A&P of Pregnancy
During a health-teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. Which answer should the nurse supply?
7 days after fertilization
A client who is pregnant with her second child comes to the clinic complaining of 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 is 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 comes to the office for her first prenatal visit. She reports that January 3 was the first day of her last menstrual period. According to Naegele's rule, what date should the nurse record as the estimated date of delivery (EDD)?
October 10
A client is in the eighth month of pregnancy. To enhance cardiac output and renal function, the nurse should advise the client to use which body position?
left lateral
A nurse is providing care for a pregnant 16-year-old. The client says that she is 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."
After instructing a primigravid client about desired weight gain during pregnancy, the nurse determines that the teaching has been successful when the client states which statement?
"Although it varies, a gain of 25 to 35 lb (11.4 to 14.5 kg) is about average.
Which client statement indicates a need for additional teaching about self-care during pregnancy?
"I should sit in a hot tub for 20 minutes to relax after working."
A client who tells the nurse that she would like to use the basal body temperature method for family planning receives instructions about the method. Which client statement indicates to the nurse that the teaching has been successful?
"It's important to take my temperature at about the same time every morning before arising."
A pregnant client at about 29 weeks' gestation asks the nurse "What can I do about this dark brown line running down my stomach?" When teaching the client about this brown line, what should the nurse tell the client?
"This is a linea nigra that will fade after the baby is born."
Which statement by the nurse would be most appropriate when responding to a primigravid client who asks, "What should I do about this brown discoloration across my nose and cheeks?"
"This usually disappears after birth."
A couple visiting the infertility clinic for the first time states that they have been trying to conceive for the past 2 years without success. After a history and physical examination of both partners, what would be the most appropriate outcome for the couple to accomplish by the end of this visit?
Describe each of the potential causes and possible treatment modalities.
Using Naegele's rule for a client whose last normal menstrual period began on May 10, the nurse determines that the client's estimated date of birth is what date?
February 17
A nurse is performing a physical examination of a primigravid client who's 8 weeks pregnant. At this time, the nurse expects to assess:
Hegar's sign.
The nurse is developing a community health education program about sexually transmitted infections. Which information about women who acquire gonorrhea should be included?
Women with gonorrhea are usually asymptomatic.
The nurse conducts the health assessment of a client who is a primigravida in the prenatal clinic. Which presumptive signs of pregnancy should the nurse expect to assess?
amenorrhea and quickening
A client diagnosed with testicular cancer expresses concerns about fertility. The client and his spouse desire to eventually have a family, and the nurse discusses the option of sperm banking. What should the nurse tell the couple about the best time to donate the sperm?
before treatment is started
A nurse is assessing the legs of a client who's 36 weeks pregnant. Which finding should the nurse expect?
bilateral dependent edema
A male client has been diagnosed as having a low sperm count during infertility studies. After giving instructions about causes of low sperm counts, the nurse determines that the client needs further instructions when the client says low sperm counts may be caused by which health problem?
decreased body temperature
A nulliparous client tells the nurse that during her last pelvic examination, the health care provider said that her uterus was in a severe retroverted position. The nurse determines that the client may experience which complication?
difficulty conceiving a child
When teaching a group of pregnant adolescent clients about reproduction and conception, the nurse is correct when stating that fertilization occurs:
in the first third of the fallopian tube
A 25-year-old client tells the nurse that she would like to become pregnant, but she has been diagnosed with blocked fallopian tubes due to pelvic inflammatory disease. When helping the client explore infertility treatment options, what is most appropriate for this client?
in vitro fertilization
After trying for a year to conceive, a couple consults an infertility specialist. When obtaining a history from the husband, the nurse asks about childhood infectious diseases. Which childhood infectious disease most significantly affects male fertility?
mumps
A female client with infertility related to anovulatory cycles is prescribed menotropins. The nurse should assess the client for which possible adverse effect of this medication?
ovarian enlargement
A primigravid client visits the clinic at 12 weeks' gestation and tells the nurse that she has a cold and her nose is stuffy. The nurse should instruct the client to treat the nasal stuffiness by using which approach?
saline nose drops
A client has been trying to achieve a pregnancy for 3 years and has just recently sought the assistance of an infertility specialist. Which tests may be conducted to analyze the causes of this client's infertility? Select all that apply.
semen analysis hysterosalpingogram basal body temperature graph hypothalamic pituitary levels
A newly pregnant client tells the nurse that she hasn't been taking her prenatal vitamins because they make her nauseated. In addition to telling the client how important taking the vitamins are, the nurse should advise her to:
take the vitamin on a full stomach.
After instructing a primigravid client about the functions of the placenta, the nurse determines that the client needs additional teaching when she says that which hormone is produced by the placenta?
testosterone
A pregnant client is seeking information from the nurse about a home birth with registered midwives. Which of the following statements lets the nurse know that the client has considered the risks and benefits of using a midwife? Select all that apply.
