OB EXAM 2 (Prep U Chapters 14, 15, 19, 20)

An obviously pregnant woman appears for her first prenatal visit. She reports a headache and generalized abdominal pain which has persisted over the past couple months. Which question should the nurse prioritize after determining the client is approximately 24 weeks' gestation, appears nervous, and is reluctant to have a full physical assessment? Do you have a family history of thyroid disease Have you been taking a prenatal vitamin Do you feel safe at home How much activity have you been able to fit into your schedule

Do you feel safe at home

The nurse is conducting an initial history and assessment on a client at 10 weeks' gestation who is pregnant with her first child. Which question is a priority for the nurse to ask the client at this time? Does anyone in your or the father's family have any genetic disorders Do you plan to breast feed or bottle feed your new baby Are you planning to develop to birth plan for use during the birthing process Was your mother or grandmother diagnosed with gestational diabetes

Does anyone in your or the father's family have any genetic disorders

A nurse is discussing smoking cessation with a pregnant client. The client tells the nurse that they do not want to stop smoking because it helps them remain calm. Which response by the nurse will best promote change in the client's behavior? You are causing your baby more harm than good by not stopped smoking Even if you are not ready to stop smoking, reducing the amount you smoke is also beneficial Filling out this questionnaire for depression may tell us why you need to smoke to stay calm You should know that smoking is associated with late-onset behavioral problems in children

Even if you are not ready to stop smoking, reducing the amount you smoke is also beneficial

A woman with preterm labor is receiving magnesium sulfate. Which finding would require the nurse to intervene immediately? Respiratory rate of 16 breaths per minute 1+ deep tendon reflexes Urine output of 45 mL/hr Alert level of consciousness

1+ deep tendon reflexes

A nurse is discussing menstruation with a female client. The nurse describes a normal amount of blood loss is approximately: 5 to 20 mL 10 to 80 mL 75 to 100 mL 120 to 150 mL

10 to 80 mL

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation. 3, 2, 1, 2, 1 4, 2, 2, 1, 1 3, 2, 1, 1, 1 4, 1, 1, 1, 1

4, 1, 1, 1, 1

A client makes an appointment at the prenatal clinic because the client thinks the client might be pregnant. Which assessment would the nurse identify as a presumptive sign of pregnancy? Amenorrhea Vagina violet in color Cervical softening Positive pregnancy test

Amenorrhea

A pregnant woman with a history of mitral valve stenosis is to be prescribed medication as treatment. Which medication class would the nurse expect the client to be prescribed? Anticoagulant Vasodilator Inotropic Angiotensin receptor blockers

Anticoagulant

A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate? You'll probably have a cesarean birth to prevent exposing your newborn Antibodies cross the placenta and provide immunity to the newborn Wait until after the infant is born, and then something can be done Antiretroviral medications are available to help reduce the risk of transmission

Antiretroviral medications are available to help reduce the risk of transmission

A nurse is teaching a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority? Avoidance of infection Constipation prevention Administration of immunoglobulins Consumption of low-fat diet

Avoidance of infection

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? Provides rich blood supply to decidua Maintains nutrient-rich decidua Continues progesterone production by corpus luteum Sustains life of placenta

Continues progesterone production by corpus luteum

A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition? Cytomegalovirus Chlamydia Gonorrhea Toxoplasmosis

Cytomegalovirus

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. The nurse determines that the medication is at a therapeutic level based on which finding? Urinary output of 20 mL per hour Respiratory rate of 10 breaths/minute Deep tendon reflexes 2+ Difficulty in arousing

Deep tendon reflexes 2+

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? Hyperglycemia Elevated platelet count Disseminated intravascular coagulation (DIC) Elevated liver enzymes

Elevated liver enzymes

Which of the following findings is most worrisome in Melissa, a woman in her 26th week of pregnancy? Generalized hair loss A hyperpigmented rash over the maxillary region bilaterally Nosebleeds Facial edema

Facial edema

The nurse is preparing to teach a client and her partner about the hormones involved in menstruation. Which hormone will the nurse point out is secreted by the corpus luteum? Luteinizing hormone Follicle stimulating hormone Progesterone Androgen

Progesterone

The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours to detect which condition? Pulmonary hypertension Pulmonary edema Pulmonary emboli Pulmonary atelectasis

Pulmonary edema

A pregnant woman with cardiac disease tells the nurse, "I want to have a healthy baby and know heavier babies are more healthy." What would be the nurse's best response to this client? Carrying a larger baby can be hard on your joints and muscles Too much weight gain could overburden your heart and circulatory system It should not be a problem to gain a few extra pounds as long as it is baby weight As long as you take your prenatal vitamins, your baby will be healthy

Too much weight gain could overburden your heart and circulatory system

A pregnant woman needs an update in her immunizations. Which vaccination would the nurse ensure that the woman receives? Measles Mumps Rubella Hepatitis B

Hepatitis B

The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or during the birth for the infant. Which statement by the mother indicates that further teaching is needed by the nurse? My baby may be very large and I may need a cesarean birth to have him If my blood sugars are elevated, my baby's lungs will mature faster, which is good Beginning at 28 weeks' gestation, I will start counting with my baby's movements every day I may need an amniocentesis during the third trimester to see if my baby's lungs are ready to be born

If my blood sugars are elevated, my baby's lungs will mature faster, which is good

A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take? Immediately stop the nurse Call the client later and apologize Contact the health care provider Tell the unlicensed assistive personnel

