Antepartum II

A nonstress test is prescribed for a pregnant client, and the client asks the nurse about the procedure. Which of the following informative statements will the nurse provide to the client?

"An ultrasound transducer that records fetal heart activity is secured over the abdomen where the fetal heart is heard most clearly."

A pregnant woman has tested positive for human immunodeficiency virus (HIV). The nurse reinforces information to the client about HIV and determines that additional counseling is necessary when the client states:

"Breast-feeding after delivery is best for my baby."

A nurse is caring for a pregnant client who was diagnosed with acquired immunodeficiency syndrome (AIDS) and asks the nurse if she will be able to breast-feed the infant after delivery. Which response by the nurse is appropriate?

"Breast-feeding is contraindicated."

A young pregnant woman with diabetes mellitus has lost 10 pounds during the first 15 weeks of gestation. The client tells the nurse, "I do not eat regular meals." Based on the client's statement, the nurse determines that the best response would be which of the following?

"Can you tell me more about what you are eating?"

A nulliparous woman asks the nurse when she will feel fetal movements. The nurse responds by telling the woman that the first recognition of fetal movement will occur at approximately:

18 weeks of gestation

A nurse is collecting data from a prenatal client. The nurse determines that which of the following places the client in the high-risk category for contracting human immunodeficiency virus (HIV)?

A history of intravenous (IV) drug use in the past year

A nonstress test is performed on a client, and the results are documented in the chart. The results are documented as a reactive nonstress test. The nurse interprets these findings as indicating:

A negative test

A nurse palpates the anterior fontanel of a neonate and notes that it feels soft. The nurse analyzes this data as indicative of:

A normal finding

The nurse is providing instructions to a pregnant client with heartburn regarding measures that will alleviate the discomfort. The nurse instructs the client to:

Drink decaffeinated coffee and tea.

A pregnant woman visiting a health care clinic for the first prenatal visit hears the health care provider discuss the preembryonic period of development with the nurse. The woman asks the nurse what this means. The nurse tells the woman that the preembryonic period is the:

First 2 weeks of fetal development following conception

A nurse is assigned to care for a pregnant client being admitted to the nursing unit. Laboratory and diagnostic studies have confirmed a diagnosis of gestational trophoblastic disease (hydatidiform mole). The nurse collects data on the client and reviews the results of the laboratory and diagnostic studies, knowing that which of the following is an unassociated finding with this diagnosis?

Hypotension

During the antenatal period of a client diagnosed with the human immunodeficiency virus (HIV), the nurse weighs and plots the weight gain pattern routinely and discusses the findings. The primary purpose of this action is to:

Identify appropriate fetal development.

A nurse is collecting data from a pregnant client and is preparing to take the client's blood pressure. The nurse positions the client:

In a sitting position

A pregnant client asks the prenatal clinic nurse what the fetal period of development means? The nurse tells the woman that the fetal period is the:

Longest period of fetal development

A nurse is teaching a pregnant woman about the physiological effects and hormone changes that occur in pregnancy, and the woman asks the nurse about the purpose of progesterone. The nurse tells the woman that the purpose of progesterone is to:

Maintain the uterine lining for implantation.

A nurse is assisting in conducting a prenatal session with a group of expectant parents. The nurse tells the parents that the primary hormone that stimulates the secretion of milk is:

Prolactin

A clinic nurse is planning care to meet the emotional needs of a pregnant woman. Which nursing intervention would least likely assist in meeting emotional needs?

Providing the mother with pamphlets and booklets to read about the pregnancy

A nurse is preparing to teach a pregnant client about the warning signs in pregnancy and prepares a list of the warning signs that indicate the need to notify the health care provider. Choose the warning signs that the nurse places on the list. Select all that apply.

√√√√ 1. Facial edema 2. Rapid weight gain 3. Visual disturbances 4. Generalized edema

A nursing student is assigned to care for an adolescent female client in the health care clinic, and the instructor reviews the menstrual cycle with the student. The instructor determines that the student understands the process of the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) if the student states:

"FSH and LH are released from the anterior pituitary gland."

