Test 3 study/Pregnancy

3 ( A positive Chadwick sign is a probable sign of pregnancy, in response to high levels of circulating estrogen)

A client asks the nurse what was meant when the HCP told her she had a positive Chadwick sign. Which of the following info about the finding would be appropriate for the nurse to convey at this time? 1. It is a purplish stretch mark on your abdomen 2. It means that you are having heart palpitations 3. it is a bluish coloration of your cervix and vagina 4. It means the doctor heard abnormal sounds when you breathed in

4 (eat only well cooked fish. Fish with mercury should be avoided swordfish, tilefish, king mackerel, shark, mercury levels dont change by cooking. sushi is raw even though salt is bad)

A 12 week client tells the nurse she and her husband eat sushi at least once per week. She states I know fish is good for me, so I make sure we eat it regularly. Which of the following responses by the nurse is appropriate? 1. you are correct fish is healthy for you 2. you can eat fish, but sushi is too salty 3. sushi is raw, raw fish is especially high in mercury 4. It is recommended that fish be cooked to destroy harmful bacteria

1

A mother is experiencing N/V every afternoon. The ingestion of which of the following spices has been shown to be a safe complimentary therapy for this complaint? 1. ginger 2. sage 3. cloves 4. nutmeg

1 (Leg cramps related to weight of growing fetus in conjunction with circ changes in extremities. Regular excercise can help reduce incidence)

A woman states that she freq awakens with painful leg cramps during the night. Which of the following assessments should the nurse make? 1. womans excercise schedule 2. her goodall sign 3. her hegar sign 4. dietary intake

2

A woman who is seen in the prenatal clinic is found to be 8 weeks preg. She confides to the nurse that she is afraid her baby may be permanently damaged because I had at least 5 beers the night I had sex." Which of the following responses by the nurse would be appropriate? 1. I would let the Dr. know if I were you 2. It is unlikely the baby was affected 3. Abortions during the 1st trimester are very safe 4. An ultrasound will tell you if the baby was affected

4 ( weight gain of 0.8 to 1 lb per week is expected during the second and 3rd trimesters only. The weigh gain is normal for the first trimester. A weight gain of 3-5 lbs is expected during the entire first trimester. Since the clients height is not stated there is no way to know if the client is underweight)

A woman whose prenatal weight was 105 lbs, weighs 109 lbs at her 12 week visit. which of the following comments by the nurse is appropriate at this time? select all 1. we expect you to gain about 1 lb per week, so your weight is a little low at this time 2. most women gain no weight during the 1st trimester, so I would suggest you eat fewer desserts 3. you entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need 4. your weight gain is exactlly what we would expect it to be at this time

2 (Vit C sources: strawberries, potatoes, zucchini, blueberries, kiwi, green beans, green peas)

A woman would like suggestions for alternate Vit. C sources because she doesnt like citrus. Which of the following suggestions is appropriate? 1. brown rice and barley 2. strawberries and potatoes 3. buckwheat and lentils 4. wheat flour and figs

2 (Cervix should be long and thick. Cervical mucus should be thin. Vaginal wall should be bluish in color as a result of increased estrogen. Ovary is enlarged because corpus luteum is still functioning to maintain preg. at 6 weeks)

A woman, 6 weeks preg, is having a vaginal exam. Which of the following would the practitioner expect to find? 1. Thin cervical muscle 2. An enlarged ovary 3. Thick cervical mucus 4. Pale pink vaginal wall

3 (Strawberry birth marks are not from strawberries!!)

After nutrition counseling, a woman G3 P1101, proclaims that she certainly cant eat any strawberries during her pregnancy. Which of the following is the likely reason? 1. allergy to strawberries 2. strawberries cause birth defects 3. old wives tales 4. premature baby died because of strawberries

2 ( high levels of estrogen and progesterone result in changes, including hypertrophy and hyperplasia o the breast tissue)

An 18 week client telephones the OB office stating " I am really scared. I think I have breast cancer. My breasts are filled with tumors" The nurse should base the response on which of the following? 1. Breast cancer is often triggered by preg. 2. Nodular breast tissue is normal during preg 3. The woman is exhibiting signs of a psychotic break 4. Anxiety attacks are especially common in the 2nd trimester

3 (The right atrium DOES contain O2 rich AND O2 poor blood. The foramen ovale is a hole between the atria. The ductus venosus lies between the umbilical vein and inferior vena cava, not aorta and pulmonary artery. The umbilical vein carries O2 rich blood)

