Passpoint - Antepartum Period

A nurse is collecting data on a client who believes she is pregnant. The nurse would suspect a hydatiform mole based on which finding?

abnormally high hCG levels

The nurse is providing care for a pregnant client in her second trimester. Glucose tolerance test results show a blood glucose level of 160 mg/dl. The nurse should anticipate that the client will need to:

be taught about diet.

A client, 6 weeks' pregnant, is diagnosed with hyperemesis gravidarum. The nurse should monitor the client for the development of which condition?

electrolyte imbalance

A nurse is obtaining a prenatal history from a client who is 8 weeks' pregnant. Which questions should the nurse ask to help determine whether the client is at risk for a TORCH infection? Select all that apply.

"Do you have any cats at home?" "Do you consume raw meats?"

A client in the first trimester of pregnancy comes to the facility for a routine prenatal visit. She tells the nurse she doesn't know whether she's ready to have a baby, even though this was a planned pregnancy. Which response should the nurse offer?

"You're feeling ambivalent, which is normal during the first trimester."

A woman who is 10 weeks pregnant tells the nurse that she is worried about her fatigue and frequent urination. Which nursing intervention should the nurse utilize?

Recognize these as normal early pregnancy signs and symptoms

The nurse is reinforcing instructions about the types of food to consume to increase folic acid intake as well as supplementation. The nurse determines that that the client has understood the information when the client states she will increase her intake of which foods? Select all that apply.

dark green, leafy vegetables egg yolks

A client has gestational diabetes. When assisting with developing the plan of care for this client, which therapy would the nurse most likely identify as important for this client to manage glucose levels?

diet

A nurse is reinforcing teaching with a client at 24 weeks of gestation regarding a glucose tolerance test to screen for gestational diabetes. The client asks, "What will be done if I have this disorder?" The nurse is correct to state that gestational diabetes is managed by which therapy?

dietary control of carbohydrates, fats, and proteins

A client with preeclampsia is prescribed magnesium sulfate to prevent seizure activity. The nurse is reviewing the results of the client's serum magnesium level and determines that the client's level is therapeutic based on which result?

6.8 mEq/L (3.4 mmol/L)

A client who's 5 weeks pregnant reports nausea and vomiting. The nurse reassures the client that these symptoms probably will subside by:

9 to 12 weeks' gestation.

The nurse is documenting a prenatal history of gravida 4, para 2 on the woman's clinic paperwork. The paperwork is sent to the birthing center for review. Upon the expectant mother's admission to the birthing center, the admission nurse is most correct to confirm which prenatal history?

A client has been pregnant 4 times and had 2 children born after 20 weeks of gestation.

Which of the following would the nurse expect to find as presumptive signs of pregnancy?

Amenorrhea and quickening

A client is scheduled for amniocentesis. When preparing her for the procedure, the nurse should complete which of the following tasks?

Ask her to void.

During her first prenatal visit, a client expresses concern about gaining weight. Which action should be the nurse's next step?

Ask the client how she feels about gaining weight and provide instructions about expected weight gain and diet.

The health care practitioner uses nitrazine paper to determine whether a pregnant client's membranes have ruptured. If the membranes are ruptured, the nurse expects the paper will turn which color?

Blue

A pregnant client is prescribed an iron supplement. Which point should the nurse include when teaching the client about taking the supplement?

Eat a diet rich in vitamin C to promote iron absorption.

A nurse is evaluating a pregnant client's fundal height. In which way should the nurse stretch the measuring tape to measure it?

From the symphysis pubis notch to the highest level of the fundus

The nurse is informed that a client hospitalized for premature labor is having occasional contractions. Which nursing intervention would be most appropriate?

Give IV and oral fluids, encouraging the client to empty the bladder.

When collecting data on a pregnant client with diabetes mellitus, the nurse stays alert for signs and symptoms of a vaginal or urinary tract infection (UTI). The nurse recognizes which condition makes this client more susceptible to such infections?

Glycosuria

A client who is 12 weeks pregnant attends a class on fetal development as part of a childbirth education program. The nurse provide which information that at 16 weeks' gestation the client's fetus will most likely present?

Have audible heart sounds

A nurse is preparing a lecture for a prenatal class. Which hormone would the nurse include in the presentation as being responsible for maintaining pregnancy during the first 3 months?

Human chorionic gonadotropin (hCG)

A nurse in a prenatal clinic is assessing a 28-year-old who's 24 weeks pregnant. Which findings would lead this nurse to suspect that the client has mild preeclampsia?

