chapter 12
To prevent exposure to hepatitis A virus, the nurse teaches the pregnant client to avoid which food?
raw fish
A petite pregnant client is concerned that she will be unable to deliver vaginally due to her small size. Which procedure should the nurse point out will help to confirm the manual measurements of her pelvis and provide information that will help determine the best method of delivery for her?
ultrasonography
what do true labor contractions feel like?
contractions beginning in the back and sweeping forward across the abdomen
A pregnant client reports occasional headaches. She wants to know what she can take to alleviate the discomfort. What would be the best response by the nurse?
"Acetaminophen is considered relatively safe to take for your headaches during your pregnancy."
A pregnant client is undergoing a fetal biophysical profile. Which parameter of the profile helps measure long-term adequacy of the placental function?
amniotic fluid volume
A client at 32 weeks' gestation tells the nurse that she has been experiencing shortness of breath when walking up the steps at home. She is concerned that something is wrong. What is the nurse's best response?
"The enlarging uterus pushes against your diaphragm and this makes breathing shallow."
The nurse discovers a new prescription for Rho(D) immune globulin for a client who is about to undergo a diagnostic procedure. The nurse will administer the Rho(D) immune globulin after which procedure?
Amniocentesis
The nurse is assigned to clients who are having the following procedures: amniocentesis, fetal nonstress test, chorionic villus sampling, percutaneous umbilical blood sampling, and Doppler assessment of fetal heart rate. For which clients will the nurse ensure that signed informed consent has been given and is in the client's record?
Amniocentesis chorionic villus sampling percutaneous umbilical blood sampling
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?
Conduct an interview in a private room to obtain her health history.
A woman in early pregnancy is concerned because she is nauseated every morning. Which measure would be best to help relieve this?
Delay breakfast until mid-morning.
A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information?
Further testing will be required to confirm any diagnosis.
A woman who is 4 months pregnant notices frequent heart palpitations and leg cramps. She is anxious to learn how to alleviate these. Which nursing diagnosis would best apply to her?
Health-seeking behaviors related to ways to relieve discomforts of pregnancy
The parents of a neonate born at 32 weeks' gestation ask about the purpose of the surfactant being given to the baby. What is the best response by the nurse?
Helps the lungs remain expanded after the initiation of breathing
When describing the role of a doula to a group of pregnant women, the nurse would include which information?
The doula primarily focuses on providing continuous labor support.
A pregnant woman states that she would like to take a tub bath but has heard from her aunt that this could be dangerous to the baby. Which instruction should the nurse give to the client?
Tub baths are fine unless you are unstable on your feet or are experiencing vaginal bleeding.
During pregnancy, the cardinal rule concerning medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy?
asthma
A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which location?
at the umbilicus
A client in her third month of pregnancy arrives at the health care facility for a regular follow-up visit. The client reports discomfort due to increased urinary frequency. Which instruction should the nurse offer the client to reduce the client's discomfort?
avoid consumption of caffeinated drinks
Which possible complication associated with back pain can lead to premature contractions?
bladder or kidney infection
What anatomic area should be examined when assessing Montgomery glands (Montgomery tubercles)?
breasts
During the physical examination at the first prenatal visit a speculum examination is performed and a bluish-colored cervix is noted. How will the nurse interpret this finding?
chadwick sign
While assessing a client's breast during the third trimester, which finding would the nurse expect?
colostrum from the nipples
A pregnant client tells the nurse her gums and tongue are tender and she keeps getting small cracks in the skin around the mouth. Which foods would the nurse suggest this client add to the diet? Select all that apply.
dark green vegetables liver eggs
A 25-year-old client at 27 weeks' gestation reports waking up with leg cramps. Which suggestion should the nurse point out to the client to help relieve this discomfort?
dorsiflex the foot while extending her leg during the cramp
A client in the first trimester reports having nausea and vomiting, especially in the morning. Which instruction would be most appropriate to help prevent or reduce the client's compliant?
eat dry crackers or toast before rising
A woman who is 4 months pregnant has pyrosis. Which suggestion would the nurse give her?
