7. Antepartum Physiology

2nd and 3rd trimester discomforts (5)

-ankle edema -varicose veins -backache -leg cramps -dyspnea (SOB)

A 25-year-old client at 18 weeks' gestation has returned to the clinic for her second prenatal visit. Her initial pulse was 60. The nurse can expect her pulse to be ______ bpm at term.

70-75 bpm (pulse may increase by 10-15 bpm at term) text

A prenatal client at 10 weeks' gestation is complaining of leakage of urine. Which self-care strategy should the nurse teach? a. Decrease the amount of fluid intake. b. Empty bladder every 4 hours. c. Empty bladder every hour. d. Wear panty liners during the day.

d. Wear panty liners during the day. text

The nurse has instructed a pregnant client in measures to prevent varicose veins during pregnancy. Which statement by the client indicates a need for further instructions? 1. "I should wear panty hose." 2. "I should wear support hose." 3. "I should wear flat nonslip shoes that have good support." 4. "I should wear knee-high hose, but I should not leave them on longer than 8 hours."

4. "I should wear knee-high hose, but I should not leave them on longer than 8 hours." (knee-high hose impedes venous return from lower legs - pt should be encouraged to wear support hose or panty hose) NCLEX

A nurse is planning care for a client who is at 35 weeks of gestation. Which of the following laboratory tests should the nurse obtain? a. rubella titer b. blood type c. group B streptococcus B-hemolytic d. 1-hr glucose tolerance test

c. group B streptococcus B-hemolytic (group B streptococcus culture done at 35-37 weeks) ATI

frequency of prenatal heath care visits

-1-32 weeks: every 4 weeks -32-36 weeks: every 2 weeks -36-40 weeks: every week

routine labs (8)

-CBC -ABO and Rh typing -urine culture -HIV -rubella titer -hepatitis B -STDs (syphilis, chlamydia, gonorrhea) -GBS (35-37 weeks)

pt teaching: constipation (3)

-drink lots of fluids -high-fiber diet -exercise reguarly

fundal height

-during 2nd and 3rd trimesters (18-30 weeks) fundal height in cm = age in weeks +/- 2 cm -16 weeks: fundus halfway between symphysis pubis and umbilicus -20-22 weeks: umbilicus -36 weeks: xiphoid process

danger signs during pregnancy (6)

-dysuria (UTI) -diarrhea (infection) -fever or chills (infection) -abdominal cramping (miscarriage) -vaginal bleeding -decreased fetal movement (distress)

pt teaching: nausea, vomiting, morning sickness (4)

-eat crackers before getting out of bed in the morning -avoid having an empty stomach -avoid spicy, greasy, gas-forming foods -drink fluids between meals (instead of with)

pt teaching: heartburn (3)

-eat small, frequent meals -sit up for 30 min after meals -antacids

pt teaching: urinary frequency (4)

-empty bladder frequently -decrease fluid intake before bedtime -use perineal pads -Kegel exercises (to reduce stress incontinence)

The nurse is describing cardiovascular system changes that occur during pregnancy to a client and understands that which finding would be normal for a client in the second trimester? (Select all that apply) 1. Increase in pulse rate 2. Increase in blood pressure 3. Frequent bowel elimination 4. Decrease in red blood cell production 5. Decrease in white blood cell production

1. Increase in pulse rate 4. Decrease in red blood cell production (during the 2nd trimester, systolic and diastolic pressures decrease by about 5-10 mm Hg until 24-32 weeks. NCLEX

The prenatal client asks the nurse about substances that can cross the placental barrier and potentially affect the fetus. The nurse most appropriately explains that which substances can cross this barrier? (Select all that apply) 1. Viruses 2. Bacteria 3. Nutrients 4. Medications 5. Antibodies

1. Viruses 3. Nutrients 4. Medications 5. Antibodies NCLEX

A nurse is assessing a prenatal client at 26 weeks' gestation. The nurse anticipates measuring the fundal height at ______ cm.

26 cm (1 cm/week between 20-36 weeks) text

A woman being evaluated in the emergency department tells the nurse she might be pregnant. The nurse obtains a Doppler and is able to hear a fetal heart beat at a rate of about 140 per minute. The nurse knows the fetus's gestational age is: a. At least 12 weeks. b. At least 16 weeks. c. 4 weeks. d. 6 weeks.

a. At least 12 weeks. text

The nursing student is preparing to teach a prenatal class about fetal circulation. Which statement should be included in the teaching plan? (Select all that apply) 1. "The ductus arteriosus allows blood to bypass the fetal lungs." 2. "One vein carries oxygenated blood from the placenta to the fetus." 3. "The normal fetal heart tone range is 140 to 160 beats per minute in early pregnancy." 4. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta." 5. "Two veins carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta."

