Maternity and Newborn Health "Antepartum" 58 Questions

A client a 20 weeks gestation states that she started consuming an increased amount of cornstarch about 3 weeks ago. Based on this assessment, the nurse should anticipate that the health care provider will order which laboratory tes? 1. Hemoglobin and hematocrit levels 2. Human chronic gonadotroprin level 3. Serum folate level 4. White blood cell count

ANS: 1 ica is the abnormal consumption of substances not considered nutritional. Pica is often related to anemia.

The clinic nurse is preparing to teach a client at 30 weeks gestation with a diagnosis of preclampsia without severe features. Which of the following statements are appropriate for the nurse to include in client teaching? 1. "Frequently monitor your blood pressure at home and report increased findings to the health care provider (HCP)." 2. "Immediately report unrelieved headaches, abdominal pain, or vision changes to the HCP." 3. "Notify your HCP immediately if you notice any vaginal bleeding." 4. "Perform fetal kick counts daily and report any decreased fetal movement to the HCP." 5. "Your labor will likely be induced as soon as you reach term gestation or before if severe symptoms of preeclampsia develop."

ANS: 1, 2, 3, 4, 5 Preeclampsia, new onset HTN (systolic >140 or systolic >90 at >20 weeks gestation. Plus proteinuria or end organ damage.

The nurse is preparations to assess a client visiting the women's health clinic. The clients obstetric history is documented as G5 T1 P2 A1 L2. Which interpretation of this notation is correct? 1. The client had 1 birth at 37 wk 0 d gestation or beyond 2. The client had 3 births between 20 wk 0 d and 36 wk 6 d gestation 3. The client has 3 currently living children 4. The client is currently not pregnant

Ans: 1 Gravidia: the number of pregnancies Term: delivered at 37 weeks 0 days gestation. Preterm: pregnancies delivered from 20 was 0 days gestation Abortion: ending before 20 was 0 days ( miscarriages, spontaneous). Living: currently Lin=vying children

The nurse is reviewing laboratory results for several prenatal clients. Which finding is most important to report to the health care provider? 1. Client at 24 weeks gestation with hemoglobin of 9 g/dL (90 g/L) and hematocrit of 29% 2. Client at 26 weeks gestation whose 1-hour (50 g) oral glucose challenge test result is 120 mg/dL (6.7 mmol/L) 3. Client at 36 weeks gestation with blood pressure of 125/85 mm Hg and trace protein detected on urine dipstick 4. Client at 37 weeks f-gestation with a WBC count of 13,000/mmm3

Ans: 1 Hgb <11 g/dL in the first trimester or third trimester or <10.5 g/dL in the second semester is considered low.

A 37-weeks-pregnant woman comes to the emergency department with a fractured ankle. Which assessment finding is the most concerning an requires the nurse to follow up? 1. Fetal heart rate remain 206/min. 2. Fetus kicked 4 times in the past hour 3. Mother reports feeling 2 contractions every hour 4. Mother's hemoglobin is 11 g/dL (110 g/L)

Ans: 1 Explanation: baseline >160 beats/min for >10 minutes. Tachycardia needs evaluation. Option 4, HGB drop and is normal in. Pregnancy.

The nurse is providing teaching to a prenatal client about the 1 hour glucose challenge test that will be performed at the next visit. Which client statement indicates a need for further teaching? 1. "Fasting is required before the 1-hour glucose challenge test." 2. "One blood sample is obtained at the end of the test." 3. "The test includes drinking a 50 g glucose solution 4. "The test's purpose is to screen for gestational diabetes, not diagnose it."

Ans: 1 GDM screening at 24-28 weeks gestation. The 1 hour glucose can be performed anytime and doesnt require fasting.

A client at 20 weeks gestation report "running the bathroom all the time," pain with urination, and foul smelling urine. Which question is most important for the nurse to ask when assessing the client? 1. "Are you having any pain in your lower back or flank area?" 2. "Do you wipe from front to back after urinating?" 3. "Have you found that you urinate more frequently since becoming pregnant?" 4. "Have you had a urinary tract infection in the past?"

Ans: 1 If cystitis goes unreported, gthe infection mar=y ascend to the kidneys and cause pyelonephritis.