Hypertension, edema, proteinuria

The nurse is providing care to a pregnant adolescent client in the first trimester. Which intervention would the nurse identify as the highest priority?

Make sure the client receives nutritional counseling and reinforce the education.

The nurse is assessing a client whose membranes ruptured prematurely 12 hours ago. Which is the nurse's highest priority to evaluate when collecting data on this client?

Maternal vital signs and fetal heart rate (FHR)

A client who's 12 weeks pregnant is reporting severe left lower quadrant pain and vaginal spotting. She's admitted for treatment of an ectopic pregnancy. Which nursing diagnosis should the nurse should give the highest priority to?

Risk for deficient fluid volume.

A newly pregnant client tells a nurse that she has not been taking her prenatal vitamins because they make her feel nauseated. What information should the nurse reinforce to the client?

Take the vitamin on a full stomach.

A client with hyperemesis gravidarum is on a clear liquid diet. The nurse instructs the unlicensed assistive personnel (UAP) to observe her tray for which food selections?

Tea and gelatin dessert

A client who's 7 months pregnant reports severe leg cramps at night. Which nursing action would be most effective in helping her cope with these cramps?

Teaching her to dorsiflex her foot during the cramp

The labor and delivery unit has 10 clients in varying stages of labor. Staffing for the upcoming shift consists of four registered nurses (RNs) and one licensed practical nurse (LPN). Which client care assignment is best?

The stable clients in the early stages of labor should be assigned to the LPN.

A nurse instructs a pregnant client about the importance of doing frequent Kegel exercises. Kegel exercises are important for which reason?

They help maintain good perineal muscle tone by tightening the pubococcygeus muscle.

A client with pregnancy-induced hypertension (PIH) receives magnesium sulfate, 4 g in 50% solution intravenous (IV) over 20 minutes. When asked by this client, what would the nurse say is the purpose of administering magnesium sulfate?

To prevent seizures

At 32 weeks' gestation, a client is admitted to the facility with a diagnosis of pregnancy-induced hypertension (PIH). What signs and symptoms will the nurse expect? Select all that apply.

edema proteinuria

At 32 weeks' gestation, a client is admitted to the facility with a diagnosis of pregnancy-induced hypertension (PIH). Based on this diagnosis, the nurse expects assessment to reveal:

edema.

A client who is at 32 weeks' gestation is diagnosed with mild preeclampsia. Which findings would the nurse expect to note when collecting data on the client? Select all that apply.

hypertension edema

A nurse is assisting with the development of a plan of care for a client at 34 weeks' gestation experiencing preterm labor. Which intervention would the nurse expect to be included to assist in halting the client's preterm labor?

promoting adequate hydration

A client with pregnancy-induced hypertension (PIH) is admitted to the hospital. The nurse would expect this client to probably exhibit which of the following symptoms?

proteinuria, headaches, and double vision

The nurse is providing care to a pregnant client with preeclampsia. Magnesium sulfate has been ordered. The nurse understands that this drug is being given to prevent which condition?

seizures

A client who has sickle cell anemia is 24 weeks' pregnant. When discussing the plan of care, which factors should the nurse identify as potential triggers for a sickle cell crisis during pregnancy? Select all that apply.

stress dehydration

A 35-year-old client who is 28 weeks' pregnant is admitted for testing. After reading the nursing notes, which rationale best explains why a pregnant client should lie on the left side when resting or sleeping in the later stages of pregnancy?

to prevent compression of the vena cava

A nurse is assisting with the development of a plan of care for a pregnant client. The interdisciplinary team determines that the client will require more frequent prenatal visits based on which data gathered?

type 1 diabetes

A client with painless vaginal bleeding is suspected of having placenta previa. The nurse will assist in preparing the client for which procedure?

ultrasound

A client is diagnosed with placenta previa at 28 weeks' gestation. Which procedure should the nurse prepare the client for?

ultrasound examination every 2 to 3 weeks

The nurse educator is discussing signs of pregnancy with newly hired nurses. Which findings would the educator include to be considered positive signs of pregnancy? Select all that apply.

visualization of the gestational sac fetal heartbeat and fetal movement on palpation

A client is expecting her second child in 6 months. During the psychosocial assessment, she says, "I've been through this before. Why are you asking me these questions?" What is an appropriate response by the nurse?

