Sherpath EAQ Ch 8: Nursing Care of the Family

The nurse is caring for a patient who reports the first day of their last known menstrual period was October 19th, 2021. Calculate the patient's estimated due date using Naegele's rule. Record answer in MM/DD/VYYYY format.

07/26/2022

A patient is receiving prenatal care from the nurse and obstetrician in a clinic setting. Order the clinical components of the prenatal appointments that the patient will experience throughout pregnancy. a. Group B streptococcus swab b. Initial fundal height measurement c. Prenatal interview d. Gestational diabetes screening

1. c 2. b. 3. a. 4. d.

While taking a patient's history at their first prenatal appointment after a positive pregnancy test, the nurse notes that the first day of their last normal menstrual period was March 8,2022. The patient reports having a regular 28-day cycle. Calculate the patient's estimate due date using Naegele's rule. Record answer in MM/DD/YYYY format.

12/15/2022

On assessing a pregnant patient, the nurse finds that the patient's fundal height is 27 cm at 28 weeks of gestation. Which conclusion would the nurse make from this finding? a. Polyhydramnios b. Ectopic pregnancy c. Multifetal gestation d. Normal development

d. Normal development

The nurse is working at the prenatal clinic and caring for a patient 28 weeks gestation with their first baby. Which assessment does the nurse need to complete to evaluate the health and wellbeing of the fetus at the appointment? Select all that apply. One, some, or all responses may be correct. a. Fundal height measurement b. Patient's vital signs c. Fetal heart tones d. Fetal movement e. Checking for edema

a, c, d

A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she does what? a. Applies cold compresses to the affected leg b. Wiggles and points her toes during the cramp c. Extends her leg and dorsiflexes her foot during the cramp d. Avoids weight bearing on the affected leg during the cramp

c. Extends her leg and dorsiflexes her foot during the cramp

A patient newly pregnant is trying to decide if she would like to see a midwife. In which setting(s) will the nurse explain that midwives are able to provide care to patients? Select all that apply. One, some, or all responses may be correct. a. Hospital b. Clinics c. Patient homes d. Ambulances e. Birth center

a, b, c, e

Which outcome is an example of maternal adaptation to pregnancy? Select all that apply. One, some, or all responses may be correct. a. Accepting the pregnancy b. Reordering of personal relationships c. Creating an emotional attachment to the fetus d. Focusing on self-care and personal goals e. Preparing for the physical birth

a, b, c, e

After assessing a pregnant patient, the nurse finds that the patient has carpal tunnel syndrome. Which symptoms helped the nurse to arrive at this conclusion? Select all that apply. One, some, or all responses may be correct. a. Tingling b. Numbness c. Increased sweating d. Dropping of objects e. Flatulence and bloating

a, b, d

Which signs and symptoms in a pregnant patient would the nurse attribute to the elevated levels of estrogen? Select all that apply. One, some, or all responses may be correct. a. Gingivitis b. Angiomas c. Constipation d. Nose bleeding e. Gastrocnemius spasm

a, b, d

The patient has been pregnant twice before and is currently pregnant at 12-weeks gestation. Patient s medical history includes: 1. a 16-week spontaneous abortion 2. live female born at 38 weeks gestation via cesarean birth. The child is now 3 years old and lives with the patient. Based on the patient's history, what is the GTPAL? a. G3 b. T1 c. P2 d. A1 e. L1

a, b, d, e

The patient has been pregnant twice before and is currently pregnant at 12-weeks gestation. Patient's medical history includes: 1. a 16-week spontaneous abortion 2. live female born at 38 weeks gestation via cesarean birth. The child is now 3 years old and lives with the patient. Which information would the nurse include for documentation of this patient's obstetrical history following GTPAL documentation of obstetrical history? Select all that apply. One, some, or all responses may be correct. a. G 3 b. T 1 c. P 2 d. A 1 e. L 1

a, b, d, e

A patient who is in the first trimester of pregnancy reports increased frequency of urination. Which advice will the nurse provide the patient? Select all that apply. One, some, or all responses may be correct. a. "Use a perineal pad." b. "Take bubble baths regularly." c. "Empty the bladder regularly." d. "Perform Kegel exercises regularly." e. "Increase fluid intake before bedtime."

