Maternal Infant Ch 9, Ch 14, 10, 11, 13 Practice Questions
The nurse is counseling a client with a BMI of 23 about weight gain during pregnancy. The nurse teaches the client that during the second and third trimester of pregnancy, dietary intake should be increase by how many calories per day above what she was eating prior to the pregnancy
300
The client states that the first day of her last menstrual period is March 23. The nurse is most correct to calculate using Naegele rule that the estimated date of delivery is:
December 30
The health care provider is concerned about a client's fetus having appropriate blood flow through the fetal vessels. Which diagnostic test does the nurse anticipate to confirm a diagnosis?
Doppler study
A client in labor stares at a silver locket that her partner holds in front of her during a contraction. What type of distraction technique is the client using?
Focusing
A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found?
Halfway between the symphysis pubis and the umbilicus
During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as:
Hegar sign.
At 28 weeks' gestation, the client has gained 7.5 lb (3.4 kg) since the last visit. What assessments would the nurse complete next?
Inspect hands for edema. Measure blood glucose level. Examine for excessive amniotic fluid.
The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy?
Positive home pregnancy test
The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client?
Primigravida
The nurse is caring for a client who is at 37 weeks' gestation and has a biophysical profile of 10. Which nursing action is best?
Schedule a health care provider appointment for one week.
The nursing instructor is teaching students about normal changes of pregnancy. The instructor talks about diastasis recti. What is the instructor presenting?
Separation of the muscles of the abdominal wall
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition?
placental insufficiency
The nurse educates the vegetarian client about which nutritional need during pregnancy?
taking a B12 supplement
A primigravida at her 12-week prenatal visit expresses concern that she hasn't felt her baby move yet. What is the best response from the nurse?
"You usually cannot feel them until approximately 16 to 20 weeks."
Assessment of pregnant woman reveals that the woman has a BMI of 31. The woman is pregnant with one fetus. The nurse would most likely recommend a total weight gain of no greater than which amount?
20 pounds
Vitamin B12 deficiency is most likely to be found in which patient?
Vegan
What birthing options will act with gravity and speed up the second stage of labor?
birthing chair
Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to:
detect fetal heart sounds with a Doppler.
A fertilized ovum is known as which structure?
zygote
The nurse assesses a 20-week gestational client at a routine prenatal visit. What will the nurse predict the fundal height to be on this client experiencing an uneventful pregnancy?
20 cm
A woman in her 15th week of pregnancy is about to undergo amniocentesis. Which of the following nursing interventions should be made first?
Obtain a signed consent form
A urinalysis is done on a client in her third trimester. Which result would be considered abnormal?
2+ Protein in urine
The nurse is teaching an active pregnant woman about nutritional needs to maintain a healthy pregnancy. The nurse determines that the teaching was successful when the woman states that she need about how many calories per day?
2,500 calories per day
You are discussing weight gain with a group of pregnant women at the clinic. One woman is very thin and her prepregnancy weight falls below the normal weight range for her height. What is her recommended weight gain during her pregnancy?
28 to 40 pounds
A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem?
Hemorrhoids
Pica is a craving for nonfood items such as laundry starch, clay, or ice. What problem is associated with pica?
Iron deficiency
The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence?
Quickening
The nurse is educating the client at 12 weeks' gestation regarding the best types of exercise throughout pregnancy. Which activities should the nurse encourage?
Stretching and breathing exercises such as yoga
A woman comes in for her annual gynecological examination and informs the nurse that she is going to try and become pregnant. She asks the nurse when the best time in the month is to become pregnant. What is the best response by the nurse?
"3 days before until 2 days after ovulation."
The client's pregnancy screening test shows that the maternal serum alpha-fetoprotein (MS-AFP) level is high. Which information should the nurse provide the client upon this finding?
"A high level of MS-AFP is associated with neural tube defects. We will schedule you for another type of test to determine if your baby has a neural tube defect."
A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a bloody mucus discharge noted in the toilet after an OB office visit several hours earlier. What is the best response from the triage nurse?
"A one time discharge of bloody mucus in the toilet might have been your mucus plug."
The nurse is assessing a primipara's fundal height at 36 weeks' gestation and notes the fundus is now located at the xiphoid process of the sternum. The client asks if this is normal. Which response to the client would be best?
"At 36 weeks' gestation, the fundus is in the normal expected location."
How can the nurse best counsel a patient with pyrosis?
"Avoid lying down 2 hours after eating."
