Antepartal Care
Which statement by a primigravida client about the amniotic fluid indicates the need for further teaching? A. The amniotic fluid helps to dilate the cervix once labor begins B. Fetal nutrients are provided by the amniotic fluid C. Amniotic fluid provides a cushion against impact of the maternal abdomen D. The fetus is kept at a stable temperature byy the amniotic fluid and sac
B
The nurse assesses a client at 24 week's gestation and is unable to find the fetal heartbeat. The fetal heartbeat was heard at the client's last visit 4 weeks ago. According to priority, the nurse should do the tasks in which order? A. Call the PCP B. Explain that the fetal heartbeat could not be found at this time C. Obtain different equipment and recheck D. Ask the client if the baby is or has been moving
D C B A
The nurse instructs a primigravida client to increase her intake of foods high in magnesium because of its role in what process? A. Prevention of demineralization of mother's bones B. Synthesis of protein, nucleic acids, and fats C. Amino acid metabolism D. Synthesis of neural pathways in the fetus
B
During a preparations for parenting class, one of the participants asks the nurse, "How will I know if I am really in labor?" What should the nurse tell the participant about true labor contractions? A. Walking around helps to decrease true contractions B. True labor contractions may disappear with ambulation, rest, and sleep C. The duration and frequency of true labor contractions remain the same D. True labor contractions are felt first in the lower back, then the abdomen
4
After conducting a class for female adolescents about human reproduction, the nurse concludes teaching has been effective when a student makes which statement? A. Under ideal conditions, sperm can reach the ovum in 15-30 minutes, resulting in pregnancy B. I will not become pregnant if I abstain from intercourse the last 14 days of my menstrual cycle C. Sperms from a healthy male usually remain viable in the female reproductive tract for 96 hours D. After an ovum is fertilized by a sperm, the ovum contains 21 pairs of chromosomes
A
An antenatal G2, T1, P0, A0, L1 client is discussing her postpartum plans for birth control with her health care provider. In analyzing the available choices, which factor has the greatest impact on her birth control options? a) breast- or bottle-feeding plan b) desire for another child in 2 years c) satisfaction with prior methods d) preference of sexual partner
A
During a birth preparation class, a primigravida client at 36 weeks gestation tells the nurse, "My lower back has really been bothering me." Which exercise would be the most helpful? A. Pelvic rocking B. Deep breathing C. Tailor sitting D. Squatting
A
The nurse is caring for a client who has a hx of gastric bypass and is now being seen for her first prenatal visit. Which interventions should be included in the plan of care? (Select all that apply) A. Take prenatal vitamins with 400 mcg of folic acid B. Refer the client to a registered dietician C. Draw glucose levels at each prenatal visit D. Counsel her that she will most likely gain all of her weight back E. Check urine at each visit for protein and glucose F. Monitor with a nonstress test beginning at 20 weeks
A B E
During a 2-hour birth preparations class focusing on the labor and birth process for primigravida clients, the nurse is describing the maneuvers that the fetus goes through during the labor process when the head is the presenting part. In which order do these maneuvers occur? A. Engagement B. Flexion C. Descent D. Internal rotation
A C B D
The nurse is caring for a client who is 12 weeks pregnant and speaks Spanish only. Which interventions should the nurse include in the plan of care at the client's initial visit? A. Provide brochures in the client's native language B. Refer the client to a high-risk clinic C. Discuss differences with the dominant culture D. Arrange for an interpreter for her appointments E. Discuss contraception and options F. Review nutritional preferences
A D F
When developing a teaching plan for a client who is 8-weeks pregnant, the nurse would suggest what foods to meet the client's increased need for folic acid? (Select all that apply) A. Spinach B. Banana C. Seafood D. Yogurt E. Beans
A E
Examination of a primigravida client having increased vaginal secretions since becoming pregnant reveals clear, highly acidic vaginal secretions. The client denies any perineal itching or burning. The nurse interprets these findings as a response r/t which factor? A. Halfway between the client's symphysis pubis and umbilicus B. At about the level of the client's umbilicus C. Between the client's umbilicus and xiphoid process D. Near the clients xiphoid process and compressing the diaphragm
B
A 40-year-old client at 8 weeks' gestation has a 3-year-old child with Down Syndrome. The nurse is discussing amniocentesis and chorionic villus sampling as genetic screening methods for the expected baby. The nurse is confident that the teaching has been understood when the client makes what statement? A. Each test identifies a different part of the infant's genetic makeup B. Chorionic villus can be performed earlier in pregnancy C. The test results take the same length of time to be completed D. Amniocentesis is a more dangerous procedure for the fetus
B
At a preconception visit, a 24-year-old client is found to have a uterus that appears split. This is an example of what type of uterine malformation? A. Septate uterus B. Bicornuate uterus C Double uterus D. Uterus didelphys
B
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse would assess the client for signs and symptoms of which of the following? A) Anemia. B) Hypertension. C) Dysmenorrhea. D) Acne vulgaris.
