LP 6, Ch 4 Success Q's

A nurse is advising a pregnant woman about the danger signs of pregnancy.The nurse should teach the mother that she should notify the physician immedi- ately if she experiences which of the following signs/symptoms? Select all that apply. 1. Convulsions.2. Double vision.3. Epigastric pain.4. Persistent vomiting. 5. Polyuria.

1, 2, 3, and 4 are correct. 1. Conculsions are a danger sign of pregnancy 2. Double vision is a danger sign of pregnancy. 3. Epigastric pain is a danger sign of pregnancy. 4. Persistent vomiting is a danger sign of pregnancy.

An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? Select all that apply. 1. Amenorrhea.2. Breast tenderness. 3. Quickening.4. Frequent urination. 5. Uterine growth.

1, 2, 3, and 4 are correct. There are three classifi- cations of signs of pregnancy: presump- tive, probable, and positive. Signs that are totally subjective, or presumptive, in- clude amenorrhea, breast tenderness, quickening, and frequent urination. Signs that are objective, but not totally ab- solute, are termed probable and include alterations in uterine shape and size and softening of the cervix. Signs that are absolute, or positive, include hearing the fetal heartbeat, detecting fetal move- ment, and ultrasound images of the fetal outline.

A woman asks the nurse about the function of amniotic fluid. Which of the follow- ing statements by the woman indicates that additional teaching is needed? 1. The fluid provides fetal nutrition.2. The fluid cushions the fetus from injury.3. The fluid enables the fetus to grow.4. The fluid provides a stable thermal environment.

1. The umbilical cord, not the amniotic fluid, delivers nutrition to the devel- oping fetus. The amniotic fluid is produced primarily by the fetus as fetal urine. In addition to the functions noted above, the baby practices "breathing" the amniotic fluid in and out of the lungs in preparation for breathing air in the ex- trauterine environment.

During a preconception counseling session, the nurse encourages a couple to pre- pare a birth plan. Which of the following is the most important goal for this action? 1. Promote communication between the couple and health care professionals. 2. Enable the couple to learn about the types of medicine used in labor.3. Provide the couple with a list of items that they should put in a bag for labor. 4. Give the high-risk couple a sense of control over having to have a cesarean.

1. Birth plans help to facilitate commu- nication between couples and their health care providers.

A nurse is discussing diet with a pregnant woman. Which of the following foods should the nurse advise the client to avoid consuming during her pregnancy? 1. Bologna.2. Cantaloupe. 3. Asparagus. 4. Popcorn.

1. Bologna should not be consumed during pregnancy unless it is thor- oughly cooked. Because pregnant women are slightly immunocompro- mised, they are especially susceptible to certain diseases. Deli meats, unless heated to steaming hot, can cause liste- riosis. Pregnant women should avoid these foods. Other foods that contain Listeria monocytogenes that should be avoided are unpasteurized milk, soft cheese, and undercooked meats.

A gravid woman who recently emigrated from mainland China is being seen at her first prenatal visit. She was never vaccinated in her home country. An injection to prevent which of the following communicable diseases should be administered to the woman during her pregnancy? 1. Influenza. 2. Mumps. 3. Rubella. 4. Varicella.

1. The woman should receive the in- fluenza injection. The nasal spray, however, should not be administered to a pregnant woman.

The nurse is caring for a pregnant client who is a vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods? 1. Tofu, legumes, broccoli.2. Corn, yams, green beans. 3. Potatoes, parsnips, turnips. 4. Cheese, yogurt, fish.

1. Tofu, legumes, and broccoli are excel- lent substitutes for the restricted foods.

A third-trimester client is being seen for routine prenatal care. Which of the fol- lowing assessments will the nurse perform during the visit? Select all that apply. 1. Blood glucose.2. Blood pressure. 3. Fetal heart rate. 4. Urine protein.5. Pelvic ultrasound.

2, 3, and 4 are correct. 2. The blood pressure is assessed at each prenatal visit. 3. The fetal heart rate is assessed at each prenatal visit. Depending on the equipment available, it will be assessed mechanically via Doppler or manually via fetoscope. The fetal heart is audible via Doppler many weeks before it is audible via fetoscope. 4. Urine protein is performed at each prenatal visit.

The nurse is assessing the laboratory report of a 40-week gestation client. Which of the following values would the nurse expect to find elevated above prepregnancy levels? 1. Glucose.2. Fibrinogen. 3. Hematocrit. 4. Bilirubin.

2. Fibrinogen levels will be elevated slightly in a 40-week pregnant woman because coagulation factors like fib- rinogen increase to help prevent ex- cessive blood loss during delivery.

The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings would the nurse highlight for the physician? 1. 17 weeks' gestation; denies feeling fetal movement. 2. 24 weeks' gestation; fundal height at the umbilicus. 3. 27 weeks' gestation; complains of excess salivation.4. 34 weeks' gestation; complains of hemorrhoidal pain.