An ultrasound of a fetus's heart shows that normal fetal circulation is occuring. which of the following statements should the nurse interpret as correct in relation to the fetal circulation? 1. The foramen ovale is a hole between the ventricles 2. The umbilical vein contains O2 poor blood 3. The right atrium contains both O2 rich and O2 poor blood 4. The ductus venosus lies between the aorta and the pulmonary artery

1 (ptyalism excessive saliva; is often accompanied by gingivitis and N/V)

During a prenatal visit a client is complaining of ptyalism. Which of the following nursing interventions is appropriate? 1. encourage the woman to brush her teeth carefully 2. advise the woman to have her BP checked regularly 3. encourage the woman to wear support hose 4. advise the woman to avoid eating rare meat

2

It is discovered that the preg woman practices pica. Which of the following complications is most often associated with this behavior? 1. hypothyroidism 2. iron deficiency anemia 3. hypercalcemia 4. overexposure to zinc

2 (traditional muslims will not tell anyone the baby name until the official naming ceremony, rarely named before 1 week old)

The nurse is interviewing a 38 week Muslim woman. which of the following questions would be inappropriate for the nurse to ask? 1. do you plan to breastfeed? 2. what do you plan to name the baby? 3. Which pediatrician do you plan to use? 4. How do you feel about having a episiotomy?

1,2,3

The nurse is providing anticipatory guidance to a woman in her 2nd trimester regarding S/S that are wnl during the latter half of the pregnancy. Which of the following comments by the client indicates that the teaching was successful? select all that apply 1. during the 3rd tri, I may exp. freq urination 2. during the 3rd tri, I may exp heartburn 3. during the 3rd tri, I may exp nagging backaches 4. during the 3rd tri, I may exp. persistant headaches 5. during the 3rd tri. I may experience blurred vision

4

A client asks the nurse "could you explain how the babys blood and my blood separate at delivery?" Which of the following responses is appropriate for the nurse to make? 1. When the placenta is born, the circulatory systems separate 2. When the doctor clamps the cord, the blood stops mixing 3. The separation happens after the baby takes the first breath. The babys O2 no longer has to come from you 4. The blood actually never mixes. Your blood supply and the babys are completely separate.

2 (kidneys secrete urine about week 12 before quickening detected. amniotic fluid is primarily fetal urine. fingernails begin at week 10. Heart beat begins 1st trimester)

A mother has just experienced quickening. Which of the following developmental changes would the nurse expect to occur at the same time in the womans pregnancy? 1. fetal heart begins to beat 2. lanugo covers the fetal body 3. kidneys secrete urine 4. fingernails begin to form

1

Because N/V are such common complaints during pregnancy, the nurse provides anticipatory guidance to a 6 week gestational client by telling her to do which of the following? 1. avoid greasy foods, 2. drink OJ before rising 3. Consume 1 tsp nutmeg each morning 4. eat 3 lg meals plus a bed time snack

1

When assessing the psychological adjustment of an 8 week gravida, which of the following would the nurse expect to see signs of? 1. ambivalence 2. depression 3. anxiety 4. ecstasy

1

During preconception counseling session the nurse encourages a couple to prepare a birth plan. Which of the following is the most important goal for this action? 1. promote communication between the couple and healthcare professionals 2. enable the couple to learn about they types of pain meds used in labor 3. provide the couple with a list of items they should take to the hospital 4. give the high risk coupld a sense of control over the likelihood of surgical delivery

2 ( at the end of the 3rd trimester thru early postpartum the WBC count rises. This is natural to protect from pathogens druing birth.)

The blood of a preg client was initially assessed at 10 weeks and reassessed at 38 weeks. Which of the following results would the RN expect to see? 1. Rise in Hct from 34-38% 2. Rise in WBC from 5000 to 15000 3. Rise in K from 3.9 to 5.2 4. Rise in Na from 137 to 150

3

The following four changes occur during pregnancy. Which of them usually increases the fathers interest and involvement in the pregnancy? 1. Learning the results of the preg. test 2. attending childbirth ed classes 3. hearing the fetal heartbeat 4. meeting the OB or midwife

4 (difficult to breathe when recumbent. At this visit will measure fundal height, FHR.)

