O'Meara Prep U: 19
A client at 36 weeks' gestation who is 2 years post bariatric surgery would be expected to have a weight gain that is
"Be sure that your lupus is stable or in remission for 6 months before getting pregnant."
A nursing instructor is teaching about causes of infertility and identifies a need for further instruction when a student states which of the following
"Diet does not play a role in infertility."
A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction
"I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring."
A nurse is talking to a newly pregnant woman who had a mitral valve replacement in the past. Which statement by the client reveals an understanding about the preexisting condition
"I understand that my fetus and I both are at risk for complications."
A 32-year-old woman with epilepsy mentions to the nurse during a routine well-visit that she would like to have children and asks the nurse for advice. Which response is most appropriate from the nurse
"I'll let the doctor know so you can discuss your medications. In the meantime, I'll give you a list of folate-rich foods you can add to your diet."
The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's teaching was successful
"Pregnancy affects insulin production, so I'll need to make adjustments in my diet."
A nurse is caring for a 45-year-old pregnant client with a cardiac disorder who has been instructed by her primary care provider to follow class I functional activity recommendations. The nurse correctly instructs the client to follow which limitations
"You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."
The nurse is assessing a pregnant client who has a history of heart disease. The nurse will prioritize assessments focusing on the heart during which time frame
28 to 32 weeks' gestation
A G4P3 client with a history of controlled asthma is upset her initial prenatal appointment is taking too long, making her late for another appointment. What is the nurse's best response when the client insists she knows how to handle her asthma and needs to leave
Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications.
Which of the following statements regarding weight and pregnancy is correct
An underweight woman should increase her caloric intake by 500 to 1000 calories a day.
The nurse is planning to instruct a patient who is 12 weeks pregnant on interventions to stop smoking. What should the nurse include in these instructions? Select all that apply
Ask a friend to help with smoking cessation actions. Ask the physician if a smoking cessation medication can be used. Follow a smoking cessation plan.
A pregnant woman with sickle cell anemia is very concerned her infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse
Both parents have to carry the trait.
A pregnant client in her 20th week of gestation, having systemic lupus erythematosus (SLE), is admitted to the healthcare unit for management of the exacerbation of SLE. Which of the following would be most appropriate to treat the client's condition
Corticosteroids
A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize
Decrease activity and rest more often.
Which change best describes the insulin needs of a client with type 1 diabetes mellitus who has just delivered an infant vaginally without complications
Decreased
Which response is most appropriate for a client with diabetes who wants to breast-feed but is concerned about the effects of breastfeeding on her health
Diabetic clients may breast-feed; insulin requirements may decrease from breast-feeding
A pregnant client with deep vein thrombosis has been diagnosed as having systemic lupus erythematosus (SLE). The nurse would monitor the client closely for the development of which complication
Fetal malnutrition
A nurse is assessing a client in her seventh month of pregnancy who has an artificial valve prosthesis. The client is taking an oral anticoagulant to prevent the formation of clots at the valve site. Which of the following nursing interventions is most appropriate in this situation
Observe the client for signs of petechiae and premature separation of the placenta
The nurse is preparing to teach a pregnant client with iron deficiency anemia about the various iron-rich foods to include in her diet. Which food should the nurse point out will help increase the absorption of her iron supplement
Orange juice
A woman is pregnant and has asthma. Her primary care provider has told her to continue taking prednisone during pregnancy, but she is concerned the drug may be teratogenic. What advice would be best to give her regarding this
Prednisone is considered safe in the doses prescribed by her care provider.
A 17-year-old primigravida with type 1 diabetes is at 37 weeks' gestation comes to the clinic for an evaluation. The nurse notes her blood sugar has been poorly controlled and the health care provider is suspecting the fetus has macrosomia. The nurse predicts which step will be completed next
Preparing for amniocentesis and fetal lung maturity assessment
A postpartum patient with systemic lupus erythematosus asks why symptoms of the disease are worse now that the baby has been born. What should the nurse explain to the patient
Symptoms may be worse because corticosteroid levels are returning to normal.