A woman at 15 weeks' gestation who works at a daycare center thinks she may have just been exposed to rubella at work. The client asks how this may affect her fetus. What is the bestresponse the nurse can give?
"By the end of the eighth week all of the organ systems and major structures are present, so exposure to any teratogen can lead to birth defects. More assessments are needed."
The nurse is providing care for a pregnant client who has been given the necessary requisitions for laboratory work by the primary care provider. The client notices that the lab tests include testing for HIV and other sexually transmitted infections, and expresses alarm, stating, "I don't understand why the doctor would suspect that I've got these diseases." What is the nurse's most therapeutic statement?
"Every pregnant client is tested for these diseases; it doesn't necessarily suggest that the doctor suspects that you have them."
A client with a prepregnant BMI of 26 is concerned about gaining weight during pregnancy. Which statement by the client indicates an appropriate goal for this pregnancy?
"I need to consume at least 1,500 nutrient-dense calories each day."
A woman has informed the nurse that she plans to have a freebirth. Which statement indicates that the woman understands what freebirth entails?
"I plan on giving birth at home without anyone around except my husband and my children."
The nurse is teaching a prenatal class on the functions of the various structures involved with a pregnancy. The nurse determines the class is successful when the class correctly chooses which function of amniotic fluid?
"It helps cushion the baby."
A client who is 28 weeks' pregnant asks the nurse if it is safe to use mineral oil to relieve constipation. What is the best response by the nurse?
"No, mineral oil may interfere with the absorption of fat-soluble vitamins from your diet."
The gravid client reports craving and sometimes eating starch. When she questions the nurse about this behavior what information should be included in the nurse's response?
"Nonfood cravings such as this are often tied to nutriitonal inbalances." "Eating things such as starch may be dangerous." "This is known as pica and can be associated with pregnancy."
A nurse is interviewing a primigravida woman about nutrition during pregnancy. During the interview, the woman asks the nurse about consuming caffeine. Which information would the nurse include when teaching the woman about caffeine intake during pregnancy?
"Pregnant women should limit the amount of caffeine to 200 mg or less per day." "Although it includes significantly smaller amounts, chocolate also contains caffeine." "If you want to reduce the amount of caffeine you drink, drink green tea instead of black
The maternal health nurse is caring for a woman in early labor with 3 cm cervical dilation. Which statement will the nurse use when teaching the client consciously controlled breathing during contractions at this stage of labor?
"Take slow, deep, full breaths."
A newly pregnant patient explains to the nurse that she is interested in midwifery care but would like to deliver in the hospital. What is the best response from the nurse?
"That's no problem because most midwives deliver in the hospital setting."
At 24 weeks' gestation a client is asked to drink a sweet orange solution and then wait an hour to have blood drawn. The client asks if this is the test to determine if she has diabetes. What is the best response by the nurse?
"This is a screening procedure. If your result is elevated you will be scheduled for a longer test to determine if you have gestational diabetes."
A pregnant client states, "I am only 6 weeks pregnant, but the morning sickness is awful. When is it going to stop?" What is the best response by the nurse?
"Usually after 12 weeks, when the placenta starts managing the production of progesterone, morning sickness ends.
A pregnant client is undergoing an amniocentesis in her third trimester and is worried why she is undergoing this procedure. Which statement by the nurse would best alleviate this client's anxieties?
"We want to be sure your baby's lungs are mature and this measures the development of the baby's lungs.
The pregnant client at 6 weeks' gestation asks the nurse if an ultrasound will reveal the sex of the fetus yet. What is the best response by the nurse?
"We will have to wait until the baby is 16 weeks' gestation to determine what the sex is."
A client is about 16 weeks' pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to this client's concern?
"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."
The nurse is teaching pregnant women about breastfeeding. One woman tells the nurse, "I may breastfeed only for 6 weeks while I am on maternity leave. I don't see any other way except to give a bottle after that." What is the best response by the nurse?
"Women should try and breastfeed exclusively for the first 6 months. We can talk about ways to fit it into your schedule."
A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer?
"You will experience quickening, and you will actually feel the baby."
A pregnant client informs the nurse that she is considering a "water birth" for the labor and delivery of her child. What does the nurse anticipate as potential complications for this type of birth?
-Contamination of the bath water with feces as the mother pushes during labor -Uterine infection
The couple preparing for the upcoming birth of their child is researching information about alternative birthing centers (ABCs). The couple demonstrate understanding of this birth setting when they identify which information as a disadvantage?
-Extended high-risk care is not immediately available. -A woman may be fatigued after birth because of a brief health care setting stay. -A woman must independently monitor her postpartal status because of a brief stay.
