PassPoint - Antepartum
After the nurse instructs a client who is scheduled for in vitro fertilization (IVF) about the procedure, which statement by the client indicates to the nurse that the instructions have been successful?
"After fertilization, three or four embryos will be transferred through the cervix."
A nurse is discussing preterm labor in a prenatal class. After class, a client asks the nurse to identify again the nursing strategies to prevent preterm labor. The client needs further instruction when they make which statement?
"Cutting back on my smoking will not help my baby."
In 6 months, a client is expecting a second child. During the psychosocial assessment, the client says to the nurse, "I've been through this before. Why are you asking me these questions?" What is the nurse's best response?
"Each pregnancy has a unique psychosocial meaning."
A nurse is teaching a pregnant client how to distinguish false labor contractions from true labor contractions. Which statement by the client indicates an understanding of this concept?
"False labor contractions are usually felt in the abdomen."
The nurse is conducting a routine risk assessment at a prenatal visit. Which question would be the best to screen for intimate partner violence?
"How safe do you feel in your home?"
A client has a cerclage placed at 16 weeks' gestation. She has had no contractions and her cervix is dilated 2 cm. The nurse is preparing the client for discharge. Which statement by the client should indicate to the nurse that the client needs further instruction?
"I can have sex again in about 2 weeks."
A nurse is caring for a client in her 34th week of pregnancy who wears an external monitor. Which statement by the client indicates an understanding of the nurse's teaching?
"I can lie in any comfortable position, but I should stay off my back."
During a prenatal visit, a pregnant client with cardiac disease and slight functional limitations reports increased fatigue. The nurse knows that the client understands the management of the disorder when the client says
"I will eat five or six small meals each day and have some protein with each meal."
During a routine prenatal visit, a pregnant client reports constipation, and the nurse teaches her how to relieve it. Which statement indicates the client's understanding of the nurse's instructions?
"I'll increase my intake of unrefined grains."
During a routine clinic visit, a 25-year-old multigravida client who initiated prenatal care at 10 weeks' gestation and is now in their third trimester states, "I've been having strange dreams about the baby. Last week I dreamed he was covered with hair." What should the nurse tell the client?
"It is not uncommon to have dreams about the baby, particularly in the third trimester."
A client who tells the nurse that they would like to use the basal body temperature method for family planning receives instructions about the method. Which client statement indicates to the nurse that the teaching has been successful?
"It's important to take my temperature at about the same time every morning before arising."
A nurse determines that a client is in false labor. After obtaining discharge orders, the nurse provides discharge teaching to the client. Which instruction is most appropriate at this time?
"Return to the facility if fever occurs."
A client is a long-distance runner and is 8 weeks pregnant with her first baby. The client tells the nurse that she would like to continue running throughout the pregnancy and asks the nurse if there are any safety risks. Which response by the nurse correctly identifies musculoskeletal changes in pregnancy that may be a safety risk to the client?
"The joints of the pelvis relax."
A primigravid client in preparation for a parenting class asks how much blood is lost during an uncomplicated vaginal birth. What should the nurse tell the client?
"The maximum blood loss considered within normal limits is 500 mL."
During routine prenatal screening, a nurse tells a client that her blood sample will be used for alpha fetoprotein (AFP) testing. Which statement best describes what AFP testing indicates?
"This test will screen for spina bifida, Down syndrome, or other genetic defects."
A pregnant client is experiencing a thin, odorless, vaginal discharge. What should the nurse instruct the client to do to prevent vaginal infections?
"Try wearing a panty liner and discarding it after every urination."
The prenatal client wants to know why the nurse is asking about their use of herbal supplements. What is the nurse's best response?
"Understanding the full picture of what herbal supplements you use to manage your health will help us better provide coordinated and safe care."
The nurse teaches a primigravid client at 10 weeks' gestation about the recommendations for exercise during pregnancy. Which client statement indicates successful teaching?
"While pregnant, I should avoid contact sports."
The nurse is providing prenatal education regarding microorganisms to be avoided during pregnancy. Which of the following statements during the counseling session would indicate to the nurse that the client understands the teaching?
"Women should avoid unpasteurized milk and cheese and undercooked meat."
A client is at an ideal weight when she conceives. During a prenatal visit 2 months later, the client asks the nurse how much weight she should gain during pregnancy. What is the nurse's best response?