"I will develop a list of questions to use in interviewing potential midwives." "I understand the complications that could occur in a home birth setting." "I realize that I may need to be transferred to a hospital if complications develop."
A client is scheduled to have in vitro fertilization (IVF) as an infertility treatment. Which client statement about IVF indicates that the client understands this procedure?
"IVF involves bypassing the blocked or absent fallopian tubes."
A pregnant client is experiencing a thin, odorless, vaginal discharge. What should the nurse instruct the client to do to prevent vaginal infections?
"Try wearing a panty liner and discarding it after every urination.
While assessing a multigravid client at 10 weeks' gestation, the nurse notes a purplish color to the vagina and cervix. The nurse documents this as what finding?
Chadwick's sign
Which recommendation would be the most appropriate preventive measure to suggest to a primigravid client at 30 weeks' gestation who is experiencing occasional heartburn?
Eat smaller and more frequent meals during the day
A client is planning to be treated for infertility with the zygote intrafallopian transfer (ZIFT) method. Which information should the nurse include when teaching the client about this type of treatment method?
Fertilization takes place outside of the body.
A client calls to schedule a pregnancy test. The nurse knows that most pregnancy tests measure which hormone?
Human chorionic gonadotropin (hCG)
A client's prenatal record shows a gravida 2, para 0111. From this information, the nurse knows that the client has been pregnant twice. What else does this information reveal about the client's obstetric history?
One pregnancy resulted in an abortion and one resulted in a preterm neonate who's living
A primigravid client at 36 weeks' gestation tells the nurse that she has been experiencing insomnia for the past 2 weeks. Which suggestion would be most helpful?
Practice relaxation techniques before bedtime
A multigravid client who stands for long periods while working in a factory visits the prenatal clinic at 35 weeks' gestation, stating, "The varicose veins in my legs have really been bothering me lately." Which instruction would be most helpful?
Take frequent rest periods with the legs elevated above the hips
A client is seeking infertility treatment after attempting pregnancy for 2 years. Of the following data from the client's history, which has the greatest impact on infertility?
The client is a gymnast weighing 105 lb (47.6 kg).
A pregnant client in her third trimester asks why she needs to urinate frequently again, as she did during the first trimester. What should the nurse tell her?
This symptom is normal and results from the fetus exerting pressure on the bladder
A client, 11 weeks pregnant, is admitted to the facility with hyperemesis gravidarum. The client 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
When measuring the fundal height of a primigravid client at 20 weeks' gestation, the nurse will locate the fundal height at which point?
at about the level of the client's umbilicus
A nurse is developing a teaching plan for a primigravid client who's 2 months pregnant. The nurse should tell the client that fetal movement can be felt beginning at which time?
between 18 and 20 weeks' gestation
A nurse is caring for a client in the first 4 weeks of pregnancy. The nurse should expect to collect which assessment findings?
breast sensitivity
A client with human papillomavirus (HPV) infection is being treated by a colposcopy. The client asks the nurse if this procedure is really necessary. The nurse can tell the client that if the HPV infection is not treated which health problem is likely to occur?
cervical cancer
Which findings are considered positive signs of pregnancy?
fetal heartbeat and fetal movement on palpation
After instructing a female client about the radioimmunoassay pregnancy test, the nurse determines that the client understands the instructions when the client states that which hormone is evaluated by this test?
human chorionic gonadotropin (hCG)
The nurse is witnessing the client's signature on the informed surgical consent for an abdominal hysterectomy. The nurse should be certain the client understands that what will be the outcome of this surgery?
infertility.
A pregnant client complains of nausea every morning and again before meals. As a result of the nausea, the client has been unable to eat enough and has lost weight. Which nonpharmacologic intervention should the nurse recommend?
keeping crackers at the bedside to eat before getting out of bed
A 30-year-old multigravid client has missed three periods and now visits the prenatal clinic because she assumes she is pregnant. She is experiencing enlargement of her abdomen, a positive pregnancy test, and changes in the pigmentation on her face and abdomen. These assessment findings reflect this woman is experiencing a cluster of which signs of pregnancy?
probable
A 15-year-old primigravid client at approximately 16 weeks' gestation tells the nurse that she has been experiencing an occasional sharp pain from the fundus to her pubic bone on the left side. The nurse determines that the client is most likely experiencing which complication
round ligament pain
A couple is visiting the clinic because they have been unable to conceive a baby after 3 years of frequent coitus. The nurse determines that the couple needs further instruction when they identify which factor as a cause of male infertility?
seminal fluid with an alkaline pH
A client and her partner, both 25 years old, are having trouble conceiving. Infertility in this couple is defined as:
the inability to conceive after 1 year of unprotected attempts.