The nurse asks a 31 week client to lie on the exam table during a prenatal exam. In which of the following positions should the client be placed? 1. orthopneic 2. lateral recumbant 3. sims 4. semi fowlers

1 (sex is ok during normal preg)

The nurse asks the woman about her husband and how he is dealing with the preg. The nurse concludes that counseling is needed when the woman makes which of the following statements? 1. My husband is ready for the preg to end so we can have sex again 2. my husband has gained alot of weight during the preg 3. My husband is more worried about finances now than before 4. My husband plays his favorite music for my belly so the baby will learn to like it

3

The nurse discusses intimacy with preg. couple. Which of the following should be included in the teaching plan? 1. vag intercourse should cease by the beginning of the 3rd trimester 2. breast fondling should be discouraged because of the potential for preterm labor 3. the couple may find it necessary to experiment with alternate positions 4. vaginal lubricant should be used sparingly throughout preg.

1,4,5

A father experiencing couvade syndrome is likely to exhibit which of the following symptoms/behaviors? 1. heartburn 2. promiscuity 3. HTN 4. bloating 5. abdominal pain

2 (Tdap recommended)

A gravid client is counseled by her HCP to have a vaccination during her 3rd trimester of preg. The client questions the HCP recommendations. Which of the following statements would be appropriate for the nurse to give the client? 1. When received during pregnancy, the rotavirus vaccine helps to prevent dehydration in newborns 2. If you recieve the tetanus, diptheria, and acellular pertussis vaccine, your baby will be protected against whooping cough 3. When received during pregnancy, the HPV vaccine helps to prevent newborns from aquiring the STI 4. If you receive the varicella vaccine, your baby will be protected from chicken pox

1 (no live virus should be given during preg)

A gravid woman recently immigrated from China is being seen at her first prenatal visit. She was never vaccinated in her home country. An injection to prevent which of the following diseases should be administered to the woman during pregnancy? 1. Influenza 2. Measles 3. Mumps 4. Rubella

2

A chinese immigrant is being seen in the prenatal clinic. When providing nutrition counseling, which of the following factors should the nurse keep in mind? 1. many Chinese eat very little protein 2. many chinese believe pregnant women should eat cold food 3. many chinese are prone to anemia 4. many chinese believe that strawberries can cause birth defects

2 (closest match. cream cheese has no nutrition benefit. salt can lead to HTN, fluid retention. pie crust has no nutritional value)

A woman confides she practices pica. Which of the following alternatives could then nurse suggest? 1. laundry starch with salt 2. ice with frozen juice 3. soap with cream cheese 4. soil with uncooked pie crust

4 (Nausea 1st trimester, dyspnea & urinary freq 3rd)

A multigravid client is 22 weeks preg. Which of the following symptoms would the nurse expect the client to exhibit? 1. Nausea 2. Dyspnea 3. Urinary freq 4. Leg cramping

3 (cultures for group B strep, if positive will give client IV antibiotics during labor to prevent vertical transmission to baby at birth. )

A woman is 36 weeks. Which of the following tests will be done during her prenatal visit? 1. Oral glucose tolerance test 2. amniotic fluid assessment 3. vaginal and rectal cultures 4. karyotype analysis

2

A woman is carrying dizygotic twins. She asks the nurse about the babies, which of the following explanations is accurate? 1. during a period of rapid growth, the fertilized egg divided completely. 2. When the woman ovulated, she expelled two mature ova 3. The babies share one placenta, and common chorion 4. The babies will definitely be the same sex, and have the same blood type

1,2,5

A woman is planning on becoming preg. which of the following actions should she be counseled to take before she stops birth control? select all that apply 1. Take a multivitamin 2. see a Dr 3. drink beer instead of vodka 4. stop all OTC meds 5. stop smoking

3 (Preg 5 times. 1 full term @ 39 weeks. 1 preterm at 28 weeks. 2 abortions. 2 living)

A woman provides the nurse with the following Hx. Delivered a son, now 7 years old, at 28 weeks. Delivered a daughter, now 5 years old, at 39 weeks gestation. Had a miscarriage 3 years ago. and had a first trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this womans gravidity and parity? 1. G4 P2121 2. G4 P1212 3. G5 P1122 4. G5 P2211

1 (PKU is genetic characterized by the absence of the enzyme needed to metabolize phenylalanine, an essential amino acid. Client with PKU consume phenylalanine, a metabolite that affects cognitive centers of the brain is created in the body. If pregnant woman with PKU eats foods high in phenylalanine, her baby would become severely developmentally disabled)

