Antepartum Period Questions

A pregnant client asks the nurse about the percentage of congenital anomalies caused by drug exposure. How should the nurse respond? 1. 1% 2. 10% 3. 20% 4. 60%

a. 1%

The caloric requirements for a client of normal weight increase by how much during pregnancy? 1. 300 kcal 2. 400 kcal 3. 500 kcal 4. 1,000 kcal

1. 300 kcal

A pregnant client comes to the facility for her first prenatal visit. When providing teaching, the nurse should be sure to cover which topic? 1. Labor techniques 2. Danger signs during pregnancy 3. Signs and symptoms of pregnancy 4. Tests to evaluate for high-risk pregnancy

2. Danger signs during pregnancy

The nurse is reviewing a client's prenatal history. Which finding indicates a genetic risk factor? 1. The client is 25 years old. 2. The client has a child with cystic fibrosis. 3. The client was exposed to rubella at 36 weeks' gestation. 4. The client has a history of preterm labor at 32 weeks' gestation.

2. The client has a child with cystic fibrosis.

What is the primary nursing diagnosis for a client with a ruptured ectopic pregnancy? 1. Anxiety 2. Acute pain 3. Deficient fluid volume 4. Anticipatory grieving

3. Deficient fluid volume

Which medication is considered safe during pregnancy? 1. Aspirin 2. Magnesium hydroxide 3. Insulin 4. Oral antidiabetic agents

3. Insulin

Infertility in a 25-year-old couple is defined as: 1. the couple's inability to conceive after 6 months of unprotected attempts. 2. the couple's inability to sustain a pregnancy. 3. the couple's inability to conceive after 1 year of unprotected attempts. 4. a low sperm count and decreased motility.

3. the couple's inability to conceive after 1 year of unprotected attempts.

A client asks how long she and her husband can safely continue sexual activity during pregnancy. How should the nurse respond? 1. "Until the end of the first trimester" 2. "Until the end of the second trimester" 3. "Until the end of the third trimester" 4. "As long as you wish, if the pregnancy is normal"

4. "As long as you wish, if the pregnancy is normal"

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: 1. start using insulin. 2. start taking an oral antidiabetic drug. 3. monitor her urine for glucose. 4. be taught about diet.

4. be taught about diet.

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? 1. To slow the delivery process 2. To reinsert the umbilical cord 3. To relieve pressure on the umbilical cord 4. To rupture the membranes

3. To relieve pressure on the umbilical cord

The nurse checks a client for signs and symptoms of ectopic pregnancy. What is the most common finding associated with this antepartum complication? 1. Temperature elevation 2. Vaginal bleeding 3. Nausea and vomiting 4. Abdominal pain

4. Abdominal pain

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? 1. "Each pregnancy has a unique psychosocial meaning." 2. "The facility requires these answers of all pregnant clients." 3. "A second pregnancy may require more psychosocial adjustment." 4. "A client can develop couvade with any pregnancy."

1. "Each pregnancy has a unique psychosocial meaning." With each pregnancy, a woman explores a new aspect of the mother role and must reformulate her self-image as a pregnant woman and a mother. The other options don't address the client's feelings.

The nurse is providing instruction to a woman who is 18 weeks pregnant. Which findings are expected at this time? Select all that apply: 1. Fundal height of approximately 18 cm 2. Quickening 3. Insomnia 4. Braxton Hicks contractions 5. Leg cramps

1. Fundal height of approximately 18 cm 2. Quickening

The nurse is assisting in planning care for a 16-year-old client in the prenatal clinic. Adolescents are prone to which complication during pregnancy? 1. Iron deficiency anemia 2. Varicosities 3. Nausea and vomiting 4. Gestational diabetes

1. Iron deficiency anemia

During a prenatal visit, the nurse measures a client's fundal height at 19 cm. This measurement indicates that the fetus has reached approximately which gestational age? 1. 12 weeks 2. 19 weeks 3. 24 weeks 4. 28 weeks

2. 19 weeks

A client is in the 8th month of pregnancy. To enhance cardiac output and renal function, the nurse should advise her to use which body position? 1. Right lateral 2. Left lateral 3. Supine 4. Semi-Fowler's

2. Left lateral

After an amniotomy, which client goal should take the highest priority? 1. The client will express increased knowledge about amniotomy. 2. The client will maintain adequate fetal tissue perfusion. 3. The client will display no signs of infection. 4. The client will report relief of pain.