Immediately stop the nurse

The nurse is reviewing the functions of the ovaries, uterus, clitoris, and vagina with a group of nursing students. What would be the best response by a nursing student about the function of the uterus? It produces female gametes or ova and secretes female sex hormones It receives the fertilized ovum and provides housing and nourishment for a fetus It receives sperm, provides an exit for menstrual flow, and serves as the birth canal It is a small erectile structure that responds to sexual stimulation

It receives the fertilized ovum and provides housing and nourishment for a fetus

What does the genetic analysis always include? Interventions for other potentially inherited conditions Evaluation of other potentially inherited conditions Planning for other potentially inherited conditions Assessment for any other potentially inherited condition

Assessment for any other potentially inherited condition

A nurse is providing care to a client diagnosed with a Class III cardiac disability who is in the second stage of labor. Which intervention will the nurse take? Encourage closed-glottis pushing efforts Prepare the client for a cesarean birth Position the client for passive descent Utilize low-dose cervical ripening agents

Position the client for passive descent

A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? Congenital anomalies Incompetent cervix Placenta previa Placental abruption (abruptio placentae)

Congenital anomalies

The nurse is caring for a postpartum client with type 2 diabetes. Which intervention will the nurse add to this client's plan of care? Assess blood glucose every 4 to 6 hours Review methods to bottle feed the newborn Assess blood glucose before and after meals Give half the amount of insulin needed while pregnant

Assess blood glucose before and after meals

A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum? Limiting sodium intake Inspecting the extremities for edema Ensuring that the client consumes a high fiber diet Assessing for cardiac decompensation

Assessing for cardiac decompensation

The nurse is comforting and listening to a young couple who just suffered a spontaneous abortion (miscarriage). When asked why this happened, which reason should the nurse share as a common cause? Maternal smoking Lack of prenatal care Chromosomal abnormality The age of the mother

Chromosomal abnormality

A woman has come to the clinic for her first prenatal visit. Which method would be the most effective way for the nurse to initiate data gathering for a health history? Ask her to complete a written questionnaire concerning her past and present status Conduct an interview in a private room to obtain her health history Wait until she is in the examining room and prepared for her physical examination Ask her some basic questions in the waiting room before taking her to the examining room

Conduct an interview in a private room to obtain her health history

A nurse is explaining the difference between an over-the-counter vitamin and a prescribed prenatal vitamin. When explaining the difference, which ingredient will the nurse describe as important for pregnancy nutrition? Folic acid Vitamin C Potassium Vitamin B12

Folic acid

A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements? Preeclampsia Placental abruption (abruptio placentae) Placenta previa Gestational hypertension

Gestational hypertension

A pregnant client is planning travel to a foreign country as part of a work assignment and needs immunizations. What should the nurse instruct the client about immunizations while pregnant? Immunizations should be restricted to live viruses only There are no restrictions on immunizations while pregnant The only immunizations that should be avoided is for the flu Live virus immunizations are contraindicated while pregnant

Live virus immunizations are contraindicated while pregnant

The nurse is providing teaching to an adolescent girl on the function of the female reproductive system. Which statement by the client best reflects understanding of the material presented? I will always count from the end of my last menstrual cycle to determine when I will ovulate A vaginal discharge that is thick and white in color indicates that I am ovulating My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal During ovulation, the egg is released directly into my uterus to help with fertilization

My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal

A woman with gestational hypertension develops eclampsia and experiences a seizure. Which intervention would the nurse identify as the priority? Fluid replacement Oxygenation Control of hypertension Birth of the fetus

Oxygenation

A client with a history of cervical insufficiency is seen for reports of pink-tinged discharge and pelvic pressure. The primary care provider decides to perform a cervical cerclage. The nurse teaches the client about the procedure. Which client response indicates that the teaching has been effective? Staples are put in the cervix to prevent it from dilating The cervix is glued shut so no amniotic fluid can escape Purse-string sutures are placed in the cervix to prevent it from dilating A cervical cap is placed so no amniotic fluid can escape

Purse-string sutures are placed in the cervix to prevent it from dilating

A woman has presented to the emergency department with symptoms that suggest an ectopic pregnancy. Which finding would lead the nurse to suspect that the fallopian tube has ruptured? Referred shoulder pain Vaginal spotting Nausea Breast tenderness

Referred shoulder pain

The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity? Lung sounds Oxygen saturation Reflexes Magnesium sulfate level

Reflexes

A pregnant woman asks the nurse about using herbal remedies while she is pregnant. The nurse recommends that the woman talk with her health care provider about their use based on which understanding? They are not rated with regard to safety during pregnancy They can create nutritional deficiencies in the mother and fetus They are known to cause teratogenic effects in the fetus They have been proven to cause early labor

They are not rated with regard to safety during pregnancy

A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client? Diminished reflexes Elevated liver enzymes Seizures Serum magnesium level of 6.5 mEq/L

Diminished reflexes

Which STI could be transmitted perinatally? Herpes simplex Chlamydia Gonorrhea Trichomoniasis

Herpes simplex

TORCH is an acronym for maternal infections associated with congenital malformations and disorders. Which disorder does the H represent? Hemophilia Hepatitis B virus Herpes simplex virus Human immunodeficiency virus (HIV)

Herpes simplex virus

A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy? High number of pregnancies Multiple gestation pregnancy Use of oral contraceptives History of endometriosis

History of endometriosis

A client at 11 weeks' gestation experiences pregnancy loss. The client asks the nurse if the bleeding and cramping that occurred during the miscarriage were caused by working long hours in a stressful environment. What is the most appropriate response from the nurse? Your spontaneous bleeding is not work-related It is hard to know why a woman bleeds during early pregnancy I can understand your need to find an answer to what caused this. Let's talk about this further Something was wrong with the fetus