The nurse is obtaining a client's history during an initial prenatal visit. The client's last menstrual period was from March 1 to March 5. Unprotected intercourse occurred on March 15. Slight vaginal spotting was noted on March 23. The client's menstrual cycles are regular and 28 days long. Using the Nagele rule what is the estimated date of birth? 1. December 8 2. December 12 3. December 22 4. December 30

Ans: 1 LMP: march 1 Subtract 3 months: December 1 Add 7 days: December 8

The nurse is caring for a client at 30 weeks gestation who is hospitalized for preeclampsia. After reviewing the client;s chart and performing an initial assessment, the nurse notes several abnormal findings. Which findings should the nurse discuss with the heath care provider immediately? 1. Dark red vaginal bleeding 2. Edema of the hands and face 3. Elevated liver enzymes 4. Urine output of 150 mL in 4 hours

Ans: 1 Manifestations are dark bleeding, abdominal pain, rigid uterus, abnormal fetal heart r ate patterns and uterine tachysystole.

The nurse reviews laboratory test results for a pregnant client at 32 weeks gestation. What is the nurse's best action based on these results? Click on the exhibit button for additional information 1. Complete the client assessment and documentation 2. Draw another sample for repeat complete blood count 3. Prepare for transfusion of packed red blood cells 4. Request a prescription for iron supplementation Exibits: HGB 11.4, Htc 34%, RBC 5.3 to 10, WBC 14,000, Platelets 230,000

Ans: 1 Normal vale's: HGB >11, Hct >33%, RBC 5.00 to 6.25, WBC 5,000-15,000, Platelets 150,000-400,000

Which meal should the nurse recommended for a pregnant client at 13 weeks gestation? 1. Baked chicken, turnip greens, peanut butter cookie, and grape juice 2. Baked swordfish, fries, baked apples, and fat-free milk 3. Chilled ham and cheese sandwich, broccoli, oranges slices, and water 4. Fried liver and onions, pasteurized cheese squares, fresh fruits cup, and water

Ans: 1 Swordfish is high in mercury, cold deli meal needs to ve avoid due to risk of listeriosis, liver has a high vitamin A and cause teratogenic.

The nurse assesses a client at term gestation who reports having contractions for the last 2 hours. The client states, "I am not sure, but I think my water broke." The nurse perform a nitrazine pH test, which turns blue. When documenting the results of the test, which client statement is most concerning to the nurse? 1. "I did have sexual intercourse with my partner 1 hour before coming in today." 2. "I have noticed constant wetness in my panties since I thought my water broke." 3. "It is difficult for me to tell if my water broke or if I just peed on myself a little bit." 4. "With my last three pregnancies, my water never broke on its own."

Ans: 1 Testing vaginal secretions with nitrazine pH test can help differentiate between amniotic fluid (alkaline), and normal vaginal fluids or urine (acidic). A bluish color suggest probable rupture of membranes (ROM). However the presence of blood or semen may result in a false positive.

The nurse is providing education to several first trimester pregnant clients. Which client requires priority anticipatory teaching? 1. Client who gardens and eats homegrown vegetables 2. Client who has gained 4 lb (1.8 kg) from pregnancy weight 3. Client who has noticed thin, milky white vaginal discharge 4. Client who practices yoga and swims in a pool 3 times a week

Ans: 1 Toxoplasmosis is a parasitic infection caused by toxoplasma Gondi, which may be acquired from exposure to infected cat feces or ingestion of undercooked meat or soil contaminated fruits/vegetables.

The nurse is admitting a client at 41 weeks gestation for induction of labor due to oligohydramnios. Considering the client's indication for induction, what should the nurse anticipate? 1. additional neonatal personnel present for birth 2. Intermittent fetal monitoring during labor 3. Need for forceps-assisted vaginal birth 4. Need for uterotonic drugs for postpartum hemorrhage

Ans: 1 (possible resuscitation) Olygohydramnios is a condition by low amniotic fluid volume. Due to fetal kidney anomalies. Fluid volume also declines gradually after 41 weeks.

