Mod 33.1 understanding of the concept of reproduction in the care of the patient during antepartum.

The nurse is caring for a client who is at 10​ weeks' gestation and experiencing​ "some gastrointestinal​ problems." Which symptom should the nurse anticipate specifically in the​ client? A. Diarrhea B. Urinary frequency C. Decreased salivation D. Ptyalism

A. Diarrhea ​Rationale: Ptyalism, or increased​ salivation, may occur during pregnancy. Urinary frequency is a genitourinary change that occurs during pregnancy. Diarrhea is an abnormal symptom and is not an expected change in the gastrointestinal system during pregnancy.

The nurse is caring for a client who is at 31​ weeks' gestation and admitted for preterm labor. The client expresses concern for her baby and missing work. Which is a nursing priority​? A. Providing emotional support B. Administering antianxiety medications C. Contacting her employers to secure work release D. Restricting family visitors

A. Providing emotional support ​Rationale: Based on the​ client's concerns, the​ nurse's priority is to provide the client emotional support. Clients experiencing preterm labor may have a difficult time coping with their concerns regarding the diagnosis. The​ nurse's role does not include restricting family visitors or contacting the​ client's employers. Concern for the unborn baby is a normal response and is not an indication for antianxiety medication.

he nurse is reviewing the histories of four new prenatal clients. Which maternal risk factor indicates the need for antenatal​ testing? A. Maternal age of 25 B. Twin gestation pregnancy C. Maternal history of depression D. Vegan dietary preference

B. Twin gestation pregnancy Rationale: Obstetrical​ factors, such as multifetal gestation and previous fetal​ loss, are indicators for antenatal testing. Demographic factors such as age younger than 17 or older than 35 years may indicate the need for antenatal testing. Mothers who are vegans may have special nutritional​ needs, but this factor alone does not indicate the need for fetal antenatal testing. A maternal history of depression is not an indicator for antenatal testing.

The nurse is caring for a client who is at 28​ weeks' gestation and diagnosed with gestational diabetes. The client expresses fear that the baby will not be healthy. Which response by the nurse provides the necessary reassurance to the​ client? A. ​"You should make an appointment in a few days to talk to the midwife about​ that." B. ​"We will help you to modify your diet to keep your blood sugar at normal levels to maintain a healthy pregnancy and​ baby." C. ​"Your pregnancy will be considered high risk from now on and you should be prepared for potential​ complications." D. ​"The test for diabetes is done primarily to determine your risk of diabetes later in life and has a minimal effect on the​ pregnancy."

B. ​"We will help you to modify your diet to keep your blood sugar at normal levels to maintain a healthy pregnancy and​ baby." ​Rationale: The response by the nurse that provides the most reassurance to the client​ is, "We will help you to modify your diet to keep your blood sugar at normal levels to maintain a healthy pregnancy and​ baby." Gestational diabetes mellitus is controlled by diet and exercise. Referring the client to the midwife negates the​ client's concern for her baby. Telling the client to be prepared for complications is not good therapeutic​ communication, nor does it provide reassurance to the client. Gestational diabetes can have a significant effect on the pregnancy and may be associated with serious outcomes for the​ fetus, which include intrauterine growth​ restriction, macrosomia, symptomatic neonatal​ hypoglycemia, and fetal demise if left untreated.

The nurse is caring for an obstetrical client during her first visit who states that she is experiencing nausea and vomiting. The nurse should identify which hormone as responsible for this​ change? A. Human placental lactogen​ (hPL) B. Estrogen C. Human chorionic gonadotropin​ (hCG) D. Progesterone

C. Human chorionic gonadotropin​ (hCG) Rationale: Increased levels of hCG are attributed to the​ client's nausea and vomiting. During​ pregnancy, estrogen enlarges the​ uterus, and causes breast tenderness and nasal stuffiness. Progesterone is essential for maintaining the pregnancy. Human placental lactogen assists in maintaining the​ fetus's glucose levels. Human chorionic gonadotropin preserves the corpus luteum.

The nurse is caring for a client who has had a positive pregnancy test. The nurse reviews the​ client's history and notes the client smokes half a pack of cigarettes a day. Which information should the nurse include in the plan of​ care? A. Encourage her to chew gum instead of smoke. B. Provide information on a​ 12-step rehabilitation program. C. Refer her to a smoking cessation program. D. Inform her that less than 10 cigarettes per day has not been proven harmful to the baby.

C. Refer her to a smoking cessation program. ​Rationale: The information that is important to include in the plan of care for the client that smokes half a pack of cigarettes a day is a referral to a smoking cessation program. Chewing gum is not a replacement for smoking cessation. A​ 12-step rehabilitation program is for drug or alcohol abuse. Any smoking adversely affects the fetus.