I can understand your need to find an answer to what caused this. Let's talk about this further

A 24-year-old woman presents with vague abdominal pains, nausea, and vomiting. An urine hCG is positive after the client mentioned that her last menstrual period was 2 months ago. The nurse should prepare the client for which intervention if the transvaginal ultrasound indicates a gestation sac is found in the right lower quadrant? Bed rest for the next 4 weeks Intravenous administration of a tocolytic Immediate surgery Internal uterine monitoring

Immediate surgery

A student nurse is preparing for a presentation that will illustrate the various physiologic changes in the woman's body during pregnancy. Which cardiovascular changes up through the 26th week should the student point out? Decreased pulse rate and increased blood pressure Increased pulse rate and decreased blood pressure Increased pulse rate and blood pressure No change in pulse rate or blood pressure

Increased pulse rate and decreased blood pressure

The nurse is caring for a postpartum client with diabetes who has developed an infection. The nurse is aware that infections in clients with diabetes tend to be more severe and can quickly lead to complications. Which complication should the nurse assess this client for? Anemia Ketoacidosis Respiratory acidosis Respiratory alkalosis

Ketoacidosis

The nurse reviews the medication therapy regimen of a pregnant woman with chronic hypertension. Which medication would the nurse most likely expect to find? Labetalol Atenolol Carvedilol Metoprolol

Labetalol

Which measure would the nurse include in the plan of care for a woman with prelabor rupture of membranes if her fetus's lungs are mature? Reduction of physical activity level Observation for signs of infection Administration of corticosteroids Labor induction

Labor induction

During pregnancy a woman's blood volume increases to accommodate the growing fetus to the point that vital signs may remain within normal range without showing signs of shock until the woman has lost what percentage of her blood volume? 40% 30% 50% 20%

40%

A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. The nurse determines that the drug is at a therapeutic level based on which result? 3.3 mEq/L 6.1 mEq/L 8.4 mEq/L 10.8 mEq/L

6.1 mEq/L

A woman with a positive history of genital herpes is in active labor. Assessment reveals vesicles in the perineum area, membranes are ruptured, dilated 5 cm, and effaced 70%. The nurse should prepare the client for which type of birth? Spontaneous vaginal Vacuum-assisted Cesarean Forceps-assisted

Cesarean

The nurse is preparing to assess a young woman's external genitalia. The nurse predicts the client is currently in the most fertile phase of the menstrual cycle based on which assessment finding of the vaginal mucus drainage? Yellow, tacky, and crumbly Distensible, stretchable quality Raw egg white consistency Clear and oily

Distensible, stretchable quality

A nurse is assessing a client, and the client asks, "I just saw my neighbor leave the office. I know she was coming in for genetic testing on the baby. Is it bad?" What is the most appropriate response by the nurse? The baby has a genetic disorder It is never good news to have those tests You will need to ask her for those results Health care of all individuals is a private matter

Health care of all individuals is a private matter

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply. Hyperthermia Hemolysis Elevated liver enzymes Leukocytosis Low platelet count

Hemolysis Elevated live enzymes Low platelet count

A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction? I need to be aware of my triggers and avoid them as much as possible It is fine for me to use my albuterol inhaler if I begin to feel tight I need to begin taking allergy shot like my friend to prevent me from having an allergic reaction this spring I will monitor my peak expiratory flow rate regularly to help me predict when an asthma attack is coming on

I need to begin taking allergy shot like my friend to prevent me from having an allergic reaction this spring

A nursing instructor is teaching students about anemia during pregnancy. Which type of anemia does the instructor teach students is most prevalent during pregnancy? Sickle-cell anemia Pernicious anemia Iron-deficiency anemia Folic acid anemia

Iron-deficiency anemia

A client with systemic lupus erythema (SLE) wants to have a baby. Which response will the nurse make after learning the client had an exacerbation of SLE 3 months ago? Now would be a good time for you to become pregnant It is best to wait until you have not had an exacerbation for 6 months Blood tests to monitor liver and kidney function are not needed while pregnant The medications that you are taking should be stopped if trying to become pregnant

It is best to wait until you have not had an exacerbation for 6 months

Which of a client's cells are most likely to reproduce by meiosis? Ova Breast tissue Endometrium Cervix

Ova

A nurse is providing care to a pregnant client newly diagnosed with human chorionic gonadotropin (hCG)-mediated hyperthyroidism. The nurse is preparing educational materials on an appropriate treatment option for the client. On which treatment will the nurse provide information to the client? Serial T4 and thyroid-stimulating hormone (TSH) assessments Thyroidectomy Initiation of thioamide therapy A course of beta blockers

Serial T4 and thyroid-stimulating hormone (TSH) assessments

A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize? A systolic blood pressure increase of 10 mmHg Weight gain of 1.2 lb (0.54 kg) during the past 1 week A dipstick value of 2+ for protein Pedal edema

A dipstick value of 2+ for protein

After conducting a refresher class on possible congenital infections with a group of perinatal nurses, the nurse recognizes the class was successful when the group identifies which congenital viral infection as the most common? CMV HIV HPV RSV

CMV

A nurse assesses a primigravida client in the eighth week of gestation. The client reports nausea and vomiting in the mornings. The client tells the nurse, "I'm not able to keep liquids down and I'm eating like a bird." The client also expresses concerns about hormonal changes and how the pregnancy will affect her physical appearance. Which client problem should the nurse assess first? Deficient fluid volume Disturbed body image Knowledge deficit Slow weight gain