1. "The ductus arteriosus allows blood to bypass the fetal lungs." 2. "One vein carries oxygenated blood from the placenta to the fetus." 4. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta." NCLEX

A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement made by the client indicates a need for further instruction? 1. "I will watch for the evidence of the passage of tissue." 2. "I will maintain strict bed rest throughout the remainder of the pregnancy." 3. "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." 4. "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding."

2. "I will maintain strict bed rest throughout the remainder of the pregnancy." NCLEX

The nurse is collecting data from a client during the first prenatal visit. The client is anxious to know the sex of the fetus and asks the nurse when she will be able to know. The nurse should respond to the client knowing that the sex of the fetus is determined by which weeks? 1. 6 to 8 2. 8 to 10 3. 12 to 16 4. 20 to 22

3. 12 to 16 NCLEX

A nurse is collecting data from a client who is at 32 weeks gestation. The nurse measures the fundal height in centimeters and expects the findings to be how many centimeters (cm)? 1. 22 cm 2. 28 cm 3. 32 cm 4. 40 cm

3. 32 cm (during 2nd and 3rd trimesters the fundal height in cm = fetus' age +/- 2 cm) NCLEX

The nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse notes that the fundal height is 30 cm. How should the nurse interpret this finding? 1. the client is measuring large for gestational age 2. the client is measuring small for gestational age 3. the client is measuring normal for gestational age 4. more evidence is needed to determine size for gestational age

3. the client is measuring normal for gestational age (during 2nd and 3rd trimesters the fundal height in cm = fetus' age +/- 2 cm) NCLEX

A 39-week-gestation pregnant client calls the maternity unit stating, "My baby has not moved very much in the past few days. Should I be concerned?" Which would be the best response made by the nurse? 1. "Six to eight fetal movements in a 24-hour period are adequate to determine that the fetus is healthy." 2. "Fetal movement is a sign of fetal health. Even if the amount has decreased, the fetus is still healthy." 3. "Continue to count fetal movements for the next 24 hours and call your health care provider if the number of movements continues to decrease." 4. "Fetal movements do not decrease as a woman nears term; therefore you should be seen by your health care provider for further evaluation."

4. "Fetal movements do not decrease as a woman nears term; therefore you should be seen by your health care provider for further evaluation." NCLEX

A primigravida asks the nurse in the clinic when she will be able to begin to feel the fetus move. The nurse responds by telling the mother that fetal movements will be noted between which weeks of gestation? 1. 8 and 10 2. 10 and 12 3. 14 and 16 4. 18 and 20

4. 18 and 20 NCLEX

The nurse is performing a measurement of fundal height in a client whose pregnancy has reached 36 weeks of gestation. During the measurement the client begins to feel lightheaded. On the basis of knowledge of the physiological changes of pregnancy, the nurse understands that which is the cause of the lightheadedness? 1. A full bladder 2. Emotional instability 3. Insufficient iron intake 4. Compression of the vena cava

4. Compression of the vena cava NCLEX

The nurse is performing an assessment on a pregnant client at 16 weeks of gestation. On assessment, the nurse expects the fundus of the uterus to be located at which area? 1. At the umbilicus 2. Just above the symphysis pubis 3. At the level of the xiphoid process 4. Midway between the symphysis pubis and the umbilicus

4. Midway between the symphysis pubis and the umbilicus

A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following responses should the nurse make? A. "This is due to an increase in blood volume." B. "This is due to pressure from the uterus on the diaphragm." C. "This is due to the weight of the uterus on the vena cava." D. "This is due to increased cardiac output."

C. "This is due to the weight of the uterus on the vena cava." ATI

A nurse is assessing a prenatal client's cardiovascular function. When should the nurse expect this client's cardiac output (CO) to begin rising? a. Eight to ten weeks b. Twelve to eighteen weeks c. Twenty to twenty-four weeks d. Thirty-four to thirty-eight weeks

a. Eight to ten weeks text

flashcards

https://www.freezingblue.com/flashcards/print_preview.cgi?cardsetID=256736

should pt be experiencing breast tenderness during 2nd trimester?

yes

The nurse is performing a physical assessment on a client during her first prenatal visit to the clinic. The nurse takes the client's temperature and notes that the temperature is 99.2° F. Based on this finding, which nursing action is most appropriate? 1. Document the temperature. 2. Notify the health care provider. 3. Retake the temperature by the rectal route. 4. Inform the client that the temperature is elevated and antibiotics may be required.