A patient is admitted for possible preterm labor. The nurse receives a prescription for a transvaginal ultrasound to be performed by the radiology department. The nurse should understand that this test is used for which primary purpose? To detect a shortened cervical length To evaluate the fetal structures To evaluate cervical dilation To evaluate the presenting fetal part

Correct answer To detect a shortened cervical length The primary purpose for a transvaginal ultrasound for the patient suspected of being in preterm labor is to evaluate the length of the cervix. This evaluation may be helpful in the prediction of preterm labor. Transvaginal ultrasound can be used early in the pregnancy to evaluate fetal structures. A transvaginal ultrasound is not specifically used to evaluate cervical dilation or the presenting fetal part

The nurse is caring for a pregnant client beginning her second trimester of pregnancy. Which question is the most appropriate for the nurse to​ ask? A. ​"Have you considering enrolling in childbirth​ classes?" B. ​"What is your labor​ plan?" C. ​"Are you aware we will test you for Group B strep​ today?" D. ​"How are you getting relief from your lower back​ pain?"

D. ​"How are you getting relief from your lower back​ pain?" ​Rationale: The​ nurse's role in the second trimester includes providing teaching about the common discomforts of​ pregnancy, such as lower back pain. Questions about childbirth classes and birth plans are appropriate questions for later in the​ pregnancy, during the third trimester. Testing for Group B strep occurs during the third trimester.

A patient diagnosed with gestational diabetes is scheduled for induction of labor because the baby is large for gestational age (LGA). Which statement is the most likely interpretation of the contributing factor to the diagnosis of LGA for a baby born to a patient with gestational diabetes? High levels of fetal insulin High levels of maternal insulin Inability of the fetus to produce insulin Inadequate amounts of fetal insulin

High levels of fetal insulin Characteristically, newborns of mothers with diabetes are large for gestational age (LGA) as a result of high levels of fetal insulin production stimulated by the high levels of glucose crossing the placenta from the mother. High levels of maternal insulin, the inability of the fetus to produce insulin, and inadequate amounts of fetal insulin are not contributing factors to a newborn that is LGA.

patient at 28 weeks of gestation states, "I frequently have leg cramps that are horribly uncomfortable." Which contributing factor should the nurse suspect led to the patient's leg cramps? Increased pressure of the uterus on the nerves Prolonged standing Circulatory congestion of the lower extremities The specific causative factors are unknown

Increased pressure of the uterus on the nerves The contributing factor to the leg cramps the patient is experiencing is the increased pressure of the uterus on the nerves. Other possible contributing factors include the imbalance of calcium-phosphorus ratio, fatigue, poor circulation to lower extremities, and pointing the toes. Prolonged standing and circulatory congestion of the lower extremities contribute to other discomforts of pregnancy.

he nurse is providing dietary counseling for a newly pregnant patient whose diet preference is lactovegetarian. Which information should the nurse include to ensure the patient is getting enough dietary calcium to support the pregnancy? Recommend a dietary calcium intake of 1200-1500 mg/day. Encourage the patient to increase dietary intake of dairy products. Instruct the patient to increase the consumption of eggs. Increase the dietary intake of riboflavin to 1.4 mcg/day.

Recommend a dietary calcium intake of 1200-1500 mg/day. Information that should be included in the dietary teaching is the specific recommendation of calcium. This enables the patient to understand how to monitor their dietary intake of calcium when choosing foods. The patient is encouraged to increase their dairy intake, but should also understand the recommendation of calcium intake to ensure an adequate amount of calcium-rich foods are consumed. Lactovegetarian diets do not include the consumption of eggs, and eggs are not a food source high in calcium. Riboflavin is a B vitamin.

A patient in the first trimester of pregnancy is being treated for hypothyroidism. The patient states, "I have been so nauseated that I cannot even take my medication for my hypothyroidism." Which possible outcome should the nurse anticipate if the patient remains untreated for hypothyroidism? The patient has an increased chance of a pregnancy loss. The fetus is at risk for congenital heart anomalies. The patient is at risk for a preterm delivery Untreated hypothyroidism will affect the patient's labor.

The patient has an increased chance of a pregnancy loss. The possible outcome for a patient with untreated hypothyroidism is an increased chance for a pregnancy loss. The rate of fetal loss is 50% for an untreated patient. The fetus is not at risk for congenital heart anomalies or preterm delivery, and the untreated hypothyroidism will not affect the patient's labor.

The nurse is caring for a client who​ asks, "Why do I need an ultrasound and all of these tests while I am​ pregnant?" Which response by the nurse provides the most appropriate explanation for antenatal testing to the​ client? A. ​"Ultrasounds are painless and your insurance will pay for​ it." B. ​"These tests ensure your baby is​ healthy." C. ​"I will ask the doctor to explain these tests to you​ later." D. ​"Tests such as ultrasounds can help screen for birth​ defects."

