Chapter 25: Pregnancy PrepU

During the health interview of a client who has just learned that she is pregnant, the nurse is assessing the client's health history. What assessment question most directly addresses a known risk for congenital malformations?

"Do you have diabetes?"

Which statement by the pregnant woman shows an understanding that she should avoid teratogens in the first trimester?

"I have to call my doctor to switch me from lithium to another drug for my bipolar disorder."

A pregnant client comes in for a routine visit and tells the nurse that she is concerned with the frequent nosebleeds that she is experiencing. What should the nurse inform her about these nosebleeds?

"Nosebleeds are common in pregnancy and caused by capillary rupture from increased progesterone."

A pregnant client states, "I am only 6 weeks pregnant, but the morning sickness is awful. When is it going to stop?" What is the best response by the nurse?

"Usually after 12 weeks, when the placenta starts managing the production of progesterone, morning sickness ends."

The 22-week prenatal client states, "I feel a pulling type of pain around my belly button." Which is the best initial response by the nurse?

"Your body is stretching as the baby grows."

A newly pregnant client says that she has heard that her nipples will leak milk during the pregnancy. The nurse should tell the client that she should be able to express colostrum from her nipples beginning at how many weeks' gestation?

24 to 28

Mrs. Kelly comes to the clinic for her usual prenatal check-up. The nurse measures the fundal height at 24 cm. What is the estimated length of her gestation?

24 weeks

A client who is of normal weight just learned that she is 10 weeks pregnant. The client asks the nurse about weight gain during pregnancy. The nurse should instruct the client that the recommended weight gain is

25 to 35 pounds.

A woman being interviewed by the nurse states that she is 6 weeks pregnant. If her report is accurate, when did the patient conceive?

4 weeks ago

A client at 26 weeks' gestation appears at the clinic for her first prenatal visit. During the health interview, she states that she has been a habitual cocaine user. The nurse understands that this client is at risk for what compllication?

Abruptio placenta

The blood tests for a primigravida client indicate that the client is Rh-negative and her partner is Rh-positive. What is an appropriate nursing intervention for this client?

Arrange for Rho immune globulin at 28 weeks' gestation

A client at 32 weeks' gestation, who has had regular prenatal care, is found to have gained 6 pounds in 1 week. Which of the following would be most appropriate for the nurse to do next?

Assess the legs for edema.

The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?

At the level of the umbilicus

A woman comes to the clinic complaining of irregular contractions lasting less than 30 seconds and occurring no more frequently than 5 times in 1 hour. She is afraid of losing the pregnancy. She is at 26 weeks of gestation with her first child. What is most likely happening to this woman?

Braxton Hicks contractions

A nurse inspects a pregnant woman's cervix and notes it to be bluish in color. What is the correct term the nurse should use to document this finding?

Chadwick's sign

A client reports that she has been pregnant four times, had two babies born at term, no preterm births, two spontaneous abortions, and has two living children. The nurse should document the client's gravida and para status as which of the following?

G4 P2022

A pregnant client tests positive for Group B Streptococcus. The nurse understands that what intervention is necessary to protect the infant?

Give the mother antibiotics 4 hours prior to delivery.

Due to the risk of fetal transmission, pregnant mothers should be screened for what disease?

Hepatitis

Urine and blood pregnancy tests measure the level of which hormone to validate the existence of pregnancy?

Human chorionic gonadotropin (hCG)

A nurse is attempting to auscultate fetal heart tones after determining that the fetus is in a longitudinal lie, cephalic presentation, and left occiput anterior position. The nurse would auscultate them at which area?

Left lower quadrant

A client in her third trimester of pregnancy is undergoing a physical assessment. Her nurse explains that she is about to estimate what position the fetus is presently in by palpating the uterine fundus to see whether the head or buttocks is presenting. What is this procedure called?

Leopold's maneuver

A 22-year-old patient comes to the office for a prenatal visit. She is in her second trimester and has had prenatal care since she was 8 weeks pregnant. Her only complaint is a new brownish line straight down her abdomen. Vital signs are unremarkable. Urine has no protein, glucose, or leukocytes. Fetal heart rate is 140; the client's uterus is palpated to the umbilicus. What physical finding is responsible for her new "brown line?"

Linea nigra

A client who is pregnant presents to the health care clinic with reports of left breast pain, redness, and warmth. The nurse recognizes these as signs of which abnormal finding of pregnancy?

Mastitis

Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing?

Obtain a clean catch urine

A client who is pregnant presents to the health care clinic for a routine checkup. She tells the nurse that her hands have been tingling over the past 2 weeks and they often become numb at night. What assessment should the nurse perform to obtain data in regards to this subjective information?

Perform the Phalen's test

In assessing a client who is in her second trimester, a nurse observes that the client is underweight and anemic from lack of dietary iron. The nurse suspects malnutrition and asks the client about her diet and eating habits. The client confesses that she has been craving and eating clay recently. The nurse recognizes this condition as which of the following?

Pica

The client has confirmation of an unruptured ectopic pregnancy. What does the nurse anticipate will be a priority intervention?

Prepare the client for termination of the pregnancy.

A nurse assesses a 23-year-old primigravida client in her first trimester. The client reports problems with excessive salivation. Which of the following conditions should the nurse document in this client?

Ptyalism

The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence?

Quickening

What cervical change should a nurse recognize as indicating that a woman has delivered a fetus vaginally?

Slit-like appearance

In examining a client who is in her third trimester, the nurse notes pinkish-red streaks with slight depressions in the skin over the client's abdomen and breasts. The nurse documents this finding as which of the following?

Striae gravidarum

A pregnant client visits the clinic for the first time. The client tells the nurse that this is her first pregnancy and that she and her husband are Ashkenazi Jews and immigrated to the United States from Israel. The nurse should encourage the client to be tested for

Tay-Sachs disease.

A young woman comes to the ED with lower abdominal pain on the right side and has been spotting blood for 2 days. She is diagnosed with an ectopic pregnancy, which is an obstetric emergency. An ectopic pregnancy is when what occurs?

The egg never leaves the fallopian tube

Which prenatal client has the greatest risk of delivering a baby with a defect?

Which prenatal client has the greatest risk of delivering a baby with a defect?

While assessing the abdomen of a pregnant client, the nurse observes striae gravidarum. The nurse should instruct the client that after delivery, the striae gravidarum will

fade to a white or silvery color.

A pregnant client at 12 weeks' gestation visits the clinic and tells the nurse that she has been vomiting severely for the past 5 days. The nurse should refer the client to a physician for possible

hyperemesis gravidarum.

The nurse is caring for a client who is 24 weeks pregnant. The client tells the nurse that she has been secreting colostrum for the past few days. The nurse should instruct the client that colostrum secretion

is normal for some women in the second and third trimesters.