1. Document the temperature. (normal temperature during pregnancy is 36.2°C-37.6°C / 98°F-99.6°F) NCLEX

A pregnant client calls the nurse at the health care provider's office and reports that she has noticed a thin, colorless vaginal drainage. Which information is most appropriate for the nurse to provide to the client? 1. Come to the clinic immediately. 2. The vaginal discharge may be bothersome but is a normal occurrence. 3. Report to the emergency department at the maternity center immediately. 4. Use tampons if the discharge is bothersome but be sure to change the tampons every 2 hours.

2. The vaginal discharge may be bothersome but is a normal occurrence. NCLEX

A pregnant primigravida is seen in the health care clinic and asks the nurse what causes the breasts to change in size and appearance during pregnancy. The nurse plans to base the response on which facts? (Select all that apply) 1. The breasts become stretched because of the weight gain. 2. The increased metabolic rate causes the breasts to become larger. 3. The breast changes occur because of the secretion of estrogen and progesterone. 4. Cortisol secreted by the adrenal glands plays a role in increasing the size and appearance of the breasts. 5. Blood vessels beneath the skin often appear as a blue, intertwining network, especially in a primigravida.

3. The breast changes occur because of the secretion of estrogen and progesterone. 5. Blood vessels beneath the skin often appear as a blue, intertwining network, especially in a primigravida. NCLEX

A pregnant client tells the nurse that she frequently has a backache, and the nurse provides instructions regarding measures that will assist in relieving the backache. Which statement by the client indicates a need for further instruction? 1. "I should wear flat-heeled shoes." 2. "I should sleep on a firm mattress." 3. "I should try to maintain good posture." 4. "I should do more exercises to strengthen my back muscles."

4. "I should do more exercises to strengthen my back muscles." (performing more exercises to strengthen the back muscles could be harmful to a pregnant pt) NCLEX

A nulliparous woman asks the nurse when she will begin to feel fetal movements. The nurse responds by telling the woman that the first recognition of fetal movement will occur at approximately how many weeks of gestation? 1. 5 weeks 2. 9 weeks 3. 13 weeks 4. 18 weeks

4. 18 weeks NCLEX

A prenatal client at 29 weeks' gestation is assessed in the prenatal clinic. All assessment data are within normal limits. When should the nurse schedule the client's next appointment? a. In 1 week b. In 2 weeks c. In 3 weeks d. In 4 weeks

b. In 2 weeks Weekly appointments are recommended after 36 weeks. Every 4th week is the recommended interval for the first 28 weeks.) text

pt teaching: backache (3)

-pelvic tilt exercises (alternately arching and straightening the back) -use the side-lying position -use proper body mechanics (lift using legs, not back)

pt teaching: hemorrhoids (2)

-warm sitz bath -cold compress

A nurse is teaching a group of prenatal clients about the importance of exercise during pregnancy. Which client would be the best candidate to continue with her exercise regime? a. A client with a cerclage and a history of several second-trimester losses b. A client with a diagnosis of preeclampsia c. A client with diagnosis of diabetes d. A client with placenta previa

c. A client with diagnosis of diabetes (exercise helps control glucose) text

The prenatal clinic nurse asks a coassigned nursing student to identify the physiological adaptations of the cardiovascular system that occur during pregnancy. The nurse determines that the student understands these physiological changes if he or she makes which statement? 1. "An increase in pulse rate occurs." 2. "A decrease in blood volume occurs." 3. "A decrease in cardiac output occurs." 4. "The systolic and diastolic blood pressures increase by 20 mm Hg."

1. "An increase in pulse rate occurs." NCLEX

A pregnant client asks the nurse about the type of exercises that are allowable during pregnancy. Which exercise should the nurse instruct the client to engage in? 1. Swimming 2. Water skiing 3. Downhill skiing 4. Aerobic exercising

1. Swimming NCLEX

The nurse is preparing an antenatal client for an initial assessment. What is the first task that the nurse should perform? a. Provide the client with a gown. b. Instruct the client to provide a clean urine specimen. c. Prepare the client for a pelvic exam. d. Draw blood for routine tests.