​D. ​"Tests such as ultrasounds can help screen for birth​ defects." Rationale: Antenatal testing helps ascertain fetal​ well-being, growth, and development during the prenatal period and allows for screening and detection of congenital abnormalities. Antenatal testing does not ensure a baby will be healthy. The​ statements, "These tests ensure your baby is​ healthy," "I will ask the doctor to explain these tests to you​ later," and​ "Ultrasounds are painless and your insurance will pay for​ it" do not address the​ client's question.

The nurse is caring for a couple attending their first prenatal visit. The client​ states, "I have had trouble with anemia in the​ past." Which response by the nurse reflects the most appropriate plan of care in managing the​ pregnancy? A. ​"You will be taking an iron supplement throughout your​ pregnancy." B. ​"A health dietary intake should provide you with the iron and vitamins you​ need." C. ​"The results of your blood work will determine what supplements will be​ recommended." D. ​"You will be instructed to take iron and folic acid throughout the​ pregnancy."

​D. ​"You will be instructed to take iron and folic acid throughout the​ pregnancy." Rationale: The goal of healthcare for the client is to prevent anemia so the client will be instructed to take an iron supplement and a folic acid supplement. If the results indicate the client has iron deficiency anemia or megaloblastic anemia caused by a folate​ deficiency, further treatment may be required. Folic acid supplementation also prevents neural tube defects. All pregnant clients are encouraged to take prophylactic supplementation of iron and vitamins in addition to their diets. Iron and folate supplementation is not deferred for laboratory results.

The nurse is teaching a patient who is beginning their second trimester of pregnancy about weight gain. The patient has a BMI of 29. Which statement by the nurse provides the patient with accurate information on weight gain throughout the remainder of her pregnancy? A normal weight gain for your pregnancy is 0.5 lb per week until you deliver. "A healthy weight gain for your pregnancy is 1 lb per week." "You can expect to gain another 12 lb before you deliver the baby." "You can expect to gain 1.5 lb per week for the remainder of your pregnancy."

"A normal weight gain for your pregnancy is 0.5 lb per week until you deliver." The statement made by the nurse that provides the patient with accurate information on weight gain throughout the remainder of the pregnancy is, "A normal weight gain for your pregnancy is 0.5 lb per week until you deliver." A patient with a BMI of 29 is considered overweight. The recommendation of gaining 1 lb per week is for a patient that has a normal BMI. A 12-lb weight gain throughout the second and third trimesters is not a sufficient enough weight to gain. A weight gain of 1.5 lb per week throughout the remainder of the pregnancy is a recommendation for a normal BMI twin gestation pregnancy.

A patient who is at 35 weeks of gestation states, "My back aches constantly. What can I do to relieve the discomfort?" How should the nurse respond? "A pelvic tilt will help relieve your back discomfort." "Elevating your feet while sitting will help relieve the pressure on your back." "You need to make sure you rest frequently." "There is not much that can be done; after you deliver the discomfort will subside."

"A pelvic tilt will help relieve your back discomfort." The response made by the nurse that provides the patient with the information needed to help relieve the back discomfort is, "The pelvic tilt will help relieve your back discomfort." The pelvic tilt will help strengthen the abdominal muscles and stretch the muscles in the back. Other interventions to help relieve back discomfort include the use of proper body mechanics and avoiding uncomfortable working heights, high-heeled shoes, lifting of heavy loads, and fatigue. Elevating the feet is recommended to prevent ankle edema and varicose veins. Resting frequently is recommended for the patient experiencing fatigue.

The nurse is teaching to a patient at 28 weeks of gestation on how to monitor fetal movement daily. The patient asks, "How can monitoring my baby's movement tell you that my baby is doing well?" Which response by the nurse is accurate? "Decreased fetal movement may indicate that further fetal assessment may be needed. "This is the least expensive way to monitor fetal activity." "You will not need any other antenatal testing for fetal well-being if you monitor yourself." "This method of monitoring poses the least risk to the baby."

"Decreased fetal movement may indicate that further fetal assessment may be needed." The accurate response is, "Decreased fetal movement may indicate that further fetal assessment may be needed." Vigorous fetal activity provides reassurance of fetal well-being. A marked decrease in activity or cessation of movement may indicate possible fetal compromise (or even death), requiring immediate follow-up. A method of monitoring fetal movement includes instructing the patient to count fetal movement three times a day for 20-30 minutes each session. If fewer than three movements are felt, the time period is extended for an hour. Further antenatal testing may be necessary for decreased fetal movement or if complications occur in the pregnancy. There are other methods of monitoring fetal well-being that do not pose a risk, such as an ultrasound, nonstress test, and biophysical profile.