a, c, d

A pregnant woman reports a sudden discharge of fluid from the vagina before 37 weeks of gestation. Which finding would the nurse infer this based on the symptom? a. Intrauterine fetal death b. Renal calculus in the patient c. Gestational diabetes mellitus d. Premature rupture of membrane

d. Premature rupture of membrane

The nurse is teaching prenatal classes to first-time parents. Which essential teaching points will the nurse include to enhance the parents' prenatal education? Select all that apply. One, some, or all responses may be correct. a. Highlighting what typical growth looks like for a fetus b. Discussions of limited exercise during pregnancy c. Importance of taking time to rest during the day d. Providing information early on about the benefits of breastfeeding e. Discussions of normal discomforts of pregnancy and when to seek treatment

a, c, d, e

Which goal is associated with prenatal care? Select all that apply. One, some, or all responses may be correct. a. To promote the health and well-being of the pregnant person. b. Provide care and promote the well-being of patients trying to conceive. c. Promoting the health and well-being of the fetus. d. Ensuring the well-being of the newborn. e. To promote health and well-being of the family.

a, c, d, e

Patient history: 39-year-old; G1PO; 37 weeks gestation with a twin pregnancy gestational diabetes; blood type is A+; GBS + Which component of the patient's history could vary from those of a typical patient receiving prenatal care in a clinic? a. Patient's age b. GBS status c. Twin pregnancy d. Blood type e. Gestational diabetes

a, c, e

The nurse is working with a patient who is 30 weeks gestation, G2P1. Which teaching point would the nurse share with the patient to help them prepare a 3-year-old sibling for the arrival of another child in the household? Select all that apply. One, some, or all responses may be correct. a. "Read age-appropriate books about becoming an older sibling with your child." b. "Avoid discussing babies as negative, as your child's associations with baby behaviors might be formed before the baby arrives." c. "Involve the child in preparations like decorating the baby's room." d. "Avoid answering the child's questions about the birth, as it might scare them." e. "Take the child to a prenatal visit. Also, let them hear the baby's heartbeat and feel the baby move."

a, c, e

Which screening or diagnostic test is completed during routine prenatal follow-up visits? a. Clean-catch urine specimen b. Cervical and vaginal smears c. Group B streptococcus swab d. Blood specimen testing

a. Clean-catch urine specimen

Which behavioral change does the nurse observe in the spouse/partner of a pregnant patient during the focusing phase? a. Engages in building a relationship with the newborn b. Has difficulty accepting changes in life plans and lifestyles c. Engages in discussions with others about the philosophy of life d. Engages in extramarital affairs because of a lack of partner's attention

a. Engages in building a relationship with the newborn

The nurse is assessing a pregnant patient and finds that the patient has had spinal surgery. Which interpretation would the nurse make from the assessment? a. Epidural anesthesia is contraindicated in the patient. b. Cesarean birth should be recommended for the patient. c. The patient may have higher chances of preterm delivery. d. The patient may have right lower quadrant pain during pregnancy.

a. Epidural anesthesia is contraindicated in the patient.

The nurse is assessing a pregnant patient. The nurse finds that the patient's estimated date of birth (EDB) is December 2, 2015. Which date would be the patient's first day of the last menstrual period (LMP)? a. February 25, 2015 b. March 25, 2015 c. February 2, 2015 d. March 2, 2014

a. February 25, 2015

The nurse is assessing a pregnant and anemic patient who is at risk for developing peripartum hemorrhage. Which laboratory test would the nurse expect the primary health care provider to order for this patient? a. Hematocrit b. Serology test c. Leukocytes d. Transvaginal ultrasound

a. Hematocrit

As the pregnancy progresses, the patient experiences shortness of breath when the fundal height is being assessed. Which action should the nurse take to minimize the shortness of breath or dizziness as a result of the weight of the growing uterus? a. Place a small towel under the patient's right hip. b. Place the patient on her right side while the measurement is done. c. Use a new paper tape measure for each visit to decrease infection. d. Place a pillow under the patient's knees whenever she is on her back.

a. Place a small towel under the patient's right hip.

The primary health care provider has ordered 300 mcg of immunoglobulin to be delivered intramuscularly to a pregnant patient. Which condition would be the reason for administering this to the patient? a. The patient is Rh negative and unsensitized. b. The patient has elevated amniotic fluid volume. c. The patient has group B streptococcal infection. d. The patient is human immunodeficiency virus (HIV) positive.

a. The patient is Rh negative and unsensitized.