b. Instruct the client to provide a clean urine specimen. text

A nurse is teaching a prenatal client about cardiovascular changes during pregnancy. The client asks the nurse why she becomes dizzy when getting up after lying on her back. What is the best explanation? a. Decreased production of estrogen and progesterone b. Increased production of fibrinogen and plasma c. Decreased absorption of hemoglobin in the blood d. Hypotension resulting from compression of the vena cava

d. Hypotension resulting from compression of the vena cava text

blood pressure

-decreases slightly, reaching lowest point during 2nd trimester -gradually increases to prepregnant levels by end of 3rd trimester (text p. 157)

pt teaching: leg cramps (3)

-extend leg, keep knee straight, dorsiflex foot (toes toward head) -heat application -foot massage

pregnancy discomforts: GI (4)

-nausea/vomiting (1st trimester) -heartburn (2nd and 3rd trimesters) -constipation (2nd and 3rd trimesters) -hemorrhoids (2nd and 3rd trimesters)

1st trimester discomforts (5)

-urinary frequency -fatigue -breast tenderness -leukorrhea (↑ vaginal discharge) -nasal stuffiness

The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid. The student responds correctly by explaining which as characteristics of amniotic fluid? (Select all that apply) 1. Allows for fetal movement 2. Surrounds, cushions, and protects the fetus 3. Maintains the body temperature of the fetus 4. Can be used to measure fetal kidney function 5. Prevents large particles such as bacteria from passing to the fetus 6. Provides an exchange of nutrients and waste products between the mother and the fetus

1. Allows for fetal movement 2. Surrounds, cushions, and protects the fetus 3. Maintains the body temperature of the fetus 4. Can be used to measure fetal kidney function NCLEX

A woman in the third trimester of pregnancy visits the clinic for a scheduled prenatal appointment. The woman tells the nurse that she frequently has leg cramps, primarily when she is reclining. Once thrombophlebitis has been ruled out, the nurse should tell the woman to implement which measure to alleviate the leg cramps? 1. Apply heat to the affected area. 2. Take acetaminophen every 4 hours. 3. Self-administer calcium carbonate tablets three times daily. 4. Purchase a chewable antacid that contains calcium and take a tablet with each meal.

1. Apply heat to the affected area. NCLEX

The client is being seen at 24 weeks' gestation at the prenatal clinic. At her last routine visit, the fundus was located at the umbilicus. Today, the fundus is measured and found to be 23 cm. How should the nurse interpret this finding? 1. Fundus is at the appropriate level. 2. Fundus is larger than expected height. 3. Fundus is smaller than expected height. 4. Growth pattern indicates intrauterine growth restriction (IUGR).

1. Fundus is at the appropriate level. (during 2nd and 3rd trimesters the fundal height in cm = fetus' age +/- 2 cm) NCLEX

The nurse is describing cardiovascular system changes that occur during pregnancy to a client. Which findings are normal for a client in the second trimester? (Select all that apply) 1. Increase in pulse rate 2. Increase in blood pressure 3. Frequent bowel elimination 4. Increase in red blood cell production 5. Decrease in white blood cell production

1. Increase in pulse rate 4. Increase in red blood cell production NCLEX

The nurse assists a pregnant client with cardiac disease to identify resources to help her care for her 18-month-old child during the last trimester of pregnancy. The nurse encourages the pregnant client to use these resources primarily for which reason? 1. Reduce excessive maternal stress and fatigue. 2. Help the mother prepare for labor and delivery. 3. Avoid exposure to potential pathogens and resulting infections. 4. Prepare the 18-month-old child for maternal separation during hospitalization.

1. Reduce excessive maternal stress and fatigue. NCLEX

A pregnant client asks the nurse about the types of exercises that are allowable during pregnancy. The nurse should tell that client that which exercise is safest? 1. Swimming 2. Scuba diving 3. Low-impact gymnastics 4. Bicycling with the legs in the air

1. Swimming NCLEX

A pregnant client tells the clinic nurse that she wants to know the sex of her baby as soon as it can be determined. The nurse informs the client that she should be able to find out the sex at 12 weeks' gestation because of which factor? 1. The appearance of the fetal external genitalia 2. The beginning of differentiation in the fetal groin 3. The fetal testes are descended into the scrotal sac 4. The internal differences in males and females become apparent

1. The appearance of the fetal external genitalia NCLEX

A pregnant client calls a clinic and tells the nurse that she is experiencing leg cramps that awaken her at night. What should the nurse tell the client to provide relief from the leg cramps? 1. "Bend your foot toward your body while flexing the knee when the cramps occur." 2. "Bend your foot toward your body while extending the knee when the cramps occur." 3. "Point your foot away from your body while flexing the knee when the cramps occur." 4. "Point your foot away from your body while extending the knee when the cramps occur."