2. The fundal height at 24 weeks should be 4 cm above the umbilicus. The fundal height at the level of the umbilicus is expected at 20 weeks' gestation.

A 36-week gestation gravid client is complaining of dyspnea when lying flat. Which of the following is the likely clinical reason for this complaint? 1. Maternal hypertension. 2. Fundal height.3. Hydramnios.4. Congestive heart failure.

2. The fundal height is the likely cause of the woman's dyspnea

A client makes the following statement after finding out that her pregnancy test is positive, "This is not a good time. I am in college and the baby will be due during final exams!" Which of the following responses by the nurse would be most appro- priate at this time? 1. "I'm absolutely positive that everything will turn out all right."2. "I suggest that you e-mail your professors to set up an alternate plan."3. "It sounds like you're feeling a little overwhelmed right now."4. "You and the baby's father will find a way to get through the pregnancy."

3. This is the best comment. It acknowl- edges the concerns that the client is having.

A 20-year-old client states that the at-home pregnancy test that she took this morn- ing was positive. Which of the following comments by the nurse is appropriate at this time? 1. "Congratulations, you and your family must be so happy." 2. "Have you told the baby's father yet?"3. "How do you feel about the results?"4. "Please tell me when your last menstrual period was."

3. It is important for the nurse to ask the young woman how she feels about being pregnant. She may decide not to continue with the pregnancy.

A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2006. Using Nagele's rule, the nurse calculates the client's estimated date of delivery as: 1. May 30, 2007. 2. June 20, 2007. 3. June 27, 2007. 4. July 3, 2007.

3. The estimated date of delivery is June 27, 2007. Nagele's rule is a sim- ple method used to calculate a client's estimated date of confinement (EDC) or estimated date of delivery (EDD) from the last normal menstrual period (LMP). The nurse learns the date of the last menstrual period from the client. He or she then subtracts 3 months from the date, adds 7 days to the date, and adjusts the year if needed

A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks' gestation; delivered a daughter, now 5 years old, at39 weeks' gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman's gravidity and parity? 1. G4 P2121.2. G4 P1212.3. G5 P1122. 4. G5 P2211.

3. This accurately reflects this woman's gravidity and parity—G5P1122.

When analyzing the need for health teaching of a prenatal multigravida, the nurse should ask which of the following questions? 1. "What are the ages of your children?" 2. "What is your marital status?"3. "Do you ever drink alcohol?"4. "Do you have any allergies?"

3. This question is important to ask in order to determine a prenatal client's health teaching needs.

A woman is 36-weeks' gestation. Which of the following tests will be done during her prenatal visit? 1. Glucose challenge test.2. Amniotic fluid volume assessment. 3. Vaginal and rectal cultures.4. Karyotype analysis

3. Vaginal and rectal cultures are done at approximately 36 weeks' gestation. Vaginal and rectal cul- tures are done to assess for the presence of group B streptococcal (GBS) bacteria in the woman's vagina and rectum

A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse's best response? "Because the organ systems in the baby are developing right now, it is risky to take medicine." "You can take any of the over-the-counter medications because they are all safe in pregnancy." "The physician will prescribe a category "X" medication for you." "You can take acetaminophen because it is a category "B" medicine."

4. Category "B" medications have been shown to be safe to take throughout pregnancy.

A 37-week gravid client states that she noticed a "white liquid" leaking from her breasts during a recent shower. Which of the following nursing responses is appro- priate at this time? Advise the woman that she may have a galactocele. Encourage the woman to pump her breasts to stimulate an adequate milk supply. Assess the liquid because a breast discharge is diagnostic of a mammary infection. Reassure the mother that this is normal in the third trimester.

4. It is normal for colostrum to be expressed late in pregnancy.

A pregnant woman must have a glucose challenge test (GCT). Which of the fol- lowing should be included in the preprocedure teaching? 1. Fast for 12 hours before the test.2. Bring a urine specimen to the laboratory on the day of the test.3. Be prepared to have 4 blood specimens taken on the day of the test. 4. The test should take one hour to complete.

4. The test does take about 1 hour to complete.

A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time? "We expect you to gain 1 lb per week, so your weight is a little low at this time." "Most women gain no weight during the first trimester, so I would suggest you eat fewer desserts for the next few weeks." "You entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need." "Your weight gain is exactly what we would expect it to be at this time."

4. The weight gain is within normal for the first trimester. For women who enter the pregnancy with a normal weight for height, the expected weight gain is: 3 to 5 lb for the entire first trimester and approximately 1 lb per week from weeks 13 to 40.

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? 1. Avoid eating greasy foods.2. Drink orange juice before rising.3. Drink 2 glasses of water with each meal. 4. Eat 3 large meals plus a bedtime snack.

Greasy foods should be avoided.

A gravida, G1 P0000, is having her first prenatal physical examination. Whichof the following assessments should the nurse inform the client that she will have that day? 1. Pap smear.2. Mammogram.3. Glucose challenge test. 4. Biophysical profile.

The client will have a Pap smear done.