"Each pregnancy has a unique psychosocial meaning."

A client with acquired immunodeficiency syndrome (AIDS) is pregnant. The client is concerned that the baby will be born with AIDS and relays this information to the nurse. Which response by the nurse would be most appropriate?

"It is very important for you to take your medications to reduce the baby's risk."

During her fourth clinic visit, a client who is 5 months pregnant tells the health care provider she was exposed to rubella during the past week and asks whether she can be immunized now. How would the nurse expect the health care provider to respond?

"No, because the live viral vaccine is contraindicated during pregnancy."

A client who is 24 weeks pregnant is diagnosed with preeclampsia. She is prescribed bed rest at home and a referral for home health visits by a community health nurse. The nurse is reviewing the discharge instructions with the client. The nurse determines that the client understands the reasons for home health visits base on which client statement?

"The community health nurse will check me and my baby and talk with my health care provider."

A client in her second trimester of pregnancy has been diagnosed with gestational diabetes. While instructing the client about home glucose monitoring the client states, "Why should I use this if the diabetes is going to resolve after I have my baby anyway?" Which response by the nurse is best?

"The monitor helps you see how your blood sugar is being controlled during your pregnancy to help prevent complications."

During an initial prenatal visit, a client reports increased clear, watery vaginal drainage. When responding to the client about this report, which statement would be most appropriate?

"This is normal during pregnancy. Just be sure to wash daily with soap and water."

A pregnant client in her third trimester states she needs to urinate frequently just as she did during the first trimester. The nursing instructor asks the nursing student what is the rationale for this. How should the student appropriately respond?

"This symptom is normal and results from the expanding uterus on the bladder."

A nurse is providing care for a pregnant client who asks how she can best deal with her fatigue. Which instruction would the nurse most likely reinforce with the client?

"Try to get more rest by going to bed earlier."

A client who's 37 weeks pregnant comes to the clinic for a prenatal checkup. To evaluate the client's preparation for parenting, the nurse might ask which question?

"What changes have you made at home to get ready for the baby?"

A client with severe preeclampsia is receiving an intravenous infusion of magnesium sulfate. The client is exhibiting signs and symptoms of magnesium toxicity. Which medication would the nurse expect to be given?

calcium gluconate

A client, who is 11 weeks' pregnant and admitted to the facility with hyperemesis gravidarum, is being cared for by a nursing student. The nursing instructor asks the nursing student to discuss hyperemesis gravidarum. How does the student respond appropriately? Select all that apply.

"The cause is unknown." "It is characterized by severe nausea and vomiting during the first half of pregnancy."

Which medication is considered safe during pregnancy?

Insulin

A client has just expelled a hydatidiform mole. She's visibly upset over the loss and wants to know when she can try to become pregnant again. Which of the following would be the nurse's best response?

"I can see that you're upset; however, you must wait at least 1 year before becoming pregnant again."

A client in her first trimester of pregnancy notes that she is always tired. Which response by the nurse is best?

"Needs for rest and sleep typically increase during the first trimester of pregnancy."

A client who's pregnant with her second child comes to the clinic reporting a pulling and tightening sensation over her pubic bone every 15 minutes. She reports no vaginal fluid leakage. Because she has just entered her 36th week of pregnancy, she's apprehensive about her symptoms. Vaginal examination discloses a closed, thick, posterior cervix. These findings suggest that the client is experiencing:

Braxton Hicks contractions.

A client is 8 weeks pregnant. When developing the plan of care, which teaching topic would be most appropriate at this time?

Common discomforts of pregnancy

When teaching a group of pregnant adolescents about reproduction and conception, where does the nurse states that fertilization occurs?

In the first third of the fallopian tube

After receiving large doses of an ovulatory stimulant such as menotropins, a client comes in for her office visit. Data collection during the nursing assessment reveals the following findings: Weight gain of 6 lb (3 kg), ascites, and pedal edema. How does the nurse interpret these findings?

The client is demonstrating signs of hyperstimulation syndrome.

A client is in the last trimester of pregnancy. The nurse should instruct her to notify her obstetrician immediately if she notices:

blurred vision.

A 17-weeks' pregnant client comes to the clinic for a well visit. When determining maternal and fetal well-being, which data collection findings by the nurse are most important? Select all that apply.

fetal activity fetal heart rate

A pregnant client at 26 weeks' gestation undergoes a glucose tolerance test. The nurse identifies the need for further action based on which results?

a 1-hour glucose level of 160 mg/dL (8.88 mmol/L) during a 3-hour glucose tolerance test

A client is admitted to the facility with a suspected ectopic pregnancy. When reviewing the client's health history for risk factors for this abnormal condition, the nurse expects to find:

a history of pelvic inflammatory disease.

