Antepartum Questions NCLEX Style

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

The nurse is reviewing fetal development with a client who is at 36 weeks gestation. Which statements describe the characteristics that develop in a fetus at this time? Select all that apply. 1. Eyelids begin to fuse. 2. Fetal heart begins to beat. 3. The fetal skin is transparent. 4. The fetus weighs approximately 1200 g. 5. The fetus is approximately 42 to 48 cm long. 6. The lecithin-sphingomyelin (L/S) ratio is greater than 2:1

5. The fetus is approximately 42 to 48 cm long. 6. The lecithin-sphingomyelin (L/S) ratio is greater than 2:1

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? 1. Increase in pulse rate 2. Increase in blood pressure 3. Frequent bowel elimination 4. Decrease in red blood cell production

1. Increase in pulse rate

The nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. Using GTPAL, what should the nurse document in the client's chart? 1. G = 3, T = 2, P = 0, A = 0, L = 1 2. G = 2, T = 1, P = 0, A = 0, L = 1 3. G = 1, T = 1, P = 1, A = 0, L = 1 4. G = 2, T = 0, P = 0, A = 0, L = 1

2. G = 2, T = 1, P = 0, A = 0, L = 1

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

The nurse is performing an assessment on a client seen in the health care clinic for a first prenatal visit. The client reports February 9 as the first day of the last menstrual period (LMP). Using Nägele's rule, what date later that same year will the nurse relay as the client's due date? 1. October 7 2. October 16 3. November 7 4. November 16

4. November 16

Which explanation should the nurse provide to the prenatal client about the purpose of the placenta? 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.

3. It is the way the baby gets food and oxygen.

The nurse is conducting a prepared childbirth class and is instructing pregnant women about the method of effleurage. The nurse instructs the women to perform the procedure by doing which action? 1. Contracting and then consciously relaxing different muscle groups 2. Massaging the abdomen during contractions, using both hands in a circular motion 3. Instructing her partner to stroke or massage a tightened muscle by the use of touch 4. Contracting an area of the body, such as an arm or leg, and then concentrating on letting tension go from the rest of the body

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

A pregnant client has been instructed on the prevention of genital tract infections. Which client statement indicates an understanding of these preventive measures? 1. "I can douche anytime I want." 2. "I can wear my tight-fitting jeans." 3. "I should avoid the use of condoms." 4. "I should wear underwear with a cotton panel liner."

4. "I should wear underwear with a cotton panel liner."

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 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

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

A pregnant client in the first trimester calls the nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement 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 to be sure to change the tampons every 2 hours."

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

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 2. Dorsiflex the foot while extending 3. Plantar flex the foot while flexing 4. Plantar flex the foot while extending

2. Dorsiflex the foot while extending

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.

The nurse is reviewing the record of a pregnant woman and notes that the health care provider has documented the presence of Chadwick's sign. The nurse understands that which hormone is responsible for the development of this sign? 1. Prolactin 2. Estrogen 3. Progesterone 4. Human chorionic gonadotropin

2. Estrogen

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

The health care provider (HCP) is assessing the client for the presence of ballottement. To make this determination, the HCP should take which action? 1. Auscultate for fetal heart sounds. 2. Assess the cervix for compressibility. 3. Palpate the abdomen for fetal movement. 4. Initiate a gentle upward tap on the cervix.

4. Initiate a gentle upward tap on the cervix.

A nurse is preparing a pregnant woman for a transvaginal ultrasound examination. The nurse should tell the woman that which will occur? 1. She will feel some pain during the procedure. 2. She will be placed in a supine left side-lying position. 3. She will feel some pressure when the vaginal probe is moved. 4. She will need to drink 2 quarts of water to attain a full bladder.

3. She will feel some pressure when the vaginal probe is moved.

The nurse has performed a nonstress test on a pregnant client and is reviewing the fetal monitor strip. The nurse interprets the test as reactive. How should the nurse document this finding? 1. Normal 2. Abnormal 3. The need for further evaluation 4. That findings were difficult to interpret

1. Normal

A pregnant client tells the clinic nurse that she wants to know the gender of her baby as soon as it can be determined. The nurse understands that the client should be able to find out the gender 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

A rubella titer is performed on a client who has just been told that she is pregnant. The results of the titer indicate that the client is not immune to rubella. Which should the nurse anticipate to be prescribed for this client? 1. Immunization with rubella 2. Retesting rubella titer during pregnancy 3. Antibiotics to be taken throughout the pregnancy 4. Counseling the mother regarding therapeutic abortion

2. Retesting rubella titer during pregnancy

A nurse provides dietary instructions to a pregnant woman regarding food items that contain folic acid. Which food item should the nurse recommend as a good source of folic acid? 1. Cheese 2. Spinach 3. Potatoes 4. Bananas

2. Spinach

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 observation made by the nurse during the assessment indicates a need for further teaching? 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.

