Antepartum 2016
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? a) To relieve pressure on the umbilical cord b) To slow the delivery process c) To reinsert the umbilical cord d) To rupture the membranes
Correct response: a) To relieve pressure on the umbilical cord Explanation: Applying manual pressure to the baby's head by gently pushing up with the fingers relieves pressure on the umbilical cord. This intervention is effective if the cord begins to pulsate. The mother may also be placed in either the knee-chest or Trendelenburg's position to ensure blood flow to the baby. This intervention isn't done to slow the delivery process. A prolapsed cord necessitates emergency cesarean birth. The nurse shouldn't attempt to reinsert the umbilical cord because doing so would further compromise blood flow. At this point, the membranes are probably ruptured already.
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 Nägele's rule, what date should the nurse record as the estimated date of delivery (EDD)? a) October 10 b) September 10 c) December 10 d) November 10
Correct: a) October 10 Explanation: The nurse can calculate EDD using Nägele's rule (add 7 days to the first day of the last menstrual period, then subtract 3 months, and finally add 1 year). In this example, January 3 + 7 days = January 10. Three months prior to that date is October 10 of the previous year. Adding 1 year, her EDD is October 10 of the current year.
A 36-year-old multigravid client is admitted to the hospital with possible ruptured ectopic pregnancy. When obtaining the client's history, which finding would be most important to identify as a predisposing factor? a) marijuana use during pregnancy b) use of estrogen-progestin contraceptives c) urinary tract infection d) episodes of pelvic inflammatory disease
Correct: d) episodes of pelvic inflammatory disease Explanation: Anything that causes a narrowing or constriction in the fallopian tubes so that a fertilized ovum cannot be properly transported to the uterus for implantation predisposes an ectopic pregnancy. Pelvic inflammatory disease is the most common cause of constricted or narrow tubes. Developmental defects are other possible causes. Ectopic pregnancy is not related to urinary tract infections. Use of marijuana during pregnancy is not associated with ectopic pregnancy, but its use can result in cognitive reduction if the mother's use during pregnancy is extensive. Progestin-only contraceptives and intrauterine devices have been associated with ectopic pregnancy
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. a) hysterosalpingogram b) semen analysis c) prothrombin time d) hypothalamic pituitary levels e) basal body temperature graph f) aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
Correct: • e) basal body temperature graph • d) hypothalamic pituitary levels • b) semen analysis • a) hysterosalpingogram Semen analysis on the part of the male is among the first testing to be completed. For the female, a hysterosalpingogram, using dye to examine the inner lining of the uterus and fallopian tubes, and basal body temperature graph, graphing the body's basal temperature over a month's time to look for the 1/2- to 1-°F (1/4 to 1/2-°C) rise that occurs after ovulation has taken place, are analyzed. If there are adequate, motile sperm, a patent uterus and ovaries, and ovulation is occurring, other etiologies will need to be assessed. These include hypothalamic pituitary functioning which produces luteinizing and follicle-stimulating hormone to cause ovulation. The prothrombin time (PT) measures the clotting ability of blood, while the AST and ALT measures damage to the liver. PT, AST, and ALT are not associated with fertility testing
During a prenatal visit, a nurse measures a client's fundal height at 19 cm. This measurement indicates that the fetus has reached approximately which gestational age? a) 24 weeks b) 19 weeks c) 28 weeks d) 12 weeks
Correct: b) 19 weeks Explanation: The fundal height measurement in centimeters equals the approximate gestational age in weeks, until week 32. Thus, fundal height at 12 weeks is 12 cm; at 24 weeks, 24 cm; and at 28 weeks, 28 cm.