Deficient fluid volume

A client with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The client explains that she has been "eating for two" so the baby is healthy. How should the nurse respond to the client? Elevated blood glucose levels cause low birth weights in infants Elevated blood glucose levels ensure the baby has mature lungs at birth Elevated blood glucose levels hasten the development of the fetus in utero Elevated blood glucose levels in the first trimester have been linked to congenital anomalies

Elevated blood glucose levels in the first trimester have been linked to congenital anomalies

A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP? Elevated lipoproteins Hemolysis Liver enzyme elevation Low platelet count

Elevated lipoproteins

A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate? Cord compression Fetal distress related to hypoxia Infection Central nervous system (CNS) involvement

Fetal distress related to hypoxia

A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion (miscarriage). The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first-trimester miscarriage? Maternal disease Cervical insufficiency Fetal genetic abnormalities Uterine fibroids (uterine myomas)

Fetal genetic abnormalities

A client tells that nurse in the doctor's office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia? Take a low-dose antihypertensive prophylactically Have her blood pressure checked at every prenatal visit Monitor the client for headaches or swelling on the body Take one aspirin every day

Have her blood pressure checked at every prenatal visit

A pregnant woman has just found out that she is having twin girls. She asks the nurse the difference between fraternal and identical twins. The nurse explains that with one set of twins there is fertilization of two ova, and with the other set one fertilized ovum splits. What type of twins result from the split ovum? Fraternal Identical Neither type results from a split ovum Both types results from the split ovum

Identical

The nurse is caring for a pregnant client with severe preeclampsia. Which nursing intervention should a nurse perform to institute and maintain seizure precautions in this client? Provide a well-lit room Keep head of bed slightly elevated Place the client in a supine position Keep the suction equipment readily available

Keep the suction equipment readily available

A nurse is reviewing a client's history and physical examination findings. Which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy? Use of oral contraceptives for 5 years Ovarian cyst 2 years ago Recurrent pelvic infections Heavy, irregular menses

Recurrent pelvic infections

Which symptom may indicate a complication (not a common discomfort) in the second or third trimester of pregnancy? Dyspnea on exertion or while lying supine Backache after long periods of standing Lower extremity edema in the evening in the absence of proteinuria Braxton Hicks contractions at 38 weeks Pain underneath the ribs on the right side

Pain underneath the ribs on the right side

A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next? Check deep tendon reflexes Measure fundal height Palpate the fundus and check fetal heart rate Obtain a voided urine specimen and determine blood type

Palpate the fundus and check fetal heart rate

A client with a multiple gestation has come to a health care facility for a regular antenatal check-up. When educating the client on pregnancy, about which complication should the nurse inform the client? Hypotension Fetal macrosomia Frequent diarrhea Placental dysfunction

Placental dysfunction

A pregnant women calls the clinic to report a small amount of painless vaginal bleeding. What response by the nurse is best? Please come in now for an evaluation by your health care provider Lie on your left side and drink lots of water and monitor the bleeding If the bleeding lasts more than 24 hours, call us for an appointment Bleeding during pregnancy happens for many reasons, some serious and some harmless

Please come in now for an evaluation by your health care provider

A woman at 35 weeks' gestation with severe polyhydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client? Preterm rupture of membranes followed by preterm birth Development of eclampsia Hemorrhaging Development of gestational trophoblastic disease

Preterm rupture of membranes followed by preterm birth

A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal? Decrease blood pressure Decrease protein in urine Prevent maternal seizures Reverse edema

Prevent maternal seizures

A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV? Urine protein Ability to sleep Hemoglobin Respiratory rate

Respiratory rate

A pregnant client with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful? The client delivers a full-term fetus at 39 weeks' gestation The client's membranes spontaneously rupture at week 30 of gestation The client experiences minimal vaginal bleeding throughout the pregnancy The client has reduced shortness of breath and abdominal pain during the pregnancy

The client delivers a full-term fetus at 39 weeks' gestation

A nurse is caring for a pregnant client admitted with mild preeclampsia. Which assessment finding should the nurse prioritize? Urine output of less than 15 mL/hr 1+ ankle edema Mild hand edema Proteinuria of 200 mg/24 hrs

Urine output of less than 15 mL/hr

The nurse is evaluating care provided to a client in the third trimester of pregnancy who has been diagnosed with gestational hypertension. Which finding indicates that treatment has been successful for this client? Urine protein 0 Increased perspiration Weight gain of 1 lb/week Diastolic blood pressure 20 mmHg over normal level

Urine protein 0

The obstetric nurse is caring for a pregnant client who has been diagnosed with a hydatidiform mole. What assessment should the nurse prioritize? Vaginal bleeding Blood pressure Pain Severe nausea and vomiting

Vaginal bleeding

A client is 11 weeks' pregnant after many years trying to conceive. After arriving home from a normal prenatal visit, she experiences mild cramping and has a gush of bright red vaginal bleeding. She calls the nurse and reports having soaked a pad with fresh blood in fewer than 30 minutes. The uterine cramping is worsening. What is the most appropriate response from the nurse? This is nothing to worry about. Many women bleed during pregnancy Lie down and call your health care provider tomorrow if symptoms continue I am sorry. There is nothing you can do because you are likely miscarrying You need to seek immediate attention from the primary care provider

