Chapter 5 - Antepartal Period: Psycho-Social Cultural Aspects

A 10-week pregnant client verbalizes feelings of ambivalence about her pregnancy. Which would be a therapeutic response by the prenatal nurse? 1. "These feelings are common during the first trimester and should decrease as your pregnancy progresses." 2. "Most women experience ambivalent feelings their entire pregnancy." 3. "You should be excited about the pregnancy as it is a wonderful experience to bring new life into the world." 4. "I am going to refer you to a psychologist for prenatal depression."

1

A clinic nurse is caring for multiple clients. Which client does she identify as high risk for experiencing a teenage birth? 1. A client who dropped out of high school 2. A client who smokes cigarettes 3. A client whose parents are divorced 4. A client who uses recreational drugs

1

A nurse from the United States is educating a client from a different country on self-care during pregnancy. At the end of the conversation, the client nods her head and smiles. How would the nurse respond to this behavior? 1. Request the client repeat the information that was taught. 2. Interpret this as an understanding of the information. 3. Smile back and continue with the appointment. 4. Assess the client's emotional health.

1

A nurse is caring for a pregnant client in her second trimester who recently received news that her fetus has a potentially fatal condition. During her appointment, the nurse notices the woman appears unattached, and seems to have distanced herself from the fetus. Which is the priority action by the nurse? 1. Recognize this as a normal response. 2. Document the findings in the prenatal record. 3. Tell the practitioner the woman is having a hard time coping. 4. Reassure the client that her and her baby will be okay, no matter what happens.

1

A nurse is caring for an adolescent primiparous client in her first trimester. Which is the highest priority for this client? 1. Deficient knowledge related to pregnancy psychosocial and emotional change 2. Risk for injury related to the birthing process 3. Decreased gastric motility related to normal physiologic pregnancy changes 4. Risk for infection related to group beta strep colonization

1

A nurse is teaching a pregnant client with schizophrenia about the care required during pregnancy. Which is the priority nursing action for the nurse? 1. Assess the woman's mood, anxiety, and emotional state. 2. Discuss expectations about pregnancy, childbirth, and parenting. 3. Educate the client on potential side effects of psychotropic medications. 4. Determine if the client has adequate support systems in place.

1

A pregnant client tells the nurse she is concerned about how her older child will react to the birth of the new baby. Which would be the most therapeutic response by the nurse? 1. "Sharing the spotlight with a new sibling can be a major crisis for a child. How old is your other child?" 2. "All pregnant women feel this way when there is another child involved. It is a normal." 3. "Children younger than 2 are usually aware of the pregnancy." 4. "Would you like me to refer you to a family counselor so you can discuss your concerns?"

1

A nurse is caring for a 30-year-old G4P2 client. She arrives at the clinic for her first prenatal visit with her husband and stepchildren. When discussing family adaptation, what developmental tasks should be included? Select all that apply. 1. Delegating household chores and tasks after the baby is born 2. Purchasing diapers, wipes, bottles, and other baby care items 3. Reorienting of relationships with relatives 4. Expanding communication to meet emotional needs 5. Preparing a birth plan that includes all members of the family

1234

A client reports decreased interest in sexual activity during her pregnancy. Which statements made by the nurse are true regarding sexual interest and activity during pregnancy? Select all that apply. 1. "All of the changes happening in your body can affect your sexual desires and responses." 2. "You may find yourself wanting to have sex more often as the end of the pregnancy draws near." 3. "Sometimes pregnant women feel more beautiful and desirable as the pregnancy advances." 4. "It is important for us to discuss how your sexual desire and activity is being affected by the pregnancy." 5. "During the second trimester, you may see an even further decrease in your sexual interest."

134

A nurse is caring for a Filipino woman in her third trimester. Which information is most helpful in providing culturally responsive care? 1. Only Western cultures recognize childbirth as a time of great celebration. 2. Every culture has a set of behaviors, beliefs, and practices that influence a woman during childbearing. 3. The woman has most likely incorporated the practices of American culture into her way of life. 4. Childbirth practices are similar among all cultures.

2

A nurse is caring for a client in her third trimester. Which actions by the client would necessitate further evaluation by the nurse? 1. The woman develops realistic expectations of labor and birth. 2. The woman does not attend child birth classes or read books about labor and birth. 3. The women deep cleans and organizes her house a few weeks prior to her due date. 4. The woman does not mentally rehearse or fantasize about labor.

2

A nurse is caring for a pregnant client who recently moved to the United States from her native country of India. Which is the priority nursing action? 1. Assume the client does not speak English and provide a bedside interpreter to ensure the client understands all medical procedures. 2. Recognize the woman's cultural influences and consider them carefully when planning care. 3. Suggest her Indian coworker care for the client since she is familiar with her beliefs and traditions. 4. Instruct the client how to adopt the practices of the United States

2

Which barriers might an American-born nurse face when caring for a client of a different nationality? Select all that apply. 1. Egocentrism 2. Ethnocentrism 3. Stereotyping 4. Communication 5. Knowledge deficit

234

The nurse is caring for a pregnant client with bipolar affective disorder. Which information is important for the nurse to understand regarding mental health disorders in pregnancy? Select all that apply. 1. Mental health issues during pregnancy always create problems for the pregnant woman. 2. The client may show difficulty with taking on the maternal role. 3. It is the role of the social worker to collaborate with community agencies and psychiatric facilities. 4. Prenatal depression and anxiety can negatively affect the growing fetus. 5. Psychiatric medications are not safe for pregnant women to take and should be discontinued right away.

24

A clinic nurse is evaluating a pregnant client at her first prenatal appointment. Which statement made by the client most warrants further questioning? 1. "I have not been taking my prenatal vitamins because they make me sick." 2. "I vomit constantly." 3. "I have depression and have a history of suicidal attempts." 4. "I am feeling really unsure about this pregnancy. I don't know if I am ready."

3

A nurse is counseling an adolescent client who presented to the clinic for her first prenatal visit. She reports she is currently living alone and the father of the baby is no longer involved. When developing the plan of care for this client, which priority outcome is identified? 1. Report increasing acceptance of changes in body image. 2. Discuss fears related to labor and birth. 3. Identify appropriate emotional support systems. 4. Develop a realistic birth plan.

3

The nurse is caring for a pregnant adolescent client during a prenatal visit. Which nursing action is a priority for this client? 1. Offer advice on smoking cessation. 2. Give the client information about adoption. 3. Assess for bruises in different stages of healing. 4. Determine what type of birth control the client plans to use after she gives birth.

3

When caring for a newly widowed client in her second trimester, which must the perinatal nurse understand the importance of? 1. Educating the woman about the quad screen 2. Assisting the woman to develop a birth plan 3. Assessing the woman's level of stress and anxiety 4. Assisting the woman to obtain financial assistance

3

Which client would you anticipate to encounter difficulties, such as language barriers and monetary struggles, during their pregnancy? 1. A woman diagnosed with preeclampsia 2. An adolescent 3. A woman who recently immigrated to the United States 4. A veteran who recently served in Iraq

3

During her prenatal appointment, a woman's preschool-age daughter asks if she can listen to the fetal heartbeat. The nurse interprets the child's behavior as? 1. An unexpected finding, as children this age are not usually interested in the pregnancy 2. A cry for attention due to her mom being preoccupied by the pregnancy 3. Over-enthusiasm and something that should be discussed with the child before the arrival of the baby 4. A normal response of the child, according to their age

4