NUR106 Module A Quiz

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. The client lost one pregnancy at 9 weeks and another at 18 weeks. Using the GTPAL system, how would you record this information?

G5 T1 P1 A2 L2

A client in her 10th week of pregnancy exhibits presumptive signs of pregnancy. Which clinical findings may the nurse determine upon assessment? Select all that apply

1 Amenorrhea 2 Breast changes 3 Urinary frequency

The nurse is teaching a childbirth class to a group of pregnant women. One of the women asks the nurse at what point during the pregnancy the embryo becomes a fetus. How should the nurse respond?

"During the eighth week of the pregnancy"

A 23-year-old primigravida is at her first prenatal appointment today. Ultrasound indicates that she is at 9 weeks' gestation. She asks when she can first expect to feel her baby move. What is the best response by the nurse?

"Many women are able to first feel light movement between 18 and 20 weeks."

A client visiting the prenatal clinic for the first time asks the nurse about the probability of having twins because her husband is one of a pair of fraternal twins. What is the appropriate response by the nurse?

"There's no greater probability of you having twins than in the general population." Rational: Fraternal twins may occur as a result of a hereditary trait, but it is related to the release of two eggs during one ovulation; the fact that the father is a fraternal twin would not influence the female's ovaries to release two eggs during one ovulation. Although this response is true, it does not answer the client's question. If there is no maternal family history of twin pregnancies, this client's pregnancy with twins would be a chance occurrence equal to the probability found in the general population.

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 Smokers generally have a nutrient-poor diet and are at risk for continuing the same diet through pregnancy. Multifetal pregnancies require nutrition above the normal requirements for pregnancy. A hemoglobin reading of 12 g/dL and fasting blood sugar of 80 mg/dL are normal values. Caffeine intake of 180 mg/day is less than the daily recommended intake.

A client at 7 weeks' gestation tells the nurse in the prenatal clinic that she has been bothered by episodes of nausea throughout the day. Which interventions should the nurse recommend? Select all that apply.

Focus on and repeat a rhythmic chant.

A negative home pregnancy test may result if the woman does what when performing the test?

10 days after intercourse took place

A man and a woman want to use the calendar (rhythm) method of contraception but do not understand how it works. During what timeframe does the nurse explain that they should refrain from intercourse?

14 days before the onset of menstruation Ovulation is anticipated approximately 14 days before menstruation; however, it is more reliable to avoid using a specific number of days and instead base calculations on the individual's cycle rather than the average 28-day cycle. Seven days before or after the end of the menstrual period and 14 days after the completion of the menstrual period are not when ovulation occurs.

A client who menstruates regularly every 30 days asks a nurse on what day she is most likely to ovulate. Because the client's last menses started on January 1, the nurse should tell her that ovulation should occur on which day in January?

16

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.

G4, T1, P1, A1, L3

Which physiologic alteration does the nurse expect in a client's hematologic system during the second trimester of pregnancy?

An increase in blood volume The blood volume increases by approximately 50% during pregnancy. Peak blood volume occurs between 30 and 34 weeks' gestation. The hematocrit decreases as a result of hemodilution. The sedimentation rate increases because of a decrease in plasma proteins. White blood cells count remains stable during the antepartum period.

A client exhibits oligohydramnios at 36 weeks' gestation. What newborn complication should the nurse anticipate?

Intrauterine growth restriction (IUGR)

A pregnant woman tells a nurse, "I think I can feel the baby move now. It feels like butterflies in my stomach. My friend calls it feeling life." What term should the nurse include when discussing fetal movement with the woman?

Quickening

The nurse is assessing a pregnant client during the third trimester. Which clinical finding is expected in the later stages of pregnancy?

Shortness of breath on exertion Shortness of breath on exertion is an expected cardiopulmonary adaptation during pregnancy caused by an increased ventricular rate and elevated diaphragm. Tachycardia, dyspnea at rest, and progressive dependent edema are pathologic signs of impending cardiac decompensation.

During a routine second-trimester visit to the prenatal clinic a client expresses concern regarding gaining weight and losing her figure. She says to the nurse, "I'm going on a diet." What is the nurse's best response?

"If you add 340 calories a day to your regular diet, you won't become overweight." Weight reduction is not advised during pregnancy; an additional 340 calories a day during the second trimester is recommended. When the client reaches the third trimester, another 120 calories should be added to her diet. A pregnant woman should not diet during pregnancy. Advising the client to eat a variety of foods provides insufficient information. The client should increase her protein and calorie intake during pregnancy. Dieting during pregnancy is harmful; the fetus may be deprived of essential nutrients. The client should not be limited to a specific weight gain. There is no specific recommendation for the amount of weight a pregnant woman should gain. However, 25 to 30 lb (11 to 16 kg) is the average generally suggested; this figure is based on the recommended caloric intake during pregnancy and the client's pre-pregnancy weight and metabolic rate.

After performing Leopold maneuvers on a laboring client, the nurse determines that the fetus is in the right occiput posterior (ROP) position. Where should the Doppler ultrasound transducer be placed to best auscultate fetal heart tones?

Below the umbilicus on the right side

A nurse is teaching a young primigravida regarding expected body changes during pregnancy. The nurse explains that most prenatal clients experience urinary frequency in the first trimester due to an increase in what?

Bladder pressure from the enlarged uterus

The 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 what?

Cardiovascular system

A 37-year-old woman agrees to have a prenatal test done in order to diagnose fetal defects. There is a history of Down syndrome in her family. Which invasive prenatal test provides the earliest diagnosis and rapid test results?

Chorionic villus sampling Rational: Chorionic villus sampling may be performed between 10 and 12 weeks' gestation. Amniocentesis may be performed after 14 weeks' gestation, when sufficient amniotic fluid is available. Direct access to the fetal circulation with percutaneous umbilical blood sampling may be performed during the second and third trimesters. The nonstress test, which is not invasive, is a technique used for antepartum evaluation of the fetus; it does not reveal fetal defects. A woman in labor with no known