Passpoint - Antepartum Period
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.
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 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
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 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)
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
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.
During a routine assessment, a pregnant client tells the nurse that she hasn't had a bowel movement for "close to a week." What should the nurse do to help this client?
Discuss the client's diet, focusing on her fiber and water intake.
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
Which intervention would the nurse recommend to a client having severe heartburn during pregnancy?
Eat several small meals daily.
A pregnant client tells the nurse that she doesn't like milk and can't possibly drink three to four glasses per day as recommended by her health care provider. Which intervention by the nurse is best?
Explaining that other dairy products, such as cheese and yogurt, may be substituted for milk
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.
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
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 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."
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 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.
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
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
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 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.
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. Correct response:
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.
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.
The nurse obtains the antepartum history of a client who's 6 weeks pregnant. Which finding should the nurse discuss with the client first?
her consumption of six to eight cans of beer on weekends
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 dietary teaching to a pregnant client. To help meet the client's iron needs, the nurse should advise her to eat:
spinach and beef.
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 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
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 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."
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 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 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 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."
During the initial prenatal visit, a client asks a nurse what physiological changes can be expected during pregnancy. The nurse begins the discussion with the presumptive changes of pregnancy. Arrange the following presumptive changes in ascending chronological order according to when they occur. Use all of the options.
-breast changes -frequent urination -uterine enlargement in which the uterus can be palpated over the symphysis pubis -quickening -appearance of linea nigra, melasma, and striae gravidarum
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:
1. a history of pelvic inflammatory disease.
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 asks how long she and her husband can safely continue sexual activity during pregnancy. Which should the nurse recommend?
"As long as you wish, if the pregnancy is normal."
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 client is scheduled for amniocentesis. When preparing her for the procedure, the nurse should complete which of the following tasks?
Ask her to void.
Which medication is considered safe during pregnancy?
insulin
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 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."
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?"
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."
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 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 primigravida client in the tenth week of pregnancy calls the clinic to report experiencing slight vaginal bleeding. Which response by the nurse would be best?
"Save any perineal pads, clots, and tissue and come to the clinic right away."
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, 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 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 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
When determining maternal and fetal well-being, which data collection finding is most important?
fetal heart rate and activity
Which findings would be considered positive signs of pregnancy?
fetal heartbeat and fetal movement on palpation
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 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'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.
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."
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 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."
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."
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
A nurse is reviewing a pregnant client's chart. Which medications would the nurse expect to see and are considered safe during pregnancy? Select all that apply.
-insulin -prenatal vitamins
A pregnant teenager, diagnosed with iron deficiency anemia, arrives at the clinic for the first prenatal visit. When reinforcing teaching in regard to proper nutrition, which foods would the nurse encourage the client to consume during pregnancy to increase iron in the diet? Select all that apply.
-spinach and hamburgers -strawberries and oranges -raisins and egg yolks
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
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
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 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 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
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
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 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
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.
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.
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 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.
The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?
They're usually felt in the abdomen.
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 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 is in the last trimester of pregnancy. The nurse should instruct her to notify her obstetrician immediately if she notices:
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 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
