Maternity: Pregnancy AT RISK

Which information would the nurse give a pregnant client about having a chorionic villus sampling (CVS) before the 10th and 12th weeks? 1. The test can cause fetal anomalies. 2. The results are not as accurate. 3. The information it provides is inadequate. 4. It must be done with the use of laparoscopic surgery.

1. The test can cause fetal anomalies.

Which statement by a new mother observing her preterm infant in the neonatal intensive care nursery indicates that she has not yet begun the bonding process? 1. "It's such a tiny baby." 2. "Do you think he'll make it?" 3. "Why does he need to be in an incubator?" 4. "My baby looks so much like my husband.

1. "It's such a tiny baby."

Which impending problem would the nurse suspect when caring for a client with bloody urine in the indwelling catheter collection bag, after an emergency cesarean birth? 1. Incisional nick in the bladder 2. Urinary infection from the catheter 3. Uterine relaxation with increased lochia 4. Disseminated intravascular coagulopathy

1. Incisional nick in the bladder

Which guideline regarding sexual intercourse would be given to a client with preterm contractions and cervical dilation of 2 cm? 1. It should be limited to once a week. 2. It is prohibited because it may stimulate labor. 3. It should be restricted to the side-lying position. 4. It is permitted as long as penile penetration is shallow.

2. It is prohibited because it may stimulate labor.

A client is admitted at 40 weeks' gestation with her cervix dilated 5 cm and 100% effaced, the presenting part at station 0, and fetal heart tones heard just above the umbilicus. Which fetal presentation is indicated by these assessment findings? 1. Face 2. Brow 3. Breech 4. Shoulder

3. Breech

Which assessment finding would the nurse expect in a client with untreated preeclampsia? 1. Increased blood pressure of 150/100 mm Hg 2. Increased blood pressure that is accompanied by a headache 3. Blood pressure above the baseline that fluctuates with each reading 4. Blood pressure higher than 140 mm Hg systolic accompanied by proteinuria

4. Blood pressure higher than 140 mm Hg systolic accompanied by proteinuria

A pregnant client with a history of preterm labor is at home on bed rest. Which instruction would be included in this client's teaching plan? 1. Place blocks under the foot of the bed. 2. Sit upright with several pillows behind the back. 3. Lie on the side with the head raised on a small pillow. 4. Assume the knee-chest position at regular intervals throughout the day.

3. Lie on the side with the head raised on a small pillow.

The nurse teaches a client who is about to undergo an amniocentesis that ultrasonography will be performed just before the procedure to determine which? 1. Gestational age of the fetus 2. Amount of fluid in the amniotic sac 3. Position of the fetus and the placenta 4. Location of the umbilical cord and placenta

3. Position of the fetus and the placenta

A 37-year-old G3P2001 client with hypertension and type 1 diabetes with good glycemic control is seen in the antepartum testing unit for a nonstress test (NST) at 36 weeks. Her obstetric (OB) history includes an intrauterine fetal death at 38 weeks. What risk factors in the client's history indicate the need for an NST? Select all that apply. One, some, or all responses may be correct. 1. Age older than 35 years 2. The risk for placenta previa 3. The risk for placental insufficiency 4. A history of stillbirth from her last pregnancy 5. Hypertension 6. Type 1 diabetes

1. Age older than 35 years 3. The risk for placental insufficiency 4. A history of stillbirth from her last pregnancy 5. Hypertension 6. Type 1 diabetes

Which method would the nurse use to assess blood loss in a client with placenta previa? 1. Count or weigh perineal pads. 2. Monitor pulse and blood pressure. 3. Check hemoglobin and hematocrit values. 4. Measure or estimate the height of the fundus.