2. The client will maintain adequate fetal tissue perfusion.

During her first prenatal visit, a pregnant client admits to the nurse that she uses cocaine at least once per day. Which nursing diagnosis is most appropriate for this client? 1. Activity intolerance related to decreased tissue oxygenation 2. Risk for infection related to metabolic and vascular abnormalities 3. Imbalanced nutrition: Less than body requirements related to limited food intake 4. Impaired gas exchange related to respiratory effects of substance abuse

3. Imbalanced nutrition: Less than body requirements related to limited food intake

The nurse is teaching a client who's 28 weeks pregnant and has gestational diabetes how to control her blood glucose levels. Diet therapy alone has been unsuccessful in controlling this client's blood glucose levels, so she has started insulin therapy. The nurse should consider the teaching effective when the client says: 1. "I won't use insulin if I'm sick." 2. "I need to use insulin each day." 3. "If I give myself an insulin injection, I don't need to watch what I eat." 4. "I'll monitor my blood glucose levels twice per week."

2. "I need to use insulin each day."

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? 1. "I can see why you'd think that because the seatbelt comes over the lower abdomen." 2. "I know that seat belts are uncomfortable." 3. "The only way to safely secure yourself in a car is to use a seatbelt." 4. "I don't use my seatbelt either."

3. "The only way to safely secure yourself in a car is to use a seatbelt."

A client who's 12 weeks pregnant attends a class on fetal development as part of a childbirth education program. The nurse says that at 16 weeks' gestation, the client's fetus will likely: 1. be able to suck and swallow. 2. open the eyes. 3. have audible heart sounds. 4. have open nostrils.

3. have audible heart sounds.

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? 1. Glycosuria, hypertension, seizures 2. Hematuria, blurry vision, reduced urine output 3. Burning on urination, hypotension, abdominal pain 4. Hypertension, edema, proteinuria

4. Hypertension, edema, proteinuria

After determining that a pregnant client is Rh-negative, the physician orders an indirect Coombs' test. What is the purpose of performing this test in a pregnant client? 1. To determine the fetal blood Rh factor 2. To determine the maternal blood Rh factor 3. To detect maternal antibodies against fetal Rh-negative factor 4. To detect maternal antibodies against fetal Rh-positive factor

4. To detect maternal antibodies against fetal Rh-positive factor

A client, 7 months pregnant, is admitted to the unit with abdominal pain and bright red vaginal bleeding. Which action should the nurse take? 1. Place the client on her left side and start supplemental oxygen, as ordered, to maximize fetal oxygenation. 2. Administer I.V. oxytocin, as ordered, to stimulate uterine contractions and prevent further hemorrhage. 3. Ease the client's anxiety by assuring her that everything will be all right. 4. Massage the client's fundus to help control the hemorrhage.

1. Place the client on her left side and start supplemental oxygen, as ordered, to maximize fetal oxygenation.

The nurse is obtaining a prenatal history from a client who's 8 weeks pregnant. To help determine whether the client is at risk for a TORCH infection, the nurse should ask: 1. "Have you ever had osteomyelitis?" 2. "Do you have any cats at home?" 3. "Do you have any birds at home?" 4. "Have you recently had a rubeola vaccination?"

2. "Do you have any cats at home?"

A client who's 30 weeks pregnant has a corrected atrial septal defect and minor functional limitations. Which pregnancy-related physiologic change places her at greatest risk for more severe cardiac problems? 1. Decreased heart rate 2. Increased plasma volume 3. Decreased cardiac output 4. Increased blood pressure

2. Increased plasma volume

Which findings would be considered positive signs of pregnancy? 1. Fatigue and skin changes 2. Quickening and breast enlargement 3. Fetal heartbeat and fetal movement on palpation 4. Abdominal enlargement and Braxton Hicks contractions

3. Fetal heartbeat and fetal movement on palpation

The nurse is caring for a client with hyperemesis gravidarum who will need close monitoring at home. When should the nurse begin discharge planning? 1. On the day of discharge 2. When the client expresses readiness to learn 3. When the client's vomiting has stopped 4. On admission to the facility

4. On admission to the facility

Which statement accurately describes estrogen and progesterone levels during the 16th week of pregnancy? 1. Both estrogen and progesterone levels are rising. 2. The estrogen level is much higher than the progesterone level. 3. Both estrogen and progesterone levels are declining. 4. The estrogen level is much lower than the progesterone level.

1. Both estrogen and progesterone levels are rising.

A client is 2 months pregnant. Which factor should the nurse anticipate as most likely to affect her psychosocial transition during pregnancy? 1. Support from her partner 2. Socioeconomic status 3. Previous health promotion activities 4. Previous experiences with health care facilities

1. Support from her partner

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? 1. Turn the client on her left side. 2. Ask the client to breathe deeply. 3. Listen to fetal heart tones. 4. Measure the client's blood pressure.

1. Turn the client on her left side. Takes pressure off of her IVC

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: 1. assess the client's readiness to stop. 2. suggest that the client reduce the daily number of cigarettes smoked by one-half. 3. provide the client with the telephone number of a formal smoking cessation program. 4. help the client develop a plan to stop.