The nurse notes on assessment that a patient who is at 33 weeks of gestation has +2 ankle edema. Which question by the nurse is best? "Do you sit for long periods of time? "How much fluid do you drink daily?" "Do you elevate your legs when resting?" "Do your dietary choices have high-sodium content?"

"Do you sit for long periods of time?" In order to determine the cause of the ankle edema, the nurse should ask if the patient sits for long periods of time. Prolonged sitting or standing is a contributing factor to ankle edema. Fluid intake is not a factor that can result in ankle edema. Elevating the legs while resting is an intervention for ankle edema. Dietary intake of foods with high-sodium content may result in generalized edema, not just specifically ankle edema.

The nurse in the clinic has designed a new prenatal intake form for obstetrical patients. Which question should the nurse include in the form for screening potential newborn health risks? "Does the baby's father have any genetic family diseases?" "Where was the father of the baby born?" "Are your periods irregular?" "Do you have any other children?"

"Does the baby's father have any genetic family diseases?" The question the nurse will include in the prenatal intake form to screen for potential newborn health problems is, "Does the baby's father have any genetic family diseases?" A genetic history on the patient and the father of the baby should be obtained to help determine whether additional antenatal testing for genetic disease may be indicated. Psychosocial information, irregular menstrual periods, and other siblings are important questions to ask, but not are directly related to genetic diseases that may be inherited.

A patient who is at 37 weeks of gestation reports heartburn. Which recommendation should the nurse provide to the patient? Answer "Eat small and frequent meals. "Do not eat in the evening after 6:00 p.m." "Take antacids that are high in calcium." "After eating, lay down on your left side to promote digestion."

"Eat small and frequent meals." The information the nurse can provide the patient with to help prevent heartburn is to eat small and frequent meals. The time of day the patient eats does not contribute to heartburn. Antacids that are low in sodium and approved by the healthcare provider can be taken to decrease heartburn. Encouraging the patient to lie on their left side after eating will contribute to the patient's heartburn. The patient should remain upright after eating to avoid heartburn.

A patient who is at 36 weeks of gestation asks, "Is it normal to frequently experience discomfort from gas and have quite a bit of flatulence?" Which response by the nurse provides the best information? "Experiencing increased flatulence is normal during pregnancy; daily exercise may help. "Excessive flatulence is not a normal finding; I will let your healthcare provider know about your concerns." "Yes, it is quite normal to experience increased flatulence; eating small and frequent meals may be helpful. "Increased flatulence usually diminishes as the pregnancy continues; what type of foods are you eating?"

"Experiencing increased flatulence is normal during pregnancy; daily exercise may help." The response by the nurse that provides the best information for the patient is, "Experiencing increased flatulence is normal during pregnancy; daily exercise may help." Decreased gastrointestinal motility leading to delayed emptying time, pressure of the growing uterus on the large intestine, and air swallowing are all factors that contribute to increased flatulence. Eating small, frequent meals helps decrease heartburn. Flatulence does not diminish as the pregnancy progresses.

The nurse is providing preconception instruction to a patient who is planning a pregnancy. The patient asks, "Why do I need to take folic acid?" Which is the best response by the nurse on the importance of avoiding a folic acid deficiency? "Folic acid deficiency is correlated with fetal neural tube defects." "Folic acid deficiency has been linked to fetal cardiac defects." "Maternal folic acid deficiency is suspected to be a causative factor in renal anomalies." "Patients deficient in folic acid who get pregnant are at higher risk for a pregnancy loss."

"Folic acid deficiency is correlated with fetal neural tube defects." An inadequate intake of folic acid has been associated with neural tube defects (NTDs) (such as spina bifida, anencephaly, or myelomeningocele) in the fetus or newborn and is also the most common cause of megaloblastic anemia during pregnancy. Folic acid deficiency is not linked to cardiac or renal defects, nor does it place the patient at a higher risk for pregnancy loss.

The nurse is teaching a childbirth class that includes a couple who are expecting their first baby. Which statement by the father indicates acceptance of the pregnancy? "I could not believe the first time I felt the baby move. "I have done my part for this baby." "I am worried that I may not be good at feeding the baby. "I can think of a better time for her to be having this baby."

"I could not believe the first time I felt the baby move." The statement made by the father about a baby that demonstrates an acceptance of the pregnancy is, "I could not believe the first time I felt the baby move." The statements, "I have done my part for this baby," "I am worried that I may not be good at feeding the baby," and "I can think of a better time for her to be having this baby" are ambivalent statements.

