Antepartum period
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. What is the best response by the nurse?
"Are there any dairy products that you do like?"
An adolescent who is 14 weeks pregnant comes to the clinic for a prenatal examination. During the examination, the client says to the nurse, "I'm still not sure if I want to keep my baby." Which response by the nurse is best?
"Tell me more about how you are feeling about the baby."
A 30-year-old primiparous client at 34 weeks' gestation comes to the prenatal facility concerned about the reddish streaks she has increasingly developed on her breasts and abdomen. She asks what these skin changes are and whether they're permanent. What is the best response by the nurse?
"These streaks are called striae gravidarum, or stretch marks; they'll grow lighter after delivery."
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 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 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 client in the early second trimester tells the nurse, "I am experiencing a significant amount of heartburn." Which suggestion would be most appropriate for the nurse to make? Select all that apply.
-"Eat small, frequent meals throughout the day." -"Keep the head of the bed elevated."
The nurse is reviewing a pregnant client's nutritional status. When determining whether the client has an adequate intake of vitamin A, the nurse should check the client's diet for consumption of which foods? Select all that apply.
-dairy products -fruits and vegetables
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 diagnosed with gestational hypertension must have weekly blood pressure checks and urine testing at a clinic. She does not have transportation. How can the nurse help this client be compliant with her care?
Ask the clinic case manager to speak with the client.
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
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
The nurse is informed by an 18-year-old pregnant client of concerns that the client may not be able to provide self-care during pregnancy. The client states that prenatal care is expensive; furthermore, the client's job does not provide insurance. What is the best action by the nurse?
Discuss community resources with the client.
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.
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 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
The nurse is caring for a client whose first day of the last menstrual period (LMP) was July 29, 2016. When the client asks what the infant's due date is, which date would the nurse give if using the Naegele rule?
May 6, 2017 To apply the Naegele rule, take the first day of the LMP, subtract 3 months and add 7 days: Adjustment has to be made if the LMP falls at the end of a month. If the first day of the LMP is July 29, subtracting 3 months would be April and adding 7 days would be April 36. April only has 30 days, so the date is advanced to May 6, 2017. The other three responses do not meet the formula for the Naegele rule.
The nurse is checking the legs of a client who's 36 weeks pregnant. Which finding should the nurse expect?
bilateral dependent edema
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 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."
The nurse is reinforcing education for a client in the first trimester of pregnancy. What statement made by the client demonstrates an understanding of the education?
"I need to take supplemental folic acid to prevent neural tube defects."
A pregnant client is visiting the clinic and reports tiny, blanched, slightly raised-end arterioles on the face, neck, arms, and chest. The nurse documents this finding on the medical record as which condition?
telangiectasias
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 tells the nurse that she dreads coming to her prenatal examinations. She states, "The health care provider is constantly reminding me that many women keep weight on after having children, and it really depresses me." How should the nurse respond?
"Have you discussed this with your health care provider?"
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 has come to the clinic for her first prenatal visit. The nurse should include which statement about using medications safely during pregnancy when reinforcing client teaching?
"Talk to your health care provider before taking over-the-counter medications."
The nurse is reinforcing instructions about the types of food to consume to increase folic acid intake. 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.
-spinach --oranges -egg yolks
A new nurse is asked to start an I.V. on an antepartum client. The new nurse has performed the procedure only once and isn't familiar with the I.V. pumps used in this facility. The new nurse should:
review the unit's procedure manual.
A nurse is assisting with the education of a client who receives a dose of human Rho(D) immune globulin at 28 weeks' gestation to prevent Rh isoimmunization. What should the nurse inform the client regarding the reason for administering the medication?
Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies.
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.
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 20-year-old female's pregnancy is confirmed at a clinic. She says her husband will be excited, but she is concerned because she herself isn't excited. She fears this may mean she'll be a bad mother. The nurse should respond by:
telling her such feelings are normal in the beginning of pregnancy.
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
The nurse is caring for a client who is 39 weeks' pregnant and reports she has been leaking fluid from her vagina for 3 days. The nurse knows that this client is most at risk for what?
uterine infection
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 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.
On her second visit to the prenatal facility, a client states, "I guess I really am pregnant. I've missed two periods now." Based on this statement, the nurse determines that the client has accomplished which psychological task of pregnancy?
accepting the pregnancy
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
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.
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.
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 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 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 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
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 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
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 with preeclampsia is scheduled to undergo a nonstress test (NST) and asks the nurse why this test is being performed. When responding to the client, which condition would the nurse most likely include as the reason?
fetal well-being
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
Which laboratory value is most helpful for determining whether or not a client is pregnant?
human chorionic gonadotropin
During a routine visit to the clinic, the client informs the nurse that the client may be pregnant. Which pregnancy test result would the nurse identify as most accurate in confirming pregnancy?
increase in human chorionic gonadotropin
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