2. The client is wearing knee-high hose.

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding? 1. A normal test result 2. An abnormal test result 3. A high risk for fetal demise 4. The need for a cesarean delivery

1. A normal test result

During a woman's prenatal visit, the nurse is measuring fundal height. The nurse knows that the woman is at 20 weeks' gestation. Based on this information, the nurse expects the fundus to be found at what area of the abdomen? 1. At the umbilicus 2. At the xiphoid process 3. Midway between the umbilicus and the xiphoid process 4. Midway between the symphysis pubis and the umbilicus

1. At the umbilicus

The nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse measures the fundal height in centimeters and expects which finding? 1. 22 cm 2. 30 cm 3. 36 cm 4. 40 cm

2. 30 cm

A health care provider has prescribed transvaginal ultrasonography for a client in the first trimester of pregnancy and the client asks the nurse about the procedure. How should the nurse respond to the client? 1. "The procedure takes about 2 hours." 2. "It will be necessary to drink 1 to 2 quarts of water before the examination." 3. "The probe that will be inserted into the vagina will be covered with a disposable cover and coated with a gel." 4. "Gel is spread over the abdomen, and a round disk transducer will be moved over the abdomen to obtain the picture."

3. "The probe that will be inserted into the vagina will be covered with a disposable cover and coated with a gel."

During a woman's 38-week prenatal visit, the nurse assesses the fetal heart rate. Which finding would the nurse note as normal? 1. 80 beats/minute 2. 100 beats/minute 3. 150 beats/minute 4. 180 beats/minute

3. 150 beats/minute

The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that the fetal heart rate is 174 beats/minute. On the basis of this finding, what is the priority nursing action? 1. Document the finding. 2. Check the mother's heart rate. 3. Notify the health care provider (HCP). 4. Tell the client that the fetal heart rate is normal.

3. Notify the health care provider (HCP).

The result of a biophysical profile (BPP) of a 28-year-old client at 36 weeks' gestation after the ultrasound components is 8. Based on this result, the nurse should take which action? 1. Notify the health care provider. 2. Prepare the client for labor induction. 3. Place the fetal heart monitor on the client in order to do a nonstress test (NST). 4. Provide the client with information regarding warning signs and symptoms of pregnancy and discharge her to home.

3. Place the fetal heart monitor on the client in order to do a nonstress test (NST).

A contraction stress test is scheduled for a pregnant woman, and she asks the nurse to describe the test. What should the nurse tell the woman? 1. Uterine contractions are stimulated by Leopold's maneuvers. 2. An external fetal monitor is attached, and the woman ambulates on a treadmill until contractions begin. 3. The uterus is stimulated to contract by the administration of small amounts of oxytocin (Pitocin) or by nipple stimulation. 4. Small amounts of oxytocin (Pitocin) are administered during internal fetal monitoring to stimulate uterine contractions.

3. The uterus is stimulated to contract by the administration of small amounts of oxytocin (Pitocin) or by nipple stimulation.

A pregnant client 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. 6 and 8 2. 8 and 10 3. 10 and 12 4. 14 and 18

4. 14 and 18

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

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 should expect which hormone to be present in the urine? 1. Estrogen 2. Progesterone 3. Follicle-stimulating hormone (FSH) 4. Human chorionic gonadotropin (hCG)

4. Human chorionic gonadotropin (hCG)

A client reports to the health care clinic and says that it has been 6 weeks since her last menstrual period. The nurse performs a pregnancy test and should expect to note the presence of which hormone in the blood test results if the client is pregnant? 1. Estrogen 2. Progesterone 3. Follicle-stimulating hormone (FSH) 4. Human chorionic gonadotropin (hCG)

4. Human chorionic gonadotropin (hCG)

The nurse is instructing a pregnant client regarding measures to increase iron in the diet. The nurse should tell the client to consume which food that contains the highest source of dietary iron? 1. Milk 2. Potatoes 3. Cantaloupe 4. Whole-grain cereal

4. Whole-grain cereal

The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instructions? 1. "I will record the number of movements or kicks." 2. "I need to lie flat on my back to perform the procedure." 3. "If I count fewer than 10 kicks in a 2-hour period I should count the kicks again over the next 2 hours." 4. "I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

2. "I need to lie flat on my back to perform the procedure."