"You should gain 25 to 35 lb (11.3 to 15.9 kg)."
A nurse on a medical-surgical unit is providing care to a 32-year-old female client at 28 weeks' gestation who is reporting increased fatigue and fever. Client was admitted via the emergency department (ED) with symptoms of increased fatigue, generalized weakness, weight loss, and night sweats. Client is single, never married, G3, T0, P2, A1, L2. They are currently at 28 weeks' gestation. Client states they have not received any prenatal care. Vital signs were obtained and an admission assessment completed.
-Assess viral load. -Anticipate chemotherapy. -acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) -complete blood cell (CBC) counts -intake and output
A nurse working on a labor and delivery unit is providing care to a 27-year-old female client who is G2P1. A call was received from the client, a 27-year-old female who is at 36 weeks' gestation, reporting painless vaginal bleeding that started as small spotting an hour ago but it has now become more constant and they have saturated 1 pad in the last hour. Client was instructed to go directly to the hospital labor and delivery unit for direct admission. Labor and delivery unit was informed of the client's direct admission. A 27-year-old female at 36 weeks' gestation is being directly admitted to the labor and delivery unit after reporting significant bright red vaginal bleeding that started as spotting this afternoon and now is a constant flow. Client denies uterine contractions, any leakage of fluid from their vagina, or being involved in any type of recent trauma. Client states that 6 weeks prior, after engaging in sexual intercourse they noticed some vaginal spotting. Ultrasonography was completed at that time, which demonstrated no abnormal findings. Vital signs: temperature, 99.1°F (37.3°C); heart rate, 100 beats/min; respiratory rate, 22 breaths/min; blood pressure, 90/64 mm Hg. Ox
-Obtain a complete blood cell (CBC) count. -Prepare the client for an ultrasound. -placenta previa -blood pressure -monitor fetal heart tones (FHT)
The nurse in a maternity unit is providing care to a 27-year-old G2P0 client who is at 7 weeks' gestation and reporting abdominal pain. A 27-year-old G2P0 client is at 7 weeks' gestation by their last menstrual period (LMP). Client had a positive pregnancy test (hCG) 2 days ago. Client had been taking oral contraceptives for the past 10 years, stopped 1 year ago when they decided to start a family. Client was directly admitted by their obstetrician for increasing abdominal pain. Client states they have been experiencing abdominal discomfort for the past few days but the pain has worsened today. Client denies any vaginal bleeding or discharge except for a week ago after intercourse. Client currently rates the pain at a level 6 out of 10 (on a scale of 0 = no pain to 10 = severe pain). Client reports feeling nauseated and vomited this morning and has had a poor appetite the last few days. Vital signs were obtained and charted. Focused physical assessment reveals a soft, slightly rounded abdomen; guarding of the abdomen on palpation; right lower quadrant pain with rebound tenderness; and normoactive bowel sounds. Client reports last bowel movement was yesterday; the stool was hard to pass.
-Obtain a stat complete blood cell (CBC) count. -Prepare for a stat computed tomography (CT) scan of the abdomen and pelvis. -appendicitis -white blood cell (WBC) count -pain level
A nurse in a telemetry unit is providing care to a 36-year-old female client who is at 28 weeks' gestation. Client was admitted to the telemetry unit after experiencing increasing shortness of breath and fatigue over the past 2 days. Client reports that shortness of breath occurs especially when trying to lie flat or with exertion. Client thought it was related to their pregnancy; client is at 28 weeks' gestation with their first child. Today the client experienced palpitations, dizziness, and some chest discomfort. Then, they passed out for a few seconds. Their spouse drove them to the emergency department (ED). Client's chest pain had subsided by the time they arrived at the ED. A 12-lead electrocardiogram (ECG) and cardiac enzymes were obtained and a myocardial infarction was ruled out but some abnormalities of the left ventricle were noted on the ECG. Client was admitted to the telemetry unit for further observation. A focused cardiac assessment revealed pulsus bisferiens, faint bibasilar crackles, harsh systolic murmur heard after S1 at the apex near the left sternal border, and a prominent "a" wave when the neck veins were evaluated. Pedal pulses are 2+ bilaterally, no edema is ob
-Prepare the client for echocardiography. -Request a prescription for a beta blocker medication. -hypertrophic cardiomyopathy -vital signs -lung sounds
When performing a vaginal examination on a pregnant client, the nurse determines the fetal head has reached the ischial spines. How would the nurse describe the station of the fetus at this time?
