maternity chapter 13 review

While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts with "Why are you asking me all these questions? What difference does it make?" Which statement would best answer the client's questions?"

"We ask these questions to detect anything that happened in your past that might affect the pregnancy."

The prenatal clinic nurse is designing a new prenatal intake information form for pregnant clients. Which question is best to include on this form?

Do genetic diseases run in the family of the baby's father?;This question has the highest priority because it gets at the physiologic issue of inheritable genetic diseases that might directly impact the baby.

The client has delivered her first child at 37 weeks. The nurse would describe this to the client as what type of delivery?

Early term births extend from 37 to 38 weeks' gestation.

If a woman has the pre-existing condition of diabetes, the nurse knows that she would be prone to what high-risk factor when pregnant?

Episodes of hypoglycemia and hyperglycemia would be a high-risk factor for a client with pre-existing diabetes.

The clinic nurse is compiling data for a yearly report. Which client would be classified as a primigravida?

Primigravida means a woman who is pregnant for the first time.

The nurse begins a prenatal assessment on a 25-year-old primigravida at 20 weeks' gestation and immediately contacts the healthcare provider because of which finding?

Respirations 30/minute;Tachypnea is not a normal finding and requires medical care.

A 25-year-old primigravida is at 20 weeks' gestation. The nurse takes her vital signs and notifies the healthcare provider immediately because of which finding?

Rhonchi in both bases; Any abnormal breath sounds should be reported to the healthcare provider.

The nurse working in an outpatient obstetric clinic assesses four primigravida clients. Which client findings would the nurse tell the physician about?

The fundal height at 24 weeks should be 24 cm. The fundal height is usually at the umbilicus at 20-22 weeks.

The nurse in the prenatal clinic is seeing a pregnant 16-year-old for the first time. What comment by the young client is the most critical for the nurse to address first?

The nurse responds to this most critical statement because of the danger of fetal alcohol syndrome.

The primigravida at 22 weeks' gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the client why she needs to be seen by a physician today?

. The fundal height at 20-22 weeks should be about even with the umbilicus. At 22 weeks' gestation, a fundal height below the umbilicus and the size of the uterus that is inconsistent with length of gestation could indicate fetal demise.

A pregnant client at 30 weeks' gestation has had a steady rise in blood pressure. She is now 20 mmHg above her systolic baseline. The nurse advises her to immediately report which symptoms?

1. Dizziness can be a sign of hypertension or preeclampsia, and should be reported immediately. 3. Spots before the eyes can be a sign of hypertension or preeclampsia, and should be reported immediately.

During the initial prenatal visit, the nurse obtains a weight of 42 kg (92.4 lb). The nurse must further assess the client for information about which of the following?

1. For a client whose weight is less than 100 lb, the nurse would obtain information on eating habits. 2. For a client whose weight is less than 100 lb, the nurse would obtain information on foods regularly eaten. 3. For a client whose weight is less than 100 lb, the nurse would obtain information on income limitations.

During a client's initial prenatal visit, the nurse must assess and document the client's current medical history, including which information?

1. The body mass index is an important part of the current medical history to be assessed and documented. 3. Homeopathic and herbal medication use is important for the nurse to assess and document in the current medical history. 4. The blood type must be assessed and documented in the current medical history, as must the Rh factor.

The nurse is explaining clinical pelvimetry to a client. The nurse explains that the anteroposterior diameters consist of which of the following?

1. The diagonal conjugate is a part of the anteroposterior diameter measurement. 3. The conjugata vera is a part of the anteroposterior diameter measurement. 4. The obstetric conjugate is a part of the anteroposterior diameter measurement.

A pregnant client calls the clinic nurse to say she is worried about symptoms she is experiencing. The nurse advises the client to come immediately to the clinic because of which reported symptoms?

1. Vaginal bleeding can indicate abruptio placentae, placenta previa, or lesions of cervix or vagina, or it can be "bloody show," and requires that the client be seen. 2. Abdominal pain can signal premature labor or abruptio placentae, and requires that the client be seen. 4. Epigastric pain must be evaluated, as it can indicate preeclampsia or ischemia in a major abdominal vessel. 5. Dizziness, blurring of vision, double vision, or spots before the eyes can indicate either hypertension and/or preeclampsia and requires the client be seen.

The nurse in the OB-GYN clinic is working with a client who is seeking her initial prenatal visit. The nurse will use the acronym TPAL to document the client's number of which of the following?

1.T: number of term births the woman has experienced 3. A: number of pregnancies ending in either spontaneous or therapeutic abortion 4. P: number of preterm births

What signs would indicate that a pregnant client's urinalysis culture was abnormal?