A nurse employed in a health care provider's office is collecting information from a pregnant client. Which of the following statements made by the client likely indicates the need for psychological referral?

"I hate the way I look and feel. The baby has done this to me and I wish I were not pregnant."

A nurse provides instructions to a client with mild preeclampsia on home care. The nurse evaluates that the teaching has been effective when the client states:

"I need to check my urine with a dipstick every day for protein and call the health care provider if it is 2+ or more."

A nursing student is conducting a clinical conference regarding the hormones related to pregnancy. The instructor asks the student about the function of thyroxine. Which statement by the student indicates an understanding of this hormone?

"It increases during pregnancy to stimulate basal metabolic rate."

A perinatal client with a history of heart disease has been instructed on care at home. Which of the following statements if made by the client would indicate the need for further instructions?

"It is best to rest on my right side."

The nursing instructor asks the nursing student about the physiology related to the cessation of ovulation that occurs during pregnancy. Which response by the student indicates an understanding of this physiological process?

"Ovulation ceases during pregnancy because the circulating levels of estrogen and progesterone are high."

A client is scheduled for an amniocentesis and tells the nurse, "I'm not sure I should have this test done." Which response by the nurse is appropriate?

"Tell me what concerns you have."

A pregnant anemic client is concerned about her baby's condition following delivery. Which nursing response would best support the client?

"The effects of anemia on your baby are difficult to predict, but let's review your plan of care to ensure you are providing the best nutrition and growth potential."

The nurse has a teaching session with a malnourished client regarding iron supplementation to prevent anemia during pregnancy. Which of the following statements, if made by the client, would indicate successful learning?

"The iron is needed for the red blood cells."

A contraction stress test is scheduled for the client. The woman asks the nurse about the test. The most accurate description of the test includes which of the following?

"The uterus is stimulated to contract by either small amounts of oxytocin (Pitocin) or by nipple stimulation."

A nurse is preparing to monitor a fetal heart rate. The nurse knows that the fetal heart rate can first be heard with a fetoscope at gestational week:

20

The nurse is collecting data from a pregnant client who is at 28 weeks' gestation. The nurse measures the fundal height in centimeters and expects the findings to be which of the following?

28 cm

A blood glucose measurement is performed on a pregnant client. The results indicate that her blood glucose is elevated. Which of the following would the nurse anticipate to be prescribed for the mother?

A 3-hour glucose tolerance test

A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The health care provider has documented the presence of Goodell's sign, and the nurse determines that this sign is indicative of:

A softening of the cervix

A nurse is teaching a prenatal class on the anatomy and physiology of the female reproductive system. When a participant in the class asks where the follicle-stimulating hormone is produced, the nurse responds that it is produced in the:

Anterior pituitary gland

A nurse is assisting in planning care for a client with a diagnosis of placenta previa. The nurse identifies which of the following as the priority goal for the client?

Client exhibits no signs of fetal distress.

A nursing student is asked to identify the location of the isthmus of the uterus. The student correctly states that the isthmus is the:

Area between the corpus of the uterus and the cervix

A perinatal client is at risk for toxoplasmosis. The nurse should teach the client which of the following to prevent exposure to this disease?

Avoid exposure to litter boxes used by cats.

Which of the following histories would place a maternity client at risk for uterine rupture?

Cesarean section birth

A client age 23 develops melasma during pregnancy. The nurse notes that the client has started wearing very heavy makeup. The client tells the nurse that she is fearful that her mate will reject her, and that she has decreased her social engagements drastically because of this change. The nurse determines that the client is experiencing which problem?

Concern about her appearance

A nursing student is assigned to a client in labor. The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. The instructor determines that the student understands the structure of the ductus venosus if the student states that it:

Connects the umbilical vein to the inferior vena cava

A pregnant client is seen in the health care clinic with reports of morning sickness. When the client asks the nurse about measures to relieve this situation, what is the nurse's appropriate suggestion?

Consume dry crackers before getting out of bed.

