OB Antepartum

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?

Influenza

A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2015. Using Nagele rule, the nurse calculates the client's estimated date of delivery as:

June 27, 2016

Which of the following developmental features would the nurse expect to be absent in a 41 week gestation fetus?

Lanugo

A nurse midwife has advised a 40 week gestation gravid to take evening primrose oil 2500 mg daily as a complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions?

Ripen the cervix

The blood of a pregnant client was initially assessed at 10 weeks gestation and reassessed at 38 weeks gestation. Which of the following results would the nurse expect to see?

Rise in WBC from 5000 cells/mm3 to 15000 cells/mm3

A woman, 26 weeks gestation, calls the triage nurse stating, "I'm really scared. I tried not to but I had an orgasm when we were making love. I just know that I will go into preterm labor now." Which of the following responses by the nurse is appropriate?

"Although oxytocin was responsible for your orgasm, it is very unlikely that it will stimulate preterm labor."

The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of the pregnancy. Which of the following comments by the client indicates that teaching was successful?

"During the third trimester I may experience frequent urination." "During the third trimester I may experience heartburn." "During the third trimester I may experience nagging backaches."

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?

Bologna

Which of the following choices can the nurse teach a prenatal client is equivalent to a 1 oz nonmeat serving of protein?

1 egg

A nurse is discussing the serving sizes in the grain food group with a new prenatal client. Which of the following foods equals 1 oz serving from the grain group? SATA

1 slice of bread 1 tortilla 1 oz dry cereal

The nurse is caring for a prenatal client who states she is prone to developing anemia. Which of the following foods should the nurse advise the gravida is the best source of iron?

Hamburger

A client who was seen in the prenatal clinic at 20 weeks gestation weighed 128 lb at that time. Approximately how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks gestation?

131 to 132 lb

The nurse is evaluating the 24 hour dairy intake of four gravid clients. Which of the following clients consumed the highest number of dairy servings during 1 day? The client who consumed: 1. 4 oz whole milk, 2 oz hard cheese, 1 cup of pudding made with milk and 2 oz of cream cheese 2. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 1.5 oz hard cheese 3. 1 cup cottage cheese, 8 oz whole milk, 1 cup buttermilk, and 0.5 oz hard cheese 4. 0.5 cup frozen yogurt, 8 oz skim milk, 4 oz cream cheese, and 1.5 cup cottage cheese

2. 1 cup yogurt, 8 oz chocolate milk, 1 cup cottage cheese, and 1.5 oz hard cheese

The following four changes occur during pregnancy. Which of them usually increases the father's interest and involvement in the pregnancy?

Hearing the fetal heartbeat

A woman delivers a fetal demise that has lanugo covering the entire body, nails that are present on the fingers and toes, but eyes that are still fused. Prior to the death, the mother stated that she had felt quickening. Based on this information, the nurse knows that the baby is about how many weeks gestation?

22 weeks

The nurse working in an outpatient obstetric office assesses for primigravid clients. Which of the client findings should the nurse highlight for the physician? SATA

24 weeks gestation; fundal height at the umbilicus 34 weeks gestation; experiences uterine cramping

A father experiencing couvade syndrome is likely to exhibit which of the following symptoms/behaviors? SATA

Heartburn Bloating Abdominal Pain

Below are four important landmarks of fetal development. Please place them in chronological order: 1. Four-chambered heart is formed. 2. Vernix caseosa is present. 3. Blastocyst development is complete. 4. Testes have descended into the scrotal sac.

3. Blastocyst development is complete. 1. Four-chambered heart is formed. 2. Vernix caseosa is present. 4. Testes have descended into the scrotal sac.

A 75 gram oral glucose tolerance test is ordered at or after 24 weeks gestation for a pregnant client to assess her physiological response to which of the following pregnancy hormones?

Human Placental Lactogen

A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant?

Chorionic Gonadotropin

The nurse is assisting a couple to develop decisions for their birth plan. Which of the following decisions should be considered nonnegotiable by the parents?

Whether or not the father will be present during labor

A woman states that she frequently awakens with "painful leg cramps" during the night. Which of the following assessments should the nurse make?

Woman's exercise sign

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 immediately if she experiences which of the following signs/symptoms? SATA

Convulsions Double Vision Epigastric Pain Persistent Vomiting

When assessing the psychological adjustment of an 8 week gravida, which of the following would the nurse expect to see signs of?

