Women's Health - Antepartum
When planning care for a woman with gestational hypertension (GH), the nurse plans to encourage which maternal behavior?
Expression of hope for a positive outcome
The nurse is preparing to teach a pregnant client about the warning signs in pregnancy and prepares a list of the warning signs that indicate the need to notify the health care provider. Which warning signs would the nurse place on the list? Select all that apply.
Facial edema Rapid weight gain Visual disturbances Generalized edema
The nurse is collecting data from a pregnant client with a history of cardiac disease. The nurse is checking for venous congestion. The nurse inspects which area, knowing that venous congestion is most commonly noted where?
Vulva
A client is a gravida IV, para III in her final trimester of pregnancy. She does not attend usual social functions because of the fear of stress incontinence. Her oldest child is in a school play, which she wants to attend. Which measure is appropriate to suggest to the client?
Wear a perineal pad to the play.
A client is seen in the health care clinic for complaints of vaginal bleeding and mild abdominal cramping. On further data collection, the nurse notes that the client's last menstrual period was 10 weeks ago. The client reports that a home pregnancy test was performed and the results were positive. On physical examination, it is noted that the client has a dilated cervix. The nurse understands that the client is at risk for which type of abortion?
Inevitable
The nurse is assisting in conducting a prepared childbirth class and is instructing pregnant women about the method of effleurage. The nurse instructs the women to perform the procedure by taking which action?
Massaging the abdomen during contractions using both hands in a circular motion
The nurse encourages the childbearing woman diagnosed with human immunodeficiency virus (HIV) to avoid alcohol and cigarettes during pregnancy and to obtain adequate rest. Which outcome is specific to this client?
Minimize the potential for developing infections.
The nurse is providing information to a pregnant woman about food items high in folic acid. Which mid-afternoon snack should be recommended to supply folic acid?
Nuts and green, leafy vegetables
The nurse is teaching a pregnant client how to perform Kegel exercises. The nurse should tell the client that these exercises are for which purpose?
Strengthen the pelvic floor in preparation for delivery.
A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse would determine whether this method of family planning would be appropriate?
"Do you plan to have any other children?"
A perinatal client with a history of heart disease has been instructed on care at home. Which statement made by the client would indicate the need for further teaching?
"It is best to rest on my right side."
A client is scheduled for an amniocentesis and tells the nurse, "I'm not sure I should have this test done." Which response by the nurse is appropriate?
"Tell me what concerns you have."
Which statement by a pregnant client who is human immunodeficiency (HIV) positive indicates her understanding of the risk to her newborn during delivery?
"There is a risk of transmission from HIV-positive mothers to their newborn, although the newborn may be asymptomatic at birth."
The nurse is preparing a pregnant client for a transvaginal ultrasound exam. The nurse should tell the client that which will occur?
The client will feel some pressure when the vaginal probe is moved.
A nurse is monitoring a pregnant client for the warning signs/symptoms of gestational hypertension. Which are signs/symptoms of this complication of pregnancy? Select all that apply.
Edema Proteinuria Thrombocytopenia
A pregnant client is positive for the human immunodeficiency virus (HIV). Based on this information, the nurse makes which determination?
HIV antibodies are detected on the enzyme-linked immunosorbent assay (ELISA) test.
The nurse is assisting in developing a teaching plan for a pregnant client with diabetes mellitus. Which instruction is the priority for this client?
How to check for signs of hypoglycemia and the required treatment
The nurse is teaching a pregnant client about the physiological effects and hormone changes that occur in pregnancy. The client asks the nurse about the purpose of estrogen. Which description characterizes the purpose of estrogen?
Estrogen stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.
A pregnant woman in the second trimester of pregnancy complains of constipation and describes the home care measures she is taking to relieve the problem. Which should the nurse determine is a harmful measure in preventing constipation?
Adding 1 tablespoon of mineral oil to a bowl of cereal daily
The nurse is working with a pregnant client regarding how to identify the existence of preterm contractions. The nurse plans to use which strategy as an effective teaching method?
Palpate for uterine contractions at the same time as the client.
The nurse caring for a client with abruptio placentae is monitoring the client for signs of disseminated intravascular coagulopathy (DIC). The nurse would suspect DIC if which is observed?