A nurse is instructing a maternity client how to keep a fetal activity diary. The nurse tells the client to:

Contact the health care provider if the baby's movements are fewer than 10 times in 2 hours.

A nurse is assigned to care for a pregnant client with a diagnosis of sickle cell anemia. The nurse plans care, knowing that which of the following problems should receive highest priority?

Dehydration

A client asks a nurse to describe how her baby is developing. The nurse bases the response on the knowledge that every organ system in the fetus is present by the end of which gestational week?

Eighth

During an office visit, a prenatal client with mitral stenosis states she has been under a lot of stress lately. During data collection the client questions everything the nurse does and behaves in an anxious manner. The appropriate nursing response or action at this time would be to:

Explain the purpose of the nurse's actions, and answer all questions.

A nurse-midwife is conducting a session on the process of fertilization with a group of nursing students. The nurse-midwife asks a student to identify the structure where fertilization of an ovum takes place. Which of the following, if identified by the student, indicates an understanding of this process?

Fallopian tube

The nurse is collecting data during the admission assessment of a client who is pregnant with triplets. The client also has a 3-year-old child who was born at 39 weeks' gestation. The nurse would document which gravida and para status on this client?

Gravida II, para I

A nurse is collecting data on a pregnant woman who is human immunodeficiency virus (HIV) positive during the 32nd gestational week. The nurse reviews the data and determines that which finding requires further follow up?

Increased shortness of breath and bilateral rales

A client is seen in the health care clinic for complaints of vaginal bleeding and mild abdominal cramping. On further data collection, the nurse notes that the client's last menstrual period was 10 weeks ago. The client reports that a home pregnancy test was performed and the results were positive. On physical examination, it is noted that the client has a dilated cervix. The nurse understands that the client is at risk for which type of abortion?

Inevitable

A nurse-midwife is performing an assessment on a pregnant client and is assessing the client for the presence of ballottement. The nurse who is assisting understands that the nurse-midwife will implement which to test for the presence of ballottement?

Initiate a sudden tap on the cervix.

A nurse is teaching a pregnant woman about the physiological effects and hormone changes that occur in pregnancy. The woman asks the nurse about the purpose of estrogen. The nurse bases the response on which of the following purposes of estrogen?

It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.

A nurse is assisting in conducting a childbirth class and is instructing pregnant women about the method of effleurage. The nurse instructs the woman to perform the procedure by:

Massaging the abdomen during contractions using both hands in a circular motion

A pregnant client asks the nurse about the hormone that stimulates postpartum contractions. The nurse tells the client that the primary hormone that stimulates postpartum contractions is:

Oxytocin

A nurse is assisting to care for a pregnant client in labor who will be delivering twins. The nurse prepares to monitor the fetal heart rates by:

Placing external fetal monitors so that each fetal heart rate is monitored separately

A nurse is instructing a pregnant client in her first trimester about nutrition. The nurse would correct which of the following misunderstandings on the part of the client about nutrition during pregnancy?

Pregnancy greatly increases the risk of malnourishment for the mother.

A client who consumes alcohol frequently is in the first trimester of pregnancy. What is the expected outcome when the nurse initiates interventions to assist the client to cease alcohol consumption?

Reducing the risk of teratogenic effects to developing fetal organs, tissues, and structures

A nurse is collecting data from a client on her first prenatal visit. Which factor indicates that the client is at risk for developing gestational diabetes during this pregnancy?

She has a history of chronic hypertension.

A nurse is teaching a pregnant client about the physiological effects and hormone changes that occur in pregnancy. The client asks the nurse about the purpose of estrogen. The nurse tells the client that estrogen:

Stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation

The plan of care for a pregnant teen should include teaching regarding which of the following concerning dental care?

Tell the dental office staff that she is pregnant.

When caring for the pregnant client with human immunodeficiency virus (HIV), which goal would be appropriate?

The client will not develop an opportunistic infection during the remainder of pregnancy.

A pregnant client 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 bases the response on which of the following?

The breast changes are a result of the secretion of estrogen and progesterone.