2. "Bend your foot toward your body while extending the knee when the cramps occur." NCLEX

A nurse is collecting data on clients who are in their first trimester of pregnancy. The nurse is concerned with identifying clients who may be at risk for the development of postpartum complications. Which client would be least likely at risk for the development of thrombophlebitis in the postpartum period? 1. A 35-year-old client who reports that she smokes 2. A 26-year-old client with a family history of thrombophlebitis 3. A 37-year-old client in her fourth pregnancy who is overweight 4. A 22-year-old client in her first pregnancy who states that oral contraceptives taken in the past have caused thrombophlebitis

2. A 26-year-old client with a family history of thrombophlebitis NCLEX

A pregnant client is seen in the health care clinic. During the prenatal visit, the client informs the nurse that she is experiencing pain in her calf when she walks. Which is the most appropriate nursing action? 1. Instruct the client to avoid walking. 2. Assess for signs of venous thrombosis. 3. Instruct to elevate the legs throughout the day. 4. Tell the client that this is normal during pregnancy.

2. Assess for signs of venous thrombosis. NCLEX

A pregnant client calls the clinic and tells the nurse that she is experiencing leg cramps and is awakened by the cramps at night. Which activity should the nurse tell the client to perform when the cramps occur? 1. Dorsiflex the foot while flexing the knee 2. Dorsiflex the foot while extending the knee 3. Plantar flex the foot while flexing the knee 4. Plantar flex the foot while extending the knee

2. Dorsiflex the foot while extending the knee NCLEX

The nurse is developing a plan of care for a pregnant client who is complaining of intermittent episodes of constipation. To help alleviate this problem, the nurse should instruct the client to take which measure? 1. Consume a low-fiber diet. 2. Drink 8 glasses of water per day. 3. Use a Fleet enema when the episodes occur. 4. Take a mild stool softener daily in the evening.

2. Drink 8 glasses of water per day. NCLEX

A pregnant client who is at 30 weeks' gestation comes to the clinic for a routine visit, and the nurse performs an assessment on her. Which observations made by the nurse during the assessment indicates a need for further teaching? (Select all that apply) 1. The client is wearing sneakers. 2. The client is wearing knee-high hose. 3. The client is wearing flat shoes with rubber soles. 4. The client is wearing pants with an elastic waistband. 5. The client is wearing sweatpants with snug elastic ankle bands.

2. The client is wearing knee-high hose. 5. The client is wearing sweatpants with snug elastic ankle bands. (varicose veins) NCLEX

The nurse is providing instructions about treatment for hemorrhoids to a client in the second trimester of pregnancy. Which statement made by the client indicates a need for further teaching? 1. "Cool sitz baths will help in relieving the discomfort." 2. "I should perform Kegel exercises as you have instructed." 3. "I should apply heat packs to the hemorrhoids to help them shrink." 4. "I can apply ice packs to the hemorrhoids to assist in relieving discomfort."

3. "I should apply heat packs to the hemorrhoids to help them shrink." NCLEX

The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. Which statement by the student indicates an understanding of the ductus venosus? 1. "It connects the pulmonary artery to the aorta." 2. "It is an opening between the right and left atria." 3. "It connects the umbilical vein to the inferior vena cava." 4. "It connects the umbilical artery to the inferior vena cava."

3. "It connects the umbilical vein to the inferior vena cava." NCLEX

A nurse is collecting data on a pregnant client in the first trimester of pregnancy diagnosed with iron deficiency anemia. The nurse should monitor the client to detect which sign/symptom indicating that this problem has not yet resolved? 1. Pink mucous membranes 2. Increased vaginal secretions 3. Complaints of daily headaches and fatigue 4. Complaints of increased frequency of voiding

3. Complaints of daily headaches and fatigue NCLEX

During a woman's 20-week prenatal visit, the nurse is measuring fundal height. The nurse locates the fundus at the level of the umbilicus. What should be the nurse's next intervention? 1. Notify the health care provider (HCP). 2. Plan to refer the client for ultrasound testing. 3. Document findings in the electronic health record. 4. Schedule the client for a return appointment in 1 week for reassessment.

