontinue all contraception now. b. Lose weight so that you can gain more during pregnancy. c. You may take any medications you have been taking regularly. d. Make sure that you include adequate folic acid in your diet.

d. Make sure that you include adequate folic acid in your diet. Rationale: A healthy diet before conception is the best way to ensure that adequate nutrients are available for the developing fetus. A womans folate or folic acid intake is of particular concern in the periconception period. Neural tube defects are more common in infants of women with a poor folic acid intake.

Which symptom is considered a first-trimester warning sign and should be reported immediately by the pregnant woman to her health care provider? a. Nausea with occasional vomiting b. Fatigue c. Urinary frequency d. Vaginal bleeding

d. Vaginal bleeding Rationale: Vaginal bleeding Signs and symptoms that must be reported include severe vomiting, fever and chills, burning on urination, diarrhea, abdominal cramping, and vaginal bleeding. These symptoms may be signs of potential complications of the pregnancy.