A client beginning week 30 of gestation comes to the clinic for a routine visit. Which of the following observations by the nurse indicates a need for teaching?

The client is wearing knee-high hose.

The nurse working in a prenatal clinic reviews a client's chart and notes that the health care provider documents that the client has a gynecoid pelvis. The nurse understands that this type of pelvis is:

The most favorable for labor and birth

A nursing instructor instructs the nursing students that surfactant is a substance needed to facilitate neonatal breathing. The instructor asks a nursing student to identify when this substance begins to be produced. The nursing student responds correctly by stating that this substance is produced at approximately which gestational week?

Week 28

A nurse is collecting data from a pregnant client with a history of cardiac disease and is checking the client for venous congestion. The nurse inspects which body area, knowing that venous congestion is commonly noted in this area?

Vulva

A nurse is collecting data from a pregnant client with a history of cardiac disease. The nurse is checking for venous congestion. The nurse inspects which of the following areas, knowing that venous congestion is most commonly noted here?

Vulva

A nursing instructor asks a student to list the functions of the amniotic fluid. The student responds correctly by stating that which of the following are functions of amniotic fluid? Select all that apply.

√√√√ 1. Allows for fetal movement 2. Is a measure of kidney function 3. Surrounds, cushions, and protects the fetus 4. Maintains the body temperature of the fetus

A nursing student is asked to describe the size of the uterus in a nonpregnant client. Which response by the student indicates an understanding of the anatomy of this structure?

"The uterus weighs about 2 ounces."

A pregnant client in the second trimester of pregnancy is admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding should the nurse expect to note if this condition is present?

Abdominal pain

A nurse is caring for a client experiencing a partial placental abruption. The client is uncooperative and is refusing any interventions until her husband arrives at the hospital. The nurse analyzes the client's behavior as likely the result of:

Acute anxiety and the need for support

A nurse is monitoring a client at risk for placental abruption. Which of the following is indicative of this complication?

Fetal distress

A nurse is preparing a pregnant client for a transvaginal ultrasound exam. The nurse tells the client that she will:

Feel some pressure when the vaginal probe is moved

A nurse is reviewing the laboratory results of a pregnant client and notes that the hemoglobin level is decreased. Physiological dilutional anemia is documented in the client's record by the health care provider. The nurse plans care, knowing that this type of anemia is a result of which situation?

Increased blood volume of the mother during pregnancy

A pregnant woman reports to the health care clinic complaining of loss of appetite, weight loss, and fatigue. Following an assessment, tuberculosis is suspected. A sputum culture is obtained and identifies the Mycobacterium tuberculosis in the sputum. The nurse provides instructions to the client regarding therapeutic management of tuberculosis and tells the client that:

Isoniazid (INH) plus rifampin (Rifadin) will be required for a total of 9 months.

A nurse is assisting in planning care to meet the emotional needs of a pregnant woman. Which of the following nursing interventions would be least likely to assist in meeting her emotional needs?

Providing the mother with pamphlets and booklets to read about the pregnancy

A nursing student prepares a teaching plan for a pregnant client newly diagnosed with diabetes mellitus. The nursing instructor suggests changing the plan if the student includes which information?

To avoid exercise because of the negative effects on insulin production

A nurse is caring for a client diagnosed with preeclampsia. Which statement by the client suggests the need for more teaching regarding possible complications of preeclampsia?

"I should expect that my urine output will decrease."

A maternity nurse is caring for a client who is admitted to the hospital with a diagnosis of gestational diabetes. This is the client's first pregnancy. Which statement by the client indicates a knowledge deficit regarding gestational diabetes?

"I shouldn't have eaten so many sweets before I became pregnant."

A client calls the health care provider's office to schedule an appointment because a home pregnancy test was performed and the results were positive. The nurse determines that the home pregnancy test identified the presence of which of the following in the urine?

Human chorionic gonadotropin (hCG)

A nurse is reviewing the health care record of a pregnant client at 16 weeks of gestation. The nurse would expect documentation that the fundus of the uterus is noted at which area?