The nurse has taken a health history on four primigravid clients at their first prenatal visits. It is high priority that which of the clients receives nutrition counseling? 1. The woman diagnosed with phenylketonuria 2. The woman with Graves disease 3. The woman with Cushings syndrome 4. The woman diagnosed with myasthenia gavis

2 (2nd trimester starts backaches as uterine body grows)

The nurse plans anticipatory guidance to a 10 week gravid client who is being seen in the prenatal clinic. Which of the following information should be a priority for the nurse to provide? 1. pain management during labor 2. methods to relieve backaches 3. breastfeeding positions 4. characteristics of the newborn

4 (Cystic fibrosis is autosomal recessive genetic disease. )

The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor? 1. My first child has cerebral palsy 2. My first child has HTN 3. My first child has asthma 4. My first child has cystic fibrosis

2,4 (primigravid may not feel movement until 19-20 weeks. Fundal height at 24 weeks should be 4 cm above the umbilicus. At 20 weeks should be at the umbilicus. )

The nurse working on an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the Dr.? Select all that apply 1. 17 weeks, denies feeling fetal movement 2. 24 weeks, fundal height at umbilicus 3. 27 weeks, salivates excessively 4. 34 weeks, experience uterine cramping 5. 37 weeks, complains hemorrhoidal pain

3

When analyzing the need for health teaching of a prenatal multigravida, the nurse should ask which of the following questions? 1. what are the ages of your children 2. what is your marital status? 3. do you ever drink alcohol? 4. do you have any allergies?

1 (hct of 32% normal in preg. At end of 2nd trimester blood volume increases by approx 50%)

Which finding would the nurse view as normal when evaluating the lab reports of a 34 week client? 1. mild anemia 2. thrombocytopenia 3. polycythemia 4. hyperbilirubinemia

1 (BP should not elevate during preg. increased HR normal with high levels progesterone, and progesterone increases temp slightly)

Which of the following VS changes should the nurse highlight for the OB? 1. prepreg BP 100/60 and 3rd trimester BP 140/90 2. prepreg RR 16, 3rd trimester RR 22 3. prepreg HR 76, 3rd trimester HR 88 4. prepreg temp 98.6. thirt trimester temp 99.2

2,4 (pressure on bladder, metabolic demands. Backaches are 2nd trimester, dyspnea 3rd trimester, diarrhea not normal complaint)

A client is in the 10th week of pregnancy. which of the following symptoms would the nurse expect this client to exhibit? Select all 1. backache 2. urinary freq 3. dyspenea on exertion 4. fatigue 5. diarrhea

1,5 (testing at 24 weeks gestation. Fast min 8-16 hrs, smoking alters test)

A preg. clients HCP has ordered a 75 gram oral glucose tolerance test to screen the client for gestational diabetes. The nurse is providing preprocedure counseling to the client. Which of the following must the client do? Select all 1. fast for 8-16 hours prior to test 2. bring a first void specimen to the lab for testing 3. consume a solid sugar cube immed. upon wakening 4. drink 16 ounces of water 1 hr prior to the test 5. smoke no cigs the day of the test

4

A woman asks the nurse about consuming herbal supplements during pregnancy. Which of the following responses is appropriate? 1. herbals are natural substances so they are safely ingested during pregnancy 2. It is safe to take licorice and cats claw but no other herbs are safe 3. A federal commission has established the safety of herbals during preg. 4. The woman should discuss everything she eats with the HCP

2,3,4,5 (umbilical cord gives nutrition. Fluid allows fetus to move freely and grow unencumbered. regulates thermal environment. fetus does swallow the fluid)

A woman asks the nurse about the amniotic fluid function. Which of the following statements indicates the teaching was successful? Select all that apply 1. fluid provides nutrition 2. fluid cushions fetus from injury 3. fluid enables the fetus to grow 4. fluid provides the fetus with stable thermal environment 5. fluid allows the fetus to practice swallowing

1,2,3,5 (alveoli form in 2nd trimester)

A woman has just completed her first trimester. Which of the following fetal structures can the nurse tell the woman are well formed at this time? select all that apply 1. genitals 2. heart 3. fingers 4. alveoli 5. kidneys

1 (morula stage: 2-4 days after fertilization. Implant day 6-8)