A client indicates the desire to become pregnant. Which of the following are important preconception education topics for the nurse to provide? SATA 1. Aim for BMI 0f 18.5 - 24.9 km/m2 2. Avoid alcohol consumption and tobacco products 3. Ensure daily intake of 400 mcg of folic acid 4. Obtain testing for rubella immunity 5. Schedule dental wellness appointment

Ans: 1, 2, 3, 4, 5

The nurse is planning education for clients in group prenatal care who are entering the second trimester of pregnancy. Which of the following are appropriate for the nurse to include in second trimester teaching? SATA 1. Anticipate light fetal movements around 16-20 weeks gestation 2. Expect to have an abdominal ultrasound for fetal anatomy evaluation 3. Gain about 1 lb (o.5 kg) per week if pre-pregnancy BMI was normal 4. Increase consumption of iron-rich foods like meat and dried fruit 5. Plan for gestational diabetes screening near the end of the second trimester

Ans: 1, 2, 3, 4, 5

The nurse is reinforcing education to a group of clients that are pregnant or planning pregnancy. Which of the following client statements about alcohol used in pregnancy should concern the nurse? SATA 1. "As long as I don't drink, an occasional glass of wine is fine." 2. "I drank alcohol heavily before realizing I was pregnant, so there is no benefit to quitting now." 3. "If I drink alcohol, my baby may have withdrawal after birth but no permanent damage." 4. "Third-trimester alcohol use is less harmful because the baby is fully developed."

Ans: 1, 2, 3, 5

The nurse is providing nutrition counseling during a preconception visit to a client who does not eat green vegetables. In addition to daily prenatal vitamin, which foods can the client add to the daily diet to decrease the risk of neural tube defects? SATA 1. Black beans and rice 2. Fortified breakfast cereal and milk 3. Medium baked sweet potato 4. Peanut butter on whole wheat toast 5. Raw carrots with cheese dip

Ans: 1, 2, 4

A client at 38 weeks gestation is brought to the emergency department after a motor vehicle crash. She reports severe, continuous abdominal pain. The nurse notes frequent uterine contractions and mild, dark vaginal bleeding. What actions should the nurse take SATA 1. Anticipate emergent cesarean birth 2. Apply continuous external fetal monitoring 3. Assess routine vital signs every 4 hours 4. Draw blood for type and crossmatch

Ans: 1, 2, 4 Placenta previa: painless bleeding. Placenta abruption: vaginal bleeding and pain, tender uterus.

A client comes to the clinic indicating that a home pregnancy test was positive. The client's last menstrual period was September 7. Today is December 7. Which are true stamens for this client? SATA 1. According to Naegele's rule, the expedited date of delivery is June 14 2. Detection of the fetal heart rate via Droppler is possible 3. Fundal height should be 24 cm above the symphysis pubis 4. The client should be feeling fetal movement 5. Urinary frequency is a common symptom

Ans: 1, 2, 5 fetal heart rate is possible using a Droppler by 10-12 weeks, urinary frequency due to hormonal changes in the real system.

The nurse is preparing to discharge a client following a first trimester miscarriage. Which of the following statements should the nurse include in discharge teaching for the client and partner? SATA 1. "Attending a support group with other people who had a pregnancy loss can be helpful." 2. "Genetic counseling is recommended for couples after their first miscarriages." 3. "One of the most important things you can do right now is communicate with your partner." 4. "The grieving period only last about 6 months following a miscarriage." 5. Trying to conceive again can help you cope by giving you something to look forward to."

Ans: 1, 3

A nurse on the Antepartum unit is caring for a pregnant client at 30 weeks gestation who was admitted with reports of vaginal bleeding. A diagnosis of placenta previa was confirmed by ultrasound. What should the nurse tell the client to anticipate? SATA 1. additional ultrasound around 36 weeks gestation 2. Clearance for sexual activity if bleeding stops 3. Discharge home if bleeding stops ad fetal status is reassuring 4. Scheduled cesarean birth before onset of labor 5. scheduled cesarean birth before to assess for cervical change

Ans: 1, 3, 4 Placenta previa, the placenta is implanted over or very near the cervix.

A pregnant client at 30 weeks gestation comes to the prenatal clinic. Which vaccines may be administered safely at this prenatal visit? SATA 1. Influenza injection 2. Influenza nasal spray 3. Measles, mumps, and rubella 4. Tetanus, diphtheria, and pertussis 5. Varicella

Ans: 1, 4 Tetanus, diphtheria, and pertussis (Tdap) at 27 and the end of the 36 weeks of gestation

A client at 37 weeks gestation is receiving IV magnesium sulfate for preeclampsia with severe features. Which of the following signs indicate that the client has developed magnesium sulfate toxicity? SATA 1. 0/4 patellar reflex 2. Blood pressure of 156/84 mmHg 3. Client voiding 600 mL in 8 hours 4. respiratory rate of 10/min 5. Somnolence

Ans: 1, 4, 5 Mild: nausea, flushing, headache, hyporeflexia. Moderate: a reflex is, hypo lace is, somnolence. Severe: respiratory paralysis, cardiac arrest. treatment: stop magnesium, give IV calcium gluconate bolus.