Midway between the symphysis pubis and the umbilicus

The client is in her second trimester of pregnancy. She complains of frequent low back pain and ankle edema at the end of the day. The nurse recommends which measure to help relieve both discomforts?

Lie on the floor with the legs elevated onto a couch or padded chair, with the hips and knees at a right angle.

A pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. The nurse responds by telling the mother that fetal movements will be noted:

Between 16 and 20 weeks' gestation

During a routine prenatal visit, a client complains of gingivitis and gums that bleed easily with brushing. When assisting to plan the care for the client, the nurse includes a goal that addresses proper nutrition to minimize this problem. The nurse determines that goal achievement has occurred when the client states which of the following?

"I am eating fresh fruits and vegetables for snacks and for dessert each day."

A nurse in the prenatal clinic is taking a nutritional history from a pregnant adolescent. Which statement by the client would alert the nurse to a potential concern regarding adequate nutritional intake during the pregnancy?

"I need to gain only ten pounds so that my baby will be small like I am."

A maternity nurse is providing an inservice educational session to nursing students regarding the process of conception. The nurse determines that a nursing student understands this process if the student states that fertilization of a mature ovum occurs in which of the following areas?

In the distal third of the fallopian tube

A nurse is providing emotional support to a client who experienced a spontaneous abortion. The nurse can best assist the client by planning care that focuses on which of the following psychosocial issues?

Feelings of guilt are often associated with grief.

A client who is 6 months pregnant is attending her first prenatal visit. On the first prenatal visit, the nurse notes that the client is gravida IV, para 0, aborta III. The client is 5 feet, 6 inches tall, weighs 130 pounds, and is 25 years old. She states, "I get really tired after working all day and can't keep up with my housework." Which factor in the above data would lead the nurse to suspect gestational diabetes?

Fetal demise

A 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 responds to the client, knowing that the sex of the fetus can be visually recognizable as early as week:

12

A nurse working in a prenatal clinic receives a telephone call from a client at 22 weeks of gestation. The client reports some vaginal discharge and has started to experience menstrual-like cramps and diarrhea. Which response by the nurse indicates a lack of understanding of the implications of the client's symptoms?

"This is probably an emergency. Have someone drive you to a hospital now."

A pregnant woman in her second trimester calls the prenatal clinic nurse to report a recent exposure to a child with rubella. Which response by the nurse would be appropriate?

"You were wise to call. I will check your rubella titer screening results and we can identify immediately if interventions are needed."

The nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse notes that the health care provider has documented the presence of Goodell's sign. The nurse determines that this sign is indicative of:

A softening of the cervix

In the prenatal clinic, a nurse is gathering data from a new client for the health history information. What is the best way for the nurse to elicit correct responses to questions that refer to sexually transmitted infections?

Establish a therapeutic relationship between the nurse and pregnant client.

A nurse is collecting data from a client who is pregnant with twins. The nurse understands that which of the following complications is likely associated with a twin pregnancy?

Maternal anemia

A nurse is told that a prenatal client is at risk for placental abruption. The nurse expects to note which risk factor documented in the client's record?

Maternal hypertension

A pregnant client with mitral valve prolapse is receiving anticoagulant therapy during pregnancy. The nurse collects data on the client and expects that the client will indicate that which of the following medications is prescribed?

Subcutaneous administration of heparin sodium 5000 units daily

A nurse is reviewing the record of a pregnant client and notes that the health care provider has documented the presence of Chadwick's sign. The nurse understands that the hormone responsible for the development of this sign is which of the following?

Estrogen

A pregnant client is positive for the human immunodeficiency virus (HIV). Based on this information, the nurse determines that:

HIV antibodies are detected on the enzyme-linked immunosorbent assay (ELISA) test.

A prenatal client diagnosed with anemia has come to the clinic. After reviewing the client's health record, the nurse notes that the laboratory values indicate low hemoglobin and hematocrit levels. Which of the following problems do the data best support?

High risk for infection

A nurse is collecting data from a client and is reviewing the client's health record to determine the risk for preterm labor. Which of the following findings would place the client at this risk?

A urinary tract infection