CH 12

35) A pregnant client at 30 weeks' gestation has had a steady rise in blood pressure. She is now 20 mmHg above her systolic baseline. The nurse advises her to immediately report which symptoms?

Dizziness 3. Spots before her eyes

4) A woman gave birth last week to a fetus at 18 weeks' gestation after her first pregnancy. She is in the clinic for follow-up, and notices that her chart states she has had one abortion. The client is upset over the use of this word. How can the nurse best explain this terminology to the client?

1. "Abortion is the obstetric term for all pregnancies that end before 20 weeks."

19) The nurse is explaining to a new prenatal client that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the client makes which statement about the reason for the exam?

1. "It will help us know how big a baby I can deliver vaginally."

1) While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts with "Why are you asking me all these questions? What difference does it make?" Which statement would best answer the client's questions?"

1. "We ask these questions to detect anything that happened in your past that might affect the pregnancy."

13) The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected findings?

1. 12 weeks' gestation, with fetal heart tones heard by Doppler fetoscope

2) During a client's initial prenatal visit, the nurse must assess and document the client's current medical history, including which information?

1. Body mass index 3. Homeopathic or herbal medication use 4. Blood type and Rh factor

29) The nurse at the prenatal clinic has four calls to return. Which phone call should the nurse return first?

1. Client at 32 weeks, reports headache and blurred vision.

20) The nurse is explaining clinical pelvimetry to a client. The nurse explains that the anteroposterior diameters consist of which of the following?

1. Diagonal conjugate 3. Conjugata vera 4. Obstetric conjugate

3) During the initial prenatal visit, the nurse obtains a weight of 42 kg (92.4 lb). The nurse must further assess the client for information about which of the following?

1. Eating habits 2. Foods regularly eaten 3. Income limitations

7) The nurse in the OB-GYN clinic is working with a client who is seeking her initial prenatal visit. The nurse will use the acronym TPAL to document the client's number of which of the following?

1. Term infants born 3. Pregnancies ending in abortion 4. Preterm infants born

27) A pregnant client calls the clinic nurse to say she is worried about symptoms she is experiencing. The nurse advises the client to come immediately to the clinic because of which reported symptoms?

1. Vaginal bleeding 2. Abdominal pain 4. Epigastric pain 5. Blurring of vision

14) The nurse working in an outpatient obstetric clinic assesses four primigravida clients. Which client findings would the nurse tell the physician about?

2. 24 weeks' gestation and fundal height is at the umbilicus

15) What signs would indicate that a pregnant client's urinalysis culture was abnormal?

2. Alkaline urine 3. Cloudy appearance 5. Hemoglobinuria

17) The nurse is seeing a client who asks about the accuracy of Nagele's rule. The nurse explains that accuracy can be compromised under which conditions?

2. Amenorrhea is present and ovulation occurs with breastfeeding. 3. Oral contraception was discontinued, but no regular menstruation was established. 4. There has been 1 or more months of amenorrhea

9) During the initial prenatal visit, the nurse assesses the history of the father of the child for which of the following?

2. Blood type and Rh type 3. Significant health problems 5. Current use of tobacco

8) The prenatal clinic nurse is designing a new prenatal intake information form for pregnant clients. Which question is best to include on this form?

2. Do genetic diseases run in the family of the baby's father?

11) The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings?

2. Have the physician see the client today.

28) A nurse examining a prenatal client recognizes that a lag in progression of measurements of fundal height from week to week and month to month could signal what condition?

2. Intrauterine growth restriction

22) The nurse is assessing a primiparous client who indicates that her religion is Judaism. Why is this information is pertinent for the nurse to assess?

2. It provides a baseline from which to ask questions about the client's religious and cultural background.

16) The nurse receives a phone call from a client who claims she is pregnant. The client reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10. What would the client's estimated date of delivery (EDD) be if she is pregnant?

2. Jan. 17

12) The nurse begins a prenatal assessment on a 25-year-old primigravida at 20 weeks' gestation and immediately contacts the healthcare provider because of which finding?

2. Respirations 30/minute

10) A 25-year-old primigravida is at 20 weeks' gestation. The nurse takes her vital signs and notifies the healthcare provider immediately because of which finding?

2. Rhonchi in both bases

31) The nurse in the prenatal clinic is seeing a pregnant 16-year-old for the first time. What comment by the young client is the most critical for the nurse to address first?

3. "On weekends, we go out and drink a few beers."

34) Screening for gestational diabetes mellitus (GDM) is typically completed between which of the following weeks of gestation?

3. 24 and 28 weeks

26) A client comes into the prenatal clinic accompanied by her boyfriend. When asked by the nurse why she is there, the client looks down, and the boyfriend states, "She says she is pregnant. She constantly complains of feeling tired, and her vomiting is disgusting." What is a priority for the nurse to do at this point?

3. Continue the interview of the client in private.

6) The client has delivered her first child at 37 weeks. The nurse would describe this to the client as what type of delivery?

3. Early term

24) If a woman has the pre-existing condition of diabetes, the nurse knows that she would be prone to what high-risk factor when pregnant?

3. Episodes of hypoglycemia and hyperglycemia

23) What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing?

3. Fundal height measurement

33) A pregnant client has a hemoglobin of 10 g/dL and a Hct of 30%. The clinic nurse recognizes the fetus is at risk for which of the following?

3. Low birth weight 4. Prematurity 5. Fetal death

30) The nurse is providing guidance for a woman in her second trimester of pregnancy and telling her about some of the signs and symptoms that she might experience. Which statement by the client indicates that further teaching is necessary?

4. "During the third trimester, I might have a persistent headache."

18) The primigravida at 22 weeks' gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the client why she needs to be seen by a physician today?

4. "Your baby might not be growing enough."

5) The clinic nurse is compiling data for a yearly report. Which client would be classified as a primigravida?

4. A client at 15 weeks' gestation who has never been pregnant before

25) Which third-trimester client would the nurse suspect might be having difficulty with psychological adjustments to her pregnancy?

4. A woman who has not investigated the kind of clothing or feeding methods the baby will need

21) The nurse is assessing a newly pregnant client. Which finding does the nurse note as a normal psychosocial adjustment in this client's first trimester?

4. Ambivalence about the pregnancy

32) The nurse is providing health teaching to a group of women of childbearing age. One woman states that she is a smoker, and asks about the effect of smoking on her fetus. The nurse tells her that which fetal complication can occur when the mother smokes?

4. Low birth rate