Petechiae, oozing from injection sites, and hematuria
A client at 32 weeks of gestation with a diagnosis of severe preeclampsia is admitted to the maternity department. The client is alone and appears very anxious. Which statement by the nurse is therapeutic?
"Tell me about your concerns."
The perinatal client is admitted to the obstetric unit during an exacerbation of a heart condition. When planning for the nutritional requirements of the client, the nurse should consult with the dietitian to ensure which dietary measure?
A diet that is high in fluids and fiber to decrease constipation
The nurse is collecting data from a prenatal client. The nurse determines that which places the client in the high-risk category for contracting human immunodeficiency virus (HIV)?
A history of intravenous (IV) drug use in the past year
A 23-year-old client develops melasma during pregnancy. The nurse notes that the client has started wearing very heavy makeup. The client tells the nurse that she is fearful that her mate will reject her and that she has decreased her social engagements drastically because of this change. The nurse determines that the client is experiencing which problem?
Concern about her appearance
A client asks the nurse to describe how her baby is developing. The nurse bases the response on the knowledge that every organ system in the fetus is present by the end of which gestational week?
Eighth
A primigravida client comes to the clinic and has been diagnosed with a urinary tract infection. She has repeatedly verbalized concern regarding safety of the fetus. Which client problem does the nurse identify as important at this time?
Fear about the safety of the fetus
A primipara is being evaluated in the clinic during her second trimester of pregnancy. Which indicates an abnormal physical finding that necessitates further testing?
Fetal heart rate of 180 beats per minute
The nurse is providing emotional support to a client who experienced a spontaneous abortion. The nurse can best assist the client by planning care that focuses on which psychosocial issue?
The feelings of guilt that is often associated with grief
The nurse is assessing a client who is at 32 weeks of gestation. It has been 4 weeks since her last visit. Which assessment needs to be reported to the health care provider?
Fundal height, 38 cm
The nurse is collecting data from a client who is pregnant with triplets. The client also has a 3-year-old child who was born at 39 weeks' gestation. The nurse should document which gravida and para status on this client?
Gravida II, para I
A client calls the health care provider's office to schedule an appointment because a home pregnancy test was performed and the results were positive. The nurse determines that the home pregnancy test identified the presence of which in the urine?
Human chorionic gonadotropin (hCG)
The nurse is collecting data on a pregnant client and is preparing to take the client's blood pressure. Which position should the nurse place the client in?
In a sitting position
The nurse-midwife is conducting a session on the process of fertilization with a group of nursing students. The nurse-midwife asks a student to identify the structure where fertilization of an ovum takes place. Which identified by the student indicates an understanding of this process?
In the fallopian tube
The nurse is gathering data from a prenatal client with heart disease. The nurse carefully evaluates vital signs, monitors for weight gain, and checks the fluid and nutritional status. For which complication is the nurse collecting data?
Increase in circulating volume
The client is in her second trimester of pregnancy. She complains of frequent low back pain and ankle edema at the end of the day. The nurse should recommend which measure to help relieve both discomforts?
Lie on the floor with the legs elevated onto a couch or padded chair, with the hips and knees at a right angle.
The nurse is collecting data from a client who is pregnant with twins. The nurse understands that which complication is associated with a twin pregnancy?
Maternal anemia
The nurse assigned to care for a client with mild preeclampsia should anticipate which specific nursing intervention for this client?
Monitoring fetal movement
The nurse is assisting a client who, at 38 weeks of gestation, reports feeling dizzy, lightheaded, and nauseated when attempting to lie down on the examining table. Her skin is pale and is both cool and moist to the touch. Which action should the nurse perform first?
Place a wedge pillow under the client's right side.
A pregnant woman who is at 38 weeks gestation arrives at the emergency department. She reports the presence of bright red vaginal bleeding and denies the presence of any pain. Based on this information, what does the nurse determine the client may be experiencing?
Placenta previa
The nurse is assisting with care for a pregnant client in labor who will be delivering twins. The nurse prepares to monitor the fetal heart rates by performing which?
Placing external fetal monitors so that each fetal heart rate is monitored separately
The nurse is assisting in conducting a prenatal session with a group of expectant parents. The nurse tells the parents that which hormone primarily stimulates the secretion of milk?