The nurse is assessing a pregnant patient who already has a 2-year-old child. During assessment, the nurse encourages the child to listen to the fetal heartbeat. Which statement summarizes the objective of this nursing intervention? a. To develop a bond between the child and the newborn b. To understand the feelings and perceptions of the child c. To help develop a bond between the child and the mother d. To make the child feel comfortable in the health care center

a. To develop a bond between the child and the newborn

Which body fluid samples are routinely obtained during the initial prenatal visit for screening and diagnostic purposes? a. Urine, cervical, and blood specimens b. Glucose and urinalysis screening c. Cervical exam and tuberculin skin testing d. Group B streptococcus swab and blood specimens

a. Urine, cervical, and blood specimens

The patient has been pregnant once before and is currently pregnant at 23 weeks gestation. Patient's medical history includes: 1. A 12 week spontaneous abortion 2. live female born at 35 weeks gestation via cesarean birth 3. live male born at 36 weeks gestation via vaginal delivery The children are now 3 and 5 vears old and live with the patient. Based on the patient's history, what is the GTPAL? a. G3 TI P1 A0 L2 b. G4 TO P1 AI LI c. G4 TO P2 A1 L2 d. G2 T1 P3 A3 LO

c. G4 TO P2 A1 L2

Which examples would the nurse discuss with a prenatal class for first time parents to highlight the three phases in which non pregnant partners accept and adjust to pregnancy? Select all that apply. One, some, or all responses may be correct. a. By the time the baby arrives, everyone will be ready to step into parenting roles. b. Reactions to the pregnancy will vary depending on the circumstances of the pregnancy. c. Intimate partner violence may increase during pregnancy d. Non pregnant partners may feel the need to connect with father figures in their lives to discuss raising children. e. Discussions about the nonpregnant partner's role during the labor and delivery experience will take place.

b, c, d, e

While assessing a pregnant patient, the nurse finds that the patient has increased flatulence, bloating, and belching. Which intervention should the nurse suggest to reduce this discomfort? a. "Drink acidophilus milk regularly." b. "Chew foods slowly and thoroughly." c. "Increase consumption of fatty food." d. "Increase fluid intake before bedtime."

b. "Chew foods slowly and thoroughly."

The nurse is assessing a pregnant patient who reports "my urine is dark and has a strong odor." Which instruction would the nurse provide the patient? a. "Get regular back rubs." b. "Increase your fluid intake." c. "Take bubble baths regularly." d. "Include dry carbohydrates in your diet."

b. "Increase your fluid intake."

The nurse is reviewing the lab reports of a patient who is 10 weeks pregnant and has a family history of diabetes mellitus. The nurse finds that the patient's 1-hour glucose tolerance test is normal. Which advice would the nurse provide the patient? a. "Increase food intake." b. "Repeat the test at 28 weeks." c. "Undergo a renal function test." d. "Undergo a 3-hour glucose test."

b. "Repeat the test at 28 weeks."

The nurse is assessing a couple as part of a prenatal interview. On assessment, the nurse finds that the patient has previously undergone uterine surgery for fibroids. Which statement would the nurse make to the patient? a. "You may be at risk for preterm delivery." b. "You may need a cesarean to deliver the baby." c. "You may be at risk for having postpregnancy allergies. d. "You may give birth to a child with congenital anomalies."

b. "You may need a cesarean to deliver the baby."

During the first trimester of pregnancy, a patient reports nasal stuffiness and nose bleeding. Which physiologic change during pregnancy does the nurse identify as the probable reason? a. Low iron level b. High estrogen level c. High progesterone level d. Low serum calcium level

b. High estrogen level

Which guidance will the nurse provide to a woman who wants to have a nurse-midwife provide obstetric care? a. She will have to give birth at home. b. She must be having a low-risk pregnancy. c. She will not be able to have epidural analgesia for labor pain. d. She must see an obstetrician as well as the midwife during pregnancy.

b. She must be having a low-risk pregnancy.

The nurse advises an alcoholic patient to stop consuming alcohol during pregnancy and seek counseling. The reason for this recommendation would be to prevent which potential complication? a. Angiomas in the fetus b. Teratogenic effect in the fetus c. Urinary infections in the patient d. Gastrocnemius spasm in the patient

b. Teratogenic effect in the fetus

While examining the breasts of a pregnant patient, the nurse observes that the patient has inverted nipples. Which interpretation would the nurse make based on this finding? a. The patient has to apply lanolin on the nipples. b. The patient's baby could have difficulty latching. c. The patient has had breast reduction surgery in the past. d. The patient has expected breast changes during pregnancy.

b. The patient's baby could have difficulty latching.