A nurse is conducting an informal teaching session for a group of pregnant women about childbirth education classes. Which information would the nurse most likely include as an outcome associated of these types of classes?
-Increased satisfaction -Reduction in amount of reported pain -Increased feelings of control
A couple preparing for the birth of their second child tells the nurse that they are considering a hospital birth this time. What can the nurse discuss with them about the disadvantages of hospital births?
-The family will be separated for at least one night. -The mother may not feel as much control over the childbirth experience. -Care may be fragmented, especially if someone other than the preferred health care provider is present at the birth.
The nurse is reviewing the birthing plan with a woman who is 24 weeks' gestation. Which statement(s) is accurate regarding births at a birthing center?
-The opportunity for medical interventions is less when the birth occurs at a birthing center. -The birthing center typically has an area for family to wait, a play area for siblings and a kitchen.
A patient is to have an amniocentesis with ultrasound. What does the nurse explain to the patient that amniocentesis can determine?
-Whether the fetal lungs are mature enough to support respiration outside of the womb. -For genetic testing.
A woman entering her third trimester of pregnancy asks the nurse how much weight she should gain during this trimester. What is the nurse's best answer?
1 lb/week
A patient of normal weight and new to the obstetric clinic asks the nurse how much weight to gain during pregnancy. What is the best response the nurse can give?
10 lbs over the first 20 weeks; 1 lb per week after that
A nurse is instructing a pregnant client on the benefits of squatting to stretch the perineal muscles. How many minutes a day should the client perform squatting?
15
The nurse is teaching a pregnant woman with a prepregnancy body mass index (BMI) of 26 about recommended weight gain. The nurse determines that the teaching was successful when the woman states that she should gain approximately how much during her pregnancy?
15 to 25 pounds (7 to 11 kilograms)
Mrs. M is a 32-year-old female whose prepregnancy weight is considered "normal." She is carrying a single fetus. What is the recommended amount of total weight gain?
25 to 35 pounds
A client in her first trimester is concerned about how weight gain will affect her appearance and questions the nurse concerning dietary restrictions. How much weight gain should the nurse point out will be safe for this cleint with a low BMI?
28 to 40 pounds (13 to 18 kilograms)
A woman being assessed by the nurse reports that she is 6 weeks pregnant. If her report is accurate, when will the nurse predict the client conceived?
4 weeks ago
A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:
4 weeks.
A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes?
46
What is the recommended amount of protein (grams/day) in pregnancy?
71 g/d
Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks' pregnant. The nurse would expect this woman's heart rate to be approximately:
85 beats per minute
The nurse is assigned to clients who are having the following procedures: amniocentesis, fetal nonstress test, chorionic villus sampling, percutaneous umbilical blood sampling, and Doppler assessment of fetal heart rate. For which clients will the nurse ensure that signed informed consent has been given and is in the client's record?
Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling
A client at 16 weeks' gestation is scheduled for prenatal testing. Which of the following would the nurse anticipate as the most likely screening test for congenital anomalies based on the current age of this pregnancy?
Amniocentesis.
A pregnant client is undergoing a fetal biophysical profile. Which parameter of the profile helps measure long-term adequacy of the placental function?
Amniotic fluid volume
A woman who recently found out she was pregnant is asking what day her baby is due. The first day of her last menstrual period was July 12, 2011. When is she due according to Naegele's Rule?
April 19, 2012
A client is scheduled for amniocentesis. Which action by the nurse would be most appropriate when preparing the client for the procedure?
Ask the client to void. Assess fetal heart rate.
During a routine antepartal visit, a pregnant woman reports a white, thick vaginal discharge. What would the nurse do next?
Ask the woman if she is having any itching or irritation.
A patient in her third trimester comes in for a routine prenatal visit. The nurse places her in a comfortable position and attaches the tocodynamometer and ultrasound monitor to the patient's abdomen. What is the purpose of this test?
Assesses fetal well-being
Why is the first prenatal visit usually the longest prenatal visit?
Baseline data is collected.
A pregnant client in her third trimester, lying supine on the examination table, suddently grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize?
Blood is trapped in the vena cava in a supine position.
Which change related to the vital signs is expected in pregnant women?
Blood pressure decreases.
A nurse is reading a journal article about childbirth and the role of doulas in childbirth. The nurse demonstrates understanding of the article when the nurse identifies which activity as a function of a doula?
Caring for the mother's emotional needs
A client at 10 weeks' gestation is complaining of ptyalism over the past 2 weeks. What intervention would the nurse recommend to this client?