The nurse is teaching a patient who is beginning the third trimester of pregnancy about the importance of monitoring fetal activity. Which patient statement indicates the need for further teaching? "I will call my healthcare provider if there are fewer than 10 movements in an hour." "I will call my healthcare provider if it is taking me longer each day to feel the movement." "I will call my healthcare provider if there are fewer than 3 movements in 8 hours." "I will call my healthcare provider if I do not feel any fetal movement in the morning."

"I will call my healthcare provider if there are fewer than 10 movements in an hour." The statement made by the patient that indicates that further teaching is required is, "I will call my provider if there are fewer than 10 movements in an hour." The patient should notify the healthcare provider if there are fewer than 10 movements in 3 hours. The patient is correct to call the healthcare provider if it is taking longer each day to feel fetal movement and if there is no fetal movement felt in the morning.

The nurse is demonstrating positions to use during the active phase of labor for a non-English-speaking couple. Which statement obtained through a translator requires further teaching of the couple? "I will lie on my back during the active phase of labor." "My husband has been helping me practice different labor positions." "I will walk around and remain as active as possible." "I will make sure that I change positions frequently during labor."

"I will lie on my back during the active phase of labor." A laboring patient should not lie flat on their back due to risk for vena cava syndrome. Choosing different laboring positions, remaining active, or walking may help a patient cope better with the discomfort of labor and promote fetal descent into the pelvis.

The nurse is teaching a patient in the third trimester about the prevention of ankle edema. Which patient statement indicates the need for further teaching? "I will make sure I sit and rest for long periods of time. "When I notice my ankles swelling, I will put my feet up. "If I am going to stand for a long time, I will take frequent breaks and elevate my feet." "I will make sure that I flex my feet frequently if I am standing for a long time."

"I will make sure I sit and rest for long periods of time." The statement made by the patient that indicates further teaching is required is, "I will make sure I sit and rest for long periods of time." Sitting or standing for long periods of time contribute to ankle edema. Elevating the feet and dorsiflexion of the feet are appropriate interventions to prevent ankle edema

he nurse is teaching new graduates about different antenatal testing procedures. Which participant statement indicates the need for further teaching about the fetal nonstress test (NST)? "The NST usually takes 2-3 hours for completion." "The test is used to assess fetal heart rate pattern and oxygenation status." "A result in the increase of the fetal heart rate is associated with fetal movement. "The test is easy to perform and has no known side effects."

"The NST usually takes 2-3 hours for completion." The information that is inaccurate is that the NST takes 3 hours to complete. A nonstress test takes 20-40 minutes to complete. It refers to a fetal heart rate tracing that shows at least two accelerations 15 beats above baseline, lasting at least 15 seconds within a 20- to 40-minute time period. A reactive NST is indicative of adequate fetaloxygenation. Accelerations in the fetal heart rate with fetal movement indicate an adequate fetal response and general fetal well-being. The NST is noninvasive and has no known side effects.

A pregnant patient with a previous child born with congenital anomalies is scheduled for a chorionic villus sampling. Which statement describes the nurse's understanding of the benefit of chorionic villus sampling? "The procedure can provide a diagnosis earlier in the pregnancy." "The sampling can be done before the 10th week of gestation." "There is no known risk to the developing fetus." "The sampling is a quick noninvasive testing procedure."

"The procedure can provide a diagnosis earlier in the pregnancy." Advantages of chorionic villus sampling (CVS) are that results are available within 24 hours and the diagnosis can be made between the 10th and 12th week gestation of pregnancy, versus an amniocentesis, which is not usually done until at least 12 weeks of gestation. CVS testing prior to 10 weeks increases the risk of fetal complications. Fetal risks include limb reduction, rupture of membranes, spontaneous abortion, and Rh sensitization in Rh-negative women. CVS is an invasive testing procedure that involves sampling of the chorionic villi of the placenta.

A patient with gestational diabetes who is at 32 weeks of gestation is scheduled for a nonstress test and asks, "How can this test tell if my baby is doing okay?" Which statement by the nurse reflects the purpose of a nonstress test? Answer "The test is reflective of your baby's oxygen status and intact nervous system." "The test allows for the measurement of the amniotic fluid volume." "Your baby's well-being is determined by the amount of movement during the test." "The test is an assessment for fetal tone and breathing."

"The test is reflective of your baby's oxygen status and intact nervous system." The nonstress test is a widely used method for fetal evaluation, which is based on the knowledge that when the fetus has adequate oxygenation and an intact central nervous system (CNS), accelerations of the fetal heart rate (FHR) occur with fetal movement. Measurement of an amniotic fluid index, fetal movement, fetal tone, and breathing are components of a biophysical profile.