A client, 11 weeks pregnant, is admitted to the facility with hyperemesis gravidarum. She tells the nurse she has never known anyone who had such severe morning sickness. The nurse understands that hyperemesis gravidarum results from:

an unknown cause.

A client comes to the prenatal clinic for her first visit. This is her first pregnancy, and she is at 10 weeks' gestation. The nurse is gathering data about the client's nutritional status. Which measures would be the most cost-effective means of gathering this information? Select all that apply.

anthropometric measurements 24-hour dietary recall

The nurse is developing a teaching plan for a client who's 2 months pregnant. The nurse should tell the client that she can expect to feel the fetus move at which time?

Between 16 and 22 weeks' gestation

A client in the 13th week of pregnancy develops hyperemesis gravidarum. Which laboratory finding indicates the need for intervention?

Ketones in urine

A pregnant client in the second trimester reveals feeling very anxious because of a lack of knowledge about giving birth. Which intervention by the nurse is most appropriate for this client?

Provide the client with the information and teach the skills needed to understand and cope during birth.

The nurse is reviewing a client's prenatal history. Which finding would suggest to the nurse that it indicates a genetic risk factor?

The client has a child with cystic fibrosis.

A client is 6 weeks pregnant with a first baby. During the initial prenatal visit, the client says to the nurse, "I just can't believe I'm really pregnant. I hope this baby is a good idea." What would the nurse conclude from the client's statement?

The client is experiencing normal ambivalence about being pregnant.

A pregnant client at 10 weeks' gestation comes to the clinic for a routine visit. During the visit, the client tells the nurse, "I am worried because I feel tired all the time and have to run to the bathroom to urinate frequently throughout the day." What is the best response by the nurse?

The client's reports are typical, early pregnancy symptoms.

A client who is 27 weeks' pregnant arrives at the health care provider's office reporting fever, nausea, vomiting, malaise, unilateral flank pain, and costovertebral angle tenderness. About which condition does the nurse anticipate reinforcing education?

pyelonephritis

The nursing instructor asks a nursing student approximately how much time is required for the blastocyst to reach the uterus for implantation. What timeframe does the student provide to the instructor?

7 days

During a home-care visit with a pregnant client, the nurse notices extension cords crossing between rooms. How should the nurse intervene?

Explain that extension cords can pose a danger to the client when she's walking; and a greater danger after her child is born.

A client, now 37 weeks pregnant, calls the clinic because she's concerned about being short of breath and is unable to sleep unless she places three pillows under her head. After listening to her concerns, the nurse should take which action?

Explain that these are expected problems for the latter stages of pregnancy.

The nurse is caring for a pregnant client in the third trimester of pregnancy. The client is concerned about being dizzy when lying down on her back. The nurse would suggest which intervention to eliminate the dizziness?

Lie on the left side when lying down.

A client comes to the clinic for a routine prenatal examination. The nurse notices that the client is disheveled and unkempt. The client explains, "I have no energy to take care of myself and I really don't care." How should the nurse intervene?

Offer to assist the client with basic care needs while waiting for the health care provider.

A client, 7 months pregnant, is admitted to the unit with abdominal pain and bright red vaginal bleeding. Which action should the nurse take?

Place the client on her left side and start supplemental oxygen, as ordered, to maximize fetal oxygenation.

A nurse is collecting data as part of an initial history on a pregnant client. The client asks about the chances of having dizygotic twins. Which statement by the nurse would be most accurate?

There is an increased risk with increased maternal age.

A client in the first trimester of pregnancy joins a childbirth education class. During this trimester, the nurse is most likely to discuss which physiologic aspect of pregnancy?

Warning signs of complications

A client has come to the clinic for her first prenatal visit. The nurse should include which statement about using drugs safely during pregnancy in her teaching?

"Consult with your health care provider before taking any medications."

The nurse is obtaining a prenatal history from a client who's 8 weeks pregnant. To help determine whether the client is at risk for a TORCH infection, the nurse should ask:

"Do you have any cats at home?"

A pregnant client concerned about gaining weight during pregnancy questions the nurse about dietary intake. Which response by the nurse is best?