A pregnant woman at 32 weeks of gestation reports feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. Which action will the nurse take first? a. Raise the woman's legs b. Turn the woman on her side c. Have the woman breathe into a paper bag d. Assess the woman's blood pressure and pulse

b. Turn the woman on her side

The nurse instructs a pregnant patient to avoid sitting for a long time and to wear loose-fitting pants. Which pregnancy discomfort is the nurse trying to prevent with this recommendation? a. Constipation b. Varicose veins c. Supine hypotension d. Urinary tract infections

b. Varicose veins

A pregnant patient with a urinary tract infection is being discharged from the hospital after recovery. What preventive measures does the nurse suggest to the patient? Select all that apply. One, some, or all responses may be correct. a. "Drink cranberry juice." b. "Drink acidophilus milk." c. "Use unscented toilet paper." d. "Drink 2 liters of fluids daily." e. "Regularly take bubble baths."

c, d

During the prenatal checkup, a patient in the third trimester reports difficulty sleeping. Which response would the nurse make to educate the patient regarding the promotion of good sleep? Select all that apply. One, some, or all responses may be correct. a. "Take an oil bath twice a day." b. "Drink acidophilus milk regularly." c. "Drink warm milk before going to bed." d. "Get a back massage or effleurage regularly." e. "Place a pillow under the back while sleeping."

c, d, e

Which are warning signs of an expectant father ineffective adaptation to his partner's first pregnancy? a. Views pregnancy with pride as a confirmation of his virility b. Expresses concern that he might faint at the birth of his baby c. Consistently changes the subject when the topic of the fetus/newborn is raised d. Experiences nausea and fatigue, along with his partner, during the first trimester

c. Consistently changes the subject when the topic of the fetus/newborn is raised

The patient has been pregnant once before and is currently pregnant at 23 weeks gestation. Patient's medical history includes: 1. a 12 week spontaneous abortion 2. live female born at 35 weeks gestation via cesarean birth 3. live male born at 36 weeks gestation via vaginal delivery The children are now 3 and 5 years old and live with the patient. Based on the patient's history, how would the nurse document this patient's GTPAL history? a. G3 T1 P1 A0 L2 b. G4 TO P1 A1 LI c. G4 TO P2 A1 L2 d. G2 TI P3 A3 LO

c. G4 TO P2 A1 L2

The nurse is assessing the fetal heart rate in a pregnant patient. The nurse finds asynchronous fetal heartbeats during auscultation. In which condition would this finding be considered normal? a. Late pregnancy b. First pregnancy c. Multifetal pregnancy d. Surrogate pregnancy

c. Multifetal pregnancy

The nurse is assessing a pregnant patient who has undergone bariatric surgery in the past. Which is a priority for the nurse to check in the patient's health records? a. Family history b. Blood pressure c. Nutritional status d. Blood glucose levels

c. Nutritional status

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. Which is thebest response by the nurse? a. "Because you're in your second trimester, you can drink as much as you like." b. "One drink every night is too much. One drink three times a week should be fine." c. "Because you're in your second trimester, there's no problem with having one drink with dinner." d. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

d. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy."

A pregnant patient reports constipation. While checking the patient's history, the nurse learns that the patient is taking oral iron supplements. Which instruction would the nurse provide the patient about relieving constipation? a. "Drink mineral oil before going to bed." b. "Discontinue taking iron supplements." c. "Take a stool softener before going to bed." d. "Drink six to eight glasses of water every day."

d. "Drink six to eight glasses of water every day."

A patient who is 6 months pregnant asks about proper placement of her seatbelt. Teaching by the nurse has been successful if the patient makes which statement? a. "I need to position the lap belt loosely directly over my bellybutton." b. "I need to place the lap belt portion snugly over the upper part of my uterus." c. "I need to place the seatbelt directly over the widest part of my abdomen." d. "I need to place the lap belt portion low across my hip bones as snugly as is comfortable."

d. "I need to place the lap belt portion low across my hip bones as snugly as is comfortable."