0 station
An adolescent primigravid client at 26 weeks' gestation has gained 25 lb (11.34 kg) since becoming pregnant. Which of the following is the recommended amount of weight gain during the third trimester?
1 lb (0.45 kg) per week.
A nurse is using Doppler ultrasound to assess a pregnant client. When should the nurse expect to begin hearing fetal heart tones?
11 weeks' gestation
At what gestational age should a primigravida expect to start feeling quickening?
18 to 20 weeks
During a health-teaching session, a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. Which answer should the nurse supply?
7 days after fertilization
A client diagnosed with gestational hypertension must have weekly blood pressure checks and urine testing at a clinic. She does not have transportation. How can the nurse help this client be compliant with her care?
Ask the clinic case manager to speak with the client.
A client is admitted for an amniocentesis. Initial assessment findings include 16 weeks' gestation, vital signs within normal limits, hemoglobin 12.2 g/dL (122 g/L), hematocrit 35% (0.35), and type O-negative blood. Which action would the nurse complete first after amniocentesis has been completed?
Assess fetal heart rate and compare to pre-procedure baseline.
A client who is 2 months' pregnant has become more introverted, stopping most social activities. What action would the nurse take upon learning this information?
Assess the client for depression using an approved depression screening tool.
When planning a class for primigravid clients about the common physiologic changes of pregnancy, the nurse should include which information in the teaching plan?
Cardiac output increases by 25% to 50% during pregnancy.
While assessing a multigravid client at 10 weeks' gestation, the nurse notes a purplish color to the vagina and cervix. The nurse documents this as what finding?
Chadwick's sign
During a visit to the prenatal clinic, a pregnant client at 32 weeks' gestation has heartburn. The client needs further instruction when they say they must do what to manage heartburn?
Consume liquids only between meals.
A nurse is caring for a client at 30 weeks' gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when the client says that she wants to breast-feed her neonate?
Discourage breast-feeding because HIV can be transmitted through breast milk.
During a visit to the clinic, a pregnant 25-year-old client who began prenatal care at 10 weeks' gestation and is now in the third trimester reports frequent constipation. Which suggestion by the nurse would be most helpful?
Eat at least four pieces of fruit daily.
Using Naegele's rule for a client whose last normal menstrual period began on May 10, the nurse determines that the client's estimated date of birth is what date?
February 17
A multigravid client at 36 weeks' gestation who is visiting the clinic for a routine visit begins to sob and tells the nurse, "My partner has been beating me up once in a while since I became pregnant, but I can't bring myself to leave them because I don't have a job and I don't know how I would take care of my other children." What is the priority action by the nurse at this time?
Help the client make concrete plans for the safety of the client and their children.
A primigravid adolescent client at approximately 15 weeks' gestation is visiting the prenatal clinic to undergo maternal quad screening. What information should the nurse include in the teaching plan for this client?
Increased levels of alpha-fetoprotein (AFP) are associated with neural tube defects.
A client is told that she needs to have a nonstress test to determine fetal well-being. After 20 minutes of monitoring, the nurse reviews the strip and finds two 15-beat accelerations that lasted for 15 seconds. What should the nurse do next?
Inform the physician and prepare for discharge; this client has a normal strip.
While assisting the physician with an amniocentesis on a multigravid client at 38 weeks' gestation, the nurse observes that the fluid is very cloudy and thick. The nurse interprets this finding as indicating which of the following?
Intrauterine infection.
A client who is 34 weeks pregnant is experiencing bleeding caused by placenta previa. The fetal heart sounds are normal and the client is not in labor. Which nursing intervention should the nurse perform?
Monitor the amount of vaginal blood loss.
After receiving large doses of an ovulatory stimulant such as menotropins, a client comes in for her office visit. Assessment reveals the following: 6-lb (3-kg) weight gain, ascites, and pedal edema. Based on this assessment, what should the nurse do next?
Notify the healthcare provider.
The nurse is assessing a pregnant client using Leopold's maneuvers. Which of the following nursing actions are appropriate for this assessment? Select all that apply.