The nurse is teaching a couple about fetal development. Which statement by the nurse is correct about the morula stage of development? 1. The fertilized egg has yet to implant in the uterus 2. the lung fields are finally formed 3. The sex of the fetus can be clearly identified 4. The eyelids are unfused and begin to open and close

2

The nurse midwife tells a client that the baby is growing and that ballotment was evident during the vag exam. How should the nurse explain what the nurse midwife means by ballottment? 1. The midwife saw that the mucous plug was intact 2. The midwife felt the baby rebound after being pushed 3. The midwife palpated the fetal parts thru the uterine wall 4. The midwife assessed that the baby is head down

2

Which of the following exercises should be taught to pregnant woman who complains of backaches? 1. kegeling 2. pelvic tilt 3. leg lifting 4. crunches

3 (ask open ended question, do not assume)

A 20 year old client states that the at home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time? 1. congrats, you and your family must be so happy 2. have you told the babies father yet? 3. How do you feel about the results? 4. Please tell me when your LMP was

2

A 26 week calls the triage nurse stating " I am really scared. I tried not to but I had an orgasm. I just know I will go into preterm labor". Which of the following responses by the nurse is appropriate? 1. Lie down, drink a quart of water, if you feel any back pressure call me right away. 2. Although oxytocin was responsible for your orgasm it is very unlikely that it will stimulate preterm labor. 3. I will inform the Dr. for you. What I want is for you to come to the hospital right now 4. The best thing for you to do right now is to take a warm shower and do a kick count.

2 (to determine if ideals mesh with OB)

A couple is preparing to interview a OB to determine who they will go to for care during preg. and delivery. To make the best choice, which of the following actions should the couple perform first? 1. take a tour of the hospital delivery area 2. develop a preliminary birth plan 3. make appts with 3 or 4 OB's 4. Search the internet for malpractice histories of the provider

1,2,3,4 (Uterine growth is a probable sign of preg.)

An antenatal client is informing the nurse of her prenatal signs and symptoms. Which of the following findings would the nurse determine are presumptive signs of pregnancy? select all that apply 1. amenorrhea 2, breast tenderness 3 quickening 4 freq. urination 5. uterine growth

1,2,4 (BMI 17= underweight, women with BMI under 18.5 at start of preg. need to gain more. (Normal weight gain for preg 25-35) for underweight up to 40 lbs. Rubella titer of 1:8 or less indicates not immune. Hct below normal risk increase of anemia)

Which of the following findings in a 8 week gestational client, G2, P1001, should the nurse highlight for the nurse midwife? select all that apply 1. Body mass index 17 2. Rubella titer 1:8 3. BP of 100/60 4. Hct 30% 5. Hgb 13.2

2 (should gain 0.8 to 1 lb per week during 2nd and 3rd trimester)

A client who was seen in the prenatal clinic at 20 weeks weighed 128 lbs at that time. Approx. how many pounds would the nurse expect the client to weigh at her next visit at 24 weeks gestation? 1. 129-130 2. 131-132 3. 133-134 4. 135-136

2 (Quickening occurs between 16-20 weeks.)

A 16 year old G1 P0000, is being seen at her 10 week gestation visit. She tells the nurse that she felt the baby move that morning. Which of the following responses by the nurse is appropriate? 1. That is very exciting, the baby must be very healthy 2. Would you please describe what you felt for me? 3. That is impossible, the baby is not big enough yet. 4. Would you please let me see if I can feel the baby?

3 (estrogen increases vasocongestion of the mucous membranes of the body. Increased vascular perfusion is essential for fetus. Can lead to gingival and nose bleeds)

A 34 week client calls the OB office stating "since last night I have had 3 nosebleeds. " Which of the following responses by the nurse is appropriate. 1. You should see the Dr. to make sure your not becoming severely anemic 2. Do you have a temp? 3. One of the hormones of pregnancy makes the nasal passages prone to bleeds 4. Do you use inhaled drugs?

