EAQ 1

which laboratory test is conducted during the initial prenatal visit?

cervical culture for Neisseria gonorrhoeae

the nurse is teaching a class of expectant parents about changes that are to be expected during pregnancy. Which changes would the nurse explain result from melanocyte-stimulating hormone?

chloasma linea nigra

Which is the most highly sensitive time within the developing embryo for the risk of malformation related to environmental teratogens

cleft palate at 8 weeks gestation

which nursing intervention would be needed before a client undergoes amniocentesis at 16 week' gestation?

ensuring that informed consent has been obtained from the client

which nursing intervention is necessary to prepare a client with a suspected placenta previa for a repeat sonogram at 16 weeks gestation

ensuring that the client drinks two 8-oz glasses of water

which assessment finding in a pregnant client would prompt the nurse to notify the primary health care provider

fundal height at the umbilicus at 16 weeks

where on the maternal abdomen would the nurse place the fetal heart transducer when the fetus is in the left sacrum anterior position

left upper quadrant

a client states her husband is a fraternal twin and asks about her probability of having twins. Which is an appropriate response by the nurse

you have no greater probability of having twins than anyone else in the general population

which cardiovascular changes would the nurse include in a prenatal class explaining physiological changes in the second trimester of pregnancy?

- cardiac output increases - blood pressure decreases - the heart is displaced upward

which factors most often interfere with access to prenatal care for all pregnant women, placing the mother and infant at risk?

- language differences - transportation barriers - lack of culturally sensitive care providers - discrimination based on sexual orientation

A newly arrived Russian immigrant attends the prenatal clinic for the first time. Although she states that she has had immunizations, she does not know which ones. Which immunizations should the nurse recommend? Select all that apply.

- tetanus, Diphtheria, Pertussis (TDAP) - Hepatitis B

a number of routine screens are preformed on the pregnant client during the course of her gestation: Place in order

1. Sickle cell screening 2. AFP testing 3. Serum glucose 4. Fetal movement test 5. Group B streptococcus culture

the primigravida would be taught by the nurse to anticipate quickening in which week of pregnancy

20th week

an increase in which factor causes urinary frequency in the first trimester of pregnancy

bladder pressure from the enlarged uterus

which prenatal test provides the earliest diagnosis of fetal defects

chorionic villus sampling

A client who menstruates regularly every 30 days asks a nurse on what day she is most likely to ovulate. Because the client's last menses started on January 1, the nurse should tell her that ovulation should occur on which day in January?

January 16

at her first prenatal visit, the client informs the nurse that her last menstrual period started on June 10. which is her expected date of birth (EDB) according to Naegele's rule

March 17

which is the nurses next action when the fundus of a healthy multipara at 16 weeks gestation is palpated at one fingerbreadth above the umbilicus

check for two distinct fetal heart rates

which iron-rich foods would the nurse encourage the client with mild anemia in early pregnancy to eat

dark leafy green vegetables legumes dried fruits ground beef patty

the nurse is conducting a routine assessment of a primigravida client and notes bruises on the client's upper arms. When questioned, the client responds that her boyfriend was upset and hit her. Which is the priority nursing action

developing a safety plan with the client

a client who is at 20 weeks gestation visits the prenatal clinic for the first time. Assessment reveals a temperature of 98.8 F, pulse of 80 beats per minute, blood pressure of 128/80 mm Hg, weight of 142 lb (prepregnancy weight was 132 lb), FHR of 140 bpm, urine that is negative for protein, and a fasting blood glucose level of 92 mg/dL. What would the nurse do after making these assessments

document the results because they are expected at 20 weeks gestation

Which instruction would the nurse give to the pregnant client with anemia:

drink orange juice with an iron supplement

which instruction would the nurse provide to the client early pregnancy scheduled for her first obstetric ultrasound?

drink water until bladder is full

which answer would the nurse give to a client who asks what is the common cause of spontaneous abortion?

embryonic defects

which description explains striae gravidarum encountered in a client in her 26th week of gestation

reddish streaks on the abdomen and breasts

a newly pregnant client reports that she is taking isotretinoin. Which statement applies to the care of this client

isotretinoin is a teratogenic and is associated with major fetal malformations, so the client should stop the medication immediately

which client care activity may the nurse safely delegate to an unlicensed health care worker

Assisting a client who is recovering from an abdominal hysterectomy to the bathroom

Which is the best advice the nurse can provide to a pregnant woman in her first trimester

Avoid drugs and don't smoke or drink alcohol

which information about the prenatal clients activities indicates to the nurse that there is a need for toxoplasmosis testing?

the client cares for the neighbors cat

A pregnant client is making her first antepartum visit. She has a 2- year old son born at 40 weeks, a 5 year old daughter born at 38 weeks, and 7-year-old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. How would the nurse, using the GTPAL format, document the client's obstetric history?

G5 T2 P1 A1 L4

A prenatal client's vaginal mucosa is noted to have a purplish discoloration. Which sign would be documented in the client's clinical record?

Chadwick

the nurse uses Leopold maneuvers to assess the client at 40 weeks gestation. Which factor would be assessed with this maneuver

Position of fetus

A woman comes into the clinic and states that she is thinking about becoming pregnant. Which can the woman do to improve the health of her baby before she becomes pregnant?