3. Document findings in the electronic health record. (At 20 weeks' gestation, the fundus can be palpated at the umbilicus - normal) NCLEX

A pregnant client tells the nurse that she has been craving "unusual foods." The nurse gathers additional assessment data and discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Laboratory studies are performed and the nurse determines that which finding indicates a physiological consequence of the client's practice? 1. Hematocrit 38% 2. Glucose 86 mg/dL 3. Hemoglobin 9.1 g/dL 4. White blood cell count 12,400 cells/mm3

3. Hemoglobin 9.1 g/dL (pica practices often lead to iron deficiency anemia, resulting in decreased Hgb) NCLEX

Which purposes of placental functioning should the nurse include in a prenatal class? (Select all that apply) 1. It cushions and protects the baby. 2. It maintains the temperature of the baby. 3. It is the way the baby gets food and oxygen. 4. It prevents all antibodies and viruses from passing to the baby. 5. It provides an exchange of nutrients and waste products between the mother and developing fetus.

3. It is the way the baby gets food and oxygen. 5. It provides an exchange of nutrients and waste products between the mother and developing fetus. NCLEX

The nurse is providing instructions regarding treatment of hemorrhoids to a client who is in the second trimester of pregnancy. Which statement by the client indicates a need for further instruction? 1. "I should avoid straining during bowel movements." 2. "I can gently replace the hemorrhoids into the rectum." 3. "I can apply ice packs to the hemorrhoids to reduce the swelling." 4. "I should apply heat packs to the hemorrhoids to help the hemorrhoids shrink."

4. "I should apply heat packs to the hemorrhoids to help the hemorrhoids shrink." (heat packs increase the blood flow to the area and worsen the discomfort from hemorrhoids) NCLEX

The clinic nurse is providing instructions to a pregnant client regarding measures that assist in alleviating heartburn. Which statement by the client indicates an understanding of the instructions? 1. "I should avoid between-meal snacks." 2. "I should lie down for an hour after eating." 3. "I should use spices for cooking rather than using salt." 4. "I should avoid eating foods that produce gas and fatty foods."

4. "I should avoid eating foods that produce gas and fatty foods." NCLEX

A clinic nurse is instructing a pregnant client regarding dietary measures to promote a healthy pregnancy. The nurse tells the client about the importance of an adequate daily fluid intake. Which client statement best indicates an understanding of the daily fluid requirement? 1. "I should drink 12 glasses of fruit juices and milk every day." 2. "I should drink 8 to 10 glasses of fluid a day, and I can drink as many diet soft drinks as I want." 3. "I should drink 12 glasses of fluid a day, and I can include the coffee or tea that I drink in the count." 4. "I should drink at least 8 to 10 glasses of fluid each day, of which at least 6 glasses should be water."

4. "I should drink at least 8 to 10 glasses of fluid each day, of which at least 6 glasses should be water." NCLEX

The nurse is teaching a woman in her first trimester measures to alleviate nausea and vomiting. Which statement by the woman would indicate that further teaching is required? 1. "I will avoid fried foods." 2. "I will eat five or six small meals a day." 3. "I will contact the clinic if the vomiting does not subside." 4. "I will eat dry crackers for breakfast after I get up."

4. "I will eat dry crackers for breakfast after I get up." (eat crackers before getting out of bed) NCLEX

A nursing student is preparing to instruct a pregnant client in performing Kegel exercises. The nursing instructor asks the student the purpose of Kegel exercises. Which response made by the student indicates an understanding of the purpose? (Select all that apply) 1. "The exercises will help reduce backaches." 2. "The exercises will help prevent ankle edema." 3. "The exercises will help prevent urinary tract infections." 4. "The exercises will help strengthen the pelvic floor in preparation for delivery." 5. "The exercises will help strengthen the muscles that support the bladder and urethra."

4. "The exercises will help strengthen the pelvic floor in preparation for delivery." 5. "The exercises will help strengthen the muscles that support the bladder and urethra." NCLEX

A client who is 8 weeks' pregnant calls the prenatal clinic and tells the nurse that she is experiencing nausea and vomiting every morning. The nurse should suggest which measure that will best promote relief of the signs and symptoms? 1. Eating a high-fat diet 2. Increasing fluids with meals 3. Eating a high-carbohydrate diet 4. Eating dry crackers before arising

4. Eating dry crackers before arising NCLEX

The clinic nurse is teaching a pregnant woman about the warning signs in pregnancy. Which, if identified as a warning sign by the woman, would indicate a need for further education? 1. Rapid weight gain 2. Visual disturbances 3. Generalized or facial edema 4. Presence of irregular painless contractions

4. Presence of irregular painless contractions (Braxton Hicks contractions are normal) NCLEX

A clinic nurse is explaining the changes in the integumentary system that occur during pregnancy to a client and should tell the client that which change may persist after she gives birth? 1. Epulis 2. Chloasma 3. Telangiectasia 4. Striae gravidarum