Palpate the client's upper abdomen using both hands. Note the shape and consistency of the palpated part. Note the mobility of the palpated part.
The nurse is teaching a pregnant client about exercises that may be helpful during pregnancy. Which points should the nurse include in the instruction? Select all that apply.
Pelvic rocking may help relieve lower back pain. Abdominal breathing lifts the abdominal wall off of the uterus. Kegel exercises help improve vaginal contractility and bladder control.
Which instruction should a nurse include in a home-safety teaching plan for a pregnant client?
Place a nonskid mat on the floor of the tub or shower.
The nurse is working in the labor and birth unit when a client with active herpes simplex virus-Type 2 (HSV-2) appears in active labor. Which adjustment in the plan of care is anticipated?
Prepare the client for a cesarean section.
A primigravid client whose cervix is 7 cm dilated with the fetus at 0 station and in a left occiput posterior (LOP) position has severe back pain. Which intervention is most indicated?
Provide firm pressure to the client's sacral area.
A 26-week gestation pregnant woman has completed a 1-hour glucose screening test. What action should the nurse take first if the glucose level is 150 mg/dL (8.3 mmol/L)?
Refer the client for a 3-hour glucose test.
A client treated with terbutaline for premature labor is ready for discharge. Which instruction should the nurse include in the discharge teaching plan?
Report a heart rate greater than 120 beats/minute to the health care provider.
After a preparation for parenting class session, a pregnant client tells the nurse that she has had some yellow-gray frothy vaginal discharge and local itching. What is the best advice for the nurse to give the client?
Schedule an appointment at the clinic for an examination.
A nurse is caring for a client who is scheduled for amniocentesis. What will the nurse teach the client about this procedure?
She needs to empty her bladder prior to the procedure.
A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of the fetus. The client's BPP score is 8. What does this score indicate?
The fetus isn't in distress at this time.
During a physical examination, a client who is 32 weeks pregnant becomes pale, dizzy, and light-headed while supine. Which action should the nurse immediately take?
Turn the client on the left side.
Lower back pain is a common concern among pregnant clients. Which comfort measure should a nurse include in the teaching plan for a pregnant client?
Use an ergonomically correct desk chair.
The nurse on the antenatal unit is planning care for four clients. The nurse should assess which client first:
a 19-year-old 18 weeks' intrauterine pregnancy (IUP) who is now 12 hours post motor vehicle accident with bright red vaginal bleeding
A client at 15 weeks' gestation presents to the obstetrical triage unit with dark brown vaginal bleeding and continuous nausea and vomiting. The client's blood pressure is 142/98 mm Hg and the fundal height is 19 cm. Which prescription is most important for the nurse to request from the primary health care provider?
a stat ultrasound
Which outcome would the nurse identify as the priority to achieve when developing the plan of care for a primigravid client at 38 weeks' gestation who is hospitalized with severe preeclampsia and receiving intravenous magnesium sulfate?
absence of any seizure activity during the first 48 hours
A client at 7 weeks' gestation is being treated for a ruptured ectopic pregnancy in the emergency department. The client's vital signs are blood pressure 84/45 mmHg, heart rate 122 beats/min, respiratory rate 26 breaths/min, temperature 98.6°F (36.8°C). What is the nurse's priority?
administering fluid resuscitation and preparing the client for surgery
A primigravid client at 35 weeks gestation is scheduled for a biophysical profile. After instructing the client about the test, which client statement indicates effective teaching about what the test measures?
amniotic fluid volume
A client, 11 weeks pregnant, is admitted to the facility with hyperemesis gravidarum. The client tells the nurse she has never known anyone who had such severe morning sickness. The nurse understands that hyperemesis gravidarum results from:
an unknown cause.