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.

The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's best response? 1. "It promotes the fertilized ovum's chances of survival." 2. "It promotes the fertilized ovum's exposure to estrogen and progesterone." 3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus." 4. "It promotes the fertilized ovum's exposure to luteinizing hormone and follicle-stimulating hormone."

3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus."

The nurse provides instructions to a malnourished client regarding iron supplementation during pregnancy. Which statement, if made by the client, would indicate an understanding of the instructions? 1. "Iron supplements will give me diarrhea." 2. "Meat does not provide iron and should be avoided." 3. "The iron is best absorbed if taken on an empty stomach." 4. "My body has all the iron it needs, and I don't need to take supplements."

3. "The iron is best absorbed if taken on an empty stomach."

A pregnant client is seen for a regular prenatal visit and tells the nurse that she is experiencing irregular contractions. The nurse determines that she is experiencing Braxton Hicks contractions. On the basis of this finding, which nursing action is most appropriate? 1. Contact the health care provider. 2. Instruct the client to maintain bed rest for the remainder of the pregnancy. 3. Inform the client that these contractions are common and may occur throughout the pregnancy. 4. Call the maternity unit and inform them that the client will be admitted in a prelabor condition.

3. Inform the client that these contractions are common and may occur throughout the pregnancy.

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."

The nurse is providing instructions to a pregnant client with genital herpes about the measures that are needed to protect the fetus. Which instruction should the nurse provide to the client? 1. Total abstinence from sexual intercourse is necessary during the entire pregnancy. 2. Sitz baths need to be taken every 4 hours while awake if vaginal lesions are present. 3. Daily administration of acyclovir (Zovirax) is necessary during the entire pregnancy. 4. A cesarean section will be necessary if vaginal lesions are present at the time of labor.

4. A cesarean section will be necessary if vaginal lesions are present at the time of labor.

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

A client in the prenatal clinic asks the nurse about the delivery date. The nurse notes that the client's record indicates that the client began her last menses on March 7, 2015, and ended the menses on March 14, 2015. Using Nägele's rule, the nurse should tell the client that the estimated date of delivery is which date? 1. January 14, 2014 2. January 21, 2014 3. December 21, 2015 4. December 14, 2015

4. December 14, 2015

The nurse is collecting data from a client during the first prenatal visit. The client is anxious to know the gender of the fetus and asks the nurse when she will be able to know. The nurse should respond to the client knowing that the gender of the fetus is determined by which weeks? 1. 6 to 8 2. 8 to 10 3. 13 to 16 4. 20 to 22

3. 13 to 16

The nurse provides instructions to a malnourished pregnant client regarding iron supplementation. Which client statement indicates an understanding of the instructions? 1. "Iron supplements will give me diarrhea." 2. "Meat does not provide iron and should be avoided." 3. "The iron is best absorbed if taken on an empty stomach." 4. "On the days that I eat green leafy vegetables or calf liver I can omit taking the iron supplement."

3. "The iron is best absorbed if taken on an empty stomach."

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

The nursing student is preparing to teach a prenatal class about fetal circulation. Which statement should be included in the teaching plan? 1. "One artery carries oxygenated blood from the placenta to the fetus." 2. "Two arteries carry oxygenated blood from the placenta to the fetus." 3. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta." 4. "Two veins carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta."

3. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta."

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."

A client in her second trimester of pregnancy is seen at the health care clinic. The nurse collects data from the client and notes that the fetal heart rate is 90 beats/min. Which nursing action is appropriate? 1. Document the findings. 2. Notify the health care provider (HCP). 3. Inform the client that everything is normal and fine. 4. Instruct the client to return to the clinic in 1 week for reevaluation of the fetal heart rate.

