OB Antepartum
A nurse in a prenatal clinic overhears a newly licensed nurse discussing conception with a client. Which of the following statements by the newly licensed nurse requires intervention by the nurse?
"Implantation occurs between two and three weeks after conception."
A nurse is caring for a client who is at 20 weeks of gestation and tells the nurse that she is concerned that exercising might pose risks to her pregnancy. Which of the following statement should the nurse make?
"Moderate exercise can help improve your circulation."
A nurse is caring for a female client who is scheduled to have a pelvic examination. The client tells the nurse, "I'm really nervous because I've never had a pelvic exam before." Which of the following is an appropriate therapeutic response by the nurse?
"Tell me more about your concerns. "This therapeutic response is an open-ended statement and encourages the client to tell the nurse more about her concerns.
A nurse is reinforcing teaching about fetal development with a group of women who are pregnant. Which of the following statements should the nurse include in the teaching?
"The baby's heartbeat is audible by a Doppler stethoscope at 12 weeks of pregnancy." The fetal heartbeat is audible by Doppler stethoscope at 12 weeks of gestation.
A nurse is reinforcing teaching with a client who has genital herpes. Which of the following client statements should the nurse identify as understanding of the teaching?
"The lesions can spread to other areas of my body"
A nurse is assisting with the admission of a client who is in preterm labor at 30 weeks of gestation and has a new prescription for betamethasone. Which of the following statements should the nurse make?
"The purpose of this medication is to boost fetal lung maturity."
A nurse is collecting data from a client who is at 11 weeks gestation and reports slight, occasional vaginal bleeding over the past 2 weeks. The provider determines that the fetus has died and that the placenta, fetus, and tissues remain in the uterus. How should the nurse document these findings?
Missed miscarriage
A nurse is reinforcing teaching with a newly licensed nurse about the complications associated with maternal gestational diabetes. Which of the following complications should the nurse include?
Newborn hypoglycemia The nurse should identify that hypoglycemia is a common complication for newborns whose mothers have gestational diabetes.
A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect?
Pelvic Pain
A nurse in a provider's office is reinforcing teaching about home care with a client who has mild preeclampsia. Which of the following information should the nurse include in the teaching?
Perform daily fetal movement counts.
A nurse is admitting a client who is at 36 weeks gestation and has painless, bright red vaginal bleeding. The nurse recognizes this finding as an indication of which of the following conditions?
Placenta Previa Painless, bright red vaginal bleeding is a manifestation of placenta previa.
A nurse is reinforcing teaching with a newly licensed nurse about the administration of depot medroxyprogesterone. Which of the following instructions should the nurse include in the teaching?
"Give the medication intramuscularly"
A nurse is reinforcing nutrition teaching with a client during the first prenatal visit. Which of the following statements by the client indicates an understanding of the teaching?
"I can eat 12 to 18 ounces of albacore tuna weekly." Women should be instructed to limit their intake of commercially caught "white tuna" or albacore tuna and tuna steaks to 6 ounces per week because they contain high levels of mercury.
A nurse is reinforcing teaching about appropriate exercises during pregnancy with a client who is at 24 weeks of gestation. Which of the following statements indicates a need for additional teaching?
"I will participate in a game of racquetball once a week"
A nurse is reinforcing teaching with a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?
"I will reduce my exercise schedule to 3 days a week."
A nurse is assisting with the admission of a client who is at 39 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?
Prepare for a cesarean birth
A nurse is reinforcing teaching about expected gestational changes with a client who is at 12 weeks of gestation. Which of the following statements by the client indicates a need for further teaching?
"I will use only nonprescription medications while pregnant."
A nurse is speaking to a client on the phone who is pregnant and taking iron supplements for iron-deficiency anemia. The client reports that her stools are black but she has no abdominal pain or cramping. Which of the following responses by the nurse is appropriate?
"This is an expected finding because of the way iron is broken down during digestion." Iron supplements turn a client's stools black. In the absence of cramping and abdominal pain, this is an expected finding. The client should be instructed to expect black stools.
A nurse is reinforcing teaching with a newly licensed nurse about the purpose of an indirect Coombs test. Which of the following statements should the nurse include in the teaching?