Chew gum. Suck on hard candies.
Increased pigmentation on the face of some pregnant women is called:
Chloasma
A new mother asks the postpartum nurse if her baby is getting enough nourishment from breastfeeding within the first 24 hours following birth. The nurse would provide her what information?
Colostrum, which is the first milk produced, is rich in calories and protein that nourishes the infant well.
A pregnant client is concerned she may develop preeclampsia, so she has stopped adding any salt to her food and is now questioning the nurse about avoiding prepared foods. The nurse should point out some salt is very beneficial and can help prevent which negative outcome for her baby?
Congenital hypothyroidism
The maternal health nurse is caring for a pregnant woman who expresses a desire to have a water birth. When discussing this option with the client, which disadvantage will the nurse identify?
Contamination of water
At 32 weeks' gestation a client with a BMI of 23 has gained 24 lb (11 kg). What is the nurse's recommendation for weight gain for the remainder of this pregnancy?
Continue to gain approximately 1 lb (.45 kg) per week during this pregnancy
A nurse assesses a primigravida client in the eighth week of gestation. The client reports nausea and vomiting in the mornings. The client tells the nurse, "I'm not able to keep liquids down and I'm eating like a bird." The client also expresses concerns about hormonal changes and how the pregnancy will affect her physical appearance. Which client problem should the nurse assess first?
Deficient fluid volume
A nursing student correctly identifies the childbirth preparation method that focuses on the premise that fear leads to tension, which leads to pain, is known as which of the following?
Dick-Read method
Which statement best describes a doula?
Doulas provide continuous labor support but do not perform any clinical procedures.
The nurse is coaching the mother during labor and tells her to breathe slowly from the chest at a rate of 6 to 12 breaths per minute. For what type of contractions would this method of breathing be best?
Early contractions
A client at 28 weeks' gestation is asking for a laxative for constipation. What action would the nurse recommend?
Eat fiber rich foods.
A pregnant client at 34 weeks' gestation reports a burning sensation in the lower esophagus. What action would the nurse recommend to increase her comfort?
Eat five to six small meals per day. Do not eat fried, fatty foods. Do not lie down immediately after eating.
A client at 10 weeks' gestation is complaining of nausea and vomiting throughout the day. What interventions would the nurse recommend to this client?
Eat small frequent meals. Avoid fried foods. Eat saltine crackers before getting out of bed.
The nurse is assessing a young female who just found out she is pregnant. She is is now reporting vague abdominal discomfort. After noting the client has a history of PID, the nurse predicts the health care provider will give priority to ruling out which situation?
Ectopic pregnancy
The nurse is educating a pregnant woman and her partner to trace a pattern on her abdomen with her fingertips as a distraction method during contractions. What type of distraction method is this considered?
Effleurage
A woman relates to the nurse that she understands that dietary fat is bad for her and that she should avoid it during pregnancy. How should the nurse respond?
Fats are essential during pregnancy, and vegetable oils are a good source.
The nurse is counseling a young woman who has just entered her second trimester, after an uneventful first trimester. She tells the nurse, "It still doesn't seem real. It's just hard to believe that I will really have a baby." Which future events should the nurse point out that will help the young woman come to believe it is real?
Feeling the baby kick Seeing an ultrasound image of the baby
Fetal circulation differs from the circulatory path of the newborn infant. In utero the fetus has a hole connecting the right and left atria of the heart. This allows oxygenated blood to quickly pass to the major organs of the body. What is this hole called?
Foramen ovale
A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embryonic stage?
From fertilization and to the end of the second week after fertilization
A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history? a. G3 P0020 b. G2 P0020 c. G2 P1020 d. G3 P0021
G3 P0020
A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history? a. G3, T1, P0, A2, L1 b. G3, T0, P1, A1, L1 c. G2, T1, P2, A1, L2 d. G2, T0, P1, A1, L1
G3, T0, P1, A1, L1
A woman who is obese comes to the clinic because she thinks that she is pregnant. The pregnancy is confirmed. The nurse is developing a teaching plan for this woman about pregnancy and challenges associated with it related to obesity. The nurse would most likely plan to address which condition(s) as being an increased risk?
Gestational diabetes Large for gestational age (LGA) neonate Difficult vaginal birth
The nurse is performing an assessment of a woman who has come to a health care facility for a diagnosis of pregnancy. The women is positive for breast changes, nausea, and amenorrhea. On physical exam, it is noted that the client has softening of the cervix. How should the nurse document this in her notes?
