Ob test #1

The nurse has taken a health history on four primigravid clients at their first prenatal visits. It is high priority that which of the clients receives nutrition counseling?

The woman who has phenylketonuria

A nurse is collecting data during an admission assessment of a patient who is pregnant with twins. The patient has a healthy 5-year-old child that was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. How would the nurse document the GTPAL for this patient?

2,1,0,0,1

A patient who has moved to another community arrives for a prenatal visit. The client is unaware of her LMP date, McDonald's method measure 28 cm., ultrasound at this visit results are 30 weeks plus or minus three weeks. What is the best estimate of gestational age of the baby based on this data?

28 weeks

Which of the following symptoms indicates probable labor? (Select all that apply)

-Cervical shortening and effacement -Changing cervical dilatation -Uterine contraction pattern demonstrating contractions that are longer, stronger, and closer together, especially with increased activity.

Which of the following statements identifies functions of amniotic fluid? (Select all that apply)

-Important to lung development -Allows for symmetrical growth -temperature control -freedom of movement -practicing of swallowing before birth -cushions and protects infant -provides waste repository

An essential component of prenatal health assessment of pregnant women is the determination of vital signs. Which of the following statements describes expected change(s) in vital signs associated with pregnancy? (Select all that apply)

-Increased depth and rate of respiration -Elevation of systolic and diastolic blood pressure by 20mm Hg -Elevation in pulse rate by approximately 10-20 beats per minute

Which of the following are indicators of spontaneous rupture of membranes? (Select all that apply)

-Nitrazine blue, ph of 7.4 -Positive for ferning -Positive for pooling

During a prenatal visit of a patient who is gravida 2, para 1, 3327 weeks based on early ultrasound, the fundal measurement (McDonald's method) is 31 cm. Which of the following statements would identify correct clinical judgment related to interpretation of this data? (Select all that apply)

-Possible intrauterine growth restriction -Possible oligohydramnios

Which of the following is/are necessary for extra uterine respiration? (Select all that apply)

-Surfactants -Capillary network -Alveoli development Alveoli, surfactant to decrease surface tension, and a capillary network are necessary for normal respiration. Steroids play a role in increasing rate of maturity of preterm infant, however, are not intricate to normal respiration

Significant folic acid in the pre-conceptual and antepartum diet is advised based on which of the following statements? (Select all that apply)

-folic acid supports rapid mitosis -folic acid supports replication of DNA -best way to increase maternal folic acid is to increase fortified grains in the diet

A client who was seen in the prenatal clinic at 20 weeks' gestation weighed 128 lb at that time. Approximately how many pounds would the nurse expect the client to weigh at their next visit at 24 weeks gestation?

132 lb

A pregnant woman at 6 weeks of gestation tells her nurse midwife that she has been experiencing nausea with occasional vomiting every day. The nurse could recommend which of the following as an effective relief measure?

Alter eating patterns to small meals every 2 - 3 hours.

A 5 week gravid patient is having a thorough pelvic and abdominal assessment. Which of the following physiologic changes associated with early pregnancy would the practitioner expect to find?

An enlarged ovary

A nurse is discussing diet with a pregnant woman. Which of the following foods should the nurse advise the client to avoid consuming during her pregnancy?

Bologna Pregnancy produces mild immunosuppression increasing susceptibility to certain diseases. Deli meats, unless heated to steaming hot, as well as unpasteurized milk, soft cheese and any undercook meat can cause literiosis. (These foods oftentimes contain Listeria monocytogenes)

Which of the following hormone elevations indicate a high probability that the client is pregnant?

Chorionic gonadotropin

A woman states that she frequently awakens with "painful leg cramps" during the night. Which of the following assessments should the nurse make?

Dietary evaluation

The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that she might experience in the coming weeks. Which of the following comments by the client indicates that further teaching is needed?

During the third trimester I may experience persistent headache

Which of the following foods reduces absorption of iron supplements?

Egg yolks

An antepartum client with mitral valve stenosis is place at risk for cardiac decompensation during pregnancy associated with which one of the following physiologic changes?

Elevated maternal heart rate by 10-20 beats per minute

The health care practitioner is educating a 40 year old client who is 16 weeks gestation regarding advisability of completing a maternal alphofetal protein test. The provider's rationale for offering this test is best described by which of the following statements?