2 (fundal height at xiphoid process, diaphragm elevated, lungs displaced)

A 36 week client is complaining of dyspnea when lying flat. Which of the following is likely the clinical reason for this complaint? 1. maternal HTN 2. fundal height 3. hydramnios 4. CHF

2 (the uterus compresses the vessels inducing hypotension=increase dizziness)

A 36 week client lies flat on her back. Which of the following maternal S/S would the nurse expect to observe? 1. HTN 2, dizziness 3. rales 4. chloasma

4

A 37 week gravid client states that she noticed a white liquid leaking from her breasts during a recent shower. Which of the following nursing responses is appropriate at this time? 1. advise the woman she may have galactocele 2. encourage the woman to pump her breast to stimulate milk 3. assess the liquid because discharge is diagnostic of mammary infection 4. reassure the mother that this is normal in the 3rd trimester

2,3,4 (urine glucose each visit, not blood. ultrasounds only as needed)

A 3rd tri client is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the visit? select all that apply 1. blood glucose 2. BP 3. FHR 4. Urine protein 5. Pelvic ultrasound

3 (HPL is insulin antagonist)

A 75 gram glucose test is ordered after 24 weeks for a preg client to assess her physiological response to which of the following preg. hormones? 1. estrogen 2. progesterone 3. human placental lactogen 4. HCG

1,5 (glucose assess at end of 2nd trimester, biophysical 3rd trimester)

A G1 P0000, is having her first prenatal physical exam. Which of the following assessments should the nurse inform the client that she will have that day? Select all 1. Pap smear 2. Mammogram 3. Glucose tolerance test 4. Biophysical profile 5. CBC

2 (serum tests are more sensitive)

A client eners the prenatal clinic. She states that she missed her period yesterday and used a home preg. test this morning. She states that the results were negative, but "I still think I am pregnant". Which of the following statements would be appropriate for the nurse to make at this time? 1. your period is probably just irregular 2. we could do a blood test to check 3. home pregnancy test are very accurate 4. you should repeat the test in one week

1 (produced by fertilized egg to keep corpus luteum alive until placenta takes over producing progesterone and estrogen the corpus luteum produces the hormones that are essential to the maintenance of the preg)

A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability the client is preg? 1. Chorionic gonadotropin 2. Oxytocin 3. Prolactin 4. Luteneinizing hormone

2 (labor contractions often begin in the back. difference is labor contractions are intermittent and rhythmic. )

A client in her 3rd trimester is concerned that she will not know the difference between labor contractions and normal aches and pains of preg. How should the nurse respond? 1. Dont worry you will know the difference when contractions start 2. The contractions may feel just like a backache but they will come and go 3. contractions are alot worse than your preg. aches and pains 4. I understand. you dont want to come to the hospital before you are in labor

3

A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers, Which of the following is the nurses best response? 1. Because the organ systems in the baby are developing right now you may take no medication 2. you can take any of the OTC meds because they are all safe in pregnancy 3. The Dr. will prescribe a med for you that has been shown not to cause fetal injury 4. The Dr. will prescribe a rectal suppository because the med will not enter your blood stream

4 (@20 weeks fundus at umbilicus, 36 weeks @ xiphoid. @ 24 weeks = 24 cm above pubis or 4 cm above umbilicus. Height will go up 1 cm each week past 20 weeks)

A client is 35 weeks. Which of the following findings would the nurse expect to see? 1. N/V 2. Maternal ambivalence 3. Fundal height 10 cm above umbilicus 4. Use of 3 pillows for sleep comfort

4

A client is having an ultrasound done at her prenatal appt. at 8 weeks gestation. She asks the nurse can you tell me what sex my baby is yet? Which of the following is appropriate for the nurse to say at this time? 1. The tech did not tell me the sex, but I will have to let the doctor tell you what it is 2. The organs are completely formed and present, but the baby is too small for them to be seen 3. The tech says that the baby has a penis, looks like your having a boy 4. I am sorry, it will not be possible to see which sex the baby is for another month or so.

3 (acknowledge client concerns, accept client, acceptance proceeds problem solving)

A client makes the following statement after finding out that her pregnancy test is positive. "This is not a good time, I am in college and the baby will be due during finals!" Which of the following responses by the nurse would be most appropriate at this time? 1. Im absolutely positive that everything will turn out alright 2. I suggest that you email your professors to set up an alternate plan 3. It sounds like your feeling a litter overwhelmed right now 4. You and the babys father will find a way to get thru the pregnancy

1 ( lead based paint! And NOT hot water.. lead leaches into hot water. only cold, let the water run thru pipes min. 2 minutes)

