Exam 1

A 25-year-old single female comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the client has human papillomavirus (HPV). The client asks, "What is that? Can you get rid of it?" Your best response is

"HPV stands for 'human papillomavirus.' It is a sexually transmitted infection (STI) that may lead to cervical cancer."

The nurse is providing nutritional education to a woman in her first pregnancy. The woman understands her dietary needs when she states

"I will need to increase my calcium and iron as well as drink additional water each day to stay well hydrated."

A common discomfort of pregnancy can be managed by changing nutritional intake and some OTC medications. In reviewing information with the patient after her first prenatal visit the nurse is confident that this woman understands the management of constipation when she states

"In addition to increasing my dietary fiber, I can use fiber supplements, drink more water and increase my activity if I have no restrictions"

A married couple is discussing alternatives for pregnancy prevention and has asked about fertility awareness methods. (Natural family planning, FAM's) the nurse's most appropriate reply is

"They can be effective for many couples, but they require motivation."

The nurse includes screening for domestic violence in the first prenatal visit for all patients. An appropriate question would be

"This is something that we ask everyone. Do you feel safe in your current living environment and relationships?"

A woman asks the nurse: "What protects my baby's umbilical cord from being pinched while the baby's inside". The nurse's best response is

"Your baby's umbilical cord is surrounded by connective tissue called Wharton's Jelly, which prevents compression of the blood vessels and ensures continued nourishment and oxygen to your baby."

The normal parameter of Fetal heart tones is 110 - 160 and can be heard by a doppler as early as?

10-12 weeks gestation

When is the embryonic period of fetal development?

15-60 days after conception

Fetal movement that is noted by the mother is a very important assessment factor to determine fetal well being. If the nurse is to ask the client if she has "felt her baby move", when is the best time for a primigravid client to note the first fetal activity?

18 - 20 weeks

A woman's obstetrical history indicates that she is pregnant for the 4th time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?

4-1-2-0-4

The prenatal clinic nurse meets with a 30-year-old woman who is experiencing her first pregnancy. The patient's quadruple marker screen result is positive at 17 weeks of gestation. The nurse explains that the patient needs a referral to

A genetics counselor/specialist

A woman had unprotected intercourse 36 hours ago and is concerned that she may become pregnant because it is her 'fertile 'time. She asks the nurse about emergency contraception. The nurse tells her that

An over the counter antiemetic can be taken 1 hour before each contraceptive dose to prevent nausea and vomiting

A client who is 32 weeks pregnant is being monitored in the Antepartum unit for pregnancy induced hypertension (gestational hypertension). She suddenly complains of continuous abdominal pain and vaginal bleeding. Which of the following nursing interventions should be included in the care of this client (select all that apply)

Assess fetal heart tones Assess vital signs Assess the amount of vaginal bleeding

A woman in the third trimester of her first pregnancy complains of excessive fatigue. Her hemoglobin is 11.2 g/dL. What action by the nurse is best?

Assess the woman's diet for adequate iron and protein

The nurse is palpating the uterus of a client who is 20 weeks pregnant to measure fundal height. Identify where the nurse will find the uterine fundus?

At or near the umbilicus

What would the prenatal clinic nurse conclude to be a contraindication for maternal serum alpha-fetoprotein testing (or quad screen) for a pregnant client?

Being 25 weeks gestation

A nurse has admitted a client with hyperemesis gravidarum and is reviewing the prescriptions. Which prescription should the nurse question?

Betamethasone (Celestone) 100mg IV every 8 hours

Prenatal testing is done to identify health issues that may interfere with the developing fetus. Within the first prenatal visit what lab tests are normally obtained? (select all that apply)

Blood type and Rh factor Complete blood count (CBC) HIV

A pregnant client at 32 weeks gestation has mild pre-eclampsia. she is discharged home with instructions to remain on bedrest. she should also be instructed to call her provider if she experiences which of the following symptoms?

Blurred vision Headache not relieved with over the counter medication Epigastric pain

Which vitamins and minerals should women include in their diet or supplements?

Calcium, iron, omega-3, zinc

A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be which of the following?

Changes in the pattern of fetal activity

What does CHOP stand for?

Cord compression Head compression Ok this is great Placenta problem

What is term?

Delivery at 37 weeks or greater

What is preterm?

Delivery prior to 37 weeks gestation

What nutritional needs does the growing fetus have?

Diets with more protein, vegetables, and fruits - diets with less sugar, fats, and salt. Also an increase of fluid intake

During her annual gynecologic check up a 17 year-old woman states that recently she has been experiencing cramping and pain during her menstrual periods. The nurse would document this complaint as?

Dysmenorrhea

How are multiples recorded as number of births?

Each SET is one measurement (Example: 1st pregnancy, living twins delivered at term would be recorded as G1 T1 P0 A0 L2)

A pregnant woman experiencing nausea and vomiting should

Eat small, frequent meals (every 2 to 3 hours)

One purpose of preconception care is to

Encourage healthy lifestyles for families desiring pregnancy

What vitamin/mineral is essential for fetal development?

Folic acid 400 mcg

A nurse is assessing a woman who is at 29 weeks of gestation. The nurse measures the woman's fundal height, which is 58.42cm (23 inches). What does the nurse conclude about this information?

Fundal height is too small

What does GTPAL stand for?