Ambivalence

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? SATA

Amenorrhea Breast tenderness Quickening Frequent Urination

A woman, 6 weeks pregnant, is having a vaginal exam. Which of the following would the practitioner expect to find?

An enlarged ovary

A 20 week gestation client is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be felt?

At the belly button

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?

Avoid eating greasy foods

A vegan is being counseled regarding vitamin intake. It is essential that this woman supplement her intake of which of the following B vitamins?

B 12 (Cobalamin)

The nurse is reading an article that states that the maternal mortality rate in the US in the year 2014 was 14. Which of the following statements would be an accurate interpretation of the statement?

In the year 2014, there were 14 maternal deaths in the US per 100,000 live births.

A client informs the nurse that she is "very constipated." Which of the following foods would be best for the nurse to recommend to the client?

Celery

A mother is experiencing nausea and vomiting every afternoon. The ingestion of which of the following spices has been shown to be a safe complementary therapy for this complaint?

Ginger

A nurse is providing diet counseling to a new prenatal client. Which of the following dairy products should the client be advised to avoid eating during the pregnancy?

Gorgonzola Cheese; a soft cheese

A nurse is providing nutrition counseling to a new gravid client advises the woman that a serving of meat is approximately equal in size to which of the following items?

Deck of Cards

A couple is preparing to interview obstetric primary care providers to determine who they will go to for care during their pregnancy and delivery. To make the best choice, which of the following actions should the couple perform first?

Develop a preliminary birth plan

A 36 week gestation gravid lies flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe?

Dizziness

During a prenatal visit, a gravid client is complaining of ptyalism. Which of the following nursing interventions is appropriate?

Encourage the woman to brush her teeth carefully

A pregnant client's primary healthcare provider has ordered a 75 gram oral glucose tolerance test (OGTT) to screen the client for gestational diabetes. The nurse is providing preprocedure counseling to the client. Which of the following must the client do? SATA

Fast for 8 to hours prior to the test Smoke no cigarettes the rest of the day

The nurse notes each of the following findings in a 10 week gestation client. Which of the findings would enable the nurse to tell the client that she is POSITIVELY pregnant?

Fetal heart rate via doppler.

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? SATA

Fibrinogen White blood cells

A gravid woman and her husband inform the nurse that they have just moved into a three-story home that was built in the 1930s. Which of the following is critical for the nurse to advise the woman to protect the unborn child?

Stay out of any rooms that are being renovated

A woman tells the nurse that she would like suggestions for alternate vitamin C sources because she isn't very fond of citrus fruits. Which of the following suggestions is appropriate?

Strawberries and Potatoes

A gravida's fundal height is noted to be at the xiphoid process. The nurse is aware that which of the following fetal changes is likely to be occurring at the same time in the pregnancy?

Surfactant is formed in the fetal lungs

A woman is planning to become pregnant. Which of the following actions should she be counseled to take before she stops using birth control? SATA

Take a daily multivitamin See a medical doctor Stop smoking cigarettes

The nurse discusses sexual intimacy with a pregnant couple. Which of the following should be included in the teaching plan?

The couple may find it necessary to experiment with alternate positions.

A pregnant client is lactose intolerant. Which of the following foods could this woman consume to meet her calcium needs?

Turnip greens

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 about 1 lb per week, so your weight is a little low at this time." "Your weight is exactly what we would expect it to be at this time."

When analyzing the need for health teaching of prenatal multigravida, the nurse should ask which of the following questions?

"What are the ages of your children?" "Do you ever drink alcohol?"

Which of the following skin changes should the nurse highlight for a pregnant woman's healthcare practitioner?

Petechiae

A client is having an ultrasound assessment done at her prenatal appointment at 8 weeks gestation. She asks the nurse, "Can you tell what sex my baby is yet?" Which of the following responses would be appropriate for the nurse to make it at this time?

"I am sorry. It will not be possible to see which sex the baby is for another month or so."

A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? SATA

Urinary Frequency Fatigue

A client is 15 weeks pregnant. She calls obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse's best response?

"The physician will prescribe a medication for you that has been shown not to cause any fetal injuries."

A woman who is seen in the prenatal clinic is found to be 8 weeks pregnant. She confides to the nurse that she is afraid her baby may be "permanently damaged because I had at least 5 beers the night I had sex." Which of the following responses by the nurse would be appropriate?

