CH 13

19) A 38-year-old client in her second trimester states a desire to begin an exercise program to decrease her fatigue. What is the most appropriate nursing response?

1. "Fatigue should resolve in the second trimester, but walking daily might help."

24) After teaching a pregnant client about the effects of smoking on pregnancy, the nurse knows that the client needs further education when she makes which statement?

1. "I am at increased risk for preeclampsia."

11) The primiparous client has told the nurse that she is afraid she will develop hemorrhoids during pregnancy because her mother did. Which statement would be best for the nurse to make?

1. "It is not unusual for women to develop hemorrhoids during pregnancy."

1) The nurse is presenting a class to women who are currently pregnant or are planning pregnancy in the near future. Which client statement indicates that additional teaching is required?

1. "The older a woman is when she conceives, the safer the pregnancy is."

36) What self-care measures would a nurse recommend for a client in her first trimester to reduce the discomfort of nausea and vomiting?

1. Avoid odors or causative factors. 2. Have small but frequent meals. 3. Drink carbonated beverages.

6) The prenatal period should be used to expose the prospective parents to up-to-date, evidence-based information about which of the following topics?

1. Breastfeeding 2. Pain relief 3. Obstetric complications and procedures

10) Which of the following are specific culturally sensitive nursing considerations the nurse integrates into care of the pregnant client?

1. Counseling about home remedies 2. Discussing components of a balanced diet 4. Encouraging use of support systems

35) A 43-year-old client has just had a positive pregnancy test. She cries, and states, "I just don't know what I'll do. I can't be pregnant." Which nursing diagnosis would be the most appropriate?

1. Decisional Conflict related to unexpected pregnancy

20) A client at 34 weeks' gestation complains about pyrosis. The nurse teaches the patient that approaches to relieve the pyrosis include which of the following?

1. Eat small, frequent meals 3. Avoid fried, fatty foods 5. Do not lie down after eating

3) A couple in their late 30s are pregnant for the first time. In evaluating the care delivered, the nurse assesses the mother for which of the following?

1. Makes appropriate healthcare choices 2. Receives effective healthcare through the pregnancy

16) Remedies for back pain in pregnancy that are supported by research evidence and may safely be taught to any pregnant woman by the nurse include which of the following?

1. Pelvic tilt 2. Water aerobics 4. Proper body mechanics

9) The OB-GYN nurse works in a clinic with a culturally diverse group of clients whose specific actions during pregnancy are often determined by cultural beliefs. The nurse recognizes that these beliefs about pregnancy and childbirth fall into which categories?

1. Prescriptive beliefs 2. Restrictive beliefs 3. Taboos

7) A Navajo client who is 36 weeks pregnant meets with a traditional healer as well as her physician. What does the nurse understand this to mean?

1. The client is seeking spiritual direction.

2) During home care of a low-risk pregnant client, the nurse provides care by assessing which of the following?

1. Urine 2. Weight 3. Diet 5. Physical activity

22) A pregnant client who swims 3-5 times per week asks the nurse whether she should stop this activity. What is the appropriate nursing response?

2. "Continuing your exercise program would be beneficial."

27) The pregnant client has asked the nurse what kinds of medications cause birth defects. Which statement would best answer this question?

2. "To be safe, don't take any medication without talking to your doctor."

8) A Chinese woman who is 12 weeks pregnant reports to the nurse that ginseng and bamboo leaves help reduce her anxiety. How should the nurse respond to this client?

2. Advise the client to give up all herbal remedies.

14) A client at 36 weeks' gestation is complaining of dyspnea when lying flat. What is the clinical reason for this complaint?

2. Fundal height

29) Absolute contraindications to exercise while pregnant include which of the following?

2. Placenta previa after 26 weeks' gestation 3. Preeclampsia-eclampsia 4. Cervical insufficiency (cerclage)

32) The nurse is preparing a brochure for couples considering pregnancy after the age of 35. Which statements should be included?

2. Preexisting medical conditions can complicate pregnancy. 3. Preterm births are more common. 4. Amniocentesis can be performed to detect genetic anomalies

5) The nurse is preparing a class for expectant fathers. Which information should the nurse include?

2. Sexual activity is safe for normal pregnancy.

28) A pregnant client complains to the clinic nurse that her varicose veins are causing more discomfort than before. Which recommendations does the nurse make to the client?

2. Walk on a daily basis. 3. Not cross her legs at the knees. 4. Wear support hose

12) Which statement, if made by a pregnant client, would indicate that she understands health promotion during pregnancy?

3. "I elevate my legs while sitting at my desk."

13) The nurse is teaching an early pregnancy class for clients in the first trimester of pregnancy. Which statement by a client requires immediate intervention by the nurse?

3. "It is normal for my vaginal discharge to be green."

21) The pregnant client in her second trimester states, "I didn't know my breasts would become so large. How do I find a good bra?" The best answer for the nurse to make would be which of the following?

3. "Look for wide straps and cups big enough for all of your breast tissue."

26) The prenatal client in her third trimester tells the clinic nurse that she works 8 hours a day as a cashier and stands when at work. What response by the nurse is best?

3. "Your risk of preterm labor is higher."

25) Which of the following drugs and drug categories can cause multiple fetal central nervous system (CNS), facial, and cardiovascular anomalies?

3. Category X: Isotretinoin

15) The nurse assessing a pregnant African American woman in the first trimester understands that a cultural practice is which of the following?

3. Eating clay to supply dietary minerals

18) The nurse in a prenatal clinic finds that four clients have called with complaints related to their pregnancies. Which call should the nurse return first?

3. Pregnant woman at 15 weeks' gestation with nausea and vomiting and a 15-pound weight loss

33) The nurse is presenting a prenatal class to a group of women pregnant for the first time who are all over 35 years of age. The nurse knows that the advantage of waiting until later to start a family is which of the following?

3. That the woman is more likely to be financially secure.

31) The nurse is discussing sexual intimacy with a pregnant couple. What should be included in the teaching plan?

3. The couple might need to experiment with different positions.

23) The nurse is presenting a class of important "dos and don'ts" during pregnancy, including travel considerations. What method of travel does the nurse recommend as most appropriate for a client in her 25th week of pregnancy?

3. Train

4) The nurse is caring for a pregnant client. The client's husband has come to the prenatal visit. Which question is the best for the nurse to use to assess the father's adaptation to the pregnancy?

4. "How are you feeling about becoming a father?"

17) A client in her third trimester of pregnancy reports frequent leg cramps. What strategy would be most appropriate for the nurse to suggest?

4. Flex the foot to stretch the calf

30) Intercourse is contraindicated if the pregnancy is vulnerable because of which diagnosis?

4. Placenta previa

34) The nurse working with mothers over 35 having their first baby knows there are some disadvantages. For what disadvantage would the nurse carefully assess in each client?

4. Whether the client has any chronic disease that will have to be addressed