1. Count or weigh perineal pads.

A client with a blood pressure of 150/90 mm Hg, 3+ proteinuria, and edema of the hands and face is diagnosed with severe preeclampsia. Which other clinical findings support this diagnosis? Select all that apply. One, some, or all responses may be correct. 1. Headache 2. Constipation 3. Abdominal pain 4. Vaginal bleeding 5. Visual disturbances

1. Headache 3. Abdominal pain 5. Visual disturbances

A 26-year-old primigravida experiencing severe abdominal pain is brought to the emergency department by ambulance with a suspected ruptured tubal pregnancy. Which is the priority nursing action? 1. Inserting an intravenous (IV) catheter 2. Asking the client to sign a surgical consent form 3. Determining whether a family member is present 4. Ascertaining the first day of the client's last menstrual period

1. Inserting an intravenous (IV) catheter

Which education is appropriate to give a client at 16 weeks' gestation whose partner has just informed her that he has genital herpes? 1. Latex or polyurethane condoms must be used when the couple is having intercourse. 2. Mutual monogamy must be practiced. 3. It will be necessary to refrain from sexual contact during pregnancy. 4. Meticulous cleaning of the vaginal area after intercourse is essential.

1. Latex or polyurethane condoms must be used when the couple is having intercourse.

Which statement by a woman with preeclampsia indicates the need for further teaching about needed dietary changes? 1. "I should avoid excess salt." 2. "I should limit my fluid intake." 3. "I should eat whole grains and raw produce." 4. "I should eat 60 to 70 grams of protein each day."

2. "I should limit my fluid intake."

Which nursing action is most appropriate for a pregnant client at 23 weeks' gestation with pica? 1. Offering referral to a mental health care provider 2. Explaining the potential danger of pica to the fetus 3. Obtaining a prescription for an iron supplement 4. Determining whether the diet is safe and nutritionally adequate

4. Determining whether the diet is safe and nutritionally adequate

Which factor will increase the risk for hypotonic uterine dystocia in a postpartum client? 1. Twin gestation 2. Gestational anemia 3. Hypertonic contractions 4. Gestational hypertension

1. Twin gestation

A pregnant client is admitted with abdominal pain and heavy vaginal bleeding. Which is the immediate nursing action? 1. Administering oxygen 2. Elevating the head of the bed 3. Drawing blood for a hematocrit level 4. Giving an intramuscular analgesic

1. Administering oxygen

A client with mild preeclampsia is admitted to the labor and birthing suite. Which signs or symptoms would the client be likely to display if she were developing hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome)? Select all that apply. One, some, or all responses may be correct. 1. Headache 2. Constipation 3. Right upper quadrant abdominal pain 4. Vaginal bleeding 5. Nausea and vomiting

1. Headache 3. Right upper quadrant abdominal pain 5. Nausea and vomiting

Which complication is the result of type 1 diabetes in a pregnant client? 1. Increased risk of hypertensive states 2. Abnormal placental implantation 3. Excessive weight gain because of increased appetite 4. Decreased amount of amniotic fluid as the pregnancy progresses

1. Increased risk of hypertensive states

While assessing a client during the fourth stage of labor, the nurse notes that the perineal pad is soaked with approximately 75 mL of lochia rubra. Which nursing action is the priority? 1. Massage the uterine fundus. 2. Document the amount and type of lochia. 3. Accompany the client to the bathroom to empty her bladder. 4. Draw blood to test for hemoglobin and hematocrit levels.

1. Massage the uterine fundus.

A client's membranes rupture, and the nurse immediately detects the presence of a prolapsed umbilical cord. The primary health care provider has been notified. Place the following nursing interventions in the order in which they would be performed. 1. Moving the presenting part off the cord 2. Placing the client in the Trendelenburg position 3. Administering oxygen by facemask 4. Checking the fetal heart rate

1. Moving the presenting part off the cord 2. Placing the client in the Trendelenburg position 3. Administering oxygen by facemask 4. Checking the fetal heart rate

Which symptom in a pregnant client lying on her back indicates the need for emergency intervention? Select all that apply. One, some, or all responses may be correct. 1. Pallor 2. Eupnea 3. Bradycardia 4. Increased blood pressure 5. Decreased oral temperature

1. Pallor

Which is a likely cause of painless vaginal bleeding during the last trimester of pregnancy? 1. Placenta previa 2. Abruptio placentae 3. Frequent sexual intercourse 4. Excessive alcohol ingestion

1. Placenta previa

Which significant clinical finding would the nurse expect when reviewing the history of a client with preeclampsia? 1. Proteinuria 2. Tachycardia 3. Increased serum glucose 4. Tonic-clonic movements