2. Alkaline urine could indicate metabolic alkalemia, Proteus infection, or an old specimen. 3. A cloudy appearance could indicate an infection. 5. Hemoglobinuria would be indicated by an abnormal urine color.

The nurse is seeing a client who asks about the accuracy of Nagele's rule. The nurse explains that accuracy can be compromised under which conditions?

2. Amenorrhea is present and ovulation occurs with breastfeeding. 3. Oral contraception was discontinued, but no regular menstruation was established. 4. There has been 1 or more months of amenorrhea.

A pregnant client has a hemoglobin of 10 g/dL and a Hct of 30%. The clinic nurse recognizes the fetus is at risk for which of the following?

3. Anemia places the fetus at risk for a low birth weight. 4. Anemia places the fetus at risk for premature birth. 5. Anemia places the fetus at risk for fetal death.

A nurse examining a prenatal client recognizes that a lag in progression of measurements of fundal height from week to week and month to month could signal what condition?

A lag in progression of measurements of fundal height from month to month could signal intrauterine growth restriction (IUGR).

The nurse is providing guidance for a woman in her second trimester of pregnancy and telling her about some of the signs and symptoms that she might experience. Which statement by the client indicates that further teaching is necessary?

A persistent headache is not normal or expected. This could be related to the complication of preeclampsia.

Which third-trimester client would the nurse suspect might be having difficulty with psychological adjustments to her pregnancy?

A woman who has not investigated the kind of clothing or feeding methods the baby will need

Screening for gestational diabetes mellitus (GDM) is typically completed between which of the following weeks of gestation?

Screening for gestational diabetes mellitus (GDM) is typically completed between 24 and 28 weeks' gestation.

The nurse is assessing a newly pregnant client. Which finding does the nurse note as a normal psychosocial adjustment in this client's first trimester?

Ambivalence toward a pregnancy is a common psychosocial adjustment in early pregnancy.

What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is ongoing?

At each prenatal visit, the blood pressure, pulse, and weight are assessed, and the size of the fundus is measured. Fundal height should be increasing with each prenatal visit.

The nurse is explaining to a new prenatal client that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the client makes which statement about the reason for the exam?

By performing a series of assessments and measurements, the examiner assesses the pelvis vaginally to determine whether the size and shape are adequate for a vaginal birth; this procedure is called clinical pelvimetry.

The nurse at the prenatal clinic has four calls to return. Which phone call should the nurse return first?

Headache and blurred vision are signs of preeclampsia, which is potentially life-threatening for both mother and fetus. This client has top priority.

The nurse is assessing a primiparous client who indicates that her religion is Judaism. Why is this information is pertinent for the nurse to assess?

It provides a baseline from which to ask questions about the client's religious and cultural background.

The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings?

Mottling of the skin is indicative of possible anemia. These abnormalities must be reported to the healthcare provider immediately.

The nurse is providing health teaching to a group of women of childbearing age. One woman states that she is a smoker, and asks about the effect of smoking on her fetus. The nurse tells her that which fetal complication can occur when the mother smokes?

Smoking can cause low birth rate.

The nurse receives a phone call from a client who claims she is pregnant. The client reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10. What would the client's estimated date of delivery (EDD) be if she is pregnant?

The due date is Jan. 17. Nagele's rule is to add 7 days to the last menstrual period and subtract 3 months. The last menstrual period is April 10, therefore Jan. 17 is the EDD.

During the initial prenatal visit, the nurse assesses the history of the father of the child for which of the following?

The father of the fetus should be assessed for blood type and Rh factor. 3. The father of the fetus should be assessed for significant health problems. 5. The father of the fetus should be assessed for current alcohol intake, drug use, and tobacco use.

A client comes into the prenatal clinic accompanied by her boyfriend. When asked by the nurse why she is there, the client looks down, and the boyfriend states, "She says she is pregnant. She constantly complains of feeling tired, and her vomiting is disgusting." What is a priority for the nurse to do at this point?

The nurse should suspect that the client is in an abusive relationship. The priority is for the nurse to get the client away from the boyfriend and continue the interview.

A woman gave birth last week to a fetus at 18 weeks' gestation after her first pregnancy. She is in the clinic for follow-up, and notices that her chart states she has had one abortion. The client is upset over the use of this word. How can the nurse best explain this terminology to the client?

The term abortion means a birth that occurs before 20 weeks' gestation or the birth of a fetus-newborn who weighs less than 500 g. An abortion may occur spontaneously or it may be induced by medical or surgical means.

The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected findings?

This is an expected finding because fetal heart tones should be heard by 12 weeks using a Doppler fetoscope.