4. Striae gravidarum NCLEX

A nurse is teaching a client who is at 6 weeks of gestation about common discomforts of pregnancy. Which of the following findings should the nurse include in the teaching? (select all that apply) A. Breast tenderness B. Urinary frequency C. Epistaxis D. Dysuria E. Epigastric pain

A. Breast tenderness B. Urinary frequency C. Epistaxis ATI

A client who is at 7 weeks of gestation is experiencing n/v in the morning. Which of the following information should the nurse include in the teaching? A. Eat crackers or plain toast before getting out of bed B. Awaken during the night to eat a snack C. Skip breakfast and eat lunch after nausea has subsided D. Eat a large evening meal

A. Eat crackers or plain toast before getting out of bed (eating at night and large evening meal can cause heartburn) ATI

A nurse is caring for a client who is pregnant and reviewing signs of complications the client should promptly report to the provider. Which of the following complications should the nurse include in the teaching? A. Vaginal bleeding B. Swelling of the ankles C. Heartburn after eating D. Lightheadedness when lying on back

A. Vaginal bleeding ATI

A client who is at 8 weeks of gestation tells the nurse that she isn't sure she is happy about being pregnant. Which of the following responses should the nurse make? A. "I will inform the provider that you are having these feelings." B. "It is normal to have these feelings during the first few months of pregnancy" C. "You should be happy that you are going to bring new life into the world" D. "I am going to make an appointment with the counselor for you to discuss these thoughts"

B. "It is normal to have these feelings during the first few months of pregnancy" ATI

The nurse is taking a history from a prenatal client at 7 weeks' gestation. The client states, "I don't know if I want this baby. How will I know if I'll be a good mother?" What is the most appropriate response by the nurse? a. "This is a normal reaction to parenthood in the first trimester." b. "This would be the best time to consider an abortion or adoption." c. "This is a sign of depression and I'd like you to see a mental health specialist." d. "This is an abnormal reaction, and I'd like you to speak with Family Services."

a. "This is a normal reaction to parenthood in the first trimester." text

operculum

mucous plug: a collection of thick mucus that blocks the cervical canal during pregnancy (estrogen)

The nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. Which instruction should the nurse provide? 1. Avoid wearing a bra. 2. Wash the breasts with warm water and keep them dry. 3. Wear tight-fitting blouses or dresses to provide support. 4. Wash the nipples and areolar area daily with soap, and massage the breasts with lotion.

2. Wash the breasts with warm water and keep them dry. NCLEX

A nurse is teaching a group of women who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the nurse include in the teaching? (Select all that apply) A. Avoid any lifting B. Perform Kegel exercises twice a day C. Perform the pelvic rock exercises every day D. Use proper body mechanics E. Avoid constrictive clothing

C. Perform the pelvic rock exercises every day D. Use proper body mechanics ATI

A client in the prenatal clinic complains of nausea and vomiting. Which intervention should the nurse suggest? a. Eat dry crackers or toast before arising in the morning. b. Eat foods high in fiber. c. Brush teeth right after eating. d. Consume liquids with meals.

a. Eat dry crackers or toast before arising in the morning. (Foods high in fiber help with constipation problems, not with nausea. Brushing teeth after meals may trigger vomiting. Consuming liquids with meals may cause overdistention of the stomach.) text

A nurse is teaching a group of first-trimester prenatal clients about the discomforts of pregnancy. A client asks the nurse, "What causes my nausea and vomiting?" The nurse knows the primary contributing factor to first-trimester emesis is: a. Human chorionic gonadotropin. b. Estrogen. c. Progesterone. d. Prostaglandins.

a. Human chorionic gonadotropin. text

A prenatal client in her third trimester of pregnancy complains of frequent leg cramps. She asks the nurse, "What can I do to prevent these cramps?" What is the nurse's best response? a. Increase milk and calcium products to six servings a day. b. Decrease milk intake to a pint a day and take calcium carbonate supplements. c. Alternate between sitting and standing positions. d. Rest often with the feet and legs elevated.

b. Decrease milk intake to a pint a day and take calcium carbonate supplements. (leg cramps are often caused by an imbalance of calcium and phosphorous ratio) text

On arrival to a 22-week prenatal appointment, a client's blood pressure is 90/52. Her intake blood pressure was 120/68. She feels well and denies dizziness. What is the most appropriate nursing response? a. Notify the provider. b. Counsel the client to increase fluid intake. c. Place the client in an exam room and continue her visit. d. Repeat the blood pressure in 15 minutes.

c. Place the client in an exam room and continue her visit. (BP is expected to be below the pt's baseline because in 2nd trimester. When the client is asymptomatic, a low BP at 22 weeks can be attributed to normal physiologic changes. No intervention or increased monitoring is indicated.) text

