Maternity ch4

An unmarried pregnant adolescent who is attending a crisis intervention group has decided to continue the pregnancy and keep the baby. Now the crisis intervention nurse's primary responsibility is to: 1 Praise the client for making a wise decision. 2 Explore other problems that the client is experiencing. 3 Make an appointment for the client to visit a prenatal clinic. 4 Provide information about where the client will be able to get assistance.

Correct4 Provide information about where the client will be able to get assistance.

A nurse is counseling a pregnant client who is a vegetarian. What should the nurse plan to do to ensure optimal nutrition during the pregnancy? 1 Refer the client to a dietitian to help plan her daily menu. 2 Encourage the client to join a group that teaches nutrition. 3 Explain that she needs to include meat in her diet at least once a day. 4 Advise the client that it is unhealthy to continue a vegetarian diet during pregnancy.

1 Refer the client to a dietitian to help plan her daily menu.

A woman arrives at the prenatal clinic stating that her pregnancy test is positive. She asks the nurse for information about an abortion. After verifying that the woman is at 8 weeks' gestation, the nurse counsels her that having an abortion is controversial and that many women have long-lasting feelings of guilt after an abortion. What is the nurse's legal responsibility? 1- To share her own thoughts on abortion with the client 2- To provide the client with correct, unbiased information 3 -To ask why the client wants information about abortion 4-To notify the health care provider because this is beyond the scope of nursing practice

2 To provide the client with correct, unbiased information

A client is concerned about gaining weight during pregnancy. What should the nurse tell the client is the cause of the greatest weight gain during pregnancy? 1 Fetal growth 2 Fluid retention 3 Metabolic alterations 4 Increased blood volume

Correct1 Fetal growth

A woman's pregnancy has been uneventful, and she has gained 25 lb. At term her hemoglobin level is 10.6 g/dL and her hematocrit is 31%. What does the nurse identify as the reason for these hemoglobin and hematocrit levels? 1 Infection 2 Hemodilution 3 Nutritional deficits 4 Concealed bleeding

Correct2 Hemodilution

A nurse is planning a prenatal class about the changes that occur during pregnancy and the necessity of routine health care throughout pregnancy. Which cardiovascular compensatory mechanisms should the nurse explain will occur? Select all that apply. 1 Systemic vasodilation 2 Increased blood volume 3 Increased blood pressure 4 Increased cardiac output 5 Enlargement of the heart

Correct2 Increased blood volume Correct4 Increased cardiac output Correct5 Enlargement of the heart

A negative home pregnancy test may result if the woman performs the test: 1 By saturating the test strip 2 On the first void of the morning 3 10 days after intercourse took place 4 While taking a prescribed tranquilizer

Correct3 10 days after intercourse took place

A client at 22 weeks' gestation asks the nurse how to prevent back pain as her pregnancy progresses. What does the nurse suggest that she wear? 1 Maternity girdle 2 Support stockings 3 Low-heeled shoes 4 Loose-fitting clothing

Correct3 Low-heeled shoes

A pregnant woman reports nausea and vomiting during the first trimester of pregnancy. The nurse explains that an increase in which hormone is the precipitating cause of the nausea and vomiting? 1 Estrogen 2 Progesterone 3 Luteinizing hormone 4 Chorionic gonadotropin

Correct4 Chorionic gonadotropin

While a client is being interviewed on her first prenatal visit she states that she has a 4-year-old son who was born at 41 weeks' gestation and a 3-year-old daughter who was born at 35 weeks' gestation and lost one pregnancy at 9 weeks and another at 18 weeks. Using the GTPAL system, how would you record this information? 1 G5 T1 P1 A2 L2 2 G4 T1 P1 A2 L2 3 G4 T2 P0 A0 L2 4 G5 T2 P1 A1 L2

Correct1 G5 T1 P1 A2 L2

A client who has missed two menstrual periods tells a nurse at the prenatal clinic that the home pregnancy test was positive. Her last menstrual period began on June 18. According to Nägele's rule, what is the estimated date of birth (EDB)? 1 March 8 2 March 11 3 March 1 4 March 25

Correct4 March 25

When working with a client who has spontaneously aborted a pregnancy, it is important for the nurse to first deal with his or her own feelings about abortion, death, and loss so that he or she may: 1 Maintain control of the situation. 2 Share personal grief with the clients. 3 Allow the clients to express their grief. 4 Teach the clients how to cope effectively.

Correct3 Allow the clients to express their grief.