"This test detects Rh-positive antibodies in the mother's blood"
A nurse is reinforcing teaching with a client who is pregnant and whose routine diagnostic testing reveals a negative rubella titer. Which of the following statements should the nurse tell the client?
"You will need an immunization following delivery." The negative rubella titer means that the client is susceptible to the rubella virus and needs to be immunized after delivery. Immunization during pregnancy is contraindicated because of possible injury to the developing fetus. Following the rubella immunization, the client should be cautioned not to conceive for 3 months.
A nurse is caring for a client who has gestational diabetes and reports feeling shaky, sweaty, and having blurred vision. The client's blood glucose level is 48 mg/dL. Which of the following foods should the nurse give to the client? (Select all that apply.)
*120 mL unsweetened fruit juice *1 tbsp honey *2 tbsp peanut butter
A nurse is reinforcing teaching with a client who is at 15 weeks of gestation and is about to undergo an amniocentesis. The nurse should reinforce that this test can identify which if the following traits of problems? (Select all that apply.)
*Neural tube defects *Chromosome defects *RH incompatibility *Fetal Gender
A nurse in the antepartum unit is assisting with the care of a client who is at 36 weeks of gestation and reports continuous abdominal pain and vaginal bleeding. The nurse should identify that the client is likely experiencing which of the following complications?
Abruptio placentae The nurse should identify that a client experiencing an abruptio placentae will experience abdominal pain, uterine tenderness upon palpation, and vaginal bleeding that can be profuse.
A nurse is collecting data from a client who is in her second trimester of pregnancy. The nurse should recognize which of the following findings as an expected physiologic change during pregnancy?
An increase in lordosis
A nurse is caring for a client who is at 34 weeks of gestation and has a suspected placenta previa. Which of the following actions should the nurse take?
Apply an external fetal monitor The nurse should immediately apply the fetal monitor to determine if the fetus is in distress.
A nurse is collecting data from a client who is at 35 weeks of gestation. Which of the following findings should the nurse report to the provider?
Blurred vision The nurse should report blurred vision to the provider, as this can indicate possible preeclampsia and requires further assessment.
A nurse is reinforcing teaching with a client who is in the first trimester of pregnancy and has a new prescription for ferrous sulfate. The nurse should encourage the client to avoid taking the medication with which of the following liquids?
Coffee
A nurse is caring for a client who is at 32 weeks of gestation and is in labor. Which of the following medications is contraindicated for this client?
Misoprostol Rationale Misoprostol can cause abortion, premature labor, and birth defects. This prescription should be clarified with the provider.
A nurse is assisting with the admission of a client who is at 10 weeks of gestation and reports abdominal pain and moderate vaginal bleeding. Incomplete abortion is the initial diagnosis. Which of the following actions should the nurse contribute to the client's plan of care?
Determine the amount and type of vaginal bleeding.
A nurse on the postpartum unit is collecting data from a client who experienced abrupto placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse recognize this client is at risk for which of the following postpartum complications?
Disseminated intravascular coagulation (DIC)
A nurse is reinforcing teaching with a client who is at 23 weeks of gestation and will return to the facility the following week for an amniocentesis. Which of the following instructions should the nurse include?
Empty her bladder immediately prior to the procedure.
A nurse is reinforcing teaching with a client about checking her basal temperature to identify when ovulation occurs. The nurse should instruct the client to check her temperature at which of the following times?
Every morning before arising
A nurse is assisting with the admission of a client who is at 38 weeks of gestation and has severe preeclampsia. When collecting data from the client, the nurse should expect which of the following findings?
Headache
A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate that the provider will order an amniotic fluid alpha-fetoprotein screening for which of the following clients?
History of delivering a child with a neural tube defect Screening for alpha-fetoprotein is indicated for the client who previously delivered a child with a neural tube defect.
A nurse is reinforcing teaching about Rho(D) immunoglobulin to a client who is pregnant. Which of the following findings can an Rh incompatibility cause?
Hydrops fetalis Hydrops fetalis is a serious condition that occurs when fluid builds up in multiple body parts of the fetus is a result of an Rh incompatibility
A nurse is caring for a client who is pregnant and reports constipation. Which of the following recommendations should the nurse make?