B
The nurse is teaching a new prenatal client about her iron defiency anemia during pregnancy. Which statement indicate that the client needs further instructions about her anemia? A. I will need to take an iron supplement now B. I may have anemia because my family is of Asian descent C. I am considered anemic if my hemoglobin is less than 11g/dL D. The anemia increases the workload on my heart
B
The topic of physiologic changes that occur during pregnancy is to be included in a parenting class for primigravida clients who are in their first half of pregnancy. Which topic would be important for the nurse to include in the teaching plan? A. Decreased plasma volume B. Increased risk for UTI's C. Increased peripheral vascular resistance D. Increased Hgb levels
B
When performing Leopold's maneuvers on a primigravida client at 22 weeks gestation, the nurse performs the first maneuver to accomplish which action? A. Locate the fetal back and spine B. Determine what is in the fundus C. Determine whether the fetal head is at the pelvic inlet D. Identify the degree of fetal descent and flexion
B
When planning a class for primigravida clients about common physiologic changes of pregnancy, the nurse should include what information in the teaching plan? A. The temperature decreases slightly early in pregnancy B. Cardiac output increases by 25-50% during pregnancy C. The circulating fibrinogen level decreases by as much as 50% during pregnancy D. The anterior pituitary gland secretes oxytocin late in pregnancy
B
The nurse is reviewing a pregnant client's immunization record. Which immunizations are contraindicated during pregnancy and are not updated at this time? (Select all that apply) A. Tetanus B. Rubella C. Mumps D. Chicken pox E. Live attenuated influenza vaccine F. Hepatitis B
B C D E
A client in the triage area who is at 19 weeks gestation states that she has not felt her baby move in the past week, and no fetal HR tones are found. While evaluating this client, the nurse identifies her as being at the highest risk for developing which problem? A. Abruptio placentae B. HELLP Syndrome C. Disseminated intravascular coagulation D. Threatened abortion
C
A client, approximately 11 weeks pregnant, and her husband are seen in the antenatal clinic. The client's husband tells the nurse that he has been experiencing nausea and vomiting and fatigue along with his wife. The nurse interprets these findings as a suggestion that the client's husband is experiencing which of the following? a) Ptyalism b) Mittelschmerz c) Couvade syndrome d) Pica
C
A newly diagnosed pregnant client tells the nurse, "If I am going to have all of these discomforts, I am not sure I want to be pregnant." The nurse interprets the client's statement as an indication of which perception? A. Fear of pregnancy outcome B. Rejection of the pregnancy C. Normal ambivalence D. Limited self-care abilities
C
The nurse teaches a client about using medroxyprogesterone as a birth control method. Which client statement indicates effective teaching A. This method of family planning requires monthly injections B. I should have my first injection during my menstrual cycle C. One possible adverse effect is absence of a menstrual period D. This drug will be given by SubQ injections
C
Which recommendation would be more helpful to suggest to a primigravida client at 37 weeks gestation with leg cramps? A. Change positions frequently throughout the day B. Alternately flex and extend the legs C. Straighten the knees, and flex the toes toward the chin D. Lie prone in bed with the legs elevated
C
A multigravida client at 32 weeks' gestation has experienced hemolytic disease of the newborn in a previous pregnancy. The nurse should prepare the client for frequent antibody titer evaluation obtained from which source? A. Placental blood B. Amniotic fluid C. Fetal blood D. Maternal blood
D
After the nurse reviews the PCP's explanation of amniocentesis with a multigravida client, which complication, if stated by the client, indicate the need for further teaching about the procedure? A. Risk of infection B. Possible miscarriage C. Risk of club foot D. Fetal organ malformation
D
An antenatal primigravid client has just been informed that she is carrying twins. The plan of care includes educating the client concerning factors that put her at risk for problems during the pregnancy. The nurse realizes the client needs further instruction when she indicates carrying twins put her at risk for which complication? A. Preterm labor B. twin-to-twin transfusion C. Anemia D. Group B Streptococcus
D
Following a positive pregnancy test, a a client begins discussing the ways things will change in the next several months. The nurse should include what information about a change the client can anticipate in the first trimester? A. Differentiating the self from the fetus B. Enjoying the role of nurturer C. Preparing for the reality of parenthood D. Experiencing ambivalence about pregnancy
D
When preparing in prenatal class about endocrine changes that normally occur during pregnancy, the nurse should include which information about the subject? A. Human placental lactogen maintains the corpus lutenum B. Progesterone is responsible for hyperpigmentation and vascular skin changes C. Estrogen relaxes smooth muscle in the respiratory tract D. The thyroid enlarges with an increase in basal metabolic rate
D
An antenatal client is discussing her anemia with the nurse in the prenatal clinic. After a discussion about sources of iron to be incorporated into her daily meals, the nurse knows the client needs further instruction when she responds with which of the following? 1. "I can meet two goals when I drink milk, and lots of iron, and meet my calcium needs at the same time." 2. "Drinking coffee, tea, and sodas decreases the absorption of iron." 3. "I can increase the absorption of iron by drinking orange juice when I eat." 4. "Cream of wheat and molasses are excellent sources of iron."