Fluctuations in AFP levels are associated with neuro tube defects

During an examination of a pregnant woman, the nurse notes that her cervix is soft on its tip. How would the nurse document this finding?

Goodell's sign Goodell's sign, softening of the cervix, is a probabe sign of pregnancy, occurring during the second month. Friability refers to cervical fragility resulting in slight bleeding when scraped or touched. Chadwick's sign refers to the deep bluish color of cervix and vagina as a result of increased circulation. Hegar's sign refers to softening and compressibility of the lower uterine segment.

A woman who is seen in the prenatal clinic is found to be 8 weeks pregnant She confides to the nurse that she is afraid her baby may be "permanently damaged because I had at least 5 beers the night I conceived". Which of the following responses by the nurse would be appropriate?

It is unlikely that the baby was affected

Nursing assessment related to a healthy gravida 1 para 0, 3657 weeks who is concerned that she is expereincing contractions included: fetal heart tones reactive and variable, irregular mild contractions which patient is able to walk and talk through, dependant pedal edema, dipstick Ua negative except for trace protein, specific gravity 1.030, ph 6.5, and dark amber appearance. Based on this information which of the following describes appropriate nursing intervention.

Offer po hydration with water

The blood of a pregnant client was initially assessed at 10 weeks' gestation and reassessed at 38 weeks' gestation. Which of the following results would the nurse expect to see?

Rise in white blood count from 5,000 cell/mm³ to 15,000 cell/mm³

PICA in pregnancy is usually associated with which one of the folllowing disorders?

Severe iron deficiency anemia

A woman is diagnosed with an ectopic pregnancy and is given an intramuscular injection of methotrexate. The nurse would tell the woman which of the following?

She should avoid alcohol until her primary care provider tells her the treatment is complete. -Methotrexate destroys rapidly growing tissue, in this case the fetus and placenta to avoid rupture of the tube and need for surgery. Follow-up blood tests are needed for 2-8 weeks. Alcohol and vitamins containing folic acid increase the risk of side effects with this medication or exacerbating the ectopic pregnancy.

Which of the following long-term goals is appropriate for a client,10 weeks' gestation, who is diagnosed with gestational trophoblastic disease (hydatiform mole)?

The client will be cancer-free one year from diagnosis

McDonald's method is not an approriate assessment prior to 20 weeks gestation. The rationale for this statement is best identified by which of the following explanations?

The fundus of the uterus is within the bony pelvis untill around 20 weeks

A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the preprocedure teaching?

The test should be drawn at one hour post glucola ingestion.

A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the preprocedure teaching?

The test should be drawn at one hour post glucola ingestion. -Fasting is not required unless doing a 3 hour glucose test. Urine specimen is not required. This is a screening exam and does not require multiple blood draws. The important information to ensure test is accurate is to have the patient identifiy when it has been one hour since ingesting glucola and must have blood drown at that time.

A patient's history identifies her GTPAL as 41123. Based on this information which of the following statements is true?

The woman has had twins

A woman at 30 weeks gestation assumes a supine position for a fundal measurement and Leopold's maneuvers. She begins to complain about feeling dizzy and nauseated. Her skin feels damp and cool. What should be the nurses first action?

Turn the woman on her side. Supine hypotension related to compression of aorta and vena cava is being experienced, so the first action would be to cause of the problem by turning the woman on her side. This should alleviate the symptoms being experienced. Assessment of vital signs can occur after the woman's position is changed.

A client is 35 weeks' gestation. Which of the following findings would the nurse expect to see?

Use of three pillows for sleep comfort

A 16 year old primigravida is being seen at her 10-week gestation visit. She tells the nurse that she felt the baby move that morning. Which of the following responses by the nurse is appropriate?

Would you please describe what you felt for me?

Which finding would the nurse view as expected when evaluating the laboratory reports of a 34- week gestation client?

anemia

The nurse is advising the patient about warning signs of pregnancy. The nurse should teach the mother that she should notify the physician immediately if she experiences which of the following signs/symptoms? (Select all that you apply)

double vision epigastric pain persistent vomiting

A gravida 1 para 0 is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day?

pap smear

Which of the following exercises should be taught to a pregnant woman who complains of backaches?

pelvic tilt