2. Notify the health care provider (HCP).

The nursing instructor asks the nursing student about the physiology related to the cessation of ovulation that occurs during pregnancy. Which response, if made by the student, indicates an understanding of this physiological process? 1. "Ovulation ceases during pregnancy because the circulating levels of estrogen and progesterone are high." 2. "Ovulation ceases during pregnancy because the circulating levels of estrogen and progesterone are low." 3. "The low levels of estrogen and progesterone increase the release of the follicle-stimulating hormone and luteinizing hormone." 4. "The high levels of estrogen and progesterone promote the release of the follicle-stimulating hormone and luteinizing hormone."

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

A nurse is assisting in conducting a prenatal session with a group of expectant parents. One of the expectant parents asks, "How does the milk get secreted from the breast?" What is the nurse's best response? 1. "Prolactin stimulates the secretion of milk, which is called lactogenesis." 2. "Oxytocin stimulates the secretion of milk, which is called lactogenesis." 3. "Progesterone stimulates the secretion of milk, which is called lactogenesis." 4. "Testosterone stimulates the secretion of milk, which is called lactogenesis."

1. "Prolactin stimulates the secretion of milk, which is called lactogenesis."

A nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The health care provider has documented the presence of Goodell's sign. What should the nurse determine that this sign indicates? 1. A softening of the cervix 2. The presence of fetal movement 3. The presence of human chorionic gonadotropin (hCG) in the urine 4. A soft blowing sound that corresponds to the maternal pulse while auscultating the uterus

1. A softening of the cervix

The 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. This finding is most closely associated with which characteristic? 1. A softening of the cervix 2. The presence of fetal movement 3. The presence of human chorionic gonadotropin in the urine 4. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus

1. A softening of the cervix

The nursing instructor asks a nursing student to list the characteristics of the amniotic fluid. The student responds correctly by listing 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

The nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Which are probable signs of pregnancy? Select all that apply. 1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Braxton Hicks contractions 5. Fetal heart rate detected by a nonelectronic device 6. Outline of fetus via radiography or ultrasonography

1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Braxton Hicks contractions

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.

The clinic nurse is discussing nutrition with a pregnant client who has lactose intolerance. Which food should the nurse instruct the client to eat to supplement the dietary source of calcium? 1. Dried fruits 2. Hard cheese 3. Creamed spinach 4. Fresh squeezed orange juice

1. Dried fruits

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

The nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant woman to describe the process of quickening. Which statement if made by the student indicates an understanding of this term? 1. "It is the thinning of the lower uterine segment." 2. "It is the fetal movement that is felt by the mother." 3. "It is the irregular, painless contractions that occur throughout pregnancy." 4. "It is the soft blowing sound that can be heard when the uterus is auscultated."

2. "It is the fetal movement that is felt by the mother."

A pregnant client in the prenatal clinic is scheduled for a biophysical profile. The client asks the nurse what this test involves. The nurse should make which appropriate response? 1. "This test measures your ability to tolerate the pregnancy." 2. "This test measures amniotic fluid volume and fetal activity." 3. "This test measures your cardiac status and ability to tolerate labor." 4. "This test only measures the amount of amniotic fluid present in the uterus."

2. "This test measures amniotic fluid volume and fetal activity."

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.

A client arrives at the clinic for the first prenatal assessment. She tells the nurse that the first day of her last menstrual period was October 19, 2014. Using Nägele's rule, which expected date of delivery should the nurse document in the client's chart? 1. July 12, 2014 2. July 26, 2015 3. August 12, 2015 4. August 26, 2015

2. July 26, 2015

The nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis. What instruction should the nurse provide? 1. Strict bed rest is required after the procedure. 2. Hospitalization is necessary for 24 hours after the procedure. 3. An informed consent needs to be signed before the procedure. 4. A fever is expected after the procedure because of the trauma to the abdomen.

3. An informed consent needs to be signed before the procedure.

The nurse is performing an assessment of a primigravida who is being evaluated in a clinic during her second trimester of pregnancy. Which finding concerns the nurse and indicates the need for follow-up? 1. Quickening 2. Braxton Hicks contractions 3. Fetal heart rate of 180 beats/minute 4. Consistent increase in fundal height

3. Fetal heart rate of 180 beats/minute

A pregnant client is seen in the health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions. The nurse determines that the client is experiencing Braxton Hicks contractions. Which nursing action should the nurse implement? 1. Contact the health care provider. 2. Instruct the client to maintain bed rest for the remainder of the pregnancy. 3. Instruct the client that these are common and may occur throughout the pregnancy. 4. Call the maternity unit and inform them that the client will be admitted in a prelabor condition.