A patient in the first trimester of pregnancy tells the nurse, "I urinate frequently and am not able to hold urine even for a short time." Which strategy would the nurse suggest to ease the patient's discomfort? a. "Apply local heat or ice." b. "Eat dry carbohydrates." c. "Get back rubs regularly." d. "Perform Kegel exercises."

d. "Perform Kegel exercises."

The nurse is caring for a gravida I patient who asks about the tests and assessments that will be done during the initial prenatal visit. Which is the best response by the nurse? a. "The provider will assess fetal heart tones." b. "The provider will determine your fundal height." c. "The provider will do a fetal assessment to determine the gestational age." d. "The provider will do a lab test to screen for human immunodeficiency virus (HIV)."

d. "The provider will do a lab test to screen for human immunodeficiency virus (HIV)."

An expectant father confides in the nurse that his pregnant wife, 10 weeks of gestation, is driving him crazy. "One minute she seems happy, and the next minute she is crying over nothing at all. Is there something wrong with her?" Which response by the nurse is accurate? a. "This is normal behavior and should begin to subside by the second trimester." b. "You seem impatient with her. Perhaps this is precipitating her behavior." c. "She may be having difficulty adjusting to pregnancy; I will refer her to a counselor that I know." d. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy.The mood swings will eventually subside as she adjusts to being pregnant.

d. "This is called emotional lability and is related to hormone changes and anxiety during pregnancy.The mood swings will eventually subside as she adjusts to being pregnant.

A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. Which response from the nurse is accurate? a. "Stop exercising, because it will harm the fetus." b. "jogging is too hard on your joints; switch to walking now." c. "You don't need to modify your exercising any time during your pregnancy." d. "You may find that you need to modify your exercise intensity later in your pregnancy."

d. "You may find that you need to modify your exercise intensity later in your pregnancy."

A pregnant patient reports severe leg cramps, especially in the reclining posture. The nurse assesses the patient's laboratory reports. Which factor would be an aggravating factor for the leg cramps in the woman? a. Elevated estrogen level b. Elevated progesterone level c. Elevated serum calcium level d. Elevated serum phosphorus level

d. Elevated serum phosphorus level

After reviewing the obstetric reports of a pregnant patient the nurse finds that the patient's fundal height has not changed in the last 4 weeks. Which condition does the nurse potentially interpret from this finding? a. Polyhydramnios b. Multifetal gestation c. Maternal malnourishment d. Intrauterine growth restriction (IUGR)

d. Intrauterine growth restriction (IUGR)

A pregnant woman's last menstrual period began on April 8, 2014, and ended on April 13. Which date would the nurse advise the woman is the estimated date of birth (EDB)? a. January 1, 2015 b. January 8, 2015 c. January 13, 2015 d. January 15, 2015

d. January 15, 2015

During the first trimester, which topic would the nurse select first to discuss with the pregnant woman? a. Fetal development b. Impact of a new baby on family members c. Location of childbirth preparation and breastfeeding classes d. Measures to reduce nausea and fatigue so she can feel better

d. Measures to reduce nausea and fatigue so she can feel better

A pregnant patient asks the nurse about a trial of labor after cesarean. What is the patient's reason for asking about this? a. The patient is in her late 30s. b. The patient is having multiple fetuses. c. The patient is having a preterm delivery. d. The patient is attempting a vaginal birth.

d. The patient is attempting a vaginal birth.

Which statement by a patient describes phase 3 of establishing a relationship with the fetus? a. The patient accepts the biologic fact of pregnancy and can state: "I am pregnant." b. The patient's thoughts are centered on themselves and the reality of being pregnant. c. The patient accepts the growing fetus and can state: "I am going to have a baby." d. The patient realistically prepares for the birth and states "I am going to be a mother."

d. The patient realistically prepares for the birth and states "I am going to be a mother."

An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. Which information would the nurse tell the couple? a. Intercourse should be avoided. b Intercourse is safe until the third trimester. c. Safer-sex practices should be used once the membranes rupture. d. Vaginal penetration is not correlated with miscarriage.

d. Vaginal penetration is not correlated with miscarriage.

An expectant couple asks the nurse about intercourse during pregnancy and if it is safe for the baby. Which information would the nurse tell the couple? a. Intercourse should be avoided. b. Intercourse is safe until the third trimester. c. Safer-sex practices should be used once the membranes rupture. d. Vaginal penetration is not correlated with miscarriage.

d. Vaginal penetration is not correlated with miscarriage.