A client who is being evaluated for suspected ectopic pregnancy reports sudden-onset, severe. Right lower abdominal pain and dizziness. Which additional assessment findings will the nurse anticipate if the client is experiencing a ruptured ectopic pregnancy? SATA 1. Blood pressure 82/64 mm Hg 2. Crackles on auscultation 3. Distended jugular veins 4. Pulse 120/min 5. Shoulder pain

Ans: 1, 4, 5 Usually occurs in the Fallopian tubes. Option 2 and 3 indicate volume overload.

The nurse is teaching a client, gravedigger 1 para 0, at 8 weeks gestation about expected weight gain during pregnancy. The client;s pregnancy BMI is 21 kg/m2. Which statement by the client indicates an appropriate understanding about weight gain? 1. "I should gain 10-15 lb (4.5 - 6.8 kg) during the first trimester 2. "I should gain a total of about 30 lb (13.6 kg) during my pregnancy." 3. "I should gain no more than 0.5 lb (o.2 kg) per week during the third trimester 4. "If I gain <20 lb (9.1 kg) during pregnancy, it will be easier to lose weight postpartum."

Ans: 2 <18. 5 underweight 18.5 - 24.9 Normal weight. 25-29.9 overweight >30 obese

The nurse provides discharge instructions to a client at 14 weeks gestation who has received a prophylactic cervical cerclage. Which client statement indicates an understanding of teaching? 1. "I need to be on bed rest for the duration of my pregnancy 2. "I will notify my health care provider if I start having low back aches." 3. "Pelvic pressure is to be expected after cerclage placement." 4. "The cerclage will be removed once my baby is at 28 weeks."

Ans: 2 A cervical cerclage is placed to prevent preterm delivery, usually in clients with histories of second trimester loss or premature birth.

The clinic nurse is collecting data on a pregnant client in the second trimester. Which finding is most concerning? 1. Client has not consistently take her prenatal vitamins 2. Client is taking listing-rail to control hypertension 3. Client reports a whitish vaginal discharge 4. Client reports mild cramping pain in the lower abdomen

Ans: 2 ACE inhibitors (enalapril, lisinopril, ramipril) and angiotensin II receptor blockers (loser tan, valsartan, telmisartan) should be avoid if planning to get pregnant.

A nurse is caring for a pregnant client at 27 weeks gestation after a motor vehicle collision with side airbag deployment. The client's blood type is O negative. Which laboratory test should the nurse anticipate? 1. Group B streptococcal culture 2. Indirect Coombs test 3. Rubella Immunity titer 4. Serum alpha-fetoprotein

Ans: 2 An indirect Cooms test is performed to screen for Rh sensitization any time hemorrhage secondary to placental abruption is suspected. Rubella in the first trimester. Option 4 to screen fetal neural tube defects. Option 1 at 35 to 37 to determine the need for antibiotics during labor.

The nurse is preparing no a nutritional teaching plan for a client planning to become pregnant. Which foods would best prevent neural tube defects? 1. Calcium rich snacks 2. Fortified cereals 3. Organ meats 4. Wild salmon

Ans: 2 Explanation: should consume 400-800 mcg of folic acid daily.

The nurse is assessing a client at 36 weeks gestation during a routine prenatal visit. Which statement by the client should the nurse investigate first? 1. "I am not sleeping as well due to cramps in my calves at night." 2. "I have noticed less kicking movements as the baby grows bigger." 3. "Over the last few weeks.=, I have not been able to wear any of my shoes." 4. "sometimes I feel short of breath after walking up a flight of stirs."

Ans: 2 Fetal movements should no decrease as the fetus increases in size.

The initial prenatal laboratory screening results of a client a 12 weeks gestation indicate a rubella timer status of nonimmune. What will the nurse anticipate as the plant of care for this client? 1. Administer measles-mumps-rubella (MMR) vaccine now 2. Administer MMR vaccine immediately postpartum 3. administer MMR vaccine in the third trimester 4. An MMR vaccine is not indicated for this client

Ans: 2 Live vaccine are contraindicated in pregnancy due to theoretical risk of contracting the disease from the vaccine.