Prolactin
The nurse is planning interventions for counseling a maternity client newly diagnosed with sickle cell anemia. The nurse understands that the important psychosocial intervention at this time would be which action?
Provide emotional support.
The clinic nurse is planning care to meet the emotional needs of a pregnant woman. Which nursing intervention would least likely assist in meeting emotional needs?
Providing the mother with pamphlets and booklets to read about the pregnancy
The nurse is assisting in planning care to meet the emotional needs of a pregnant woman. Which nursing intervention would be least likely to assist in meeting her emotional needs?
Providing the mother with pamphlets and booklets to read about the pregnancy
The nurse assists a pregnant client with cardiac disease in identifying resources to help her care for her 18-month-old child during the last trimester of pregnancy. The nurse encourages the pregnant client to use these resources primarily to accomplish which?
Reduce excessive maternal stress and fatigue.
A client who consumes alcohol frequently is in the first trimester of pregnancy. Which is the expected outcome when the nurse initiates interventions to assist the client to cease alcohol consumption?
Reducing the risk of teratogenic effects to developing fetal organs, tissues, and structures
During the antenatal period of a client diagnosed with the human immunodeficiency virus (HIV), the nurse result of her rubella screening is positive. routinely and discusses the findings. Which is the primary purpose of this action?
To identify appropriate fetal development
The nurse is preparing to monitor a fetal heart rate. The nurse knows that the fetal heart rate can first be heard with a fetoscope at which gestational week?
Week 20
A nursing instructor instructs the nursing students that surfactant is a substance needed to facilitate neonatal breathing. The instructor asks a nursing student to identify when this substance begins to be produced. The nursing student responds correctly by stating that this substance is produced at approximately which gestational week?
Week 28
The nurse is gathering data from a pregnant client about physiological risk factors. The nurse should be sure to obtain which priority data?
Weight and height
A pregnant client is anxious to know the gender of the fetus and asks the nurse when she will be able to know. The nurse responds by telling the client that the gender of the fetus can usually be determined by which range of weeks?
12 to 16
A pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. She also wants to know when she can hear the fetus's heartbeat with a fetoscope rather than a Doppler. During which time frame will the client both hear the heartbeat with a fetoscope and feel the fetus move?
16 and 20 weeks of gestation
A pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. The nurse responds by telling the mother that fetal movements will be noted between which weeks of gestation?
16 and 20 weeks' gestation
The nurse is assisting in planning care for a client with a diagnosis of placenta previa. The nurse identifies which as the priority goal for the client?
The client exhibits no signs of fetal distress.
The nurse is providing information about health care to a pregnant client who is positive for human immunodeficiency virus (HIV). What is the primary reason to avoid alcohol and cigarettes during pregnancy and to get adequate rest?
To avoid further stress on the maternal immune system
A young pregnant woman with diabetes mellitus has lost 10 pounds during the first 15 weeks of gestation. The client tells the nurse, "I do not eat regular meals." Based on the client's statement, which is the best response by the nurse?
"Can you tell me more about what you are eating?"
A pregnant client in the second trimester of pregnancy is admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding should the nurse expect to note if this condition is present?
Abdominal pain
The nurse is gathering data from a 16-year-old pregnant client during her initial prenatal clinic visit. The client is beginning week 18 of her first pregnancy. Which client statement indicates a need for further investigation?
"I don't like my face anymore. I always look like I have been crying."
The nurse is assigned to care for a pregnant client with a diagnosis of sickle cell anemia. The nurse plans care, knowing that which problem should receive highest priority?
Dehydration
A nursing student prepares a teaching plan for a pregnant client newly diagnosed with diabetes mellitus. The nursing instructor suggests changing the plan if the student includes which information?
To avoid exercise because of the negative effects on insulin production
The nurse is collecting data from a pregnant client when the client asks the nurse about the purpose of the fallopian tubes. Which is the accurate response the nurse should make?
Are where fertilization occurs
A perinatal client is at risk for toxoplasmosis. Which instruction should the nurse reinforce with the client to prevent exposure to this disease?
Avoid exposure to litter boxes used by cats.
The nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse notes that the health care provider has documented the presence of Goodell's sign. The nurse determines that this sign is indicative of which?
A softening of the cervix
The nurse is caring for a client experiencing a partial placental abruption. The client is uncooperative and is refusing any interventions until her husband arrives at the hospital. The nurse analyzes the client's behavior as likely the result of which situation?
Acute anxiety and the need for support
The nurse is caring for a pregnant client who was diagnosed with acquired immunodeficiency syndrome (AIDS) and asks the nurse if she will be able to breast-feed the infant after delivery. Which response by the nurse is appropriate?
"Breast-feeding is contraindicated."
During a routine prenatal visit, a client complains of gingivitis and gums that bleed easily with brushing. When assisting to plan the care for the client, the nurse includes a goal that addresses proper nutrition to minimize this problem. The nurse determines that the goal has been achieved when the client makes which statement?
"I am eating fresh fruits and vegetables for snacks and for dessert each day."
A client is pregnant, has a history of heart disease, and has been instructed on care at home. Which statement by the client would indicate that she understands her needs?
"I should avoid stressful situations."
A pregnant woman reports that she has just finished taking the prescribed antibiotics to treat a urinary tract infection. The mother expresses concern that her baby will be born with an infection. Which response should the nurse make to help reduce the maternal fears that the newborn will be born with an infection?
"Now that you have taken the medication as prescribed, we will continue to monitor you closely by repeating the urine culture before you leave today."
A pregnant anemic client is concerned about her baby's condition following delivery. Which nursing response would best support the client?
"The effects of anemia on your baby are difficult to predict, but let's review your plan of care to ensure you are providing the best nutrition and growth potential."
A pregnant woman in her second trimester calls the prenatal clinic nurse to report a recent exposure to a child with rubella. Which response by the nurse would be appropriate?
"You were wise to call. I will check your rubella titer screening results, and we can identify immediately if interventions are needed."
A pregnant client is seen in the health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions, and the nurse determines that the client is experiencing Braxton Hicks contractions. Which nursing action should the nurse take?
Instruct the client that these are common and may occur throughout the pregnancy.
A prenatal client has acquired the sexually transmitted infection, condyloma acuminatum (human papillomavirus). When assisting in planning care, which treatment should the nurse consider to be safe for this client?
Laser Therapy
The nurse is collecting data on a client with severe preeclampsia. Which signs and symptoms would be noted in severe preeclampsia? Select all that apply.
Oliguria Proteinuria 3+ Blood pressure 168/116 mm Hg
The nurse is reviewing the health history of a pregnant client. Which data noted in the client's health history would indicate a risk for spontaneous abortion?
Syphilis
The pregnant woman complains of being awakened frequently by leg cramps. The nurse reinforces instructions to the client's partner and should tell the client to perform which measure?
Dorsiflex the client's foot while extending the knee.
The nurse is providing instructions to a pregnant client with genital herpes about the measures that need to be implemented to protect the fetus. Which instruction should the nurse provide to the client?
A cesarean section will be necessary if vaginal lesions are present at the time of labor.
A nonstress test is performed on a client, and the results are documented in the chart. The results are documented as a reactive nonstress test. Which interpretation should the nurse make of these results?
A negative test
A client asks the nurse to describe how her developing baby will get enough blood and oxygen. The nurse responds that the fetal circulatory system accomplishes this task by which means? Select all that apply.
Bypassing the fetal lungs to circulate oxygen rich blood Using the fetus's beating heart to pump blood in the circulatory system Carrying more oxygen on fetal hemoglobin than maternal hemoglobin Making the fetal cardiac output higher per unit of body weight than the maternal cardiac output
A client who is pregnant will be treated by a dermatologist for acne. The nurse understands that which treatment for acne should be avoided with this client?
Oral tetracycline hydrochloride
A pregnant client asks the nurse about the hormone that stimulates postpartum contractions. The nurse tells the client that the primary hormone that stimulates postpartum contractions is which?
Oxytocin
The nurse is instructing a pregnant client in her first trimester about nutrition. The nurse should correct which misunderstanding on the part of the client about nutrition during pregnancy?
Pregnancy greatly increases the risk of malnourishment for the mother.
