O'Meara prep U 15

Gynecologic health is an important part of a woman's health history. Which of the following statements best illustrates the way to begin a menstrual history

"I'd like to ask you some questions about your menstrual periods."

A pregnant woman enjoys exercising at a local health spa once a week. Which comment would lead the nurse to believe she needs additional health teaching

"Nothing feels nicer than a hot sauna after exercise."

A community health nurse is visiting a 16-year-old new mother. The nurse explains to the client and her mother the genetic screening that is required by the state's law. The client asks why it is important to have the testing done on the infant. What is the nurse's best response

"PKU, congenital hypothyroidism, and galactosemia are conditions that could result in disability or death if untreated." The first aim is to improve management, that is, identify people with treatable genetic conditions that could prove dangerous to their health if left untreated.

When counseling a client about exercise in pregnancy, which statement is correct

"Plan to exercise a minimum of 3 times a week for 30 minutes."

The nurse is counseling a couple who are concerned that their children might inherit sickle cell disease. Which response from the couple indicates a need for further teaching

"The father cannot pass the disorder onto his son or the mother to her daughter."

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

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

A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching

"The temperature of the water should be at least 105° F."

Which statements are important to include when counseling a client about alcohol consumption during pregnancy? Select all that apply

"There is no safe amount of alcohol to consume during pregnancy." "Alcohol is a teratogen." "Fetal alcohol syndrome may lead to IUGR, microcephaly, facial deformities, and intellectual

A client in her second trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also reports increased pigmentation on her breasts and genitalia. Which statement by the nurse is most appropriate

"This is called facial melanoma and should fade after the birth." The skin and complexion of pregnant women undergo hyperpigmentation, primarily as a result of estrogen, progesterone, and melanocyte stimulating hormone levels. The increased pigmentation that occurs on the breasts and genitalia also develops on the face to form the "mask of pregnancy," or facial melasma (cholasma). This is a blotchy, brownish pigment that covers the forehead and cheeks in dark-haired women. The nurse would inform the client that this is a normal occurrence in pregnancy and should fade after birth.

A client asks the nurse questions about female hygiene and wants to know if she should douche to clean her vagina. Which response by the nurse would be most appropriate

"You do not need to douche; the vagina is self-cleaning."

A pregnant client is scheduled to undergo chorionic villi sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed

10 to 12 weeks of gestation

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

20 weeks

The nurse is reviewing client data following a regular monthly appointment at 6 months' gestation. Which fundal height requires no further intervention

24 cm

The nurse is instructing a pregnant patient to consume a diet high in complete proteins. Which food item should the nurse recommend as an example of a complete protein

A boiled or fried egg

What instruction should a nurse offer to a pregnant client or a client who wishes to become pregnant to help her avoid exposure to teratogenic substances

Avoid medications.

During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings

Both findings are normal at this point of the pregnancy.

A pregnant woman has a child at home who has been diagnosed with neurofibromatosis. She asks the nurse what she should look for in the new baby that would indicate that it also has neurofibromatosis. What sign should the nurse instruct the woman to look for in the new baby

Café-au-lait spots

A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which symptom is an indicator of true labor

Contractions beginning in the back and sweeping forward across the abdomen

A nurse is caring for a client who has just been told that her unborn baby carries a genetic disorder associated with significant health related issues. The client asks, "Should I kill the baby?" What is the most appropriate nursing diagnosis for this client

Decisional conflict related to continuation of pregnancy

A client at 24 weeks' gestation with hyperpigmentation of the face tearfully tells the nurse, "I have these horrible brown spots all over my face. They are so ugly!" Which nursing diagnosis would be most appropriate

Disturbed body image

A client in her second trimester of pregnancy has developed varicose veins and experiences leg cramps. Which suggestion would be most appropriate

Elevate legs while sitting. The nurse should encourage the client to elevate her legs while sitting; this will prevent pooling and engorgement of veins in the lower extremities.

A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information

Further testing will be required to confirm any diagnosis.