You need to seek immediate attention from the primary care provider

The nurse is caring for a pregnant woman in her third trimester who is HIV positive. The client voices concerns about how to prevent transmitting HIV to her infant. Which response by the nurse is most appropriate? Your infant will be tested after birth to determine if the virus is present and, if not, we will discuss how to avoid future transmission You will not be able to breastfeed your infant once born. Your infant will need to receive formula Your infant will begin receiving antiretroviral therapy immediately if tests show the infant is HIV positive This is something you need to discuss with your infant's health care provider

You will not be able to breastfeed your infant once born. Your infant will need to receive formula

A nursing instructor teaching a maternity course realizes a student needs more instruction upon overhearing the student make which of the following statements? Different sexual positions can determine the sex of the fetus Ingesting certain foods before intercourse has no bearing on the sex of the fetus Some couples mistakenly believe that they can influence the sex of the fetus Timing sex at specific times during the menstrual cycle does not influence fetal gender

Different sexual positions can determine the sex of the fetus

A school nurse who is teaching a health course at the local high school is presenting information on human development and sexuality. When talking about the role of hormones in sexual development, which hormone does the nurse teach the class is the most important for developing and maintaining the female reproductive organs? Estrogen Progesterone Androgens Follicle-stimulating hormone

Estrogen

The nurse cares for multiple clients planning to have children. Which client will the nurse identify as priority for needing a referral for prenatal genetic testing? A female client who is 38 years of age A male client who is 45 years of age A female client diagnosed with diabetes mellitus A male client with family history of sickle cell disease

A male client with family history of sickle cell disease

A nursing instructor is teaching students about preexisting illnesses and how they can complicate a pregnancy. The instructor recognizes a need for further education when one of the students makes which statement? A pregnant woman with a chronic condition can put herself at risk A pregnant woman with a chronic illness can put the fetus at risk A pregnant woman does not have to worry about contracting new illnesses during pregnancy A pregnant woman needs to be careful of and cautious about accidents and illnesses during her pregnancy

A pregnant woman does not have to worry about contracting new illnesses during pregnancy

A female client is concerned about the rate of fertility because the client is older than age 35 years. The client states, "Have I given up the chance to be a parent?" Which response from the nurse is accurate? You are well past you peak point. Your fertility peaks in your 20s and gradually declines until death You are just approaching your peak. A woman's fertility peaks around 40 and gradually declines until age 45 A woman's fertility peaks in the 20s, declines gradually until age 35, and then rapidly declines until it ends Pregnancy is not expected at this point. You are well beyond fertility, which peaks in the 20s and then rapidly declines

A woman's fertility peaks in the 20s, declines gradually until age 35, and then rapidly declines until it ends

A client diagnosed with anorexia nervosa presents to the clinic for a routine prenatal visit at 24 weeks' gestation. Which is an important action for the nurse to take during the visit? Question the client about the use of laxatives Weigh the client in a hospital gown Ask whether the client has had episodes of binge eating Inform the client of any weight gained since the last visit

Weight the client in a hospital gown

While conducting the first prenatal health history visit, the nurse learns that a pregnant client is taking various herbal remedies and over-the-counter medications for minor ailments. Which nursing diagnosis should the nurse identify as being appropriate for the client at this time? Risk for injury to fetus related to lifestyle choices Deficient knowledge regarding exposure to teratogens during pregnancy Health-seeking behaviors related to strong cultural desire to have a healthy child Health-seeking behaviors related to guidelines for nutrition and activity during pregnancy

Deficient knowledge regarding exposure to teratogens during pregnancy

The nurse is reviewing the process of egg maturation and ovulation with a client. What occurs during ovulation in the ovarian cycle that the nurse should include in the teaching session with the client? Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature The empty ruptured cavity in the ovary becomes the corpus luteum and begins to secrete progesterone and estrogen About day 14, a surge of hormones cause the ovum to burst through the ovary The uterus is prepared for implantation of an ovum

About day 14, a surge of hormones cause the ovum to burst through the ovary

A G4P3 client with a history of controlled asthma is upset her initial prenatal appointment is taking too long, making her late for another appointment. What is the nurse's best response when the client insists she knows how to handle her asthma and needs to leave? Remind her to continue taking asthma medications, to monitor peak flow daily, and to monitor the baby's kicks in the second and third trimesters Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications Schedule an appointment for her to return to discuss her asthma management Note in the chart that the woman was not counseled about her asthma

Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications

A woman's obstetrician prescribes vitamin K supplements for a client who is on antiepileptic medications beginning at 36 weeks' gestation. The mother asks the nurse why she is taking this medication. The nurse's best response would be: Vitamin K helps in keeping the placenta healthy Antiepileptic therapy can lead to vitamin K-deficient hemorrhage of the newborn Administration of vitamin K aids in lung maturity of the fetus The antiepileptic medications can cause the mother's platelets to drop

Antiepileptic therapy can lead to vitamin K-deficient hemorrhage of the newborn

A nurse is providing information regarding ovulation to a couple who want to have a baby. Which fact should the nurse tell the clients? Ovulation takes place 10 days before menstruation The lifespan of the ovum is only about 48 hours At ovulation, a mature follicle ruptures, releasing an ovum When ovulation occurs, there is a rise in estrogen

At ovulation, a mature follicle ruptures, releasing an ovum

A nurse is interviewing a couple at a preconception counseling session. The couple is of Greek heritage and are concerned about the possibility of their children being born with a genetic disorder. Based on the nurse's understanding of genetic disorders, the nurse would identify this couple as being at risk for which condition? B-thalassemia a-thalassemia Sickle cell anemia Tay-Sachs disease