A client who is pregnant for the first time asks the nurse about the changes in her body. While describing the changes in each body system, the nurse mentions that the system that undergoes the most profound change of all during pregnancy is the: 1 Urinary system 2 Endocrine system 3 Cardiovascular system 4 Gastrointestinal system

Correct3 Cardiovascular system

A nurse is teaching a class of expectant parents about nutritional needs during pregnancy. What information should the nurse include? 1 Carbohydrate needs decrease during pregnancy. 2 Protein needs increase to at least 70 g/day during pregnancy. 3 Phosphorus and calcium needs decrease gradually throughout pregnancy. 4 Caloric needs increase gradually up to 100 more kcal/day throughout pregnancy.

Correct2 Protein needs increase to at least 70 g/day during pregnancy.

A nurse is assessing a pregnant 16-year-old client. What factors that may affect the outcome of the pregnancy should the nurse consider? Select all that apply. 1 Tendency to abuse drugs 2 Inappropriate dietary choices 3 Immature reproductive system 4 Underdeveloped musculoskeletal system 5 Undeveloped secondary sex characteristics

Correct2 Inappropriate dietary choices Correct3 Immature reproductive system Correct4 Underdeveloped musculoskeletal system

All women of childbearing age are advised to include at least 400 micrograms of folic acid in the daily diet to lessen the risk of neural tube defects in pregnancy. What should the nurse recommend to meet the recommendation? Select all that apply. 1 Vitamin A 2 Vitamin B6 3 Vitamin B9 4 Vitamin B12 5 Legumes, dark-green leafy vegetables, and citrus fruits 6 Eggs, meat, and poultry

All women of childbearing age are advised to include at least 400 micrograms of folic acid in the daily diet to lessen the risk of neural tube defects in pregnancy. What should the nurse recommend to meet the recommendation? Select all that apply. Correct3 Vitamin B9 Correct5 Legumes, dark-green leafy vegetables, and citrus fruits

A 23-year-old woman arrives at the prenatal clinic because she thinks that she is pregnant. Her last menstrual period began on March 31, and her pregnancy test reveals a positive result. According to Nägele's rule, what is this client's expected date of birth (EDB)? A. July 8 B. Jan 7 C. Dec 7 D. Dec 24

B. Jan 7

A woman who is pregnant for the first time is concerned about regaining her figure after her baby is born and wishes to diet during pregnancy. What should the nurse advise her? 1 Inadequate food intake can result in a low-birth-weight infant. 2 Dieting is recommended to lessen the incidence of stillbirth. 3 Dieting is recommended to make the birthing process easier. 4 Inadequate food intake can cause gestational diabetes mellitus.

Correct1 Inadequate food intake can result in a low-birth-weight infant.

While discussing dietary needs during pregnancy, a client tells the nurse, "I don't like to drink milk, because it makes me constipated." What should the nurse recommend? 1 Replacing nonfat milk with whole milk 2 Substituting a variety of cheeses for the milk 3 Dealing with constipation in some way other than omitting milk 4 Increasing the number of prenatal capsules to allow milk to be omitted

3 Dealing with constipation in some way other than omitting milk

During a client's first visit to the prenatal clinic, a nurse discusses a pregnancy diet. The client states that her mother told her that she should restrict her salt intake. What is the nurse's best response? 1 "Your mother is always correct. You should use less salt to prevent swelling during pregnancy." 2 "Because you need salt to maintain body water balance, it is not restricted. Just eat a well-balanced diet." 3 "Salt is an essential nutrient that is naturally reduced by the body's estrogen. There's no reason to restrict salt in your diet." 4 "We no longer recommend that salt intake be as restricted as much as in the past, but you still shouldn't add salt to your food."

2 "Because you need salt to maintain body water balance, it is not restricted. Just eat a well-balanced diet."

A woman visits the prenatal clinic because an over-the-counter pregnancy test has rendered a positive result. After the initial examination verifies the pregnancy, the nurse explains some of the metabolic changes that occur during the first trimester of pregnancy. Select all that apply. 1 Sleep needs increase. 2 Fluid retention increases. 3 Body temperature decreases. 4 Calcium requirements increase. 5 The need for carbohydrates decreases.

A woman visits the prenatal clinic because an over-the-counter pregnancy test has rendered a positive result. After the initial examination verifies the pregnancy, the nurse explains some of the metabolic changes that occur during the first trimester of pregnancy. Select all that apply. Correct1 Sleep needs increase. Correct2 Fluid retention increases Correct4 Calcium requirements increase.

