O'Meara Prep U: 20
A 25-year-old client at 22 weeks' gestation is noted to have proteinuria and dependent edema on her routine prenatal visit. Which additional assessment should the nurse prioritize and alert the RN or health care provider
Initial BP 100/70 mm Hg; current BP 140/90 mm Hg
Which recommendation would the nurse give to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection
Participate in early prenatal care.
A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV
Respiratory rate
The nurse is concerned that a pregnant patient is experiencing abruptio placentae. What did the nurse assess in this patient
Sharp fundal pain and discomfort between contractions
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. The nurse determines that the medication is at a therapeutic level based on which finding
deep tendons reflexes 2+
A woman with gestational hypertension develops eclampsia and experiences a seizure. Which intervention would the nurse identify as the priority
oxygenation
A woman at 35 weeks' gestation with severe hydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client
preterm rupture of membranes followed by preterm birth
A client with a history of cervical insufficiency is seen for reports of pink-tinged discharge and pelvic pressure. The primary care provider decides to perform a cervical cerclage. The nurse teaches the client about the procedure. Which client response indicates that the teaching has been effective
"Purse-string sutures are placed in the cervix to prevent it from dilating."
A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate
"Antiretroviral medications are available to help reduce the risk of transmission."
Upon entering the room of a client who has had a spontaneous abortion (miscarriage), the nurse observes the client crying. Which response by the nurse would be most appropriate
"I'm sorry you lost your baby."
A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. The nurse determines that the drug is at a therapeutic level based on which result
6.1 mEq/L
A patient with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The patient explains that she has been "eating for two" so the baby is healthy. How should the nurse respond to the patient
"Elevated blood glucose levels in the first trimester have been linked to congenital anomalies."
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
A 40-year-old female client with a chronic pelvic infection expresses her desire to conceive post-treatment. When discussing this with the client the nurse keeps in mind that the client is at increased risk for which of the following
Ectopic pregnancy
A patient in her late twenties visits the clinic to begin the process of in vitro fertilization (IVF). Her husband in his late fifties asks if there are any tests to check for any irregularities. What tests should the nurse discuss with this couple
Examination of egg and sperm
An infant was born at term but has intrauterine growth restriction (IUGR). What findings in the infant's history would contribute to this problem? Select all that apply
Maternal smoking Intrauterine infection of the fetus
A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal
Prevent maternal seizures
A woman receives magnesium sulfate as treatment for preterm labor. The nurse assess and maintains the infusion at the prescribed rate based on which finding
Respiratory rate of 16 breaths/minute
A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection
Safety of antiviral therapy during pregnancy has not been established.
A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available
calcium gluconate
While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios. Which information would the nurse use to support this suspicion? Select all that apply
difficulty obtaining fetal heart rate reports of shortness of breath history of diabetes
A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP
elevated lipoproteins
A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply
hemolysis elevated liver enzyme slow platelet count
A pregnant patient with intermittent preterm contractions at 30 weeks has been on weekly home care assessments for 1 month without health care visits to the doctor or any activities outside the home. The nurse has established adequate fetal growth and is aware that contractions have been occurring roughly two times a day. The patient makes little effort to look at the nurse or discuss her plans for the upcoming delivery. The nurse makes which diagnosis of the current needs of this patient
At risk for depression because of extended activity restriction, as evidenced by affect
A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage. The client looks frightened and confused and states that she does not believe in abortion. Which statement by the nurse is best
"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."
A nurse is teaching a prenatal class and is asked the purpose of amniotic fluid. Which statements are correct? Select all that apply
Amniotic fluid promotes fetal movement enhancing musculoskeletal development. Sufficient amounts of amniotic fluid cushion the fetus from trauma. Amniotic fluid allows the fetal umbilical cord to be relatively free from compression. Sufficient amounts of amniotic fluid help the fetus maintain a constant body temperature.
The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity
Reflexes
A nurse is teaching a pregnant woman how to perform fetal kick counts. The nurse determines that the teaching was successful when the client states that she will call her healthcare provider if it takes longer than what time frame to reach 10 kicks
2 hours
A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priorityfor this client
Administer IV NS with vitamins and electrolytes.
A woman in her 20s has experienced a spontaneous abortion (miscarriage) at 10 weeks' gestation and asks the nurse at the hospital what went wrong. She is concerned that she did something that caused her to lose her baby. The nurse can reassure the woman by explaining that the most common cause of miscarriage in the first trimester is related to which factor
Chromosomal defects in the fetus
A client with a high-risk pregnancy has been prescribed inpatient bed rest. When assessing the client each morning, which risk factor of is common with this treatment plan
Depression
A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints
Ectopic pregnancy
A client tells that nurse in the doctor's office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia
Have her blood pressure checked at every prenatal visit.
A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next
Palpate the fundus and check fetal heart rate.
A patient having an examination to check the placement of an intrauterine device (IUD) is diagnosed as being pregnant. For which action should the nurse prepare the patient at this time
Removal of the IUD
The nurse is caring for a client who has a multifetal pregnancy. What topic should the nurse prioritize during health education
Signs of preterm labor
A 25-year-old pregnant client has just been diagnosed with hyperemesis gravidarum. Which instruction should the nurse prioritize during a teaching session
Take your anti-nausea medicine around the clock.
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 woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client
diminished reflexes
A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical
elevated blood pressure
A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate
fetal distress related to hypoxia
A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this a
hydatidiform mole.
A pregnant client has tested positive for cytomegalovirus. What can this cause in the newborn
microcephaly
A 28-year-old primigravida client with type 2 diabetes mellitus comes to the health care clinic for a routine first trimester visit reporting frequent episodes of fasting blood glucose levels being lower than normal, but glucose levels after meals being higher than normal. What should the nurse point out that these episodes are most likely related to
normal response to the pregnancy
A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion
strong abdominal cramping
A nurse is assessing the following antenatal clients. Which client is at highest risk for having a multiple gestation
the 41-year-old client who conceived by in vitro fertilization
A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy
use of IUD for contraception
A pregnant women calls the clinic to report a small amount of painless vaginal bleeding. What response by the nurse is best
visit your healthcare provider