The nurse is preparing a patient for a biophysical profile. The patient asks the nurse, "Why do I need this test?" Which response by the nurse provides the primary reason for a biophysical profile? "This procedure allows us to evaluate the baby's well-being." "This procedure will enable us to identify the baby's characteristics." "This procedure will help estimate the gestational age of the baby." "The procedure will allow us to see what position the baby is in."

"This procedure allows us to evaluate the baby's well-being." The primary reason for a biophysical profile is because this procedure allows the healthcare team to evaluate the baby's well-being. The biophysical profile is a comprehensive assessment of five variables over a 30-minute time period. Although an ultrasound is used to evaluate fetal characteristics, gestational age, or the position of the baby, the biophysical profile is used to help identify a compromised fetus or to confirm its health, as well as to assess the placental functioning.

The nurse is performing prenatal assessments in the clinic. Which patient should the nurse identify as requiring nutritional teaching? A patient who is overweight at 24 weeks of gestation and has gained 25 lb during the pregnancy An underweight patient at 12 weeks of gestation who has gained 5 lb A patient who is normal weight and at 20 weeks of gestation has gained 20 lb A patient who is normal weight, a twin gestation at 37 weeks of gestation, and with a total weight gain of 40 lb

A patient who is overweight at 24 weeks of gestation and has gained 25 lb during the pregnancy A patient who is overweight at 24 weeks of gestation who has gained 25 lb during the pregnancy will require nutritional teaching. The recommended weight gain for a patient who is overweight is 15-25 lb. The remaining patients are within the expected range of weight for their weight category and gestational age.

The nurse is caring for a client at 32​ weeks' gestation who​ asks, "Why do I waddle when I​ walk?" Which explanation by the nurse provides the client with accurate​ information? A. ​"A hormone causes the pelvic joints to​ relax." B. ​"A low calcium intake can cause you to walk​ differently." C. ​"I am concerned you have an underlying musculoskeletal​ disorder." D. ​"You are experiencing a change in the center of​ gravity."

A. ​"A hormone causes the pelvic joints to​ relax." ​Rationale: The joints of the pelvis relax due to hormonal​ influences, resulting in a waddling gait. A change in the center of gravity results in lordosis. A low calcium intake will not result in a waddling gait. The changes in the​ client's gait are due to​ hormones, not an underlying musculoskeletal disorder.

The nurse caring for a client who is at 35​ weeks' gestation is planning to teach the client about the premonitory signs of labor. Which statement is appropriate to include in the​ teaching? A. ​"You may notice that you breathe easier when the baby drops down into your​ pelvis." B. ​"Expect to see bleeding each day from now​ on." C. ​"You may notice you need to urinate less frequently as you get closer to​ labor." D. ​"Your swelling will start to go away​ now."

A. ​"You may notice that you breathe easier when the baby drops down into your​ pelvis." ​Rationale: The​ client's session should include the​ statement, "You may notice that you breathe easier when the baby drops down into your​ pelvis." As lightening​ occurs, the pregnant client may experience easier breathing. As the pregnancy​ continues, the client may experience increased dependent​ edema, backache, leg​ pain, urinary​ frequency, and vaginal discharge. Bloody show is the loss of the​ blood-tinged cervical mucus plug. Vaginal bleeding is abnormal and should be reported to the healthcare provider.

nurse is conducting a dietary assessment for a pregnant adolescent. Assessment of the dietary intake of which nutrient should be a priority​? A. Vitamin K B. Calcium C. Magnesium D. Vitamin B12

B. Calcium ​ Rationale: Inadequate intake of calcium is frequently a problem for this age group. Adequate calcium is important to continue to support the growth and calcium maintenance of the adolescent as well as the growth and development of the fetus. Vitamin K and magnesium are not found to be deficient in the adolescent. Vitamins B6​, ​A, and D are found to be deficient in this age​ group, not vitamin B12.

A patient who is at 37 weeks of gestation states, "I feel like I am going to faint sometimes, and I am so clumsy on my feet. I am afraid I will fall." Which intervention by the nurse will benefit the patient? Counsel the patient on changing position slowly. Provide the patient a pamphlet on exercises to prepare for childbirth. Encourage the patient to decrease all activities. Demonstrate good body mechanics for lifting and picking up items.