1. Proteinuria

Which assessment finding presents the highest risk for cardiac shock? 1. Pulse 104 beats/minute 2. Respirations 22 breaths/minute 3. Temperature 98.9°F (37.2°C) 4. Blood pressure 114/68 mm Hg

1. Pulse 104 beats/minute

Which prophylactic medication would the nurse anticipate administering to a pregnant client who has mitral valve stenosis during the intrapartum period? 1. Diuretic 2. Antibiotic 3. Cardiotonic 4. Anticoagulant

2. Antibiotic

Assessment of a primigravida at 32 weeks' gestation shows a blood pressure of 170/110 mm Hg, 4+ proteinuria, and edema of the face and extremities. With which complication are these findings consistent? 1. Eclampsia 2. Severe preeclampsia 3. Chronic hypertension 4. Gestational hypertension

2. Severe preeclampsia

A 16-year-old adolescent visits the prenatal clinic because she has missed three menstrual periods. Before her physical examination she says, "I don't know what the problem is, but I just can't be pregnant." Which is the nurse's most appropriate response? 1. "Many young women are irregular at your age." 2. "You probably are pregnant if you had intercourse." 3. "Why did you decide to come to the prenatal clinic?" 4. "Should I ask the primary health care provider to talk to you?"

3. "Why did you decide to come to the prenatal clinic?"

The nurse gently performs Leopold maneuvers on a client with a suspected placenta previa. Which would the nurse expect to find during this assessment? 1. Firm engagement of the fetal head 2. Difficulty palpating small fetal parts 3. A high, floating fetal presenting part 4. A hard and tetanically contracted uterus

3. A high, floating fetal presenting part

A primigravida at term has dark red vaginal bleeding and complains of pain continuing between contractions. The nurse palpates the abdomen, which is firm and shows no sign of relaxation. Which problem is suggested by these assessment findings? 1. Placenta previa 2. Precipitous birth 3. Abruptio placentae 4. Breech presentation

3. Abruptio placentae

Which is the most important nursing intervention for a client who is at 26 weeks' gestation with pyelonephritis? 1. Limiting fluid intake 2. Examining the urine for protein 3. Checking for signs of preterm labor 4. Maintaining her on a moderate-sodium diet

3. Checking for signs of preterm labor

The nurse teaching a prenatal class is asked why infants of diabetic mothers are larger than those born to women who do not have diabetes. On which information about pregnancy and diabetes would the nurse base the response? 1. Taking exogenous insulin stimulates fetal growth. 2. Consuming more calories covers the insulin secreted by the fetus. 3. Extra circulating glucose causes the fetus to acquire fatty deposits. 4. Fetal weight gain increases as a result of the common response of maternal overeating.

3. Extra circulating glucose causes the fetus to acquire fatty deposits.

Which action would the nurse take first for a client who is in active labor and experiences sudden vaginal bleeding and increased uterine tone without relaxation between contractions? 1. Transport the client for a cesarean birth. 2. Check the perineum for rupture of membranes. 3. Change the underpad and position the client on her left side. 4. Assess the fetal heart rate, uterine activity, and blood pressure.

4. Assess the fetal heart rate, uterine activity, and blood pressure.

Which assessment would the nurse include in the plan of care for a postpartum client with large, painful varicose veins? 1. Monitoring daily clotting times 2. Assessing for peripheral pulses 3. Monitoring daily hemoglobin values 4. Assessing for signs of thrombophlebitis

4. Assessing for signs of thrombophlebitis

Which conclusion is indicated by a positive contraction stress test (CST)? 1. A nonstress test is needed. 2. An immediate cesarean birth is needed. 3. The fetal heart rate is within the expected limits for the average fetus. 4. Late decelerations of the fetal heart rate are occurring with each contraction.

4. Late decelerations of the fetal heart rate are occurring with each contraction.

Cramping and vaginal spotting occurring at 12 weeks' gestation in conjunction with a closed cervix is characteristic of which problem? 1. Missed abortion 2. Inevitable abortion 3. Incomplete abortion 4. Threatened abortion

4. Threatened abortion