Goodell sign
The nurse is caring for a neonate whose mother received no medical care for either of her pregnancies. When assessing the neonate's status, which would indicate a potential A, B, and O incompatibility?
Hemolytic anemia
While in utero, a fetus swallows many substances that are deposited in the fetal intestinal system as meconium. What problem can arise from this occurrence?
If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia.
A nurse is conducting a teaching program for a group of pregnant women in their first trimester. As part of the program, the nurse is describing how the fetus receives oxygen and nutrients and eliminates waste products. Which area would the nurse include as the location where this exchange takes place?
In the intervillous spaces
A nurse observes a woman in labor and her spouse as they practice breathing exercises to manage the client's pain. Before each contraction, she takes a deep, cleansing breath and then breathes at a controlled pace. During each contraction, she gradually shifts from slow, deep breaths to shallow, rapid ones and then back to slow, deep ones. Her spouse coaches her and performs effleurage on her abdomen. The nurse recognizes that this couple is using which method of pain management?
Lamaze
A client in her second trimester of pregnancy arrives at a health care facility reporting heartburn. What instructions should the nurse offer to help the client deal with heartburn?
Limit consumption of food before bedtime. Sleep in a semi-Fowler position. Avoid overeating.
A nurse recommends to parents who are planning to become pregnant that they attend prenatal classes. Which of the following would be the parents' learning objectives for attending such a prenatal class?
Management of health conditions affecting pregnancy and birth
A client reports that her last menstrual period was on August 1. Using Naegele's rule, what would the nurse anticipate as the client's due date?
May 8
The nurse is assessing a pregnant client at 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are?
Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples
A nurse counsels a pregnant woman regarding her recommended daily allowance of calories. She advises her to obtain her carbohydrate calories from complex carbohydrates rather than simple carbohydrates. What is the best rationale for this guidance?
More consistent regulation of glucose and insulin
The nurse is assessing a client at 14 weeks' gestation at a routine prenatal visit and notes the fundal height is at the umbilicus. The nurse will most likely interpret this finding to indicate which situation?
Multiple fetal pregnancy
Women who are obese in pregnancy are at higher risk for developing all of the following EXCEPT Macrosomia Pregnancy-induced hypertension Gestational diabetes Neural tube defects Cesarean birth
Neural tube defects
A nurse suggests to a client planning to start a family that she and her partner should attend childbirth education classes. Which of the following are taught in childbirth classes?
Nutritional needs in pregnancy Stress management Healthy relationships
A nurse is teaching a pregnant client how to perform tailor sitting. She cautions the client to put one leg in front of the other and to not put one ankle on top of another to avoid which of the following potential complications?
Occluding blood supply to the lower legs
The nutritional needs of an adolescent pregnant patient are unique because
Owing to typical food choices, an adolescent is often lacking calcium, iron, and folic acid in the diet
A client expresses a concern to the nurse about maintaining sexual responsiveness and preventing incontinence after giving birth. Which of the following exercises should the nurse most strongly recommend for these purposes?
Pelvic floor contractions
A client is complaining of lower backache during her pregnancy. Which of the following exercises would best help her alleviate this pain?
Pelvic rocking
During the initial prenatal visit, a client indicates that she frequently experiences stress incontinence. Which of the following should the nurse recommend to the client to help relieve this condition?
Perform Kegel exercises
A nurse recommends to a couple, who are soon to be parents that they attend early prenatal classes. Which of the following topics would be covered in an early prenatal class?
Physical and emotional changes of pregnancy
A nurse is providing care to a couple who is planning to get pregnant within a short time and who need proactive nutritional strategies prior to conceiving. The nurse would most likely recommend which type of care?
Preconception visits
A client's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is this client experiencing?
Presumptive
Assessment for surfactant level via LS ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to:
Prevent alveoli from collapsing on expiration.
What is the main purpose of the chorionic villi?
Provide an exchange site for the exchange of nutrients and wastes
A client comes to the clinic with concerns about her pregnancy. She is in her first trimester and is now experiencing moderate abdominal pain on the right side. What would be the nurse's first action?
Recommend an abdominal ultrasound to the doctor since this may be ectopic pregnancy
A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the patient's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation and enlargement of the birth canal. This hormone is which of the following?
Relaxin
A teenager arrives in the emergency department in active labor having no prenatal care. Upon examination in L & D, the nurse notices a cluster of pinpoint vesicles with a red base on her vulva; the teenager asks the nurse to not touch "her rash" because it hurts when touched. At this point, which intervention should the nurse perform next?