In the first trimester, sharp pains in the lower abdomen are common. They are not repetitive but often are associated with position changes or fetal movements. What are these indicative of

Growing pains

A 33-year-old G1 P0000 patient is on home care for preterm contractions. The patient tells her home care nurse that she is afraid to have a bowel movement and has stopped taking her Fe supplement. The nurse teaches the patient the importance of iron and also suggests

Increasing her intake of oatmeal with milk

A patient who is 2 months pregnant is concerned about frequent urination. What should the nurse instruct the patient about this occurrence

It is caused by pressure on the bladder from the uterus.

The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended for prenatal care

Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth.

Assessment for surfactant level via LS ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to

Prevent alveoli from collapsing on expiration

During the embryonic stage of pregnancy, what changes would the mother note in her body to signal that she is pregnant

She will miss her menstrual cycle.

A pregnant patient is concerned that orgasm will be harmful to the developing fetus. What should the nurse include when responding to this patient's concern

Some women experience orgasm intensely during pregnancy.

At a prenatal appointment, a woman who is 3 months pregnant confides to you that she ingests starch because of a craving she has had since adolescence. She is now 26 years old. What would be your most appropriate response

Suggest she have a hemoglobin assessment done because of the association between pica and iron-deficiency anemia

During a routine antepartal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse do next

Tell the woman that this is entirely normal.

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

A multigravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out

The end of the second trimester

The nurse is planning a class for nurses learning to teach early prenatal classes. Which statement indicates that teaching has been effective

The goal of early prenatal care is to optimize the health of the woman and the fetus.

A pregnant client has heard about Down syndrome and wants to know about the risk factors associated with it. What would the nurse include as a risk factor

advanced maternal age

Amniotic fluid does not grow stagnant because

amniotic fluid is constantly formed by the amnion. Rationale: Amniotic fluid is formed by the amnion; a main portion of it is swallowed by the fetus and then excreted by the fetus back into the fluid area. The fluid is constantly being produced and filtered

A nurse at the health care facility assesses a client at 20 weeks' gestation. The client is healthy and progressing well, without any sign of complications. Where should the nurse expect to measure the fundal height in this client

at the level of the umbilicus

A pregnant woman is asked to observe fetal movements as a fetal-assessment technique. You would instruct her to

count fetal movements for 1 hour at the same time each day.

Which finding from a woman's initial prenatal assessment would be considered a possible complication of pregnancy that requires reporting to a primary care provider for management

episodes of double vision

A nurse is caring for a pregnant client who is in labor. Which maternal physiologic responses should the nurse monitor for in the client as the client progresses through birth? Select all that apply

increase in heart rate increase in blood pressure increase in respiratory rate

A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age

mistaking implantation bleeding for last menstrual period (LMP)

A lactose intolerant client is concerned about getting enough calcium in her diet. Which foods could the nurse suggest she include in her diet to increase her calcium intake? Select all that apply

peanut salmonds broccoli molasses

A nurse is discussing the importance of good nutrition to a young pregnant client. The nurse would point out that the growing fetus is getting nutrition from the mother via which structure

placenta

The nurse is assisting a primigravid on calculating the due date of her baby using Naegele's rule. The most important information provided by the mother is

the first day of the last menstrual period.

A number of inherited diseases can be detected in utero by amniocentesis. Which disease can be detected by this method

trisomy 21 (Down syndrome)

A nurse is describing the various birth methods to pregnant couples. Which information would the nurse include as part of the Lamaze method

use of specific breathing and relaxation techniques

During a clinical rotation at a prenatal clinic, a client asks a nurse what causes certain birth defects. The nurse replies that they can be caused by teratogens. What does the severity of the defects depend on? Select all that apply

when during development the conceptus is exposed to the teratogen the particular teratogen to which the fetus is exposed A teratogen is a substance that causes birth defects. The severity of the defect depends on when during development the conceptus is exposed to the teratogen and the particular teratogenic agent to which the fetus is exposed.