A nurse is teaching a class of expectant parents about changes that are to be expected during pregnancy. What changes does the nurse explain result from the melanocyte-stimulating hormone? Select all that apply. 1 Chloasma 2 Linea nigra 3 Effacement 4 Morning sickness 5 Cervical softening 6 Urinary frequency

Correct1 Chloasma Correct2 Linea nigra

A nurse is discussing diet with a pregnant client who is 5 feet 4 inches tall and whose prepregnancy weight was 120 lb. What should the nurse include about the changes in calories and nutrients, compared with the prepregnancy diet, during the second trimester? 1 Decreasing daily fat consumption by 220 calories 2 Increasing total daily caloric intake by 340 calories 3 Increasing total daily caloric intake by 460 calories 4 Decreasing daily carbohydrate consumption by 130 calories

Correct2 Increasing total daily caloric intake by 340 calories

A nurse teaches the warning signs that should be reported throughout pregnancy. Which statement by the client indicates an understanding of the prenatal instructions? 1 "I'll call the clinic if I have abdominal pain." 2 "Mild, irregular contractions mean that my labor is starting." 3 "I need to call the clinic if my ankles start to swell at night." 4 "A whitish vaginal discharge means that I'm getting an infection."

Correct1 "I'll call the clinic if I have abdominal pain."

A client elects to have her pregnancy terminated after finding out at 16 weeks' gestation that she is carrying a fetus with Down syndrome. What should the nurse conclude about an abortion at this stage of the pregnancy? 1 The client is exhibiting emotional instability. 2 There is a high risk for a postabortion infection. 3 Contraceptive counseling should be deferred to a later time. 4 An opportunity for the client to express feelings about her decision should be provided.

Correct4 An opportunity for the client to express feelings about her decision should be provided.

A strict vegetarian (vegan) becomes pregnant and asks the nurse whether there is anything special she should do in regard to her diet during pregnancy. What is most the important measure for the nurse to instruct the client to take? 1 Eat at least 40 g/day of protein. 2 Drink at least 1 quart/day of milk. 3 Take a vitamin supplemented with iron every day. 4 Plan to eat from specific groups of vegetable proteins each day.

Correct4 Plan to eat from specific groups of vegetable proteins each day.

Using the five-digit system, determine the obstetric history in this situation: The client is 38 weeks into her fourth pregnancy. Her third pregnancy, a twin gestation, ended at 32 weeks with a live birth, her second pregnancy ended at 38 weeks with a live birth, and her first pregnancy ended at 18 weeks. 1 G4, T2, P1, A1, L2 2 G4, T1, P2, A1, L1 3 G4, T1, P1, A1, L3 4 G4, T2, P1, A1, L1

3 G4, T1, P1, A1, L3

After reading that nutrition during pregnancy is important for optimal growth and development of a baby, a pregnant woman asks the nurse what foods she should be eating. The nurse begins the teaching/learning process by: 1 Asking the client what she usually eats at each meal 2 Explaining to the client why spicy foods should be avoided 3 Instructing the client to add calories while continuing to eat a healthy diet 4 Providing the client with a list of foods for reference when planning meals

Correct1 Asking the client what she usually eats at each meal

A pregnant client asks a nurse for information about toxoplasmosis during pregnancy. What should the nurse teach the client about how to prevent the transmission of toxoplasmosis? 1 Pork and beef should be cooked well before being eaten. 2 Salads with mayonnaise dressing should be avoided during the summer. 3 Raw shellfish are intermediary hosts and should be avoided during pregnancy. 4 Toxoplasmosis is a disease that is prevalent in underdeveloped countries, not in developed ones.

Correct1 Pork and beef should be cooked well before being eaten.

A client at 7 weeks' gestation tells the nurse in the prenatal clinic that she has been bothered by episodes of nausea, but no vomiting, throughout the day. What should the nurse recommend? Select all that apply. 1 Focus on and repeat a rhythmic chant. 2 Sit upright for 30 minutes after meals. 3 Take low-sodium antacids after meals. 4 Drink carbonated beverages with meals. 5 Eat small, frequent meals and eat dry crackers in between.

Correct1 Focus on and repeat a rhythmic chant. Correct5 Eat small, frequent meals and eat dry crackers in between

What are the indicators of nutritional risk in pregnancy in a client who is of normal weight? Select all that apply. 1 Smoker 2 Twin gestation 3 Hemoglobin of 12 g/dL 4 Term delivery 2 years ago 5 Caffeine intake of 180 mg/day 6 Fasting blood sugar of 80 mg/dL

Correct1 Smoker Correct2 Twin gestation

A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and got a positive result. She confides that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl whether she has told anyone else, she replies, "Yes, but my mother doesn't believe me." Legally, who should the nurse notify? 1 Police concerning a possible sex crime 2 Health care provider to confirm the pregnancy 3 Child protective services for immediate intervention 4 Girl's mother about the pregnancy test's positive result