3. Instruct the client that these are common and may occur throughout the pregnancy.

A pregnant woman 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? 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.

3. The breast changes occur because of the secretion of estrogen and progesterone.

A nonstress test is prescribed for a pregnant client, and she asks the nurse about the procedure. How should the nurse respond? 1. "The test is a procedure that will require an informed consent to be signed." 2. "The test will take about 2 hours and will require close monitoring for 2 hours after the procedure is completed." 3. "The test is done to see if the baby can handle the stress of labor, and that medicine is given to make the uterus contract." 4. "A round, hard plastic disk called an ultrasound transducer picks up and marks the fetal heart activity on the recording paper and is secured over the abdomen."

4. "A round, hard plastic disk called an ultrasound transducer picks up and marks the fetal heart activity on the recording paper and is secured over the abdomen."

A pregnant client asks the nurse, "What should I expect during a nonstress test?" Which information should the nurse provide to the client? 1. "The test is an invasive procedure and requires that you sign an informed consent." 2. "The fetus is challenged by uterine contractions to obtain the necessary information." 3. "The test will take about 2 hours and will require close monitoring for 2 hours after the procedure is completed." 4. "An ultrasound transducer that records fetal heart activity is secured over the abdomen where the fetal heart is heard most clearly."

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

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."

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."

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."

A pregnant client visits a clinic for a scheduled prenatal appointment. The 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 instructions? 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."

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."

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 after arising out of bed in the morning."

4. "I will eat dry crackers after arising out of bed in the morning."

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? 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."

4. "The exercises will help strengthen the pelvic floor in preparation for delivery."

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."

A pregnant woman has a positive history of genital herpes but has not had lesions during this pregnancy. What should the nurse should plan to tell the client? 1. "You will be isolated from your newborn infant after delivery." 2. "Vaginal deliveries can reduce neonatal infection risks, even if you have an active lesion at the time." 3. "There is little risk to your newborn infant during this pregnancy, during the birth, and after delivery." 4. "You will be evaluated at the time of delivery for herpetic genital tract lesions, and if any are present, a cesarean delivery will be needed."

4. "You will be evaluated at the time of delivery for herpetic genital tract lesions, and if any are present, a cesarean delivery will be needed."

A client who has just been told that she is pregnant wants to know when the baby's heart will be completely developed and beating. The nurse reads in the client's chart that the health care provider has determined the client to be at 6 weeks' gestation. What is the nurse's best response? 1. "Your baby's heart right now consists of two parallel tubes, so we can't hear it today." 2. "Your baby's heart right now is beginning to partition into four chambers and has begun to beat, so we should be able to hear it with a Doppler." 3. "Your baby's heart right now is beginning to partition into four chambers and has begun to beat, so we should be able to hear it with a fetoscope." 4. "Your baby's heart right now has double heart chambers and has begun to beat, so we should be able to see it beat using an ultrasound machine."

4. "Your baby's heart right now has double heart chambers and has begun to beat, so we should be able to see it beat using an ultrasound machine."

The nurse in the prenatal clinic is providing nutritional counseling to a pregnant client. The nurse instructs the client to increase the intake of folic acid and tells the client that which food item is highest in folic acid? 1. Pork 2. Cheese 3. Chicken 4. Green leafy vegetables

4. Green leafy vegetables

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 purpose of estrogen. Which response should the nurse give the client for the purpose of estrogen? 1. It maintains and relaxes the uterine lining for implantation. 2. It stimulates metabolism of glucose and converts the glucose to fat. 3. It prevents the involution of the corpus luteum and maintains the production of progesterone until the placenta is formed. 4. It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.

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

The nurse is reviewing a nutritional plan of care with a pregnant client and is identifying the food items highest in folic acid. The nurse determines that the client understands the foods that supply the highest amounts of folic acid if the client states that she will include which item in the daily diet? 1. Milk 2. Yogurt 3. Bananas 4. Leafy green vegetables

4. Leafy green vegetables

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

The nurse is collecting data from a client seen in the health care clinic for a first prenatal visit. The nurse asks the client when the first day of her last menstrual period was and the client reports February 9, 2015. Using Nägele's rule, the nurse determines what is the estimated date of confinement (delivery)? 1. October 7, 2015 2. October 16, 2015 3. November 7, 2015 4. November 16, 2015

4. November 16, 2015