A pregnant woman of Jewish descent comes to the clinic for counseling and tells the nurse that she is worried her baby may be born with a genetic disorder. Which disease does the nurse identify to be a risk for this client's baby based on the family's ancestry
Tay-Sachs disease
A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum
assessing for cardiac decompensation
Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 130/86 mm Hg; week 20 - 138/88 mm Hg; week 24 - 136/82 mm Hg; and week 28 - 138/88 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure
assessing for cardiac decompensation
A nurse is teaching a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority
avoidance of infection
When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule would be most appropriate
bi-monthly visits until 28 weeks, then weekly visits
The nurse is teaching a pregnant woman with iron-deficiency anemia about her prescribed iron supplement. The nurse determines that the teaching was successful when the client states that she will take the supplement with
citrus juice.
A woman with cardiac disease has come to the office for prenatal counseling. Assessment supports the decision to caution the woman against pregnancy. The woman most likely fits the criteria for which functional risk classification
class IV
A nurse is reading a journal article about genetic inheritance. Information on which condition would the nurse most likely read about in the section on autosomal recessive disorders? Select all that apply
cystic fibrosis phenylketonuria Tay-Sachs disease
The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize
dyspnea, crackles, and irregular weak pulse
A nurse is admitting a pregnant woman with sickle cell anemia to the emergency department. Which findings would lead the nurse to suspect the client is in crisis? Select all that apply
fever joint pain
A pregnant woman diagnosed with cardiac disease 4 years ago is told that her pregnancy is a high-risk pregnancy. The nurse then explains that the danger occurs primarily because of the increase in circulatory volume. The nurse informs the client that the most dangerous time for her is when
in weeks 28 to 32
In women with cardiac failure, the maternal blood pressure becomes insufficient to provide an adequate supply of blood to the placenta. The infant will likely experience some undesired effects, including which of the following
low birth weight
A pregnant client has a history of asthma. After reviewing the possible medications that may be prescribed during her pregnancy to control her asthma, the nurse determines additional teaching is needed when the client identifies which drug as being used
misoprostol
A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information
recessive inheritance
The nurse is caring for a pregnant client who is in her 30th week of gestation and has congenital heart disease. Which finding should the nurse recognize as a symptom of cardiac decompensation with this client
swelling of a face
The nurse is caring for a pregnant client who is in her 30th week of gestation and has congenital heart disease. Which finding should the nurse recognize as a symptom of cardiac decompensation with this client
swelling of the face
A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make
"Be sure that your lupus is stable or in remission for 6 months before getting pregnant."
The nurse is caring for a pregnant client who has a class II heart disease. The nurse is prepared to intensify monitoring during which period of the pregnancy
Second trimester
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.
A pregnant woman is diagnosed with hyperthyroidism and is prescribed propylthiouracil as part of the treatment plan. When teaching the woman about this medication and its effect on the fetus, which information would the nurse include
"Your baby might be born with an enlarged thyroid gland."
A client with asthma is confused by her primary care provider continuing her medication while she is pregnant, since she read online the medications can cause birth defects. What is the nurse's best response
"Your primary care provider will order safe doses of your medication."
The nurse is caring for a pregnant client who has a class II heart disease. The nurse is prepared to intensify monitoring during which period of the pregnancy
second trimester
A couple who is in for fertility testing ask the nurse what tests are commonly performed to assess fertility. The nurse replies that there are only three primary tests that are used. What are these tests
semen analysis, ovulation monitoring, and tubal patency assessment
A client is 33 weeks pregnant and has had diabetes since age 21. When checking her fasting blood glucose level, which value would indicate the client's disease is controlled
85 mg/dl Explanation: Recommended fasting blood glucose levels in pregnant clients with diabetes are 60 to 95 mg/dl. A fasting blood glucose level of 45 g/dl is low and may result in symptoms of hypoglycemia. A blood glucose level below 120 mg/dl is recommended for 2-hour postprandial values. A blood glucose level above 136 mg/dl in a pregnant client indicates hyperglycemia.
Charlene McCoy, who has several children already, reports for a first prenatal visit. She seems preoccupied and withdrawn, and she makes consistently negative remarks about the pregnancy. Reviewing her records, you note that she is receiving a serotonin reuptake inhibitor. What should you do
Alert the RN or primary care provider
Your patient is very conscious of the weight she gained during her pregnancy. She has decided to breastfeed her baby and asks you how many calories a day extra she should be eating so that she and her baby are healthy. She states she does not want to gain any extra weight from over-eating. What would be your best response
"You should be eating an extra 200 kcal over what you were eating while you were pregnant."
A nursing instructor is teaching students about caring for a pregnant patient with a pre-existing disease. Which of the following does the instructor suggest has added to an increased incidence of pregnant women with a pre-existing disease
More women waiting until after age 30 years to get pregnant
