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. A young couple are very excited to discover they are pregnant and ask the nurse when to expect the baby. Based on a July 20 LMP, which day will the nurse predict for delivery? A. April 27 B. March 13 C. April 13 D. May 20

A. April 27

As part of the first prenatal visit, the nurse is assessing a pregnant woman's obstetrical history, which includes an 18-month-old daughter, born 2 days after her estimated date of birth; a 3-year-old son born at 35 weeks' gestation; and two lost pregnancies, one at 12 weeks and one at 21 weeks. How should the nurse document this history? A. G5 T1 P2 A1 L2 B. G4 T1 P1 A2 L2 C. G5 T2 P2 A1 L1 D. G4 T1 P2 A2 L2

A. G5 T1 P2 A1 L2

The nurse is assessing a client at her first prenatal visit and notes that she is exposed to various chemicals at her place of employment. Which statement by the client would indicate she needs additional health education to protect her and her fetus? A. "I only work four hours a day so I don't get exposed too much." B. "The gloves they provide irritate my hands, so I don't use them." C. "There hasn't been a chemical spill in three years." D. "I have an assistant helping me now to handle the chemicals."

B. "The gloves they provide irritate my hands, so I don't use them."

The nurse is assessing a client at her first prenatal visit and notes the fundal height is palpable at the level of the umbilicus. The nurse predicts the client is at which gestational age? A. 18 weeks B. 20 weeks C. 24 weeks D. 22 weeks

B. 20 weeks

The nurse will be assisting a client during an amniocentesis. Which nursing intervention should the nurse prioritize? A. Caution about the opioid premedication. B. Be certain she is aware of potential complications. C. Ensure she understands the need for 2 days of bed rest. D. Expect test results within 1 week.

B. Be certain she is aware of potential complications.

The nurse is assessing a client at 12 weeks' gestation who reports enjoying her usual slow, long daily walk. The nurse should point out which recommendation to this client? A. Reduce walking to half a block daily. B. Continue this as long as she enjoys it. C. Stop and rest every block. D. Engage in aerobics for greater benefits.

B. Continue this as long as she enjoys it.

. 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? A. Use plantar flexion exercises three times every day. B. Dorsiflex the foot while extending her leg during the cramp. C. Encourage her to drink more fluids, 10 glasses a day. D. Avoid any supplementation of vitamins or minerals.

B. Dorsiflex the foot while extending her leg during the cramp.

. A client who is uncertain when her LMP occurred is given an EDD of April 23 after the first ultrasound. Based on this information, the nurse determines the client's LMP was probably which day? A. July 13 B. July 16 C. July 19 D. July 21

B. July 16

The nurse is assessing a client at her first prenatal visit and reports her LMP started December 1. Which date will the nurse predict for the EDD? A. October 7 B. September 8 C. July 7 D. August 8

B. September 8

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? A. There is no evidence of congenital anomalies or deformities. B. The fetal heart rate increases with activity and indicates fetal well-being. C. The fetus is developing at a fast rate but doing fine. D. The results indicate a stress test is needed for further evaluation.

B. The fetal heart rate increases with activity and indicates fetal well-being.

The nurse takes a call from a worried client who was seen several hours earlier for her 35-weeks' gestation visit, which included a pelvic examination. Which instruction should the nurse prioritize if the client is reporting a small amount of vaginal spotting? A. Return right away. B. Watch it and report if heavy increase in bleeding. C. The bleeding, called Chadwick sign, is a normal part of pregnancy. D. The cervical mucus plug may have been expelled.

