OB Ch 12 Prep U

A client with a prepregnant BMI of 26 is concerned about gaining weight during pregnancy. Which statement by the client indicates an appropriate goal for this pregnancy?

"I need to consume at least 1,500 nutrient-dense calories each day."

A pregnant client is undergoing a fetal biophysical profile. Which parameter of the profile helps measure long-term adequacy of the placental function?

amniotic fluid volume

A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which location?

at the umbilicus

A nurse is providing education to a client who is 8 weeks' pregnant. The client stated she does not like milk. What is a source of calcium that the nurse can recommend to the client?

dark, leafy green vegetables

What anatomic area should be examined when assessing Montgomery tubercles?

breasts

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history?

G3, T0, P1, A1, L1

A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion. How would the nurse document this information on the patient chart?

G5 P3114

A client 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

When providing preconception care to a client, the nurse would identify which medication as being safe to continue during pregnancy?

famotidine (antacid)

A young woman with scoliosis has just learned that she is pregnant. Several years ago, she had stainless-steel rods surgically implanted on both sides of her vertebrae to strengthen and straighten her spine. However, her pelvis is unaffected by the condition. What does the nurse anticipate in this woman's pregnancy?

potential for greater than usual back pain

What is the most effective way for a nurse to assess a woman's usual food intake during her pregnancy?

Ask her to describe her intake for the last 24 hours.

The nurse advises a pregnant client to keep a small high-carbohydrate, low-fat snack at the bedside. The nurse should point out this will assist with which condition?

Nausea and vomiting

A nurse is caring for a client in her second trimester of pregnancy. During a regular follow-up visit, the client reports varicosities of the legs. Which instruction should the nurse provide to help the client alleviate varicosities of the legs?

Refrain from crossing legs when sitting for long periods.

A woman who is pregnant for the first time has arrived to the labor department thinking she was in labor only to be diagnosed with Braxton Hicks contractions and sent home. Prior to leaving ther unit, the woman asks, "How will I know when it is 'true' labor?" Which signs/symptoms should the woman assoicate with true labor? Select all that apply.

- pain in back that wraps across the abdomen that increases in frequency and intensity - pink-tinged blood and mucus mixture on underwear - sudden gush of clear fluid coming from the vagina

A client in her second trimester of pregnancy arrives at a health care facility reporting heartburn. What instructions should the nurse offer to help the client deal with heartburn? Select all that apply.

- Limit consumption of food before bedtime. - Sleep in a semi-Fowler's position. - Avoid overeating.

If a client is receiving total parenteral nutrition (TPN) for hyperemesis gravidarum, which bedside lab tests need to be performed daily? Select all that apply.

- blood glucose testing - urine for ketones

The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which signs and symptoms would the nurse include? Select all that apply.

- headache with visual changes in the third trimester - sudden leakage of fluid during the second trimester - lower abdominal pain with shoulder pain in the first trimester

During the inital history and physical of a 30-year-old primapara client, the nurse has identified some teratogens the fetus is being exposed to at this phase of the pregnancy. Which lifestyle data could result in teratogenic exposure to the fetus? Select all that apply.

- smoking 2 packs of cigarettes a day - drinking alcoholic beverages 3 times a week - snorting cocaine once or twice a month

The nurse is providing care for a pregnant client who has been given the necessary requisitions for laboratory work by the primary care provider. The client notices that the lab tests include testing for HIV and other sexually transmitted infections, and expresses alarm, stating, "I don't understand why the doctor would suspect that I've got these diseases." What is the nurse's most therapeutic statement?

"Every pregnant client is tested for these diseases; it doesn't necessarily suggest that the doctor suspects that you have them."

The nurse is conducting a teaching session for breastfeeding mothers. Which statement by a mother requires further clarification by the nurse?

"I am glad I can have my two cups of coffee in the morning again."

The nurse is assessing a client's risk for sexually transmitted infections. Which statement by the client would be cause for concern?

"I am unsure who the father of the baby is. I will be raising it alone."

A nurse is teaching a client who is 30 weeks pregnant about ways to deal with heartburn. The nurse determines a need for additional teaching based on which client statement?

"I should lie down for 1/2 hour after eating."

A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during her pregnancy. Which client statement alerts the nurse to the need for further teaching?

"I should substitute intercourse with nonsexual touch to avoid harming the fetus."

