Chapter 20:

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? 1 Deficient fluid volume 2 Disturbed body image 3 Knowledge deficit 4 Slow weight gain

1

A nurse is teaching a woman diagnosed with gestational diabetes about meal planning and nutrition. The nurse determines that additional teaching is needed based on which client statement? 1 "I need to avoid any fat with my meals." 2 "I should get most of my calories from good complex carbs." 3 "Having a bedtime snack is good for me." 4 "It's okay to eat small meals or snacks throughout the day."

1

A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth? 1 The viral load 2 Amniocentesis results at 34 weeks 3 The mother's age 4 Prophylactic ART to infant at birth

1

elevated liver enzymes

This lab value alteration alerts the nurse to the possibility of interference with drug metabolism.

A woman who is 10 weeks' pregnant calls the physician's office reporting "morning sickness" but, when asked about it, tells the nurse that she is nauseated and vomiting all the time and has lost 5 pounds. What interventions would the nurse anticipate for this client? 1 Lab work will be drawn to rule out acid-base imbalances. 2 An ultrasound will be done to reassess the correctness of gestational dates. 3 Since morning sickness is a common problem for pregnant women, the nurse will suggest the woman drink more fluids and eat crackers. 4 The nurse will encourage the woman to lie down and rest whenever she feels ill.

1

The nurse is teaching a client who is diagnosed with preeclampsia how to monitor her condition. The nurse determines the client needs more instruction after making which statement? 1 "If I have changes in my vision, I will lie down and rest." 2 "I will weigh myself every morning after voiding before breakfast." 3 "I will count my baby's movements after each meal." 4 "If I have a severe headache, I'll call the clinic."

1

x A patient with heart disease who is 28 weeks pregnant asks the nurse why office appointments have been scheduled every week for the next 4 weeks. What should the nurse respond to the patient? 1 This is the routine schedule for all pregnant patients. 2 This is when most patients have a risk of going into early labor. 3 During weeks 28 and 32, blood volume peaks, and heart function can be affected. 4 Extra care is needed to make sure the fetus is developing normally during this time period.

3

A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints? 1 Healthy pregnancy 2 Ectopic pregnancy 3 Molar pregnancy 4 Placenta previa

2

A woman who is 8 months' pregnant comes to the clinic with urinary frequency and pain on urination. The client is diagnosed with a urinary tract infection (UTI). Which medication would the nurse anticipate the physician will prescribe? 1 tetracycline 2 amoxicillin 3 bactrim 4 septra

2

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply. 1 hyperthermia 2 hemolysis 3 elevated liver enzymes 4 leukocytosis 5 low platelet count

2, 3, 5

When describing the characteristics of the amniotic fluid to a pregnant woman, the nurse would include which information? 1 It is usually an acidic fluid. 2 It is composed primarily of organic substances. 3 The amount gradually fluctuates during pregnancy. 4 It limits fetal movement in utero.

3

A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection? 1 Antiviral drug therapy cures the infection completely. 2 Kissing during the primary episode does not transmit the virus. 3 Safety of antiviral therapy during pregnancy has not been established. 4 Recurrent HSV infection episodes are longer and more severe.

3

A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical? 1 increased perspiration 2 weight loss 3 susceptibility to infection 4 blood pressure elevation

4

A woman at 10 weeks gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize? 1 report of frequent mild nausea 2 blood pressure of 120/84 mm Hg 3 history of bright red spotting 6 weeks ago 4 fundal height measurement of 18 cm

4 a fundal height of 18 cm is larger than expected and should be further investigated for gestational trophoblastic disease (hydatidiform mole). One of the presenting signs is the uterus being larger than expected for date