B. Watch it and report if heavy increase in bleeding.

The nurse is meeting with a client at 28 weeks' gestation. To prepare her for the final trimester, which factor should the nurse prioritize in the teaching session? A. preventing anemia B. decreasing shortness of breath C. decreasing bleeding gums D. preventing varicosities

B. decreasing shortness of breath

The nurse is teaching a pregnant client some nonpharmacologic ways to handle common situations encountered during pregnancy. The nurse determines the session is successful when the client correctly chooses which condition that can be minimized if she avoids drinking fluids with her meals? A. nosebleeds B. heartburn C. blood clots D. constipation

B. heartburn

The nurse is assessing a client at 30 weeks' gestation who reports increased constipation. Which suggestion should the nurse prioritize for this client? A. taking mineral oil B. increasing fluid intake C. reducing iron supplement D. increasing intake of meat

B. increasing fluid intake

A pregnant client reports difficulty sleeping well. Which suggestion for sleeping should the nurse prioritize to assist this client? A. on her stomach with a pillow under her breasts B. on her side with the weight of the uterus on the bed C. on her back with a pillow under her knees and hips D. on her back with a pillow under her head

B. on her side with the weight of the uterus on the bed

The nurse is preparing to administer a prescribed medication to the pregnant client. Which order should the nurse question? A. penicillin B. rubella C. acetaminophen D. folic acid

B. rubella

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records? A. G2 T2 P1 A0 L2 B. G2 T1 P1 A1 L1 C. G3 T0 P1 A1 L2 D. G3 T2 P2 A0 L1

C. G3 T0 P1 A1 L2

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? A. Travel no more than 120 miles daily. B. Sit in the back seat with feet elevated. C. Stop and walk every 2 hours. D. Limit trips away from home, greater than 200 miles

C. Stop and walk every 2 hours.

The health care provider has prescribed an over-the-counter antacid for a pregnant client in her first trimester who is having ongoing nausea, vomiting, and heartburn. Which instruction concerning the antacid should the nurse prioritize after noting the client is also prescribed a multivitamin supplement? A. Avoid caffeinated beverages. B. Take only at bedtime. C. Take antacid 1 hour after the multivitamin. D. Take with dairy products.

C. Take antacid 1 hour after the multivitamin.

The nurse is assessing a 24-year-old pregnant client who reports excessive vaginal discharge that is messy and unpleasant but without a strong odor, itching, or irritation present. Which response should the nurse prioritize? A. Douche frequently with mild soap and water. B. See her primary care provider. C. Use sanitary pads. D. Decrease her fluid intake.

C. Use sanitary pads

A 38-year-old client and partner are carriers of the Tay-Sachs gene, have one child with Tay-Sachs, and are concerned to learn she is pregnant again. The nurse predicts the health care provider will order which test if the couple wants to know if this baby will also be born with Tay-Sachs? A. a multiple marker screening test B. amniocentesis C. chorionic villus sampling D. percutaneous umbilical blood sampling

C. chorionic villus sampling

Charlene McCoy, who has several children already, reports for a first prenatal visit. She seems preoccupied and withdrawn, and she makes consistently negative remarks about the pregnancy. Reviewing her records, you note that she is receiving a serotonin reuptake inhibitor. What should you do? A. Reassure her that ambivalence is normal. B. Refer her for drug and alcohol counseling. C. Give her printed material to read at home. D. Alert the RN or health care provider.

D. Alert the RN or health care provider.

. A client at 27 weeks' gestation still walks daily but reports "terrible" heartburn at night. Which action should the nurse point out will best address this situation? A. Stop or severely curtail her exercise. B. Take sodium bicarbonate. C. Seek emergency medical care. D. Elevate the head of the bed.

D. Elevate the head of the bed.

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? A. Soak feet every night and perform pelvic rocks. B. Lie on right side with feet elevated and a heating pad on the back. C. Take breaks at work and sit in a semi-Fowler position with feet below. D. Rest when possible with feet elevated at or above the heart.

D. Rest when possible with feet elevated at or above the heart.

The nurse has just received the results of a pregnant client's MSAFP screening and notes the levels are elevated. The nurse should prioritize which discussion with the client? A. risk for Down syndrome B. risk for neural tube defects C. test needs to be repeated D. further testing is required

D. further testing is required

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? A. heartburn B. faintness C. slowed GI transit time D. nausea and vomiting

D. nausea and vomiting

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? A. contraction stress test B. amniocentesis C. nonstress test D. biophysical profile

amniocentesis