Gravida, Term, Preterm, Abortion, Living

Hormonal shifts in pregnancy and the physiological changes that occur affect every body system. As the nurse which of the following symptoms or presentation would you consider abnormal?

Headaches occurring in the third trimester

The nurse caring for a pregnant client knows that her health teaching regarding fetal circulation has been effective when the client reports that she has been sleeping

In a side-lying position

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?

Increased pulse rate

Screening at 24 weeks gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for

Macrosomia

A 30 week gestational age pregnant client presents to the labor suite with complaints of contractions and pressure. Medications that the nurse can expect the MD to order for administration are as follows: (select all that apply)

Magnesium sulfate Terbutaline (Brethine) Betamethasone

Asking the pregnant woman about her use of recreational drugs is an essential component of the prenatal history. Harmful fetal effects that may occur from recreational drug use include (Select all answers that apply.)

Miscarriage/spontaneous abortion Low birth weight

What does MINE stand for?

Move to the left ID labor progress No action needed Execute actions

What is folic acid needed for?

Neural tube development

Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a client with this condition should be aware that the optimal pharmacological therapy for pain relief is

Non-steroidal anti-inflammatory drugs (NSAIDS)

The clinic nurse reviews the complete blood count results of a 30-year-old woman who is now 33 weeks' gestation. The patient's hemoglobin value is 11.2 g/dL and her hematocrit is 38%. The clinic nurse interprets these findings as

Normal pregnancy values for the third trimester

A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period (LMP) was February 14. Her expected date of birth (EDB) would be?

November 21

A 19 year old G1P0 client is 32 weeks gestation who is being treated with Magnesium Sulfate for pre-eclampsia. Which are priority assessments with this medication? (Select all that apply)

Observe for vaginal bleeding Check deep tendon reflexes Check respiratory rate

A pregnant woman at 12 weeks' gestation tells you that she is a vegetarian. What could be the first appropriate nursing action?

Obtain a 24 hr diet recall history

A 34 week pregnant woman is experiencing preterm labor. The nurse will provide the following interventions for her client? (select all that apply)

Obtain a urine specimen Place on a fetal monitor Lay on side

A nurse instructs a 20 year old female college student about oral contraceptives. After the teaching session, the nurse confirms that the client understands the information when she makes which of the following statements?

Oral contraceptives should be taken at the same time each day

A nurse is planning breast education for women. What information does the nurse plan to provide about breast cancer screening recommendations?

Periodic screening if high risk

A woman is 39 weeks gestation with severe abdominal pain that remains constant is being admitted to the labor and delivery unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, has dark red vaginal bleeding and a tense rigid abdomen. The nurse suspects the onset of which of the following

Placenta abruption

Intrauterine growth restriction is the result of poor placental perfusion. What pregnancy risk factors may contribute to intrauterine growth restriction? (select all that apply)

Poor nutrition Drug abuse Hypertension Smoking

What is abortion (in relation to GTPAL)?

Pregnancy loss at less than 20 weeks (includes induced or spontaneous)

A patient on the high-risk OB unit is receiving magnesium sulfate. The nurse notes that her magnesium level is 14 mEq/L. Which of the following actions by the nurse is most appropriate?

Prepare to administer calcium gluconate

A nurse is caring for a client who is prescribed Rho immune globulin standard dose IM (Rhogam). The nurse should understand the action of this medication as which of the following

Rhogam prevents the formation of Rh antibodies in mothers who are Rh negative

Signs and symptoms that a woman should report immediately to her health care provider include (select all that apply)

Rupture of membranes Vaginal bleeding Headaches that do not respond to usual therapy

What may interfere with normal fetal development?

STDs, hypertension, diabetes, infections, environmental hazards, lifestyle choices (smoking, alcohol, drugs, poor nutrition, trauma)

A woman with the diagnosis of hyperemesis gravidarum requires hospitalization. In addition to her need to be hospitalized what else is significant?

She has vomiting severe and persistent enough to cause weight loss, dehydration and electrolyte imbalance.

A woman is at 14 weeks gestation. The nurse would expect to palpate the fundus at which level?

Slightly above the symphysis pubis

A number of changes occur during pregnancy. What changes persist after birth?

Striae gravidarum

The amniotic fluid has many functions and we know that amniotic fluid is necessary for fetal well-being. Please select the purpose of the fluid for fetal well-being. (Select all that apply)

Temperature control Permits free movement of the baby Cushioning of the baby from minor trauma Nutrition for the baby

At 35 weeks of pregnancy a woman experiences preterm labor. Although tocolytics are administered and she is placed on bed rest, she continues to experiences regular contractions and her cervix is beginning to dilate and efface. What additional medication should be considered to assist the development of the fetus?

Terbutaline (brethine)

What is living (in relation to GTPAL)?

The number of living children

What is the embyronic period of fetal development (also known as the critical period?

The time of organ development

What is gravida?

The total number of pregnancies

A nurse is caring for a client who has a possible ectopic pregnancy at 8 weeks gestation. Which of the following manifestations should the nurse expect to identify as consistent with this diagnosis?

Unilateral abdominal pain

What does VEAL stand for?

Variable Early Acceleration Late

Activity is an important component of prenatal teaching. Activity that is considered safe for a client that states she does not participate in any activity or exercise program at this time would be?

Walking

Which statement would indicate that the client requires additional instruction about breast self -examination?

Yellow discharge from my nipple is normal if I am having my period