1. assess the client's readiness to stop.

A pregnant client comes to the clinic after missing several scheduled prenatal appointments. During the initial assessment, the client states, "I haven't been coming to some of my appointments because I go to a homeopathic specialist who takes great care of me." Which response by the nurse is best? 1. "That's fine; you can see whichever health care professional you prefer." 2. "You should mention the homeopathic specialist to your physician so he can help devise the best care plan for you." 3. "You really need to come to each scheduled appointment here; missing appointments could be harmful." 4. "Don't you want to continue to be cared for by your clinic physician?"

2. "You should mention the homeopathic specialist to your physician so he can help devise the best care plan for you."

A client with pregnancy-induced hypertension (PIH) receives magnesium sulfate, 4 g in 50% solution I.V. over 20 minutes. What is the purpose of administering magnesium sulfate to this client? 1. To lower blood pressure 2. To prevent seizures 3. To inhibit labor 4. To block dopamine receptors

2. To prevent seizures

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? 1. "I'll decrease my intake of green, leafy vegetables." 2. "I'll limit fluid intake to four 8-oz glasses." 3. "I'll increase my intake of unrefined grains." 4. "I'll take iron supplements regularly."

3. "I'll increase my intake of unrefined grains."

A client in her second trimester of pregnancy has been diagnosed with gestational diabetes. While instructing the client about home glucose monitoring the client states, "Why should I use this if the diabetes is going to resolve after I have my baby anyway?" Which response by the nurse is best? 1. "You know, you're probably right but the physician wants you to use it." 2. "You've been misinformed; you'll probably continue to have diabetes after delivery." 3. "I have to teach you how to use it; when you get home you can do whatever you choose." 4. "The monitor helps you see how your blood sugar is being controlled during your pregnancy to help prevent complications."

4. "The monitor helps you see how your blood sugar is being controlled during your pregnancy to help prevent complications."

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). Which condition makes this client more susceptible to such infections? 1. Electrolyte imbalances 2. Decreased insulin needs 3. Hypoglycemia 4. Glycosuria

4. Glycosuria (predisposes the pregnant diabetic client to vaginal infections (especially Candida vaginitis) and UTIs, because the hormonal changes of pregnancy affect vaginal pH and the bladder. )

What key psychosocial tasks must a woman accomplish during the third trimester? 1. Resolving grief over the loss of old roles 2. Developing a mother image 3. Coping with common discomforts and changes 4. Overcoming fears she may have about the unknown, loss of control, and death

4. Overcoming fears she may have about the unknown, loss of control, and death

An 18-year-old pregnant woman tells the nurse that she's concerned that she may not be able to take care of herself during her pregnancy. She states that prenatal care is expensive and her job doesn't provide insurance. The nurse should recognize that the client: 1. may not take care of herself. 2. may not be fit to take care of a child. 3. needs to take a second job. 4. should be referred to community resources available for pregnant women.

4. should be referred to community resources available for pregnant women.

The nurse is discussing posture with a client who's 18 weeks pregnant. Why should the nurse caution her to avoid the supine position? 1. This position impedes blood flow to the fetus. 2. This position may trigger heart palpitations. 3. This position may cause gastroesophageal reflux. 4. This position promotes pregnancy-induced hypertension (PIH).

1. This position impedes blood flow to the fetus.

The nurse is collecting data on a client who is believed to be pregnant. Which signs or symptoms indicate a hydatidiform mole? 1. Rapid fetal heart tones 2. Abnormally high human chorionic gonadotropin (hCG) levels 3. Slow uterine growth 4. Lack of symptoms of pregnancy

2. Abnormally high human chorionic gonadotropin (hCG) levels

A client in her 15th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this client? 1. Deficient knowledge (pregnancy complications) 2. Deficient fluid volume 3. Anticipatory grieving 4. Acute pain

2. Deficient fluid volume

A client, 7 months pregnant, is receiving the tocolytic agent terbutaline (Bricanyl), 17.5 mcg/minute I.V., to halt uterine contractions. She also takes prednisone (Orasone), 5 mg by mouth twice per day, to control asthma. To detect an adverse interaction between these drugs, the nurse should monitor the client for: 1. increased uterine contractions. 2. pulmonary edema. 3. asthma exacerbation. 4. hypertensive crisis.

2. pulmonary edema.

The nurse is providing care for a pregnant woman. The woman asks the nurse how she can effectively deal with her fatigue. The nurse should instruct her to: 1. take sleeping pills for a restful night's sleep. 2. try to get more rest by going to bed earlier. 3. take her prenatal vitamins. 4. tell her not to worry because the fatigue will go away soon.

2. try to get more rest by going to bed earlier.