A
The nurse is caring for a 24 year old primigravida client scheduled for emergency surgery because of a probable ectopic pregnancy. What is the most important thing for the nurse to do? A. Prepare to witness an informed consent for surgery B. Assesss the client for massive external bleeding C. Explain that the fallopian tubes can be salvaged D. Monitor the client closely for uterine contractions
A
When developing a series of parent classes on fetal development, the nurse should include which feature as being developed by the end of the third month? A. External genitalia B. Myelinization of nerves C. Brown fat stores D. Air ducts and alveoli
A
When providing care to the client who has undergone a dilatation and curettage after a spontaneous abortion, the nurse administers hydroxyzine as prescribed. What is the expected outcome? A. Absence of nausea B. Minimized pain C. Decreased uterine cramping D. Improved uterine contractability
A
Which statement best identifies the rationale for why the nurse reinforces the need for continued prenatal care throughout the pregnancy with an adolescent primigravida client? A. Pregnant adolescents are at high risk for pregnancy-induced hypertension B. Gestational diabetes during pregnancy commonly develops in adolescents C. Adolescents need additional instruction r/t common discomforts D. The father of the baby is rarely involved in the pregnancy
A
A 17-year-old gravid client presents for a regularly scheduled 26-week prenatal visit. She appears disheveled, is wearing ill-fitting clothing, and does not make eye contact with the nurse. Which items should the nurse discuss with the client? A. Intimate partner violence B. Substance abuse C. Depression D. Blood glucose screening E. Hcg
A B C D
A prenatal client wants to begin a yoga-based exercise class to keep her healthy during pregnancy. What information should the nurse include in the plan of care? (Select all that apply) A. Drink plenty of water before, during, and after a workout B. Take precaution to prevent overwhelming C. Avoid jerky, high-impact motions D. Modify any positions that put strain on the abdomen E. Participate in only classes specifically designed for pregnant clients
A B C D
A primiparas client at 10 weeks gestation questions the nurse about the need for an ultrasound. She states "I feel fine, so why should I have the test?" The nurse should incorporate which statement as the underlying reason for performing the ultrasound now? (Select all that apply) A. The test helps us view the gross anatomy of the fetus B. We need to determine gestational age C. The test will determine if the fetus is viable D. We must determine fetal position E. We must determine that there is a sufficient nutrient supply for the fetus
A B C D
A primigravida client at 32 weeks gestation is enrolled in breastfeeding classes. Which statements indicate the client understand the breastfeeding education? (Select all that apply) A. My milk supply will be adequate since I have a whole bra size during pregnancy B. I can hold my baby several different ways during feedings C. If my infant latches on properly, I will not develop mastitis D. If I breastfeed, my uterus will quickly return to prepregnancy size more quickly E. I need to feed my baby when I see feeding cues and not wait until she is crying
B D E
After instructing a primigravida client about the desired weight gain during pregnancy, the nurse determines that the teaching has been successful when the client makes which statement? A. A total weight gain of approximately 20 lbs. is reccommended B. A weight gain of 6.6 lbs. in the second and third trimester is considered normal C. A weight gain of 12 lb. every trimester is reccommended D. Althoughth it varies, a gain of 25-35 lb. is average
D
After instructing participants in a birth education class about the methods for coping with discomforts in the first stage of labor, the nurse determines on of the pregnant clients needs further instruction when she says she has been practicing what technique? A. Biofeedback B. Effleurage C. Guided imagery D. Pelvic tilt exercises
D
A 20-year-old primigravida client tells the nurse that her mother had a friend who died from a hemorrhage about 10 years ago during a vaginal birth. Which response would be the most helpful? A. Today's modern technology has resulted in a low maternal mortality rate B. Do not concern yourself with things of the past C. In North America, mothers seldom die during birth D. What is it that concerns you, labor or birth?
D
A couple is visiting the clinic because they have been unable to conceive a baby after 3 years of frequent coitus. After a history and physical examination of both partners, what would be the most appropriate outcome for the couple by the end of this visit? A. Choose an appropriate infertility treatment method B. Acknowledge that only 50% of infertile couples achieve a pregnancy C. Discuss alternative methods of having a family, such as adoption D. Describe each of the potential causes and possible treatment modalities
D
A primigravida client at 8 weeks gestation tells the nurse that since having had a sexual relationship with a new partner 2 weeks ago has been noticing flu-like symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to the PCP because the nurse suspects which STI? A. Gonorrhea B. Chlamydia C. Syphilis D. Herpes Genitalis
D