"I'll ask the dietitian to speak with you about normal weight gain during pregnancy."

A client with type 1 diabetes mellitus has just learned she's pregnant. The nurse is teaching her about insulin requirements during pregnancy. Which guideline should the nurse provide?

"Insulin requirements usually decrease during the first trimester."

A nursing student is surprised that a young couple is seeking treatment for Infertility. When asked by the nursing instructor to define it in a 25-year-old couple, how does the student respond?

"It is the couple's inability to conceive after 1 year of unprotected attempts."

A client is at her ideal weight when she conceives. During a prenatal visit 2 months later, she asks the nurse how much weight she should gain during pregnancy. What is the nurse's best response?

"You should gain 24 to 32 lb."

The nurse is caring for a client suspected of having a hydatidiform mole. Which signs and symptoms would confirm this diagnosis?

"snowstorm" pattern on ultrasound with no fetus or gestational sac

After reinforcing the signs of true and false labor with a pregnant client, the nurse determines that the client has an accurate understanding of the information when the client states that "false labor contractions:

"usually occur in the abdomen."

A 30-year-old client comes to the office for a routine prenatal visit. After reading the chart entry shown, the nurse should prepare the client for which study?

1-hour glucose tolerance test

When assessing a client for signs and symptoms of ectopic pregnancy, what is the most common sign or symptom associated with this antepartum complication the nurse would expect to find?

Abdominal pain

The nursing instructor asks the nursing student when should a client who's Rh(D)-negative and D-negative and who has not already formed Rh antibodies receive Rh(D) human immunoglobulin (RhIg) to prevent isoimmunization. Which appropriate timeline does the student provide to the instructor?

At about 28 weeks' gestation and again within 72 hours after delivery

Which statement accurately describes estrogen and progesterone levels during the 16th week of pregnancy?

Both estrogen and progesterone levels are rising.

A client in the third trimester of pregnancy is having contractions 5 minutes apart that began suddenly. The nurse identifies that it is the client's seventh month. The client is admitted directly to the obstetrics department. Which intervention has priority?

Check fetal heart tones.

During a routine prenatal visit, a pregnant client reports heartburn. Which suggestions in the plan of care should the nurse include to minimize the client's discomfort? Select all that apply.

Eat small, frequent meals. Drink six to eight 8-ounce glasses of fluid daily.

A famous pregnant client comes to the health care provider's office for a routine prenatal examination. While the client is in the office, the media arrives asking for information about the client. What should the nurse do?

Inform the media that you can't comment about whether the person is being seen in the office

A nurse is preparing a presentation for a pregnant client with diabetes. Which information would the nurse include to explain why a pregnant diabetic client is at risk for having a large-for-gestational-age infant?

Insulin acting as a growth hormone on the fetus

A client in the third trimester has come to the clinic for a routine checkup. The nurse reinforces the importance of lying on the left side when resting or sleeping. Which rationale should the nurse give to the client for this position?

It will prevent compression of the vena cava.

A client who is 34 weeks' pregnant is experiencing bleeding caused by placenta previa. The fetal heart sounds are normal, and the client is not in labor. Which intervention would be most appropriate at this time?

Monitor the amount of vaginal blood loss.

As a client progresses through pregnancy, she develops constipation. Which factor, if asked, would the nurse state is the primary cause of this problem during pregnancy?

Reduced intestinal motility

A client treated with terbutaline for preterm labor is ready for discharge. Which instruction should the nurse include in the discharge teaching plan?

Report a heart rate greater than 120 beats/minute to the health care provider.

A client is 2 months pregnant. Which factor should the nurse anticipate as most likely to affect her psychosocial transition during pregnancy?

Support from her partner

A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. Her BPP score is 8. How does the nurse correctly interpret this finding?

The fetus isn't in distress at this time.

During an examination, a pregnant client at 32 weeks' gestation becomes dizzy, light-headed, and pale while supine. Which action would the nurse do first?

Turn the client to the left side.

The nurse is collecting data on a pregnant woman in the clinic. In the course of the data collection, the nurse learns that this woman smokes one pack of cigarettes per day. The first step the nurse should take to help the woman stop smoking is to:

assess the client's readiness to stop.