Report this finding to the health care provider immediately so he or she can plan the birth route.
A patient is concerned about the mercury levels in fish and asks the nurse which fish are safe to eat. The best response is
Shrimp, canned tuna, pollack, and catfish
Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy?
Soft systolic murmur
A pregnant woman asks the nurse about abdominal and perineal exercises that she can do to make her muscles stronger. Which type of exercise would the nurse encourage the pregnant woman to practice approximately 15 minutes per day to stretch the perineal muscles and make them more supple for birthing?
Tailor Sitting
The maternal health nurse is caring for a pregnant woman with a body mass index (BMI) of 31. Which childbirth technique will the nurse avoid when teaching the client?
Tailor Sitting
A pregnant client is visiting the clinic and complains about the tiny, blanched, slightly raised end arterioles on her face, neck, arms, and chest. The nurse should explain that these are normal during pregnancy and referred to as which of the following?
Telangiectasias
When needed, total parenteral nutrition (TPN) is often administered at home to reduce health care costs. When teaching a patient how to safely administer TPN, the home care nurse emphasizes
Testing blood glucose every 6 hours
A woman expresses to you a desire to attempt to birth without pain medications. She likes the idea of a labor coach, but she is apprehensive about having anyone other than her husband and the doctor in the room at the time of delivery. What method of childbirth education would best suit this woman?
The Bradley method
A birth in which the lights are kept low, noise is kept to a minimum, and the newborn is placed into a warm bath immediately following delivery is called
The Leboyer method
A couple is writing out the birth plan for their labor and delivery. They desire an atmosphere with a dark, warm room and soft music playing. They opt for delayed cord clamping and an immediate warm bath after the infant is born. What type of birth does the nurse understand the parents are requesting?
The Leboyer method
When describing the characteristics of the amniotic fluid to a pregnant woman, the nurse would include which information?
The amount gradually fluctuates during pregnancy.
A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding?
The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.
The nurse-midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell sign. Which description illustrates this alteration?
The cervix softens.
When a nurse is providing sibling education classes to children, what information can the nurse include that will address safety for the pregnant mother?
The children should not leave toys on the floor.
A pregnant client informs the nurse that she is used to exercising daily on the treadmill and usually feels exhausted when finished. What should the nurse advise the client about this form of exercise?
The client should never exercise to the point of exhaustion during pregnancy.
A mutligravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out?
The end of the second trimester
What does the nurse understand is the benefit of educating the pregnant mother about performing Kegel exercises during her pregnancy?
The exercises can help reduce pain and promote perineal healing in the postpartum period.
A Maternal serum alpha-fetoprotein (MSAFP) test reveals an hCG level of 2.5 MoM. The nurse interprets these results as indicating which of the following?
The fetus is at greater risk for Down's syndrome
The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse?
The intestines are displaced by the growing fetus.
The maternal health nurse cares for several pregnant women. Which woman does the nurse identify as using the Bradley method?
The laboring woman's partner assists the woman in breathing exercises.
The nursing instructor is illustrating the circulatory flow between the mother and fetus. The instructor determines the session is successful when the class correctly chooses which structure with which route?
The one umbilical vein carries oxygen-rich blood to the fetus from the placenta.
The maternal health nurse is caring for a pregnant client who is considering having a doula present at the birth. Which advantage does the nurse express to the client regarding a doula-assisted birth?
The rate of medical-assisted delivery is lower.
How does fetal circulation differ from circulation after birth?
The umbilical vein carries oxygenated blood, while deoxygenated blood is carried by the umbilical arteries.
During a physical exam, the physician notates that the pregnant client has a positive Chadwick sign. What client findings would be noted for this symptom?
The vagina has a bluish, purple discoloration.
A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information?
The window of opportunity for conception is from 3 days before to 2 days following ovulation.
A nurse in an obstetric clinic is preparing the staff for a prenatal appointment with an incarcerated pregnant woman. What does the nurse explain is the main difference when an incarcerated client comes to the clinic?
There will be correction officers with the woman throughout her appointment.
The nurse recieves a call from a concerned client, who is 39 weeks' gestation, indicating the woman has "blood tinged mucous seeping from the vagina." What does the nurse understand about this?
This is known as "bloody show" and is a normal finding at this time.
A nurse is obtaining a health history and social profile from a newly pregnant patient and asks the patient about physical activity. The nurse specifically investigates if the patient goes hiking or camping. The nurse asks about these activities primarily for which reason?
To assess the patient's risk for Lyme disease
A client in her third trimester is scheduled for a nonstress test. What is the purpose of the nonstress test for the client?