A client at 39 weeks gestation with preeclampsia has a blood pressure of 170/100 mm Hg, 2+ proteinuria, and moderate peripheral edema. Immediately after hospital admission, she develops seizures and uterine contractions. Magnesium sulfate is prescribed. Which finding indicates that the drug has achieved the desired therapeutic effect? 1. Blood pressure < 130/80 mm Hg 2. Seizure activity stops 3. Urine has 1+ protein 4. Uterine contractions stop

Ans: 2 Magnesium sulfate recent/control seizure activity. Delivery is the only cure for preeclampsia-e maps is syndrome.

The nurse is caring for a client in the first trimester during an initial prenatal clinic visit. Based on the information provided by the client, which factor places the client at an increased risk for preterm labor? 1. Age 25 2. Periodontal disease 3. vegetarian diet 4. White ethnicity

Ans: 2 Preterm is defined before 37 weeks and 0 days

The graduate nurse (GD) is caring for a client at 20 weeks gestation with secondary syphilis. The client reports an allergic reaction to penicillin as a child but does not know what kind of reaction occurred. When discussing the client's potential treatment plan with the precepting nurse, which statement by the GN indicates an appropriate understanding? 1. "Doxycycline is an acceptable alternative to penicillin for treatment of symphysis during pregnancy." 2. "The client will require penicillin desensitization to receive appropriate treatment." 3. "The newborn can be treated after birth if Antepartum treatment in contraindicated." 4. "Treatment is only effective if provided during the primary stage of syphilis."

Ans: 2 The only adequate prenatal treatment is IM penicillin injection (benzathine penicillin G). If client has penicillin allergy the nurse should anticipate penicillin desensitization so that the adequate treatment can be provided.

A 14-year-old client confides to the school nurse that she is pregnant, likely in the second semester, and has not had prenatal care. Which of the following topics should the nurse discuss with the client at this time? SATA 1. Desire for adoption planning services 2. Emotional response to the pregnancy 3. Family/social support systems 4. Nutritional habits and substance abuse 5. Plan for finishing his school

Ans: 2, 3, 4

The graduate nurse (GN) and supervising nurse are preparing to follow-up with a client who had a spontaneous abortion at 6 weeks gestation at home. Which of the following stamens by the GN are appropriate? SATA 1. "Although the client is Rh negative, it is unnecessary to administer Rh immune globulin due to the client's early gestational age." 2. "I will reinforce teaching with the client about abstaining from sexual intercourse for two weeks." 3. "The client should call the health care provider for foul-smelling vaginal discharge, heavy vaginal bleeding, or severe pain." 4. "The client should continue prenatal vitamins with Ron and take ibuprofen as needed for pain. 5. "To maintain perineal hygiene, the client should soak nightly in a bathtub and use mild soap."

Ans: 2, 3, 4

The nurse is reinforcing instructions to a client at 34 weeks gestation who is preparing to travel by airplane. Which of the following instructions are appropriate? SATA 1. Avoid getting up during the flight unless you need the restroom 2. Carry a copy of your most up-to-date prenatal record 3. Increase fluid intake before and during the flight 4. Secure the lap belt below the abdomen and across your hips when seated 5. Wear compression hose and lose-fitting clothing

Ans: 2, 3, 4, 5 Fluid prevent dehydration and reduce the risk of thrombus, compression stocking improve venous return and decreased the risk of clot formation.

A client suspects she is pregnant and comes for prenatal evaluation. Which assessment findings indicate definitive evidence (positive signs) of pregnancy? SATA 1. cervical softening on examination 2. Fetal heart tone detected by Doppler device 3. Positive serum human gonadotropin test 4. Report of fetal movement felt belly 5. Visualization of fetus by ultrasound

Ans: 2, 5

A client with diabetes visits the clinic reporting breast tenderness, vaginal discharge, and urinary frequency. Which action is most important for the nurse to perform? 1. Ask if the client performs breast. Self-exams 2. ask the client about characteristics of vaginal discharge 3. assess the date of the client's last menstrual period 4. Review the client's home blood sugar loss

