Antepartum Virtual Escape Room
What suggestion should the nurse make to help Nadia relieve the nausea? (1) Eat three small meals a day (2) Increasing dietary calcium intake (3) Eat small amounts more frequently (4) Drinking 2 quarts (1.9 L) or more of fluid a day
(3) Eat small amounts more frequently
Nadia's laboratory blood tests reveal that she has anemia. Nadia refuses iron supplements. The nurse teaches her that the best source of iron is liver. What other foods does the nurse encourage the Nadia to eat? Select all that apply. (1) Dark leafy green vegetables (2) Legumes (3) Dried fruits (4) Broiled halibut (5) Ground beef patty
✓ (1) Dark leafy green vegetables ✓ (2) Legumes ✓ (3) Dried fruits ✓ (5) Ground beef patty
Nadia is undergoing an ultrasound examination during the first trimester. The nurse explains that an ultrasound during the first trimester is utilized in order to do what? (1) Estimate fetal age (2) Detect hydrocephalus (3) Rule out congenital defects (4) Approximate fetal linear growth
(1) Estimate fetal age
The nurse obtains Nadia's obstetrical history during the prenatal visit. Nadia has two children at home, one born at 38 weeks' gestation and the second born at 34 weeks' gestation. She has also had one miscarriage, at 18 weeks, and an elective abortion. Using the GTPAL system, what is Nadia's obstetrical history? (1) G5 T1 P1 A2 L2 (2) G4 T2 P2 A1 L4 (3) G2 T3 P3 A2 L1 (4) G3 T2 P1 A3 L3
(1) G5 T1 P1 A2 L2
During her sixth month of pregnancy, Nadia visits the prenatal clinic. As part of the assessment a complete blood count and urinalysis are performed. Which laboratory finding should alert the nurse to the need for further assessment? (1) Hemoglobin of 10 g/dL (100 mmol/L) (2) Urine specific gravity of 1.020 (3) Glucose level of 1+ in the urine (4) White blood cell count of 9000/mm3 (9 × 109/L)
(1) Hemoglobin of 10 g/dL (100 mmol/L)
Nadia at 24 weeks' gestation arrives at the clinic for a routine examination. She tells the nurse, "I feel puffy all over." In light of this statement, what is the nurse's most important assessment? (1) Obtaining her blood pressure (2) Determining how much salt she uses (3) Asking the extent of her daily fluid intake (4) Reviewing her history for total weight gain
(1) Obtaining her blood pressure
Nadia at 16 weeks' gestation is scheduled for a sonogram followed by amniocentesis. The nurse instructs the Nadia to drink 8 oz (237 mL) of fluid and not void before the sonogram. What should the nurse explain as the purpose of this? (1) To improve visualization of the fetus (2) To hydrate the mother and increase circulation (3) To hydrate the fetus and decrease fetal movement (4) To replace fluid lost during the procedure
(1) To improve visualization of the fetus
Nadia client who is at 20-weeks' gestation visits the prenatal clinic. Assessment reveals temperature of 98.8° F (37.1° C), pulse of 80 beats per minute, blood pressure of 128/80 mm Hg, weight of 142 lb (64.4 kg) (pre-pregnancy weight was 132 lb (59.9 kg), fetal heart rate (FHR) of 140 beats per minute, urine that is negative for protein, and fasting blood glucose level of 92 mg/dL (5.2 mmol/L). What should the nurse do after making these assessments? (1) Report the findings because the client needs immediate intervention. (2) Document the results because they are expected at 20-weeks' gestation (3) Record the findings in the medical record because they are not within the norm but are not critical. (4) Prepare the client for an emergency admission because these findings may represent jeopardy to the client and fetus.