The nurse is assessing a client at her first prenatal visit and notes that she is exposed to various chemicals at her place of employment. Which statement by the client would indicate she needs additional health education to protect her and her fetus?

"The gloves they provide irritate my hands, so I don't use them."

At her prenatal visit a client reports that she cannot find any shoes that are comfortable. Assessment of her legs reveals dependent edema. The nurse suggests that the client attempt which actions to help reduce the edema? Select all that apply.

- Elevate feet and legs when sitting or lying. - Avoid foods high in sodium, sugar, and fats. - Drink 6 to 8 glasses of water each day.

The diagonal conjugate of a pregnant woman's pelvis is measured. Which measurement would the nurse interpret as presenting a potential problem?

12.0 cm

A client who is in her first trimester is anxious to have an ultrasound at each visit. The nurse explains that it is not necessary and schedules a second ultrasound to be performed when she is about:

18 to 20 weeks pregnant.

The nurse assesses a 20-week gestational client at a routine prenatal visit. What will the nurse predict the fundal height to be on this client experiencing an uneventful pregnancy?

20 cm

The nurse is reviewing client data following a regular monthly appointment at 6 months' gestation. Which fundal height requires no further intervention?

24 cm

A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:

4 weeks

At the first prenatal visit of all clients who come to the clinic appropriate blood screenings are obtained. The nurse realizes that a hemoglobin A1c above which level is concerning for diabetes and warrants further testing?

6.5%

A client in the third trimester of pregnancy has to travel a long distance by car. The client is anxious about the effect the travel may have on her pregnancy. Which instruction should the nurse provide to promote easy and safe travel for the client?

Always wear a three-point seat belt.

The nurse discovers a new prescription for RhoGAM for a client who is about to undergo a diagnostic procedure. The nurse will administer the RhoGAM after which procedure?

Amniocentesis

A client in her third month of pregnancy arrives at the health care facility for a regular follow-up visit. The client reports discomfort due to increased urinary frequency. Which instruction should the nurse offer the client to reduce the client's discomfort?

Avoid consumption of caffeinated drinks.

Why is the first prenatal visit usually the longest prenatal visit?

Baseline data is collected.

The nurse will be assisting a client during an amniocentesis. Which nursing intervention should the nurse prioritize?

Be certain she is aware of potential complications.

The client states that the first day of her last menstrual period is March 23. The nurse is most correct to calculate using Naegele rule that the estimated date of delivery is:

December 30

A client in the first trimester reports having nausea and vomiting, especially in the morning. Which instruction would be most appropriate to help prevent or reduce the client's compliant?

Eat dry crackers or toast before rising.

A woman in her third trimester is suffering from heartburn. What should the nurse advise her to do?

Eat small meals frequently rather than large meals.

A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information?

Further testing will be required to confirm any diagnosis.

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of a miscarriage within the first trimester. The nurse is correct to document the history as:

G = 3, T = 1, P = 0, A = 1, L = 1

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

G3 P0020

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records?

G3 T0 P1 A1 L2

The nurse is educating a woman about the importance of folic acid before conception and during pregnancy, to prevent neural tube defects in the fetus. The client plans to take prenatal vitamins and minerals. What food source would the nurse recommend to add to the womans diet?

Green leafy vegatables

A woman who is 4 months pregnant notices frequent heart palpitations and leg cramps. She is anxious to learn how to alleviate these. Which nursing diagnosis would best apply to her?

Health-seeking behaviors related to ways to relieve discomforts of pregnancy

The nurse is caring for a neonate whose mother received no medical care for either of her pregnancies. When assessing the neonate's status, which would indicate a potential A, B, and O incompatibility?

Hemolytic anemia

Which nursing intervention should the nurse perform when assessing fetal well-being through abdominal ultrasonography in a client?

Instruct the client to refrain from emptying her bladder.

A client who is uncertain when her LMP occurred is given an EDD of April 23 after the first ultrasound. Based on this information, the nurse determines the client's LMP was probably which day?

July 16

A client in her second trimester of pregnancy visits a health care facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which precaution should the nurse instruct the pregnant client to take when practicing aerobic exercises?

Maintain tolerable intensity of exercise.

A nurse is giving a prenatal class on teratogens that have an affinity for specific body tissues. Which teratogen is accurately paired with the specific body tissue affected?

Mercury attacks the nervous tissue.