A nurse is reinforcing education for a client entering the third trimester of pregnancy. The nurse determines that the client understands the education when the client states which symptom will be immediately reported?

blurred vision

A nurse is caring for a client who is four weeks pregnant. When collecting data on this client, the nurse would most likely note which finding?

breast sensitivity

A primigravida client is 16 weeks pregnant. Which client instruction would be most important to reinforce in order to prevent toxoplasmosis?

cooking meats thoroughly

During a prenatal visit, a pregnant client with cardiac disease and slight functional limitations reports increased fatigue. To help combat this problem, the nurse should advise her to:

divide daily food intake into five or six meals.

When determining maternal and fetal well-being, which data collection finding is most important?

fetal heart rate and activity

A client makes a routine visit to the prenatal clinic. Although she believes that she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. The health care provider diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal:

grapelike clusters.

A nurse is assisting the health care team to develop a plan of care for a 16-year-old client in the prenatal clinic. The client is at highest risk for which complication that should be addressed by the team?

iron deficiency anemia

A nurse is working with the multidisciplinary team providing care to a pregnant client with hyperemesis gravidarum who will need close monitoring at home. The nurse as part of the team would expect to assist in beginning discharge planning at which time?

on admission to the facility

A client is pregnant with triplets and is at greater risk for complications. The nurse reinforces education about the signs and symptoms of which conditions? Select all that apply.

placenta previa hypertension of pregnancy preterm labor anemia

A pregnant client arrives in the emergency department and states, "My baby is coming." The nurse sees a portion of the umbilical cord protruding from the vagina. Why should the nurse apply manual pressure to the baby's head?

to relieve pressure on the umbilical cord

A client is in the eighth month of her first pregnancy when her health care provider prescribes a biophysical profile to be conducted the next day. When preparing the room for this test, which equipment would the nurse most likely gather? Select all that apply.

ultrasound machine fetal monitor

A client with a history of heart failure becomes pregnant. The nurse would monitor the client closely at which time because the risk to client and fetus is greatest?

weeks 28 to 32

A client's membranes rupture during the 36th week of pregnancy. Eighteen hours later, the nurse measures the client's temperature at 101.8° F (38.8° C). After initiating prescribed antibiotic therapy, the nurse should prepare the client for:

delivery.

Which findings would be considered positive signs of pregnancy?

fetal heartbeat and fetal movement on palpation

A client who's planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. Which statement would be the nurse's best response?

"Folic acid supplements improve pregnancy outcomes by preventing certain complications."

A client arrives at the clinic for a scheduled amniocentesis. Which question should the nurse ask?

"Have you emptied your bladder?"

The nurse is caring for a client in her 34th week of pregnancy who wears an external monitor. Which statement by the client indicates an understanding of the nurse's teaching?

"I can lie in any comfortable position, but I should stay off my back."

A client comes to the clinic for her first prenatal visit. While the nurse is obtaining the client's vital signs, the client asks, "When will you be able to hear my baby's heart beat?" Which response by the nurse would be most appropriate?

"At about 11 weeks, we'll be able to hear them with an ultrasound device."

Which intervention would the nurse recommend to a client having severe heartburn during pregnancy?

Eat several small meals daily.

As part of a prenatal nutritional education program for a 17-year-old pregnant client who is concerned about weight gain, a nurse is reinforcing the information. Which statement by the nurse would be most appropriate?

"During pregnancy, you need to gain weight to help make sure your baby is healthy."

The nurse is providing care for a pregnant 16-year-old client. The client says that she's concerned she may gain too much weight and wants to start dieting. The nurse should respond by saying:

"Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems."

A pregnant client is brought to the emergency department after being an unrestrained driver in a motor vehicle accident. When questioned about seatbelt use, the client states that she thought a seatbelt would harm her baby. Which response by the nurse is best?

"The only way to safely secure yourself in a car is to use a seatbelt."

A pregnant client is obese. The nurse is working as part of the interdisciplinary team developing the client's plan of care. Based on the understanding of potential complications, the nurse would expect to monitor the client closely for which condition on follow-up visits?

preeclampsia

During a prenatal visit, the nurse measures a client's fundal height at 19 cm. The client asks what does this mean. How should the nurse respond?

"This measurement indicates that the fetus has reached approximately 19 weeks."

The nurse is discussing posture with a client who's 18 weeks pregnant. The clients asks why should she avoid the supine position. How does the nurse respond?

"This position impedes blood flow to the fetus."

A client in the seventh month of pregnancy reports back pain and wants to know what can be done to relieve it. After consulting with the supervising nurse about the client's report, which instruction would the nurse most likely reinforce?