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? 1. Suggest that the client take Milk of Magnesia when she returns home. 2. Recommend that the client take castor oil before bedtime. 3. Discuss the client's diet, focusing on her fiber and water intake. 4. Ask the physician to prescribe a laxative for this client.

3. Discuss the client's diet, focusing on her fiber and water intake.

The nurse has a client at 30 weeks' gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her baby? 1. Encourage breast-feeding so that she can get her rest and get healthier. 2. Encourage breast-feeding because it's healthier for the baby. 3. Encourage breast-feeding to facilitate bonding. 4. Discourage breast-feeding because HIV can be transmitted through breast milk.

4. Discourage breast-feeding because HIV can be transmitted through breast milk.

The nurse prepares a client who's 28 weeks pregnant for a nonstress test (NST). Which intervention is likely to stimulate fetal movements during this test? 1. Having the client drink orange juice 2. Instructing the client to brush her hand over a nipple 3. Advising the client not to eat for 12 hours before the test 4. Positioning the client on her left side

1. Having the client drink orange juice

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. 2. grand multiparity (five or more births). 3. use of an intrauterine device for 1 year. 4. use of a hormonal contraceptive for 5 years.

1. a history of pelvic inflammatory disease.

A pregnant client tells the nurse that she dreads coming for her prenatal examinations. She states, "When I see the physician, he constantly reminds me that so many women keep weight on after having children; it really depresses me." How should the nurse respond? 1. "I'm sure he's just kidding." 2. "Have you asked the physician why he feels it's important for him to say that to you?" 3. "You should report him to the American Medical Association because he continually harasses you." 4. "He's just being truthful; women do tend to lose their figures after childbirth."

2. "Have you asked the physician why he feels it's important for him to say that to you?"

A client, now 37 weeks pregnant, calls the clinic because she's concerned about being short of breath and is unable to sleep unless she places three pillows under her head. After listening to her concerns, the nurse should take which action? 1. Make an appointment because the client needs to be evaluated. 2. Explain that these are expected problems for the latter stages of pregnancy. 3. Arrange for the client to be admitted to the birth center for delivery. 4. Tell the client to go to the hospital; she may be experiencing signs of heart failure from a 45% to 50% increase in blood volume.

2. Explain that these are expected problems for the latter stages of pregnancy.

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: 1. amniocentesis. 2. delivery. 3. sonography. 4. tocolytic drug therapy.

2. delivery.

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? 1. "Are you planning to have epidural anesthesia?" 2. "Have you begun prenatal classes?" 3. "What changes have you made at home to get ready for the baby?" 4. "Can you tell me about the meals you typically eat each day?"

3. "What changes have you made at home to get ready for the baby?"

A client has come to the clinic for her first prenatal visit. The nurse should include which statement about using drugs safely during pregnancy in her teaching? 1. "During the first 3 months, avoid all medications except those prescribed by your health care provider." 2. "Medications that are available over the counter are safe for you to use, even early on." 3. "All medications are safe after you've reached the fifth month of pregnancy." 4. "Consult with your health care provider before taking any medications."

4. "Consult with your health care provider before taking any medications."

A client is scheduled for amniocentesis. What should the nurse do to prepare the client for the procedure? Select all that apply 1. Ask the client to void. 2. Instruct the client to drink 1 L of fluid. 3. Ask the client to lie on her left side. 4. Assess fetal heart rate. 5. Insert an I.V. catheter. 6. Monitor maternal vital signs.

1. Ask the client to void. 4. Assess fetal heart rate. 6. Monitor maternal vital signs.

When collecting data on a client during her first prenatal visit, the nurse discovers that the client had a reduction mammoplasty. The mother indicates she wants to breast-feed. What information should the nurse give to this mother regarding breast-feeding success? 1. "It's unlikely that you will be able to breast-feed following this type of surgery." 2. "I support your commitment; however, you may have to supplement each feeding with formula." 3. "You should check with your surgeon to determine whether breast-feeding would be possible." 4. "You should be able to breast-feed without difficulty."

2. "I support your commitment; however, you may have to supplement each feeding with formula." Breast reduction surgeries are done in a way to protect the milk sacs and ducts, so breast-feeding after surgery is possible. Still, it's good to check with the surgeon to determine what breast reduction procedure was done. There is the possibility that reduction surgery may have decreased the mother's ability to meet all of her baby's nutritional needs

A client who's planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. Which of the following would be the nurse's best response? 1. "Pregnancy is a human process; you don't have to worry." 2. "You practice good health habits; just follow them and you'll be fine." 3. "Nothing you can do will guarantee a healthy pregnancy; it's all up to nature." 4. "Folic acid supplements improve pregnancy outcomes by preventing certain complications."

4. "Folic acid supplements improve pregnancy outcomes by preventing certain complications."