B-thalassemia

Which response is most appropriate for a client with diabetes who wants to breastfeed but is concerned about the effects of breastfeeding on her health? Diabetic clients who breastfeed have a hard time controlling their insulin needs Diabetic clients shouldn't breastfeed because of potential complications Diabetic clients shouldn't breastfeed; insulin requirements are doubled Diabetic clients may breastfeed; insulin requirements may decrease from breastfeeding

Diabetic clients may breastfeed; insulin requirements may decrease from breastfeeding

A pregnant woman with sickle cell anemia is very concerned her infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse? Both parents have to carry the trait There is a good change the infant will inherit the disease from the mother The infant inherits the disease from the father If the mother goes into crisis while pregnant, the baby will develop sickle cell anemia

Both parents have to carry the trait

A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client? Diet Long-acting insulin Oral hypoglycemic drugs Glucagon

Diet

A pregnant client with type I diabetes asks the nurse about how to best control her blood sugar while she is pregnant. The best reply would be for the woman to: Limit weight gain to 15 pounds during the pregnancy Check her blood sugars frequently and adjust insulin accordingly Exercise for 1 to 2 hours each day to keep the blood glucose down Begin oral hyperglycemic medications along with the insulin she is currently taking

Check her blood sugars frequently and adjust insulin accordingly

A pregnant client with a history of heart disease has been admitted to a health care center reporting breathlessness. The client also reports shortness of breath and easy fatigue when doing ordinary activity. The client's condition is markedly compromised. The nurse would document the client's condition using the New York Heart Association (NYHA) classification system as which class? Class I Class II Class III Class IV

Class III

The nursing instructor is illustrating the various phases of the uterine cycle to a group of nursing students. The instructor determines the session is successful when the students correctly choose which action occurring during the secretory phase? Days 1-5 are the days you will typically experience menstrual flow Day 10 is part of the proliferation phase of your menstrual cycle Day 14 of your menstrual cycle is normally when you will ovulate Days 27 and 28 are when you have declining hormonal secretions

Day 14 of your menstrual cycle is normally when you will ovulate

A young married woman says that she is planning a tubal ligation because intellectual disability runs in her husband's family and she does not want any children with this problem. Which nursing diagnosis would best apply to this couple? Anxiety related to marital issues Deficient knowledge of genetically inherited disorders Spiritual distress related to inappropriate approach to the issue of having children Sexual dysfunction related to the possibility of having a child with intellectual disability

Deficient knowledge of genetically inherited disorders

During which stage of fetal development is exposure to teratogens most damaging? Pre-embryonic stage Embryonic stage Fetal stage Mitosis stage

Embryonic stage

A woman is 10 weeks' pregnant and tells the nurse that this pregnancy was unplanned and she has no real family support. The nurse's most therapeutic response would be to: Encourage her to identify someone that she can talk to and share the pregnancy experience Tell her to move home so her family will be nearby to help her Remind her that she is still early in the pregnancy and she will feel better about it as the pregnancy progresses Offer to meet with the client on a regular basis to provide her someone to talk to about her concerns

Encourage her to identify someone that she can talk to and share the pregnancy experience

A pregnant client with deep vein thrombosis has been diagnosed as having systemic lupus erythematosus (SLE). The nurse would monitor the client closely for the development of which complication? Increased placental weight Postterm birth of infant Fetal macrosomia Fetal malnutrition

Fetal malnutrition

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Positive office pregnancy test Fetal movement felt by examiner Hegar sign Chadwick sign

Fetal movement felt by examiner

A nurse is admitting a pregnant woman with sickle cell anemia to the emergency department. Which findings would lead the nurse to suspect the client is in crisis? Select all that apply. Fever Joint pain Increased skin turgor Pallor Fatigue

Fever Joint pain Fatigue

The nurse is assessing a 16-year-old female on a routine well-child visit. Which assessment finding will the nurse predict this healthy female will report concerning her menstrual cycles? Flow usually lasts 4-6 days The usual cycle is 36 days There's abundant clear mucus at the beginning Menstruation began at age 15

Flow usually lasts 4-6 days

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum? Follicle-stimulating hormone Luteinizing hormone Estrogen Progesterone

Follicle-stimulating hormone

A pregnant woman is diagnosed with iron-deficiency anemia and is prescribed an iron supplement. After teaching her about the prescribed iron supplement, which statement indicates successful teaching? I should take my iron with milk I should avoid drinking orange juice I need to drink plenty of fluids to prevent constipation I will call the health care provider if my stool is black and tarry

I need to drink plenty of fluids to prevent constipation

A couple has just learned that their son will be born with Down syndrome. The nurse shows a lack of understanding when making which statement? We have counseling services available, and I recommend them to everyone facing these circumstances I will alert your entire family about this so you don't have to I will support you in any decision that you make I will give you as much information as I can about this condition

I will alert your entire family about this so you don't have to

A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize? Antihypertensive drugs Diuretic drugs IV fluids Antibiotics

IV fluids

The nursing instructor is illustrating the various phases of the uterine cycle to a group of nursing students. The instructor determines the session is successful when the students correctly choose which action occurring during the secretory phase? While the ovarian follicles are producing increased amounts of estrogen, the endometrium begins to slough off If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall Withdrawal of hormones causes the endometrial cells to change, and menstruation begins An ovum matures

If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall

An anatomy professor is teaching a class of pre-nursing students about the female reproductive system. One student asks, "Where is the opening to the vagina?" The best answer the professor can give is: Between where you pee and where you poop In what is called the vestibule, which is located between the labia minora By the Bartholin glands Between the labia majora and by the paraurethral glands