Ans: 3

The nurse is counseling a pregnant client who is HIV positive. Which information is appropriate to discuss? 1. Infant should be exclusively breastfed for 6 months to receive maternal antibodies 2. Infant will no require treatment for HIV after birth 3. Prescribed antiretroviral therapy should be continued during pregnancy 4. Tetanus-diphtheria-pertussis vaccine should be avoided until after birth

Ans: 3

The nurse is documenting assessments of pregnant clients in the Antepartum unit. Which client's assessment findings are most important to report to the health care provider? 1. Client at 28 weeks gestation with an asymptomatic systolic murmur 2. Client at 34 weeks gestation with 1+ edema of bilateral lower extremities 3. Client at 35 weeks gestation with painful general lesions 4. Client at 39 weeks gestation with brownish, mucous vaginal discharge

Ans: 3

The nurse receives report on 4 first trimester pregnant clients. Which client should the nurse assess first? 1. Client with Hydatidiform mole reporting dark brown vaginal discharge 2. Client with hyperemesis gravidarum reporting excessive vomiting and weight loss 3. Client with suspected ectopic pregnancy reporting abdominal and shoulder pain 4. Client with threatened miscarriage who says, "I am a Jehovah's Witness."

Ans: 3 Fertilized egg grow outside the uterine cavity, frequently in the Fallopian tubes.

Which client in a prenatal clinic should the nurse assess first? 1. Client at 11 weeks gestation with backache and pelvic pressure 2. Client at 16 weeks gestation with earache and sinus congestion 3. Client at 27 weeks gestation with headache and facial edema 4. Client at 37 weeks gestation with white vaginal discharge and urinary frequency

Ans: 3 Gestational HTN is a new onset high blood pressure (>140/90) that occurs at 20 weeks gestation without proteinuria. The development of proteinuria and HTN indicates preeclampsia.

A client who is 8 weeks pregnant reports morning sickness. What is the most appropriate response by the nurse? 1. Advise the client to consume hot, versus cold, foods 2. Instruct the client to drink 2 glasses of water with each meal 3. Suggest the client consume high-protein snacks on awakening 4. Tell the client that morning sickness should pass in a few weeks.

Ans: 3 High protein or carbohydrates and low fat.

The nurse is performing assessment of several clients during routine prenatal visits. Which client should the nurse discuss with the health care provider first? 1. Client a 30 weeks gestation with darkened patches of skin on the face 2. Client a 32 weeks gestation with painless, flesh colored bumps on the Persians areas 3. Client a 34 weeks gestation with intense itching on the hands and feet that worsens at night but no rash 4. Client a 38 weeks gestation with stretch marks on the abdomen that have become reddened and pruritic

Ans: 3 Intrahepatic cholestiasis of pregnancy increases the risk of intrauterine fetal demise.

The graduate nurse is assisting the nurse preceptor to provide education to a client diagnosed with a molar pregnancy. which statement by the graduate nurse requires the precepting nurse to intervene? 1. "A uterine evacuation procedure is the typical treatment for removing the abnormal tissue." 2. "We can provide you with resources for coping with perinatal loss if needed." 3. "You may start trying to conceive again as soon as you and your partner feel ready." 4. "You will need Rh immune globulin following a molar pregnancy because you have Rh-negative blood type."

Ans: 3 It is a type of gestational trophoblastic disease that results from abnormal fertilization.

The nurse is caring for a client at 21 weeks gestation with reports of occasional, bothersome heartburns (pyrosis). which of the following lifestyle changes should the nurse recommended? SATA 1. Avoid intake of daisy products 2. Drink large amounts of fluids with meals 3. Eat several small meals each day 4. Eliminate fried, fatty food 5. Lie down of the left side after meals

Ans: 3, 4 It si common during pregnancy: Keep the head of the bed elevated using pillow, sit upright after meals, eat small and frequent meals, avoid tight clothes, eliminate fatty, caffeine, citrus, chocolate, spicy foods, tomatoes, carbonate drinks, peppermint.