Counsel the patient on changing position slowly. The intervention by the nurse that addresses the patient's statement is to instruct the patient to change position slowly. Changing position slowly allows adjustment for the cardiovascular volume that may cause hypotension. Exercises for childbirth, decreasing activities, and the demonstration of good body mechanics when lifting items do not correlate with complaints of "feeling faint or clumsy on the feet."

patient who is at 32 weeks of gestation states, "I am experiencing urine leakage when I sneeze or cough." Which exercise should the nurse recommend the patient do to strengthen the perineal muscles? Kegel exercises Pelvic tilt exercises Swimming Partial sit-ups

Kegel exercises Kegel exercises strengthen the perineal muscles and can help prevent cystocele, rectocele, uterine prolapse, and stress incontinence later in life. A technique that is frequently used to teach a patient how to do a Kegel exercise is to tell the woman to think of their perineal muscles as an elevator. When they relax, the elevator is on the first floor. To do the exercises, the woman contracts, bringing the elevator to the second, third, and fourth floors. The patient keeps the elevator on the fourth floor for a few seconds and then gradually relaxes the area. Pelvic tilt exercises are useful for relieving back pain, partial sit-ups can strengthen the abdominal muscles, and swimming is a good form of general exercise while pregnant.

The nurse is evaluating the serum ferritin levels of an obstetrical patient who has been treated for iron deficiency anemia. Which laboratory result indicates that the treatment for iron deficiency anemia has been successful? Laboratory result is a serum ferritin level of 13.4 mg/L. Laboratory result is a serum ferritin level of 11.5 mg/L. Laboratory result is a serum ferritin level of 7.0 mg/L. A serum ferritin level is not reflective of the patient's iron stores.

Laboratory result is a serum ferritin level of 13.4 mg/L. The greatest need for increased iron intake occurs in the second half of pregnancy. When the iron needs of pregnancy are not met, maternal hemoglobin falls below 11 g/dL. Serum ferritin levels indicating adequate iron stores are above 12 mg/L.

The nurse is caring for a patient who is at 20 weeks of gestation and admitted for bleeding. The patient is diagnosed with a placenta previa. Which intervention should the nurse include in the plan of care to best monitor the patient's bleeding? Pad count and weight Assessment of fetal heart tones Pain management Monitor quantitative hCG levels

Pad count and weight The intervention the nurse will include in the plan of care to assess the patient's bleeding is a pad count and weight. A pad count and weight will provide an estimate of blood loss. The fetal heart tones would reveal fetal distress with large amounts of blood loss, but would not be the best way to track bleeding. Placenta previa is a painless condition. Quantitative human chorionic gonadotropin (hCG) levels are not monitored for a patient diagnosed with placenta previa.

The nurse is preparing childbirth education to a non-English-speaking couple that has expressed fear regarding their inability to provide physical care for their new baby. Which is the best intervention for the nurse to integrate into the plan of care for the couple? Refer the couple to a prenatal class taught in their native language. Provide brochures with pictures for the couple to review. Schedule an interpreter during prenatal visits. Use teaching models to demonstrate procedures.

Refer the couple to a prenatal class taught in their native language. The best intervention to implement into the plan of care for a non-English-speaking couple expressing fear regarding their inability to provide physical care for their baby is to refer the couple to a prenatal class taught in their native language. Prenatal classes include education on care for the mother, newborn, and family before and after the birth of the baby. Brochures with pictures do not provide an explanation of newborn care in their native language or allow the couple to ask questions. An interpreter should always be available for every prenatal visit. The use of a teaching model without an interpreter present will not provide adequate education for the couple or offer them the opportunity to ask questions.

The laboratory results for an obstetrical patient indicate a hemoglobin of 11.2 g/dL. Which statement is the most likely interpretation of this hemoglobin result for this patient The result is a reflection of the normal physiological changes in pregnancy. The patient is nutritionally deficient in iron. The level reflects the destruction of hemoglobin. The level indicates that the patient may require iron supplementation.

The result is a reflection of the normal physiological changes in pregnancy. Anemia in pregnancy is defined as hemoglobin levels of less than 11 g/dL. Anemia is anticipated in pregnancy because of increased plasma volume, so a hemoglobin level above 11 g/dL is considered normal. The diagnosis is not based on symptoms. Below 7 g/dL is severe anemia.

The nurse is caring for a client who is at 38​ weeks' gestation who is positive for group B streptococcus​ (GBS). Which information should the nurse provide the​ client? A. ​"You will be taking an antibiotic for the remainder of your​ pregnancy." B. ​"You will be given an antibiotic treatment during​ labor." C. ​"Your baby will receive treatment after it is​ born." D. ​"No treatment is necessary because you are​ asymptomatic."

​ B. ​"You will be given an antibiotic treatment during​ labor." Rationale: The client who is GBS positive will be treated with an antibiotic during labor. GBS is one of the major causes of early onset neonatal infection that can be transmitted by vertical transmission from the mother during birth or by horizontal transmission from colonized nursing personnel or colonized babies. If the maternal infection is not resolved prior to​ delivery, IV antibiotics will be prescribed during labor. Treatment is not delayed until after birth. The client will not be prescribed a prophylactic antibiotic throughout the pregnancy.