In what is called the vestibule, which is located between the labia minora

A nurse caring for a 43-year-old client explains to the client that ovarian functions gradually decrease around this age. What is the implication of decreased ovarian function? Susceptibility to fractures Increases the risk of heart disease Changes in sexual response Inability to become pregnant

Inability to become pregnant

A 25-year-old client at 22 weeks' gestation is noted to have proteinuria and dependent edema on her routine prenatal visit. Which additional assessment should the nurse prioritize and convey to the RN or health care provider? Initial BP 120/80mm Hg; current BP 130/88 mm Hg Initial BP 100/70 mm Hg; current BP 140/90 mm Hg Initial BP 140/85 mm Hg; current BP 130/80 mm Hg Initial BP 110/60 mm Hg; current BP 112/86 mm Hg

Initial BP 100/70 mm Hg; current BP 140/90 mm Hg

The clinic nurse is obtaining baseline information for the medical record which will be sent to the hospital. When asking the client about religious preference, the client says, "Why? What difference does that make?" How will the nurse respond? It is know to whom to call if you ask for a member of a specific faith community It is identify religious beliefs that may affect you or the fetus during your stay It is to aid research on how many birth occur yearly in a religious denomination It is to notify faith members of your arrival at the hospital

It is to identify religious beliefs that may affect you or the fetus during your stay

A pregnant client asks why a maternal serum alpha-fetoprotein level has been ordered. What should the nurse explain to the client about this test? It screens for placenta function It measures the fetal liver function It may reveal chromosomal abnormalities It tests the ability of the client's heart to accommodate the pregnancy

It may reveal chromosomal abnormalities

Which statement should be incorporated into the teaching plan developed to present instruction about the female menstrual cycle to nursing students? Menses ensues when the levels of estrogen and progesterone fall The follicular phase is dominated by progesterone and testosterone Progesterone influences the growth of endometrial lining Estrogen is the dominant hormone during the luteal phase

Menses ensues when the levels of estrogen and progesterone fall

A woman with an artificial mitral valve develops heart failure at the 20th week of pregnancy. Which measure would the nurse stress with her during the remainder of the pregnancy? Obtaining enough rest Maintaining a high fluid intake Beginning a low-impact aerobics program Discontinuing her prepregnancy anticoagulant

Obtaining enough rest

A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you to consider? Restricting visitors to reduce the noise level Organizing nursing care at times other than visiting hours Asking the hospital's visitor program to call on her to prevent loneliness Spending increased time with her yourself to prevent loneliness

Organizing nursing care at times other than visiting hours

Which recommendation would the nurse give to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection? Pat or blot the skin dry Have regular cancer screening examinations Participate in early prenatal care Take tub baths regularly

Participate in early prenatal care

The nurse is teaching a pregnant client with type 2 diabetes about diet during pregnancy. Which client statement indicates that the nurse's teaching was successful? I'll basically follow the same diet that I was following before I became pregnant Because I need extra protein, I will have to increase my intake of milk and meat Pregnancy affects insulin production, so I will need to make adjustments in my diet I will adjust my diet and insulin based on the results of my urine tests for glucose

Pregnancy affects insulin production, so I will need to make adjustments in my diet

Which client immunization titer is most important to assess and document in the prenatal record of the pregnant woman? Polio Rubella Rotavirus Diptheria

Rubella

After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies which action as the primary function of the ovaries? Carrying the ovum to the endometrium Secreting estrogen and progesterone Secreting mucus that supplies lubrication for intercourse Implanting a fertilized ovum

Secreting estrogen and progesterone

The nurse is monitoring a pregnant client who is receiving intravenous magnesium sulfate for eclampsia. During the last assessment, the nurse was unable to elicit a patellar reflex. What should the nurse do? Check the fetal heart rate Measure blood pressure Stop the current infusion Increase the infusion rate

Stop the current infusion

The nurse is assessing a client with a body mass index (BMI) of 34 who is in the 12th week of pregnancy. Which laboratory test does the nurse anticipate being prescribed for this client? Hemoglobin Serum glucose Pulse oximetry Arterial blood gas (ABG)

Serum glucose

A newly married female is talking to the nurse about her desire to get pregnant soon. Which suggestion would the nurse make to assist this client? Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle It is recommended to check her mucus and have intercourse when the mucus is opaque and scant If she has irregular menstrual cycles, that should not interfere with her conceiving as long as she has intercourse on the same days every month If ovulation occurs on Day 14 of her menstrual cycle, she should have intercourse one week later on Day 21

Sexual intercourse should occur between Day 13 and 15 of her menstrual cycle

A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information? Sickle cell anemia is recessively inherited Sickle cell anemia has more than one polygenic inheritance pattern Sickle cell anemia is dominantly inherited Sickle cell anemia is not inherited; it occurs following a malaria infection

Sickle cell anemia is recessively inherited

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother? Early prenatal care Age at the time of pregnancy Having a planned pregnancy Social support

Social support

The nurse is caring for a pregnant client admitted for abdominal trauma following an assault. The nurse will monitor the client for which potential complications? Select all that apply. Spontaneous abortion (miscarriage) Placental abruption (abruptio placentae) Uterine rupture Gestational hypertension Preterm labor

Spontaneous abortion (miscarriage) Placental abruption (abruptio placentae) Uterine rupture Preterm labor

Nurses are expected to know how to use the first genetic test. What is it? The developmental assessment The family history The physical assessment The psychosocial assessment

The family history

A pregnant client is having a nonstress test. Which cause(s) does the nurse consider when the results demonstrate abnormal findings? Select all that apply. The fetus is asleep There is reduced oxygen to the fetus The client is experiencing sepsis The client smoked before the test The client has an elevated blood glucose