Increased cellulose and fluid in the dietIncreasing fiber and fluid and getting regular exercise are simple and effective ways to deal with constipation during pregnancy.
A nurse in a prenatal clinic is caring for a client who is at 12 weeks of gestation. The client asks about the cause of her heartburn. Which of the following responses should the nurse make?
Increased progesterone production causes decreased motility of smooth muscle. Increased progesterone production causes a relaxation of the cardiac sphincter and delayed gastric emptying, which can result in heartburn.
A nurse is assisting in the care of a client who is scheduled for a cesarean birth based on the fetal lungs having reached maturity. Which of the following findings indicates that the fetal lungs are mature?
Lecithin/sphingomyelin (L/S) ratio of 2:1 An L/S ratio of 2:1 is an indication of fetal lung maturity.
A charge nurse observes a newly licensed nurse checking fetal heart tones (FHT) for a client who is at 12 weeks gestation. Which of the following actions by the nurse indicates a need for intervention by the charge nurse?
Listens with a fetoscope
A nurse in a prenatal clinic is caring for a client who is 38 weeks of gestation and has heavy, red vaginal bleeding,.without contractions, that started spontaneously. She is in no distress and states that she can "feel the baby moving." The client should undergo an ultrasound to determine which of the following findings?
Location of the placenta
A nurse is reinforcing teaching with a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse recognizes that which of the following is the most common risk factor for a placental abruption?
Maternal hypertension Maternal hypertension is the most common risk factor for placental abruption
A nurse is assisting with the care of a client who is at 37 weeks of gestation and has placenta previa. Which of the following risks is the primary reason the nurse should avoid performing a pelvic examination?
Profound bleeding
A nurse is collecting data from a client who is at 18 weeks of gestation and tells the nurse that she felt light fluttering in her stomach the previous day. The nurse should use which of the following terms to document this finding?
Quickening Clients often describe quickening as a fluttering sensation they first perceive as early as the 14th week of gestation. It reflects fetal movement.
A nurse is reinforcing teaching with a client who is being fitted for a contraceptive diaphragm. Which of the following information should the nurse include?
Replace the device after a 20% weight loss It is important for the device to fit appropriately in the vaginal vault in order to provide adequate contraceptive protection. The client should replace the diaphragm after a 20% weight loss or gain.
A nurse is assisting with the care of a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?
Respiratory rate of 16 breaths/min The client's respiratory rate should be at least 12/min as a precaution against excessive depression of impulses at the myoneural junction. Based on this finding, the nurse can continue the infusion.
A nurse is caring for a client who tells the nurse that she thinks she might be pregnant because she is able to feel the baby move. Which of the following statements should the nurse make?
This is a presumptive sign of pregnancy Changes that are felt by the client are presumptive signs of pregnancy such as quickening, breast changes, and fatigue.
A nurse is reinforcing teaching about common discomforts of pregnancy during the first trimester with a client who is pregnant. Which of the following manifestations should the nurse include in the teaching?
Urinary urgency Urinary urgency and frequency are common discomforts occurring during the first trimester. Hormones cause vascular engorgement and altered bladder function. Education should also include regular emptying of the bladder, performing Kegel exercises, and limiting fluid intake prior to bedtime.
A nurse is reinforcing nutritional teaching with a client who is at 8 weeks of gestation. Which of the following statements should the nurse include?
You should increase your folic acid intake during your pregnancy The nurse should reinforce teaching with the client about increasing her folic acid intake throughout pregnancy. Adequate intake of folic acid protects the fetus against neural tube defects.
A nurse is caring for a client who is at 36 weeks of gestation and has suspected placenta previa. For which of the following findings should the nurse monitor the client?
a large amount of bright red vaginal bleeding without pain With placenta previa, the placenta implants in the lower part of the uterus, partly or completely obstructing the cervical os, or outlet to the vagina. Clients who have placenta previa have sudden, painless vaginal bleeding, typically in the third trimester.
A nurse is caring for a client who has just learned that she is pregnant. The nurse should reinforce with the client to call her provider if she experiences which of the following manifestations?
facial edema Facial edema is an indication of pregnancy-induced hypertension, which should be reported to the client's provider.