The nurse is caring for a client who is 36​ weeks' gestation and diagnosed with gestational diabetes mellitus. Which maternal complication will the client be monitored​ for? A. Preeclampsia B. Anemia C. Oligohydramnios D. Preterm labor

​A. Preeclampsia Rationale: Preeclampsia or eclampsia occurs more often in pregnant women with​ diabetes, especially when​ diabetes-related vascular changes already exist. Clients with gestational diabetes are​ 4?5 times more likely to develop gestational hypertension. Gestational diabetes does not place the client at an increased risk for anemia or preterm labor. The client with diabetes is at risk for hydramnios.

A pregnant client asks the nurse when the​ 1-hour oral glucose tolerance test​ (OGTT) will be performed to screen for gestational diabetes. Which response by the nurse is the most​ accurate? A. ​"You will be screened between 24 and 28​ weeks' gestation." B. ​"Screening is initiated between 16 and 20​ weeks' gestation." C. ​"Your screening is generally prescribed between 20 and 24​ weeks' gestation." D. ​"You will only need to be screened if you have any risk​ factors."

​A. ​"You will be screened between 24 and 28​ weeks' gestation." Rationale: The​ 1-hour OGTT screening test for gestational diabetes is performed at between 24 and 28​ weeks' gestation. All clients are screened for gestational diabetes.

The nurse caring for a pregnant client with diabetes mellitus interprets the results of the​ client's nonstress test​ (NST) as nonreactive. Which intervention should the nurse​ anticipate? A. Prepare client for urgent cesarean birth. B. Arrange for a biophysical profile. C. Provide ordered supplemental oxygen. D. Administer oxytocin.

​B. Arrange for a biophysical profile. Rationale: If the NST is nonreactive a biophysical profile may be performed. A biophysical profile is indicated when there is a risk of placental insufficiency or fetal compromise. Indications for a biophysical profile include material diabetes mellitus and nonreactive NST. Oxytocin is used to induce or augment labor in a pregnant client. It is not standard practice to administer oxygen in this case. There is no indication of fetal distress in the case​ presented, so it is not reasonable to anticipate a cesarean birth delivery.

The nurse is caring for a client who is at 28​ weeks' gestation and diagnosed with heart disease. Which condition should prompt the nurse to contact the healthcare provider​ immediately? A. Emotional stress on the job B. Increased dyspnea at rest C. Mild ankle edema D. Weight gain of 1 pound in a week

​B. Increased dyspnea at rest Rationale: Increased dyspnea at rest must be reported immediately because it may be an indication of congestive heart failure. Mild ankle edema and weight gain of 1 pound a week are expected physical findings during the third trimester. Emotional stress on the job can increase cardiac demand and should be reported only if the client experiences symptoms such as palpations or an irregular heart rate.

The nurse is providing a prenatal class instruction on different exercises that can be done to prepare for childbirth. Which exercise should the nurse include that specifically helps reduce back​ strain? A. Partial situps B. Tailor sitting C. Pelvic tilt D. Kegel

​C. Pelvic tilt Rationale: The pelvic tilt can reduce back strain as it strengthens the abdominal muscles. Kegel exercises strengthen the pelvic floor muscles. Tailor sitting is used to stretch the inner thighs. Partial​ sit-ups strengthen abdominal muscle tone.

The nurse is teaching smoking cessation to a newly pregnant client who still smokes. Which fetal complication of cigarette smoking should the nurse​ include? A. Postterm gestation B. Large for gestational age C. Prematurity D. Congenital anomalies

​C. Prematurity Rationale: The nurse will teach the client about the risk of prematurity associated with smoking. Postterm​ gestation, congenital​ anomalies, and newborns who are large for gestational age are not risk factors associated with maternal smoking.

A client with type 2 diabetes mellitus requiring insulin has just discovered that she is pregnant. The nurse is teaching the client about insulin requirements during pregnancy. Which guideline should the nurse​ provide? A. ​"Insulin requirements do not change during​ pregnancy." B. ​"Insulin requirements increase greatly during the first​ trimester." C. ​"Insulin requirements increase greatly during​ labor." D. ​"Insulin requirements increase during the last two​ trimesters."

​D. ​"Insulin requirements increase during the last two​ trimesters." Rationale: Maternal insulin requirements fluctuate throughout​ pregnancy; decreasing during the first​ trimester, then increasing during the second and third trimesters. During the second half of​ pregnancy, fetal growth accelerates and there is an increased utilization of glucose by the fetus. In response to​ this, the placental​ hormone, human placental lactogen​ (hPL), creates insulin resistance in the maternal tissues to have sufficient glucose available for the fetus. This increased insulin resistance may result in an increase in maternal insulin requirements. During​ labor, insulin requirements diminish due to the increased maternal energy expenditure.