Reproduction NCLEX questions:
An obese 36 year old multigravida client at 12 weeks has a history of HTN. Was treated with methyldopa - Aldomet prior to pregnancy. Which statement is false and would need more education?
1. "I need to reduce my calorie intake to 1200 calories per day." ******* 2. "A regular diet is recommended during pregnancy." 3. "I should eat more frequent meals if I get heartburn." 4. "I need to consume more fluids and fiber each day." Pregnancy is not a time to begin a diet.
A primigravida client's baseline blood pressure at her initial visit at 12 weeks' gestation was 110/70mm Hg. During an assessment at 38 weeks' gestation, which one would indicate a MILD preeclampsia?
1. B/P of 160/110 on 2 separate occasions. 2. Proteinuria, more than 5 g in 24 hours. 3. Serum creatinine of 1.4 ml/dl. 4. Weight gain of 2 lb in the last week. **** The weight gain of 2 lb/ week during the third trimester shows possible full body edema. With severe preeclampsia, BP of 160 mm Hg systolic and 100 mm Hg diastolic on 2 occasions & oliguria are signs. Proteinuria 3+ & 4+ or more than 5 g in 24 hours. Normal serum creatinine range from 0.5 ml/dl. Creatinine level of 1.4 is greatly elevated.
Which of the following statements about a fetal biophysical profile would be incorporated into the teaching plan for a primigravid client with insulin-dependent diabetes?
1. It determines fetal lung maturity. 2. It is noninvasive using real-time ultrasound. **** 3. It will correlate with the newborn's Apgar score. 4. It requires the client to have an empty bladder. It's a noninvasive test using real-time ultrasound, assesses 5 parameters: fetal heart rate reactivity, fetal breathing movements, gross fetal body movements, fetal tone, and amniotic fluid volume.
In which of the following maternal locations would the nurse place the ultrasound transducer of the external electronic fetal heart rate monitor if a fetus at 34 weeks' gestation is in the left occipitoanterior LOA position?
1. Near the symphysis pubis. 2. Two inches above the umbilicus. 3. Below the umbilicus. ***** 4. At the level of the umbilicus. As the uterus contracts, the abdominal wall rises and, when external monitoring is used, presses against the transducer. The fetus in LOA the transducer is placed below the umbilicus on the side where the fetal back is located and uterine displacement during contractions is greatest. If the fetal back is near the symphysis pubis, the fetus is presenting as a transverse lie. If the fetus is in a breech position, the fetal back may be at or above the umbilicus.
During an interview, a multigravida client at 35 weeks gestation was admitted to the hospital with placenta previa and ordered on strict bed rest states, "My last baby was born 6 weeks early and had to stay in the special care nursery." Which of the following would nurse formulate as the priority nursing diagnosis?
1. Risk for constipation r/t bed rest. 2. Interrupted family processes r/t hospitalization. 3. Anxiety r/t unknown outcome of client/fetus. ***** 4. Impaired physical mobility r/t vaginal bleeding. The client's statement reflects concern for her present fetus based on her previous experience. Anxiety is the priority.
A 36-year-old multigravida client is admitted to the hospital with possible ruptured ectopic pregnancy. When obtaining the client's history, which of the following would be most important to identify as a predisposing factor?
1. Urinary tract infection. 2. Marijuana use during pregnancy. 3. Episodes of PID. ***** 4. use of estrogen-progestin contraceptives. Anything that causes a narrowing or constriction in the fallopian tubes so that a fertilized ovum cannot be properly transported to the uterus for implantation predisposes an ectopic pregnancy.