The nurse perform initial assessment of four clients in a prenatal clinic. Which client findings are abnormal and require further assessment? 1. Client at 9 weeks gestation with a norm al BMI and a weight gain of 2 lb (1kg) from pre-pregnancy weight 2. Client at 15 weeks gestation with headaches relieved by acetaminophen 3. Client at 19 weeks gestation with bleeding gums after brushing and flossing teeth 4. Client at 20 weeks gestation with an increase in diastolic blood pressure of 15 mmHg since last visit

Ans: 4

A pregnant client a 39 weeks gestation is brought to the emergency department in stable condition following a motor vehicle collision. The client, who is secured supine on a backboard, suddenly becomes pale with a blood pressure of 88/50 mm Hg. Which action should the nurse take first? 1. Administer normal saline fluid bolus 2. Ask about any prenatal complications 3. Initiate fetal heart rate monitoring 4. Tilt the backboard to one side

Ans: 4 After an accident, uterine displacement is the first step to address supine hypotension (due to aortocaval compression and decreased venous return to the heart). Isotonic fluid to correct r hypotension.

A pregnancy client comes in for a routine first prenatal examination. According to the last menstrual period, the estimated gestational age is 12 weeks. Where would the nurse expect to palpate the uterine fundus in this client? 1. 12 cm above the umbilicus 2. At the level of the umbilicus 3. Halfway between the symphysis pubis and the umbilicus 4. Just above the symphysis pubis

Ans: 4 At 16 weeks the fundus is halfway. At 20-22 at the umbilical area. At 36 weeks the fundus at xiphoid. At 38-40 engages into the maternal pelvis and the fundal height drops.

The nurse is caring for a client who reports severe abdominal pain and vaginal spotting. The client had a positive urine pregnancy test at home, and her last menstrual period was 8 weeks ago. Which client report to the nurse is most concerning? 1. Abdominal pain rated as 8 out of 10 2. History of pelvic inflammatory disease 3. Intermittent nausea and vomiting for the past 7 days 4. Right shoulder

Ans: 4 Ectopic pregnancy include lower abdominal and pelvic pain, amenorrhea, spotting or bleeding, mass on pelvic examination.

The nurse at the women's clinic is caring for several clients who are pregnant. The nurse should alert the health care provider to see which client first? 1. Client in the first trimester who reports frequent nausea and vomiting 2. Client in the first trimester with malaise, myalgia, and temperature of 100.8 F (38.2 C) 3. Client in the second trimester who reports dysuria and urinary frequency 4. Client in the third trimester with right upper quadrant pain and nausea

Ans: 4 HELLP ( hemolysis, elevated liver enzymes, low platelet count) syndrome is form of preeclampsia that most often develops during the 3rd trimester of pregnancy.

A nurse is caring for a client a 12 weeks gestation who is admitted for hyperemesis gravidarum. Which clinical manifestation should the nurse expect? 1. Abdominal pain and low-grade fever 2. Blood pressure >140/90 mmHg 3. High urine protein level 4. Moderate to high urine ketones

Ans: 4 HG is characterized for severe nausea and vomiting during pregnancy. Routine labs is urinalysis that include an elevated urine specific gravity and ketonuria.

The obstetric nurse is reviewing phone messages. Which client should the nurse call first? 1. A client 18 weeks gestation taking ceftriaxone and reporting middle diarrhea 2. Client at 22 weeks gestation with twins who is taking acetaminophen twice a day 3. Client at 28 weeks gestation taking metronidazole and reporting dark colored urine 4. Client at 32 weeks gestation taking ibuprofen for moderate back pain

Ans: 4 Nsaids must be avoided during 3rd trimester due to risk of causing premature closure of the ductus arteriosus

A pregnant client in the first trimester tells the clinic nurse she will be traveling to an area with a known Zika virus outbreak and expresses concern regarding disease transmission. Which statement by the nurse is most appropriate? 1. "If you experience Zika symptoms, notify your health care provider." 2. "Take precautions against mosquito bites throughout the trip." 3. "You are not far enough along for the Zika virus to affect your baby." 4. "You should consider postponing your trip i=until after you have the baby."

Ans: 4 Zika virus is transmitted via mosquito, sexual contact and infected bodily fluids.

The nurse in an outpatient clinic is caring for a 34 weeks gestation. The client is taking ferrous sulfate for anemia and reports constipation. Which of the following recommendations are appropriate for this client? SATA 1. Consume daisy products with ferrous sulfate pills 2. Continue daily moderate-intensive exercises 3. Increase intake of raw fruits and vegetables 4. Limit intake of coffee to 3 cups per day 5. Take a stimulant laxative daily for a week

Ans; 2, 3 Constipation is caused by increased progesterone and iron supplements.