Start taking prenatal vitamins

which weight change in the obese prenatal client during the 6th month of pregnancy would indicate to the nurse that the client is successfully managing her weight gain?

Weight gain of 2 Lb

which response would the nurse provide to the mother questioning why her teenage daughter was foolish and became pregnant despite several discussions with the mother about birth control

although teenagers can intellectually discuss birth control, they often don't believe that they will become pregnant

the couple in the fertility clinic has learned that one of them carries a gene for a serious condition and that the other parent does not carry the gene. They have been told that there is a 50% chance that their child will have this condition. Which pattern of genetic inheritance is this?

autosomal dominant

A couple seeking genetic counseling are heterozygous carriers of Tay-Sachs disease. They ask the nurse what the chances are that each of their children will inherit the disease. The nurse responds that the probability is what?

25%

which physiological alteration does the nurse expect in a clients hematological system during the second trimester

an increase in blood volume

which suggestion for coping with morning sickness would the nurse give to a pregnant client?

eat protein before bedtime

which would the nurse explain to the newly pregnant primigravida about how and when the fetal heartbeat will be heard

electronic doppler ultrasonography at 10- 12 weeks

which is a primary focus of teaching for a pregnant adolescent at her first prenatal clinic visit

encouraging her to continue regularly scheduled prenatal care

Before an amniocentesis, both parents express anxiety about the fetus's safety during the test. Which nursing intervention is most appropriate in promoting the parents' ability to cope?

explaining the procedure step by step

during their initial visit to the prenatal clinic, a couple asks the nurse whether the woman should have an amniocentesis for genetic studies. Which factor indicates that an amniocentesis may be indicated?

family history of genetic abnormalities

A primigravida, unsure of the date of her last menstrual period, is told by the nurse that she appears to be at 22 weeks gestation. Which data support this conclusion

fundus just above the umbilicus

which food would the nurse recommend to a pregnant client to most significantly increase the clients intake of folic acid

half a cup of cooked spinach

Where would the fundal height be located in a pregnant client at 16 weeks gestation

half the distance to the umbilicus

Which laboratory finding on a client at 24 weeks' gestation would the nurse report to the health care provider

hemoglobin 10.8

Which laboratory finding of a pregnant client would alert the nurse to the need for further assessment

hemoglobin of 10 g/dL

which client statement indicates understanding of prenatal instructions regarding when to consult with a health care provider

ill call the clinic if i have abdominal pain

at her first prenatal clinic visit a primigravida has blood drawn for a rubella antibody screening test, and the results are positive. Which intervention is important when the nurse discusses this finding with the client?

informing her that her result indicates immunity to rubella

which would the nurse do to prepare a client in her third trimester who is scheduled for an amniocentesis?

instruct her to void immediately before the test

which information about nausea and vomiting in the first trimester would the nurse provide to the pregnant client

it may be related to an increased human chorionic gonadotropin level (hCG)

Which exercise would the nurse instruct the women in a childbirth preparation class to use for toning the muscles of the pelvic floor

kegel exercises

which is a consequence of neonate of maternal smoking during pregnancy

low birth weight

a pregnant clients blood test reveals an increased AFP level. Which condition is indicated with this result

neural tube defect

which condition is detected by an AFP test

neural tube defects

which client would the nurse identify as being the greatest risk for a hypertensive disorder of pregnancy

obese primigravida

The nurse explains to the pregnant client that the serum alpha-fetoprotein test screens for which condition

open neural tube defects - trisomy 18 - trisomy 21

which finding would be a concern when assessing a client at 35 weeks gestation

painful intermittent contractions

a sonogram performed on a client in the third trimester reveals a low-lying placenta. Which would the nurse teach the client that she is at risk for

painless vaginal bleeding

a nurse explains to the client that infertility caused by a defect in the tube is most often related to which condition

past infection

a pregnant client has a history of preterm births followed by neonatal deaths. Which is an indication of preterm labor that this client would be instructed to report

pelvic pressure

why is a multiple-gestation pregnancy considered a high risk

perinatal mortality is two to three times more likely in multiple than in single births

the nurse teaches a client who is about to undergo an amniocentesis that ultrasonography will be performed just before the procedure to determine

position of the fetus and the placenta

which factor contraindicates sexual intercourse during pregnancy

premature rupture of membranes

A pregnant client in the third trimester tells the nurse in the prenatal clinic that she is experiencing heartburn after every meal. Which explanation would the nurse provide regarding the cause of the heartburn?

the esophageal sphincter relaxes and allows acid to be regurgitated

Which information would the nurse include in the explanation of a Papanicolaou (Pap) test to the client in the Family Planning Clinic

the pap smear screens for cervical cancer

At which time during prenatal development would the nurse tell the client to expect the greatest fetal and maternal weight gain

third tirmester

Which would be the focus of an assessment of a pregnant client who is engaging in the practice of pica

to determine if harmful items are being ingested

A client at 28 weeks gestation calls the clinic for a routine examination. Which finding is of greatest concern to the nurse

puffy fingers - sign of mild preeclampsia