A teenager arrives in the emergency department in active labor having no prenatal care. Upon examination in L & D, the nurse notices a cluster of pinpoint vesicles with a red base on her vulva which the teenager asks the nurse to not touch "her rash" because it hurts when touched. At this point, which intervention should the nurse perform next?

Report this finding to the health care provider immediately so he or she can plan the birth route.

A nurse is caring for a client who is 8 months pregnant. Which instruction is the nurse most likely to give her?

Rest on the left side for at least 1 hour in the morning and afternoon.

A 31-year-old client at 28 weeks' gestation reports frequent low back pain and ankle edema by the end of the day. Which suggestion should the nurse prioritize for this client?

Rest when possible with feet elevated at or above the heart.

Which client immunization titer is most important to assess and document in the prenatal record of the pregnant woman?

Rubella

A client in her third trimester of pregnancy wishes to formula feed her baby. What instruction should the nurse provide?

Serve the formula at room temperature.

The health care provider has prescribed an over-the-counter antacid for a pregnant client in her first trimester who is having ongoing nausea, vomiting, and heartburn. Which instruction concerning the antacid should the nurse prioritize after noting the client is also prescribed a multivitamin supplement?

Take antacid 1 hour after the multivitamin.

The client is 32 weeks pregnant and has been referred for biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective?

The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.

When describing the role of a doula to a group of pregnant women, the nurse would include which information?

The doula primarily focuses on providing continuous labor support.

The nurse is assisting a pregnant client who has just underwent a nonstress test that was ruled reactive. Which factor will the nurse point out when questioned by the client about the results?

The fetal heart rate increases with activity and indicates fetal well-being.

The nurse teaches a sedentary pregnant client with a BMI of 35 about the importance of healthy lifestyle during pregnancy. Which goal would be appropriate for this client?

Walk for 30 minutes 5 days a week.

A pregnant client in her second trimester informs the nurse that she needs to travel by air the following week. Which precaution should the nurse instruct the client to take during the flight?

Wear support hose.

A woman in her second trimester of pregnancy is beginning to experience more headaches. In addition to suggesting holding an ice pack to the forehead, the health care provider recomends which medication to provide some relief from the pain?

acetaminophen

A woman in her second trimester of pregnancy is beginning to experience more headaches. In addition to suggesting holding an ice pack to the forehead, the health care provider recommends which medication to provide some relief from the pain?

acetaminophen

A woman with a history of genital lesions caused by herpes simplex virus (HSV) has been admitted to the labor unit at 39 weeks' gestation. She said she was given medicine prophylaxically a few weeks ago to prevent lesions at the time of birth. Which medication is safe to give to a pregnant women with HSV?

acyclovir

A client with hyperemesis gravidarium is started on TPN. What parameter does the nurse need to assess at least twice a day?

blood glucose

A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which symptom is an indicator of true labor?

contractions beginning in the back and sweeping forward across the abdomen

The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy?

excessive vomiting

A nurse is taking a history during a client's first prenatal visit. Which assessment finding would alert the nurse to the need for further assessment?

history of diabetes for 4 years

An adolescent who is 8 weeks' pregnant is at her first perinatal visit. During the health history interview, the nurse asks the client, "Are you afraid of anyone?" What is the nurse assessing with this question?

intimate partner violence

A pregnant woman has been diagnosed with pica since she eats lead pain chips for their sweetness. The nurse educating this woman should strongly encourage her to abandon this practice because it may have which consequence to the fetus?

neurological challenges

A client in her third trimester of pregnancy visits the health care center and asks why she is constipated. The nurse would include which most likely cause when responding to the client?

pressure on intestine by the growing fetus

A pregnant client in her second trimester visits a health care center. She informs the nurse that at times she experiences difficulty breathing. What would the nurse identify as the most likely cause of the client's report?

pressure on the diaphragm by the growing fetus

A pregnant client reports chewing on ice throughout the day. Which laboratory value would the nurse evaluate?

serum iron level

Untreated hyperemesis can lead to preterm birth. What is the cause of the preterm birth?

severe dehydration resulting in hypoperfusion of the placenta

The nurse educates the vegetarian client about which nutritional need during pregnancy?

taking a B12 supplement

A nurse is caring for a pregnant client in her second trimester of pregnancy. The nurse educates the client to look for which danger sign of pregnancy needing immediate attention by the primary care provider?

vaginal bleeding