To determine the well-being of the fetus
A nurse is preparing a patient for rhythm strip testing. She places the woman into a semi-Fowler's position. What is the appropriate rationale for this measure?
To prevent supine hypotension syndrome
A woman is only 30 weeks pregnant, but the physician determines that the fetus must be delivered for the safety of the mother. The physician orders a glucocorticosteroid injection to be given. Why does the physician order this injection?
To promote the formation of surfactant in the fetal lungs
A woman has a positive pregnancy test and comes to the nurse with left lower quadrant pain. Bimanual examination reveals a tender mass. Which of the following is suspected?
Tubal pregnancy
A nurse is reviewing the obstetric history of a pregnant woman who has come to the clinic for a visit. The history reveals that the woman is "gravida 3, para 2." Which interpretation by the nurse would be appropriate?
Two previous pregnancies, two live births, and currently pregnant
A pregnant woman has come to the clinic for her first prenatal visit. The nurse informs the woman that the physician will do a pelvic examination at this time and that she should go empty her bladder. What is the primary reason the nurse instructs the patient to empty her bladder?
Urinating now will allow easier identification of organs.
The nurse is preparing a 38-year-old pregnant woman for an amniocentesis to determine if there are any congenital disorders or fetal abnormalities present. Which of the following is a nursing consideration before and during the testing?
Use an external fetal heart monitor to ensure fetus is not in distress.
The nurse teaches a sedentary pregnant client with a BMI of 35 about the importance of healthy lifestyle during pregnancy. Which goal would be appropriate for this client?
Walk for 30 minutes 5 days a week.
The nurse takes a call from a worried client who was seen several hours earlier for her 35-weeks' gestation visit, which included a pelvic examination. Which instruction should the nurse prioritize if the client is reporting a small amount of vaginal spotting?
Watch it and report if heavy increase in bleeding.
What medication can the nurse tell the patient that, when taken as directed, is non-teratogenic and safe during pregnancy?
acetaminophen
The fluid-filled, inner membrane sac surrounding the fetus is which structure?
amnion
When developing a plan of care, the nurse needs to make which assessments for a pregnant client with a BMI of 18.3?
assess for maternal fatigue assess for poor fetal growth assess for preterm labor
A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which area?
at the level of the umbilicus
The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?
at the level of the umbilicus
A client with hyperemesis gravidarum is started on total parenteral nutrition (TPN). What parameter does the nurse need to assess at least twice a day?
blood glucose
The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy?
breast changes amenorrhea morning sickness
A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks' gestation, a 2-year-old son born at 39 weeks' gestation, and a spontaneous abortion (miscarriage) 1 year ago at 6 weeks' gestation. Using the GTPAL method, the nurse would document her obstetric history as: a. 3 2 1 0 3. b. 3 1 2 2 3. c. 4 1 1 1 3. d. 4 2 1 3 1.
c. 4 1 1 1 3.
A group of nursing students are preparing a presentation for a health fair illustrating the structures found during a pregnancy. Which structures should the students point out form a protective barrier around the developing fetus?
chorion and amnion
The nurse is teaching about an iron supplement that client is going to take every day. The nurse teaches the client to take the iron supplement with which type of fluid?
citrus juice
A nursing instructor is teaching about nonpharmacological techniques used for pain relief in labor. What are some techniques that the nurse would include in teaching?
conscious relaxation consciously controlled breathing effleurage focusing imagery
The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG?
continues progesterone production by corpus luteum
During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called
couvade syndrome
A nursing student learning about childbirth preparation in a maternity course correctly identifies which of the following to be a major determinant of the plans women make for childbirth?
culture
A nurse is providing education to a client who is 8 weeks' pregnant. The client stated she does not like milk. What is a source of calcium that the nurse can recommend to the client?
dark, leafy green vegetables
Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy?
dilation of the renal pelvis
The nurse explains to a pregnant woman that the germ layers that develop in the embryo and become different organs and tissues consist of which layers?
ectoderm mesoderm endoderm
When counseling a lacto-ovo-vegetarian client, the nurse would recommend including which source of protein in the diet during pregnancy?
eggs
The nursing student is preparing a presentation which will illustrate the various stages of fetal development. The student will label which stage as the time when the various tissues of the growing embryo begin to assume specific functions?
embryonic
A nurse is assessing a client's nutritional intake during pregnancy. What is the best method for accomplishing this?
enacting a 24-hour nutrition recall
The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy?
excessive vomiting
A young couple, 8 weeks' pregnant with their first child, are being assessed at their first prenatal visit. They ask about scheduling an ultrasound to find out the gender of the fetus. For when should the nurse recommend this ultrasound be scheduled?
for 16 weeks' gestation
The nurse is creating an educational pamphlet for pregnant mothers. Which is the bestdescription of fetal development for the nurse to emphasize?
gestational age, length, weight, and systems developed
A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse? a. gravida 2, para 1 b. gravida 4, para 2 c. gravida 3, para 4 d. gravida 2, para 4
gravida 3, para 4
The nurse is discussing the insulin needs of a primiparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse's understanding that the placenta produces:
hPL, which deceases the effectiveness of insulin.