A gravid woman and her husband inform the nurse that they have just moved into a three story home that was built in the 1930's. Which of the following is critical for the nurse to advise the woman to protect the unborn child? 1. stay out of any rooms being renovated 2. drink water only from the hot water tap 3. refrain from entering the basement 4. climb the stairs only once per day

1 (surfactant is usually forming in the fetal lungs by the 36 week. Eyes open and close at 28 weeks. Fetal resp. movement at 24 weeks. Spinal column formed well before end of 1st trimester)

A gravidas fundal height is noted to be at the xiphoid process. The nurse is aware that which of the following fetal changes is likely to be occurring at the same time in the pregnancy? 1, Surfactant is formed in the fetal lungs 2. Eyes begin to open and close 3. Respiratory movements begin 4. Spinal column is completely formed

3 (primrose converts to prostaglandin which readies cervix for dilation)

A midwife has advised a 40 week gravid to take evening primrose oil 2500 mg daily as a complementary therapy. This suggestion was made because evening primrose has been shown to perform which of the following actions? 1. relieve backstrain 2. improve development of colostrum 3. ripen the cervix 4. reduce hemorrhoids

4 (best sources folic acid are dark green leafy veges, oranges and OJ are good too)

A nurse identified the following nursing dx for a prenatal client; Altered nutrition; less than body requirements related to poor folic acid intake. Which of the following foods should the nurse suggest the client consume? 1. potatoes and grapes 2, cranberries and squash 3. apples and corn 4. oranges and spinach

1

A nurse is discussing diet with a preg. woman. Which of the following should the nurse advise the client to avoid consuming during preg? 1. bologna 2. cantaloupe 3. asparagus 4. popcorn

2,3

A nurse is providing health ed to a group of women who are planning to become pregnant. Which of the following actions should the nurse advise the women to take throughout their pregnancy? select all 1. avoid consuming well done meat 2. avoid traveling to locations where zika is 3. engage in daily excercise 4. consume 1 serving of seafood a day 5. drink beer and wine instead of spirits like whiskey and vodka

1,2,3,5 (increase fiber for hemorrhoids to soften stools)

A nurse is working in the prenatal clinic. Which of the following findings seen in a 3rd trimester preg. woman would the nurse consider to be wnl? select all that apply 1. leg cramps 2. varicose veins 3. hemorrhoids 4. fainting spells 5. lordosis

3

A preg woman informs her nurse that her LMP was on sept 20, 2015. Using Nageles rule, the nurse calculates the clients estimated due date as: 1. may 30, 2016 2. June 20, 2016 3. June 27, 2016 4. July 3, 2016

2,5 (Hct would be lower, glucose wnl, bilirubin wnl)

The nurse is assessing the lab report of a 40 week gestation client. which of the following values would the nurse expect to find elevated above prepregnancy levels? select all that apply 1. glucose 2 fibrogen 3. hematocrit 4. bilirubin 5. WBC's

1

The nurse is assisting the couple to develop decisions for their birth plan. Which of the following decisions should be considered nonnegotiable by the parents? 1. if the father is present during the delivery 2. if the woman will have an episiotomy 3. if the woman will be able to have epidural 4. if the father will be able to take pictures of the delivery

1

The nurse is caring for a client who is a vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods? 1. Tofu, legumes, broccoli 2 corn, yams, green beans 3, potatoes, parsnips, turnips 4. cheese, yogurt, fish

2 (hamburger has the most iron)

The nurse is caring for a client who states she is prone to anemia. Which of the following foods should the nurse advise as the best source of iron? 1. raisins 2. hamburger 3. broccoli 4. Molasses

1 (positive signs are irrefutable showing fetus in utero. Ultrasound, FHR, HCP palpates fetus)

The nurse notes each of the following findings in a 10 week gestation client. Which of the following findings would enable the nurse to tell the client that she is positively pregnant? 1. Fetal heart rate via doppler 2. positive preg. test 3. positive chadwick sign 4. montgomery gland enlargement

3 (sign of hemohrragic condition)

Which of the following skin changes should the nurse highlight for the preg womans HCP? 1. linea nigra 2. melasma 3. petechiae 4. spider nevi

1

Why is it important that women of childbearing age be counseled to plan their pregnancy? 1. Much of the organs development occurs before the missed menstrual period 2. Insurance companies must preapprove many prenatal expenses 3. It is recommended that women be preg. no more than 3 times during their lifetime 4. The CV system is stressed when preg are less than 2 years apart