A nurse assesses four clients in the prenatal clinic. Which client will present with the most accurate fundal height related to gestational age? a. The client who develops polyhydramnios b. The client with uterine fibroids c. The client who develops hypertension d. The client with a 70-pound weight gain

c. The client who develops hypertension (There may be difficulty accurately palpating the fundus in a pt who develops polyhydramnios (extra amniotic fluid), uterine size may be distorted in a pt who develops uterine fibroids, there may be difficulty accurately palpating the fundus in the pt with obesity.) text

A second-trimester client in the prenatal clinic complains of ankle edema. Which intervention should the nurse suggest? a. Avoid walking as much as possible. b. Wear ankle socks daily. c. Practice plantar flexion when standing. d. Elevate legs when sitting.

d. Elevate legs when sitting. text

The nurse is teaching a pregnant client about the physiological effects and hormonal changes that occur during pregnancy. The client asks the nurse about the role of estrogen in pregnancy. Which responses should the nurse give the client about the role of estrogen? (Select all that apply) 1. It maintains and relaxes the uterine lining for implantation. 2. It stimulates metabolism of glucose and converts the glucose to fat. 3. It increases the blood flow to mucous membranes and causes them to swell and soften. 4. It prevents the involution of the corpus luteum and maintains the production of progesterone until the placenta is formed. 5. It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.

3. It increases the blood flow to mucous membranes and causes them to swell and soften. 5. It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation. NCLEX

A nurse provides teaching regarding how to relieve discomfort to a client in her second trimester of pregnancy that is having frequent low back pain and ankle edema at the end of the day. Which statement made by the client indicates an understanding of the teaching? 1. "When I get home I should lie on my left side, with my feet in a dorsiflexed position." 2. "I should soak in a tub bath of hot water when I get home and then perform pelvic tilt exercises." 3. "When I get home I should lie on my right side, with my feet elevated on a pillow, and put a heating pad on my back." 4. "When I get home I should lie on the floor, with my legs elevated onto a couch, and turn my hips and knees at right angles."

4. "When I get home I should lie on the floor, with my legs elevated onto a couch, and turn my hips and knees at right angles." NCLEX

A client presenting for confirmation of pregnancy after a positive home pregnancy test is unsure of the date of her last menstrual period (LMP). How can the nurse ensure the most accurate estimation of the client's gestational age? a. Date the pregnancy according to the client's best recollection of her LMP. b. Perform a pelvic exam to estimate uterine size. c. Attempt to auscultate the fetal heart. d. Refer the client for ultrasound.

d. Refer the client for ultrasound. text

The nurse is assessing the fundal height of a client at 12 weeks' gestation. The nurse should expect the fundus to be: a. Level with the umbilicus. b. Halfway between symphysis and umbilicus. c. Slightly below the symphysis pubis. d. Slightly above the symphysis pubis.

d. Slightly above the symphysis pubis. (The fundal height is expected to be slightly above the symphysis pubis for a client at 12 weeks. The fundus is expected to be at the level of the umbilicus at 20-22 weeks, and halfway between the symphysis and umbilicus at 16 weeks.) text

A nurse is researching the topic of fluid retention during pregnancy. Which factor contributes to fluid retention? a. Increased serum protein b. Decreased intracapillary pressure and permeability c. Decreased nitrogen retention d. Increased level of steroid sex hormones

d. Increased level of steroid sex hormones text

should pt be experiencing nausea and vomiting during 2nd trimester?

no

should pt be experiencing urinary frequency during 2nd trimester?

no

heart rate/pulse

pulse increases 10-15/min around 32 weeks

The nurse is teaching a group of prenatal clients about nipple hygiene for breastfeeding. What is the most appropriate measure for breast hygiene in pregnancy? a. Remove dried colostrum with a moist cloth. b. Disinfect the nipples with alcohol. c. Wash daily with soap and water. d. Avoid removing dried colostrum.

a. Remove dried colostrum with a moist cloth. text

A client in the prenatal clinic at 24 weeks' gestation says the nurse-midwife told her she has inverted nipples, and asks whether she needs to do anything to prepare her nipples for breastfeeding. What is the nurse's best response? a. Wear a support bra even when sleeping. b. Go braless and expose nipples to the sunlight and air. c. Start wearing breast shells and attempting to evert the nipples now. d. Wait until 36 weeks to attempt to evert the nipples.

d. Wait until 36 weeks to attempt to evert the nipples. text