Which change in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy?
increased lordosis
During a routine antepartal visit, a pregnant woman says, "I've noticed my gums bleeding a bit since I've become pregnant. Is this normal?" The nurse bases the response on the understanding of which effect of pregnancy?
influence of estrogen and blood vessel proliferation
The husband of a pregnant woman in her first trimester tells the nurse that his wife is increasingly preoccupied with herself and her fetus as more signs of the pregnancy present themselves. What should the nurse point out to the husband is probably occurring in this situation?
introversion
A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone?
maintains the endometrial lining of the uterus during pregnancy
A nurse is teaching a preconception class and discussing the importance of nutrition modifications during the preconception phase. The nurse stresses an increase in folic acid and protein. Which foods are high in protein?
meat tofu beans
A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age?
mistaking implantation bleeding for LMP
A 39-year-old woman is pregnant with her first child and appears to be thrilled about it. Now in her second trimester, she talks enthusiastically with the nurse about the latest maternity clothes she has bought and models them for the nurse. She also discusses the latest trends in health foods, which she has adopted since learning of her pregnancy. The nurse interprets this information as reflecting which primary emotional response to pregnancy?
narcissism
The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended for prenatal care?
once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth
A woman has just given birth to a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify what findings as normal?
one vein two arteries
A pregnant woman is taught many different types of exercises during pregnancy to help relieve pain, prevent complications, and facilitate an easier delivery. Which of the following exercises is taught to relieve backache during pregnancy?
pelvic rocking
A nurse is discussing the importance of good nutrition to a young pregnant client. The nurse would point out that the growing fetus is getting nutrition from the mother via which structure?
placenta
What problem does the nurse address in the plan of care for a pregnant client post bariatric surgery?
poor absorption of fat-soluble vitamins
After teaching a class on the stages of fetal development, the nurse determines that the teaching was successful when the group identifies which stages?
pre-embryonic embryonic fetal
A young patient tells the nurse that she wants to get pregnant and it would be her first pregnancy. In which type of classes should the nurse instruct this patient to enroll?
preconception classes
A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are:
prolactin and oxytocin.
To prevent exposure to hepatitis A virus, the nurse teaches the pregnant client to avoid which food?
raw fish
A nurse is caring for a client in the first trimester of her second pregnancy. Which of the following education classes would be most appropriate for the nurse to suggest?
refresher course
A pregnant client reports chewing on ice throughout the day. Which laboratory value would the nurse evaluate?
serum iron level
Untreated hyperemesis can lead to preterm birth. What is the cause of the preterm birth?
severe dehydration resulting in hypoperfusion of the placenta
A young woman comes to the clinic and informs the nurse that she and her husband are thinking about having a baby. She tells the nurse that she has read about the importance of increasing folic acid before conceiving. Which foods should the nurse tell the patient to consume to increase her level of folic acid?
spinach collard greens kale turnip greens
A pregnant woman is undergoing testing on her first prenatal visit. A blood specimen is obtained for a rapid plasma reagin test. The nurse explains that this test will evaluate for which condition?
syphilis
A pregnant client asks the nurse how the fetus breathes if it is floating in the amniotic fluid. The best explanation by the nurse is:
the fetus receives oxygen through the umbilical vein.
During initial examination in the labor room, the nurse notes a large amount of white, bubbly discharge around the vaginal walls that has a foul smell. The nurse suspects the woman has which type of sexually transmitted infection?
trichomoniasis
While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a:
trisomy numeric abnormality.
A 33-year-old pregnant client asks the nurse about testing for birth defects that are safe for both her and her fetus. Which test would the nurse state as being safe and noninvasive?
ultrasound
A group of nursing students are analyzing the fetal circulation. After the session, the students correctly point out which fetal structure contains the highest concentration of oxygen?
umbilical vein
The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. What will the mother likely experience at that time?
urinary frequency