A pregnant client states that they frequently ingest laundry starch. The nurse should assess the client for which condition?
anemia
During a nonstress test (NST), the electronic tracing displays a relatively flat line for fetal movement, making it difficult to evaluate the fetal heart rate (FHR). To mark the strip, a nurse should instruct the client to push the control button at which time?
at the beginning of each fetal movement
Examination of a primigravid client having increased vaginal secretions since becoming pregnant reveals clear, highly acidic vaginal secretions. The client denies any perineal itching or burning. The nurse interprets these findings as a response related to which factor?
control of the growth of pathologic bacteria
A pregnant client comes to the facility for her first prenatal visit. When providing teaching, the nurse should be sure to cover which topic?
danger signs during pregnancy
A client's membranes rupture during the 36th week of pregnancy. Eighteen hours later, the nurse measures the client's temperature at 101.8° F (38.8° C). After initiating ordered antibiotic therapy, the nurse should prepare the client for:
delivery
On arrival at the emergency department, a client tells the nurse that they suspect they may be pregnant and they been experiencing a small amount of bleeding and severe pain in the lower abdomen. The client's blood pressure is 70/50 mm Hg, and the pulse rate is 120 bpm. The nurse notifies the primary health care provider (HCP) immediately because of the possibility of which complication?
ectopic pregnancy
When evaluating a pregnant client's fundal height, the nurse should measure in which way?
from the symphysis pubis notch to the highest level of the fundus
A dilatation and curettage (D&C) is scheduled for a primigravid client admitted to the hospital at 10 weeks' gestation with abdominal cramping, bright red vaginal spotting, and passage of some of the products of conception. The nurse should assess the client further for the expression of which feeling?
guilt
A primigravid client at 8 weeks' gestation tells the nurse that since having had sexual relations with a new partner 2 weeks ago, the client has noticed flu-like symptoms, enlarged lymph nodes, and clusters of vesicles on their vagina. The nurse refers the client to a primary health care provider (HCP) because the nurse suspects which sexually transmitted infection?
herpes genitalis
A primigravid client visits the clinic at 12 weeks' gestation and tells the nurse that they have a cold and their nose is stuffy. The client tests negative for COVID-19. The nurse should instruct the client to treat the nasal stuffiness by using which approach?
herpes genitalis
The topic of physiologic changes that occur during pregnancy is to be included in a parenting class for primigravid clients who are in their first half of pregnancy. Which topic would be important for the nurse to include in the teaching plan?
increased risk for urinary tract infections
Which medication is considered safe during pregnancy?
insulin
A pregnant client with diabetes mellitus is at risk for having a large-for-gestational-age neonate because:
insulin acts as a growth hormone on the fetus.
A client is in the eighth month of pregnancy. To enhance cardiac output and renal function, the nurse should advise the client to use which body position?
left lateral
A nurse is assessing a client who's 29 weeks pregnant. What is the most cost-effective method for assessing fetal well-being?
maternal fetal activity count
A client at 6-weeks' gestation comes to the emergency department, and a transvaginal ultrasound confirms ectopic pregnancy with the tube intact. The client will be treated medically. What medication will the nurse prepare to administer to this client?
methotrexate
A primigravida, currently about 8 weeks' gestation, and their spouse ask when they should begin the preparation for birth classes that discuss maternal nutrition during pregnancy. Which time would be most appropriate for the nurse to suggest that they begin the classes?
now during the first trimester of pregnancy
The nurse is caring for a 38-year-old primigravida in the third trimester of pregnancy. The nurse plans to assess the client for manifestations of which complication?
preeclampsia
A client who is 14 weeks pregnant states, "Ever since I've been pregnant, I've had a hard time moving my bowels." Increased levels of what hormone are responsible for this common discomfort of pregnancy?
progesterone
A 32-year-old multigravida client returns to the clinic for a routine prenatal visit at 36 weeks' gestation. The assessments during this visit include blood pressure, 140/90 mm Hg; pulse, 80 beats/min; and respiratory rate, 16 breaths/min. What further information should the nurse obtain to determine if this client is becoming preeclamptic?
proteinuria
A primigravid client at 26 weeks' gestation visits the clinic and tells the nurse that her lower back aches when she arrives home from work. The nurse should suggest that the client perform which exercise?
tailor sitting
A 20-year-old client visiting the clinic requests the use of oral contraceptives. When reviewing the client's history, which finding would alert the nurse to a possible contraindication to using these agents?
thrombophlebitis
A primigravid client with diabetes at 38 weeks' gestation asks the nurse why she had a fetal acoustic stimulation during her last nonstress test. Which should the nurse include as the rationale for this test?
to startle and awaken the fetus
A client at 36 weeks' gestation with type 1 diabetes has an abnormal biophysical profile and is scheduled for a contraction stress test. After explaining the purpose of the test, the nurse determines that the client understands the instruction when they state that the test is done to detect which problem?
uteroplacental sufficiency