"It is unlikely that your baby was affected."

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 appropriate at this time?

"It sounds like you're feeling a little overwhelmed right now."

When assessing the fruit intake of a pregnant client, the nurse notes that the client usually eats one piece of fruit per day and drinks a 12 oz glass of fruit juice per day. Which of the following is the most important communication for the nurse to make?

"It would be even better if you were to consume more whole fruits and less fruit juice."

The nurse takes the history of a client, G2 P1001, at her first prenatal visit.. Which of the following statements would indicate that the client should be referred to a genetic counselor?

"My first child has cystic fibrosis."

The nurse asks a woman about how the woman's husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which of the following statements?

"My husband is ready for the pregnancy to end so that we can have sex again."

The nurse is interviewing a 38 week gestation Muslim woman. Which of the following questions would be INAPPROPRIATE for the nurse to ask?

"What do you plan to name the baby?"

A 16 year old, G1 P0000, is being seen at her 10 week gestation visit. She tells the nurse that she felt the baby move this morning. Which of the following responses by the nurse is appropriate?

"Would you please describe what you felt for me?"

A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but "I still think I am pregnant." Which of the following statements would be appropriate for the nurse to make at this time?

"Your period is probably just irregular." "We could do a blood test to check."

An 18 week gestation client telephones the obstetrician's office stating, "I'm really scared. I think I have breast cancer. My breasts are filled with tumors." The nurse should base the response on which of the following?

Nodular breast tissue is normal during pregnancy

A gravida, G1 P0000, is having her first prenatal physical exam. Which of the following assessments should the nurse inform the client that she will have that day? SATA

Pap Smear Complete Blood Count

Which of the following findings in an 8 week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? SATA

BMI of 17 kg/m2 Rubella titer of 1:8 Hematocrit of 30%

A third trimester client is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the visit? SATA

Blood Pressure Fetal Heart Rate Urine Protein

Why is it essential that women of childbearing age be counseled to plan their pregnancies?

Much of the organogenesis occurs before the mussed menstrual period.

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?

Fundal height

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, at 39 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?

G5 P1122

A woman has just completed her first trimester. Which of the following fetal structures can the nurse tell the woman are well formed at this time? SATA

Genitals Heart Fingers Kidneys

It is discovered that a pregnant woman practices pica. Which of the following complications is most often associated with this behavior?

Iron-Deficiency Anemia

Which of the following exercises should be taught to a pregnant woman who complains of backaches?

Pelvic tilting

Which of the following vital sign changes should the nurse highlight for a pregnant woman's obstetrician?

Prepregnancy BP 100/60 and third trimester BP 140/90

During a preconception counseling session, the nurse encourages a couple to prepare a birth plan. Which of the following is the most important goal for this action?

Promote communication between the couple and healthcare professionals.

A 37 week gestation client states that she noticed a "white liquid" leaking from her breasts during a recent shower. Which of the following nursing responses is appropriate at this time?

Reassure the mother that this is normal in the third trimester

A woman in her third trimester advises the nurse that she wishes to breastfeed her baby, "but I don't think my nipples are right." Upon examination, the nurse notes that the client has inverted nipples. Which of the following actions should the nurse take at this time?

Refer the client to a lactation consultant for advice

A woman confides in the nurse that she practices pica. Which of the following alternatives could the nurse suggest to the woman?

Replace ice with frozen juice

A woman asks the nurse about the function of amniotic fluid. Which of the following statements by the woman indicates that the teaching was successful? SATA

The fluid cushions the fetus from injury. The fluid enables the fetus to grow. The fluid provides the fetus with a stable thermal environment. The fluid enables the fetus to practice swallowing.

The nurse midwife tells a client that the baby is growing and that ballottement was evident during the vaginal exam. How should the nurse explain what the nurse midwife means by ballottement?

The nurse midwife felt the baby rebound after being pushed.

An ultrasound of a fetus's heart shows that normal fetal circulation is occurring. Which of the following statements should the nurse interpret as correct in relation to the fetal circulation?

The right atrium contains both oxygen-rich and oxygen-poor blood.

A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit?

Leg cramping

A Chinese immigrant is being seen in the prenatal clinic. When providing nutrition counseling, which of the following factors should the nurse keep in mind?

Many Chinese believe pregnant woman should eat cold foods

Which finding would the nurse view as normal when evaluating the laboratory reports of a 34 week gestation client?