"Try using pelvic tilt exercises while avoiding lifting heavy objects."

A nurse is discussing nutrition with a primigravida client. The nurse is informed that the client knows that calcium is important during pregnancy but that client and the client's family do not consume many milk or dairy products. What advice should the nurse give?

"You should consume other nondairy foods that are high in calcium."

A client has just been diagnosed with having a hydatidiform mole. When reviewing the client's medical record, what is the most significant risk factor?

prior molar gestation

During a health-teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. Which timeframe should the nurse appropriately supply?

7 days after fertilization

A client in the fifth month of pregnancy is having a routine clinic visit. When gathering data from the client, the nurse would be alert for which common second trimester condition?

physiologic anemia

A pregnant client comes to the facility for her first prenatal visit. When providing teaching, the nurse should be sure to cover which topic?

Danger signs during pregnancy

A client is in the 8th month of pregnancy. Which body position does the nurse advise the client to assume to enhance cardiac output and renal function when laying down?

Left lateral

A client in the first trimester of pregnancy reports constant fatigue. Which response by the nurse is best?

"Needs for rest and sleep typically increase during the first trimester of pregnancy."

A pregnant client asks the nurse whether she can take castor oil for her constipation. How should the nurse respond?

"No, it can initiate premature uterine contractions."

A nurse is caring for a client after evacuation of a hydatidiform mole. Which discharge instruction would be most appropriate for the nurse to reinforce with the client?

"Use birth control for at least 1 year."

A client who's 4 months pregnant asks the nurse how much and what type of exercise she should get during pregnancy. How should the nurse counsel her?

"Walk briskly for 10 to 15 minutes daily, and gradually increase this time."

A client is 33 weeks' pregnant and has had diabetes since age 21. When checking the fasting blood glucose level, which value would indicate the client's disease is controlled?

85 mg/dL (4.7 mmol/L)

During a routine prenatal visit, a pregnant client reports constipation, and the nurse teaches her how to relieve it. Which client statement indicates an accurate understanding of the nurse's instructions?

"I'll increase my intake of unrefined grains."

A client in the first trimester of pregnancy reports experiencing nausea every morning and asks about medicine to prevent it. Which response from the nurse would be most helpful?

"Let's talk about some methods to control nausea without medication."

A pregnant client is concerned about lack of fetal movement. Which response by the nurse would be most therapeutic?

"Lie down once a day and count the number of fetal movements for 15 to 30 minutes."

A nurse is caring for a pregnant adolescent. As the nurse gathers data on the client at each prenatal visit, the nurse would be alert for which complication as common in this age group?

gestational hypertension iron-deficiency anemia

A client is admitted to the facility in preterm labor. To halt her uterine contractions, the nurse expects the health care provider to prescribe:

terbutaline.

A client at 28 weeks' gestation presents to the emergency department with contractions. Following admission and hydration, the health care provider writes an order for the nurse to give 12 mg of betamethasone I.M. The nurse recognizes this medication is given for which action?

to promote fetal lung maturity

A client in the 13th week of pregnancy develops hyperemesis gravidarum. Which laboratory result would the nurse need to report to the supervising registered nurse?

urine positive for ketones

What is the primary nursing diagnosis for a client with a ruptured ectopic pregnancy?

Deficient fluid volume

A client who's 24 weeks pregnant has sickle cell anemia. When preparing the plan of care, the nurse should identify which factor as a potential trigger for a sickle cell crisis during pregnancy?

Dehydration

During a physical examination, a client who's 32 weeks pregnant becomes pale, dizzy, and light-headed while supine. Which action should the nurse immediately take?

Turn the client on her left side.

A nurse is caring for a 15-year-old pregnant adolescent who is taking an iron supplement. After reviewing instructions for taking the iron supplement, the nurse determines that the teaching was successful when the client tells the nurse that she will take the supplement with which fluid to help increase the absorption of iron?

a glass of orange juice

A pregnant client is screened for tuberculosis during at the first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. The nurse determines that the result is positive based on which finding?

an indurated wheal larger than 10 mm in diameter appearing in 48 to 72 hours

An adolescent prenatal client asks about getting fat while pregnant. To prevent which condition, the nurse says, "Because of your age, you need to gain enough weight to be in the upper portions of your recommended weight"?

birth of a low-birth-weight neonate

A pregnant client is receiving heparin. While the client is receiving this drug, which data would the nurse immediately report to the supervising nurse?

bleeding from an orifice