The nurse is collecting data from a client on her first prenatal visit. Which factor indicates that the client is at risk for developing gestational diabetes during this pregnancy?
She has a history of chronic hypertension.
A pregnant client asks the nurse about the type of exercises that are allowable during the pregnancy. The nurse should instruct the client that which is the safest exercise in which to engage?
Swimming
The nurse is preparing a 36-year-old gravida II, para I pregnant client for an amniocentesis. She is at 16 weeks of gestation. Which action should the nurse take before the procedure to ensure fetal safety?
Test the ultrasound equipment to ensure proper functioning.
The nurse is discussing prenatal testing with a woman who is approximately 6 weeks pregnant and shares that which tests are expected to be conducted during the first trimester? Select all that apply.
Urinalysis Rubella titer Complete blood count
A hepatitis B screen is performed on a pregnant client, and the results indicate the presence of antigens in the maternal blood. Which does the nurse anticipate to be prescribed?
Administration of immune globulin and vaccine in the infant soon after birth
The nurse instructs a pregnant client diagnosed with human immunodeficiency virus (HIV) to report immediately to the health care provider any early signs of vaginal discharge or perineal tenderness. Which is the primary expected outcome for this intervention?
Assists in identifying infections that may need to be treated
The nurse is providing health care information to a pregnant client who is human immunodeficiency virus (HIV) positive. The nurse instructs the client that it is important to avoid alcohol and cigarettes during pregnancy and to get adequate rest primarily to accomplish which goal?
Avoid further stress on the maternal immune system.
The nurse is assisting in caring for a client who has a placenta previa. The nurse understands that a cervical examination should not be performed on the client primarily because it could do which?
Cause hemorrhage.
The nurse is reinforcing a teaching session to a group of adolescent pregnant clients and is discussing the importance of nutrition. The nurse includes which information in the discussion?
Describing the appropriate amount of weight gain required during the pregnancy
The nurse is collecting data on a pregnant client in her twenty-second week. The nurse prepares to use a fetoscope to auscultate the fetal heart rate. The nurse hears a fetal heart rate of 115 beats per minute. Which action should the nurse take?
Document the assessment.
The nurse is assessing a client during a prenatal visit. The nurse takes the client's temperature and notes that the temperature is 99.2° F. Which nursing action is appropriate?
Document the temperature.
The nurse working in a prenatal clinic receives a telephone call from a client at 22 weeks of gestation. The client reports some vaginal discharge and has started to experience menstrual-like cramps and diarrhea. Which responses by the nurse indicate a understanding of the implications of the client's symptoms? Select all that apply.
-"Lie on your left side for an hour and try to drink some fluids." -"It is important that you urinate frequently to keep your bladder empty." -"Palpate for contractions and call back if there are more than four contractions in the next hour." -"Can you identify what you ate and drank, what medications you took, and your activity during the past 24 hours?"
The nurse collects data from a pregnant client diagnosed with iron deficiency anemia during her third trimester for additional risk factors associated with the anemia. Which finding would support potential further maternal compromise?
Vaginal spotting twice since the last prenatal visit
The nurse is reviewing the record of a pregnant client and notes that the health care provider has documented the presence of Chadwick's sign. The nurse determines that which hormone responsible for the development of this sign?
Estrogen
The nurse is collecting data from a client who suspects she is pregnant. The nurse is checking the client for probable signs of pregnancy. Which are the probable signs of pregnancy that the nurse should note? Select all that apply.
Ballottement Chadwick's sign Uterine enlargement Braxton Hicks contractions
The nurse in the prenatal clinic is collecting data regarding the client's nutritional knowledge. The nurse determines that the client understands the food items that are high in folic acid when the client states that she will be sure to eat which food item?
Beans
A licensed practical nurse (LPN) is assisting in the care of a client in preterm labor who is being started on intravenous magnesium sulfate to stop the contractions. The LPN checks to see that which is available on the unit as an antidote to magnesium sulfate?
Calcium gluconate
In the prenatal clinic, the nurse is gathering data from a new client for the health history information. Which action is the best way for the nurse to elicit correct responses to questions that refer to sexually transmitted infections?
Establish a therapeutic relationship between the nurse and pregnant client.