(2) Document the results because they are expected at 20-weeks' gestation
While reviewing Nadia's laboratory results, the nurse notes that her maternal serum alpha-fetoprotein level is lower than expected. What does the nurse recognizes that this may be associated with? (1) Fetal demise (2) Down syndrome (3) Neural tube defects (4) Esophageal obstruction
(2) Down syndrome
Nadia's pregnancy has been uneventful, and she has gained 25 lb (11.3 kg). At term her hemoglobin level is 10.6 g/dL (106 mmol/L) and her hematocrit is 31%. What is the physiologic reason for these hemoglobin and hematocrit levels? (1) Infection (2) Hemodilution (3) Nutritional deficits (4) Concealed bleeding
(2) Hemodilution
During a routine prenatal visit, Nadia tells the nurse that she often gets muscle weakness and leg cramps. What condition does the nurse suspect, and what suggestion is made to correct the problem? (1) Hypercalcemia; avoid eating hard cheeses (2) Hypocalcemia; increase her intake of milk (3) Hyperkalemia; consult her healthcare provider (4) Hypokalemia; increase intake of green leafy vegetables
(2) Hypocalcemia; increase her intake of milk
Nadia is concerned about eating properly and wants to know how to ensure the baby is getting enough nutrients to grow. You will tell Nadia which of the following: (1) "You will need to consume approximately 550 kcals more each day" (2) "You can just maintain your current diet because you are a healthy weight" (3) " It is best to increase your calories by 300 kcals more than your pre-pregnancy needs" (4) "You should eat 120 kcal less than you are now to prevent gestational diabetes"
(3) " It is best to increase your calories by 300 kcals more than your pre-pregnancy needs"
What is the priority nursing intervention before Nadia undergoes amniocentesis? (1) Starting an intravenous infusion of normal saline (2) Performing a vaginal and rectal examination (3) Ensuring that informed consent has been obtained from the client (4) Informing the client that the procedure may precipitate an infection
(3) Ensuring that informed consent has been obtained from the client
Nadia asks the nurse how to prevent back pain as her pregnancy progresses. What does the nurse suggest that she wear? (1) Maternity girdle (2) Support stockings (3) Low-heeled shoes (4) Loose-fitting clothing
(3) Low-heeled shoes
Nadia is experiencing nausea and vomiting. What does the nurse determine about this discomfort? (1) It is always present during early pregnancy. (2) It will disappear when lightening occurs. (3) It is a common response to an unwanted pregnancy. (4) It may be related to an increased human chorionic gonadotropin level.
(4) It may be related to an increased human chorionic gonadotropin level.
The nurse is caring for Nadia whose contraction stress test result (CST) is positive. The nurse remains with the Nadia and continues to assess the fetal and maternal monitor strips. Which complication does the nurse anticipate? (1) Preeclampsia (2) Placenta previa (3) Fetal prematurity (4) Uteroplacental insufficiency
(4) Uteroplacental insufficiency
Nadia reports that her last menstrual period began on April 15. According to Nägele's rule, what is the expected date of delivery (EDD)? (1) January 8 (2) January 22 (3) February 8 (4) February 22
2) January 22
You know that Nadia wasn't expecting to get pregnant so she wasn't taking prenatal vitamins. When teaching Nadia's about the health of her unborn child, which nutrient will you encourage her to take to decrease the risk of neural tube defects? (1) Vitamin B12 (2) Folic acid (3) Calcium (4) Vitamin C
2) folic acid
Nadia is excited and frightened. She wants to be absolutely sure she is pregnant before she announces her pregnancy. What is most reliable way to be positive at this time? (1) Order a blood draw to look for the presence of hCG (2) Order an ultrasound (3)Collect urine to test for hCG (4) Order a CT scan to assess for the presence of a uterine tumor
2) order an ultrasound
Nadia is here in the clinic because she has been increasingly fatigued and is nauseous. She says her period is 5 days late. You understand that Nadia is exhibiting which classification of pregnancy related symptoms? (1) Presumptive (2) Positive (3) Probable (4) Unable to determine
1) presumptive