Mild Anemia

A nurse has identified the following nursing diagnosis for a prenatal client: Altered nutrition: less than body requirements related to poor folic acid intake. Which of the following foods should the nurse suggest the client consume?

Oranges and Spinach

The nurse plans to provide anticipatory guidance to a 10 week gravid client who is being seen in the prenatal clinic. Which of the following information should be a priority for the nurse to provide?

Pain management during labor Methods to relieve backaches

The nurse asks a 31 week gestation client to lie on the examining table during a prenatal examination. In which of the following positions should the client be placed?

Semi-Fowler

After nutrition counseling, a woman, G3 P1101, proclaims that she certainly can't eat any strawberries during her pregnancy. Which of the following is the likely reason for this statement?

The woman believes in old wives' tales.

A client asks the nurse what was meant when the physician told her she had a positive Chadwick sign. Which of the following information about the finding would be appropriate for the nurse to convey at this time?

"It is a purplish stretch mark on your abdomen." "It is a bluish coloration of your cervix and vagina."

A 12 week gestation client tells the nurse that she and her husband seat sushi at last once per week. She states, "I know that fish is good for me, so I make sure we eat it regularly." Which of the following responses by the nurse is appropriate?

"It is recommended that fish be cooked to destroy harmful bacteria."

A client asks the nurse, "Could you explain how the baby's blood and my blood separate at delivery?" Which of the following responses is appropriate for the nurse to make?

"The blood actually never mixes. Your blood supply and the baby's blood supply are completely separate.

A client in her third trimester is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy. How should the nurse respond?

"The contractions may feel just like a backache, but they will come and go"

The nurse is teaching a couple about fetal development. Which statement by the nurse is correct about the morula stage of development?

"The fertilized egg has yet to implant into the uterus."

A 38 week gestation client, Bishop score 1, is advised by her nurse midwife to take evening primrose daily. The office nurse advises the client to report which of the following side effects that has been attributed to the oil?

Skin rash

A 20 year old client states that the at home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time?

"How do you feel about these results?"

a mother has just experienced quickening. Which of the following developmental changes would the nurse expect to occur at the same time in the woman's pregnancy?

Lanugo covers the fetal body

A nurse is working in the prenatal clinic. Which of the following findings seen in third trimester pregnant women would the nurse consider to be within normal limits? SATA

Leg Cramps Varicose Veins Hemorrhoids Lordosis

The partner of a gravida accompanies her to her prenatal appointment. The nurse notes that the father of the baby has gained weight since she last saw him. Which of the following comments is most appropriate for the nurse to make to the father?

"I am so glad to see that you are taking so much interest in your partner's pregnancy."

A gravid client is counseled by her primary healthcare provider to have a vaccination during her third trimester of pregnancy. The client questions the healthcare provider's recommendation. Which of the following statements would be appropriate for the nurse to give the client?

"If you receive the tetanus, diptheria, and acellular pertussis vaccine, your baby will be protected against the whooping cough."

A 34 week gestation woman calls the obstetric office stating, "Since last night I have had three nosebleeds." Which of the following responses by the nurse is appropriate?

"One of the hormones of pregnancy makes the nasal passages prone to bleeds"

The nurse has taking a health history on four primigravid clients at their first prenatal visits. It is high priority that which of the following clients receives nutrition counseling?

The woman diagnosed with phenylketonuria.

A woman asks the nurse about consuming herbal supplements during pregnancy. Which of the following responses is appropriate?

The woman should discuss everything she eats with a healthcare practitioner

A nurse is providing health education to a group of women who are planning to become pregnant. Which of the following actions should the nurse advise the women to take throughout their pregnancies? SATA

The women should avoid traveling to locations where the zika virus is endemic. The women should engage in a daily exercise program.

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?

Tofu, legumes, broccoli

A client is 35 weeks gestation. Which of the following findings would the nurse expect to see?

Use of three (3) pillows for sleep comfort

A woman is 36 weeks gestation. Which of the following tests will be done during her prenatal visit?

Vaginal and Rectal Cultures

A client states that she is a strong believer in vitamin supplements to maintain her health. The nurse advises the woman that it is recommended to refrain from consuming excess quantities of which of the following vitamins during pregnancy?

Vitamin D

A woman is carrying dizygotic twins. She asks the nurse about the babies. Which of the following explanations is accurate?

When the woman ovulated, she expelled two mature ova.