Correct3 Child protective services for immediate intervention

A primigravida in the first trimester tells a nurse that she has heard that hormones play an important role in pregnancy. Which hormone should the nurse tell the client maintains pregnancy? 1 Prolactin 2 Estrogen 3 Progesterone 4 Somatotropin

Correct3 Progesterone

The school nurse is teaching a group of 16-year-old girls about the female reproductive system. One student asks how long after ovulation it is possible for conception to occur. The most accurate response by the nurse is based on the knowledge that an ovum is no longer viable after: 1 12 hours 2 24 hours 3 48 hours 4 72 hours

Correct2 24 hours

A woman has just received the news that she is pregnant. She is ambivalent about the pregnancy because she had planned to go back to work when her youngest child started school next year. What developmental task of pregnancy must the woman accomplish in the first trimester of pregnancy? 1 Recognize her ambivalence. 2 Accept that she is pregnant. 3 Prepare for the birth of the baby. 4 Recognize the fetus as an individual separate from the mother.

Correct2 Accept that she is pregnant.

A primigravida in her 10th week of gestation is concerned because she has read that nutrition during pregnancy is important for the growth and development of the fetus. She wants to know something about the foods she should eat. How should the nurse respond initially? 1 By instructing her to continue eating her regular diet 2 By asking her what she has eaten over the last 3 days 3 By giving her a list of foods to help her plan her meals more efficiently 4 By emphasizing to her the importance of limiting highly seasoned foods

Correct2 By asking her what she has eaten over the last 3 days

While conducting prenatal teaching, a nurse should explain to clients that there is an increase in vaginal secretions during pregnancy called leukorrhea. What causes this increase? 1 Decreased metabolic rate 2 Increased production of estrogen 3 Secretion from the Bartholin glands 4 Supply of sodium chloride to the vaginal cells

Correct2 Increased production of estrogen

A nurse is counseling a woman who has just been found to have a multiple gestation. Why does the nurse consider this pregnancy high risk? 1 Postpartum hemorrhage is an expected complication. 2 Perinatal mortality is two to three times more likely in multiple than in single births. 3 Optimal psychological adjustment after a multiple birth requires 6 months to 1 year. 4 Maternal mortality is higher during the prenatal period in the setting of multiple gestation.

Correct2 Perinatal mortality is two to three times more likely in multiple than in single births.

Which assessment findings of a child would indicate a need for genetic consultation? Select all that apply. 1 Fetal alcohol syndrome 2 Visual or hearing problems 3 Family history of mental illness 4 Development and speech delays 5 Excessive bleeding or excessive clotting

Correct2 Visual or hearing problems Correct3 Family history of mental illness Correct4 Development and speech delays Correct5 Excessive bleeding or excessive clotting

A client visits her health care provider to confirm a suspected pregnancy. While giving the nursing history, the client states that her last menstrual period began on April 11 and that she noted some spotting on May 8. In light of these data, what does the nurse estimate as the expected date of birth (EDB)? 1 January 8 2 January 11 3 January 18 4 January 25

Correct3 January 18

A client whose weight was average for her height before becoming pregnant is concerned because she has gained 15 lb (6.9 kg) after only 23 weeks of pregnancy. What is the nurse's most appropriate response? 1 "You have not gained enough weight. Can you increase your daily intake of calories?" 2 "Your weight is not a concern. I'll refer you to the dietitian, who will review your diet." 3 "You've gained too much weight for 23 weeks' gestation. Are your rings getting tight?" 4 "Your weight is expected for someone at 23 weeks' gestation. Continue the pregnancy diet."

Correct4 "Your weight is expected for someone at 23 weeks' gestation. Continue the pregnancy diet."

A pregnant single client who is attending a crisis intervention group has finally decided to go through with the pregnancy and keep the baby. What is the crisis intervention nurse's primary responsibility at this time? 1 Confirming that this really is what the client wants to do 2 Exploring other problems that the client may be experiencing 3 Selecting a health care provider that the client can visit for prenatal care 4 Providing information about resources from which the client may receive assistance

Correct4 Providing information about resources from which the client may receive assistance

A pregnant woman tells a nurse in the prenatal clinic that she knows that folic acid is very important during pregnancy and that she is taking a prescribed supplement. She asks the nurse what foods contain folic acid (folate) so she may add them to her diet in its natural form. Which foods should the nurse recommend? Select all that apply. 1 Beef and fish 2 Milk and cheese 3 Chicken and turkey 4 Black and pinto beans 5 Enriched bread and pasta

Correct4 Black and pinto beans Correct5 Enriched bread and pasta