The fetus is asleep There is reduced oxygen to the fetus The client is experiencing sepsis The client smoked before the test The client has an elevated blood glucose

The nurse is assessing the past history of a woman at her first prenatal appointment. If the woman has no history of vaccination of the choices listed, which vaccine would the nurse schedule this client to receive? The flu vaccine, after the first trimester of pregnancy is complete The measles vaccine, during the woman's second trimester The varicella vaccine, before she reaches 36 weeks' gestation The human papillomavirus vaccine, if younger than 26 years of age

The flu vaccine, after the first trimester of pregnancy is complete

While conducting a class for a group of pregnant women in their first trimester, one of the woman asks, "How is my baby's sex determined?" Which factors should the nurse include in the response? Select all that apply. The male gamete is responsible for sex determination Sex determination occurs at the time of ovulation by the combination of the sex chromosomes of the sperm and ovum Certain sexual positions and foods influence sex determination The Y chromosome contains the genes for maleness The 22 autosomes from the ovum and sperm combine to determine the sex of the fetus

The male gamete is responsible for sex determination The Y chromosome contains the genes for maleness

A client who is 20 weeks' pregnant takes medication for hyperthyroidism caused by Graves disease. Which medication adjustment does the nurse anticipate being prescribed for this client? The medication prescription will be changed to methimazole The medication prescription will be changed to levothyroxine The medication prescription will be changed to proplythiouracil All hyperthyroid medication will be discontinued

The medication prescription will be changed to methimazole

Most cultures have their own beliefs surrounding pregnancy and prenatal care of the woman. A nurse is assigned to a family that is newly immigrated and alone in the community. The client needs bed rest and help with her activities of daily living. One cultural issue that needs to be assessed is: The role of the male partner in giving care to his wife Traditions surrounding water temperature in health care The sleeping arrangement in this family The meaning of pregnancy in this family

The role of the male partner in giving care to his wife

In preparing for a preconception class, the nurse plans to include a discussion of potential risk factors. Which risk factor would be most important to include? The use of OTC drugs with teratogens The importance of healthy lifestyle Family history of pregnancy complications Importance of taking adequate vitamin and mineral supplements

The use of OTC drugs with teratogens

The nurse is teaching a couple trying to conceive about the changes in the cervical mucus near the time of ovulation. The nurse determines the session is successful when the couple correctly choose mucus in which form as indicating ovulation has occurred? Thin and copious Thick and tacky Scant amount Mucus is not visible at ovulation

Thin and copious

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education? I will ovulate every month on Day 21 of my cycle My menstrual cycles are controlled by progesterone When I ovulate, there is a follicle on my uterus that forms showing that an ova was released Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

Which factor would contribute to a high-risk pregnancy? Blood type O positive First pregnancy at age 33 History of allergy to honey bee pollen Type 1 diabetes

Type 1 diabetes

A client comes to the prenatal clinic for her first visit. When determining the client's estimated date of delivery/birth, the nurse understands that which method is the most accurate? Naegele rule Gestational wheel Birth calculator Ultrasound

Ultrasound

The nurse is caring for several families in the prenatal obstetrics office setting. Which is most important for the nurse? Knowing the names of each family member who will be in the delivery room Understanding the client's plan to update family on the gender of the newborn Asking specific questions about the financial and legal history of family members Understanding and accepting the various types of family units, such as lesbian, gay, and transgender

Understanding and accepting the various types of family units, such as lesbian, gay, and transgender

The nurse is caring for several families enrolled in Medicaid in the prenatal setting. Which statement by an expectant mother would alert the nurse to assess the family further? I plan to give birth in a hospital setting with my family at my side In my culture, we have family help us care for the baby in our home for several months We just moved here from another state and I am still getting used to the new town My sister-in-law is due to have her baby the same month as our baby is due

We just moved here from another state and I am still getting used to the new town

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client? While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth If fertilization does not occur, the corpus luteum degenerates and hormonal levels fall Withdrawal of hormones causes the endometrial cells to change, and menstruation begins An ovum matures and is released

While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth

A young adult client with anorexia nervosa is concerned about missing menstrual periods for several months. How will the nurse respond? It is unlikely that you are pregnant You may still ovulate and can be pregnant Being pregnant will help cure the eating disorder Spontaneous abortions are common with your condition

You may still ovulate and can be pregnant

A client presents to the prenatal clinic for a first trimester visit. The client has a history of Class A pregestational diabetes. The client asks the nurse how the disease will be managed during their pregnancy. How will the nurse respond? You are on insulin now, you will continue with that treatment regimen Your diabetes will be managed based on your glucose levels Because you have diabetes, you will need to give birth early Testing for fetal well-being will begin during your first trimester

Your diabetes will be managed based on your glucose levels

A client with asthma is confused by her primary care provider continuing her medication while she is pregnant, since she read online the medications can cause birth defects. What is the nurse's best response? Your primary care provider will order safe doses of your medication It's OK to not use them if you would feel more comfortable They won't cause any major defects I'll let your primary care provider know how you feel about it

Your primary care provider will order safe doses of your medication

The nurse is caring for a client with sickle cell disease who is in the 24th week of pregnancy. Which response will the nurse make when the client asks why weekly examinations are needed for the remainder of the pregnancy? Your baby is at risk for having sickle cell disease You are at risk for bleeding and need to be monitored Your risk of having a crisis increases as the pregnancy progresses Your baby is growing too large and you might need to give birth sooner

Your risk of having a crisis increases as the pregnancy progresses