eat small meals and do not lay down after meals
During a follow-up visit to the prenatal clinic, a pregnant client asks the nurse about using a hot tub to help with her backache. The nurse recommends against the use based on the understanding that what can occur?
fetal tachycardia
One vitamin has been identified as helping to prevent neural tube defects when consumed in adequate amounts before conception through the early weeks of pregnancy. Which vitamin is it?
folic acid
The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which signs and symptoms would the nurse include? Select all that apply.
headache with visual changes in the third trimester sudden leakage of fluid during the second trimester lower abdominal pain with shoulder pain in the first trimester
A client in her second trimester of pregnancy visits a health care facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which precaution should the nurse instruct the pregnant client to take when practicing aerobic exercises?
maintain a tolerable intensity of exercise
The nurse advises a pregnant client to keep a small high-carbohydrate, low-fat snack at the bedside. The nurse should point out this will assist with which condition?
nausea and vomiting
A pregnant woman has been diagnosed with pica since she eats lead paint chips for their sweetness. The nurse educating this woman should strongly encourage her to abandon this practice because it may have which consequence to the fetus?
neurologic challenges
A young woman with scoliosis has just learned that she is pregnant. Several years ago, she had stainless-steel rods surgically implanted on both sides of her vertebrae to strengthen and straighten her spine. However, her pelvis is unaffected by the condition. What does the nurse anticipate in this woman's pregnancy?
potential for greater back pain
During the initial prenatal visit, the nurse performs what assessment to guide teaching about nutrition during pregnancy?
prepregnancy bmi
A nurse is caring for a client who is 8 months pregnant. Which instruction is the nurse most likely to give her?
rest on the left side for at least one hour in the morning and at night
A 31-year-old client at 28 weeks' gestation reports frequent low back pain and ankle edema by the end of the day. Which suggestion should the nurse prioritize for this client?
rest whenever possible with the feet elevated at or above the heart
A client in her third trimester of pregnancy wishes to formula feed her baby. What instruction should the nurse provide?
serve the formula at room temperature
Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy?
soft systolic murmur
The nurse is assisting a primigravida on calculating the due date of her baby using Naegele rule. The most important information provided by the mother is:
the first day of her last menstrual period
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 nurse is assessing a primipara's fundal height at 36 weeks' gestation and notes the fundus is now located at the xiphoid process of the sternum. The client asks if this is normal. Which response to the client would be best?
"At 36 weeks' gestation, the fundus is in the normal expected location."
A primigravida at her 12-week prenatal visit expresses concern that she hasn't felt her baby move yet. What is the best response from the nurse?
"You usually cannot feel them until approximately 16 to 20 weeks."
A nurse is teaching a group of primigravida women who are in their first trimester. One of the women asks the nurse about sexual activity during pregnancy. Which information would the nurse most likely incorporate into the response?
Because of pelvic congestion, women may experience increased clitoral sensitivity.
A pregnant client is planning a vacation to a different state and questions the nurse concerning precautions. Which suggestion should the nurse prioritize for this client who will be traveling by automobile?
Stop and walk every 2 hours.
The nurse is educating the client at 12 weeks' gestation regarding the best types of exercise throughout pregnancy. Which activities should the nurse encourage?
Stretching and breathing exercises such as yoga
The client is 32 weeks' pregnant and has been referred for a biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective?
The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.
The nurse is assisting a pregnant client who underwent a nonstress test that was ruled reactive. Which factor will the nurse point out when questioned by the client about the results?
The fetal heart rate increases with activity and indicates fetal well-being.
The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy?
excessive vomiting
The diagonal conjugate of a pregnant woman's pelvis is measured. Which measurement would the nurse interpret as presenting a potential problem?
12.0 cm
During the initial assessment of a 22-year-old pregnant client, the nurse learns that the client usually smokes 2 packs of cigarettes per day. The nurse is planning an education session about lifestyle changes during pregnancy. Which goal would be the most realistic and individualized for this client during this initial clinic visit?
The client reduces her smoking by 50 percent by the next clinic visit.