A client is at her ideal weight when she conceives. During a prenatal visit 2 months later, she asks the nurse how much weight she should gain during pregnancy. What is the nurse's best response? A. "You should gain less than 10 lb." B. "You should gain 10 to 15 lb." C. "You should gain 16 to 24 lb." D. "You should gain 24 to 32 lb." Rationale: For a client entering pregnancy in her ideal weight range, a gain of 24 to 32 lb (11 to 15 kg) is adequate to meet her needs and the needs of her fetus. Weight gain below the recommended range predisposes the client to complications during pregnancy, labor, and delivery. The nurse is providing care for a pregnant woman. The woman asks the nurse how she can best deal with her fatigue. The nurse should instruct her to: A. take sleeping pills for a restful night's sleep B. try to get more rest by going to bed earlier. C. take her prenatal vitamins. D. tell her not to worry because the fatigue will go away soon. Rationale: She should listen to the body's way of telling her that she needs more rest and try going to bed earlier. Sleeping pills shouldn't be consumed prenatally because they can harm the fetus. Vitamins won't take away fatigue. False reassurance is inappropriate and doesn't help her deal with fatigue now. A client is scheduled for amniocentesis. When preparing her for the procedure, the nurse should do which of the following? A. Ask her to void. B. Instruct her to drink 1 L of fluid. C. Prepare her for I.V. anesthesia. D. Place her on her left side Rationale: To prepare a client for amniocentesis, the nurse should ask her to empty her bladder to reduce the risk of bladder perforation. Before transabdominal ultrasound, the nurse may instruct the client to drink 1 L of fluid to fill the bladder (unless ultrasound is done before
amniocentesis to locate the placenta). I.V. anesthesia isn't given for amniocentesis. The client should be supine during the procedure; afterward, she should be placed on her left side to avoid supine hypotension, promote venous return, and ensure adequate cardiac output. When assessing a pregnant client with diabetes mellitus, the nurse stays alert for signs and symptoms of a vaginal or urinary tract infection (UTI). Which condition makes this client more susceptible to such infections? A. Electrolyte imbalances B. Decreased insulin needs C. Hypoglycemia D. Glycosuria Rationale: Glycosuria predisposes the pregnant diabetic client to vaginal infections (especially Candida vaginitis) and UTIs, because the hormonal changes of pregnancy affect vaginal pH and the bladder. Electrolyte imbalances and hypoglycemia aren't associated with vaginal infections or UTIs. Insulin requirements may decrease in early pregnancy; however, as the client's food intake improves and maternal and fetal glycogen stores increase, insulin requirements also rise. After developing severe hydramnios, a primigravid client exhibits dyspnea, along with edema of the legs and vulva. Which procedure should the nurse expect her to undergo and why? A. Artificial rupture of the membranes to reduce uterine pressure B. Amniocentesis to temporarily relieve discomfort C. I.V. oxytocin administration to induce labor D. Cesarean delivery to prevent further fetal damage Rationale: A client with hydramnios may undergo amniocentesis to relieve discomfort. However, because fluid production continues, the relief is temporary. Artificial rupture of the membranes, I.V. oxytocin administration, or cesarean delivery wouldn't relieve hydramnios. A client who's 2 months pregnant complains of urinary frequency and says she gets up several times at night to go to the bathroom. She denies other urinary symptoms. How should the nurse intervene? A. Advise the client to decrease her daily fluid intake.
B. Refer the client to a urologist for further investigation. C. Explain that urinary frequency isn't a sign of urinary tract infection (UTI). D. Explain that urinary frequency is expected during the first trimester Rationale: Urinary frequency is expected during the first trimester as the growing uterus exerts pressure on the client's bladder. Although the client should increase fluid intake during pregnancy, she should avoid drinking fluids after 6 p.m. to reduce the need to get up at night. Because urinary frequency is a normal discomfort of pregnancy and the client has no other signs or symptoms of UTI, referral to a urologist is unnecessary. Urinary frequency, dysuria, and voiding of small amounts of urine indicate UTI. A client in the 13th week of pregnancy develops hyperemesis gravidarum. Which laboratory finding indicates the need for intervention? A. Urine specific gravity 1.010 B. Serum potassium 4 mEq/L C. Serum sodium 140 mEq/L D. Ketones in urine Rationale: Ketones in the urine of a client with hyperemesis gravidarum indicate that the body is breaking down stores of fat and protein to provide for growth needs. The other laboratory values listed are all within normal limits. Which findings would be considered positive signs of pregnancy? A. Fatigue and skin changes B. Quickening and breast enlargement C. Fetal heartbeat and fetal movement on palpation D. Abdominal enlargement and Braxton Hicks contractions Rationale: Fetal heartbeat and fetal movement on palpation are considered positive signs of pregnancy because they can't be caused by any other condition. Fatigue can be caused by chronic illness or anemia. Skin changes can result from cardiopulmonary disorders, estrogenprogesterone oral contraceptives, obesity, or a pelvic tumor. Excessive flatus or increased peristalsis can cause the perception of quickening. Breast changes can be related to hyperprolactinemia induced by tranquilizers,
infection, prolactin-secreting pituitary tumor, pseudocyesis, or premenstrual syndrome. Abdominal enlargement can result from ascites, obesity, or uterine or pelvic tumor, and the perception of Braxton Hicks contractions can result from hematometra or a uterine tumor. A client is admitted to the facility in preterm labor. To halt her uterine contractions, the nurse expects the physician to prescribe: A. betamethasone (Celestone). B. dinoprostone (Prepidil). C. ergonovine (Ergotrate Maleate). D. ritodrine (Yutopar). Rationale: Ritodrine, a beta-receptor agonist, is approved by the Food and Drug Administration for inhibition of preterm uterine contractions. Betamethasone is used to accelerate surfactant production in preterm labor. Dinoprostone is used to induce fetal expulsion and promote cervical dilation and softening. Ergonovine maleate is used to impede uterine blood flow - for example, in hemorrhage. A client has just expelled a hydatidiform mole. She's visibly upset over the loss and wants to know when she can try to become pregnant again. Which of the following would be the nurse's best response? A. "I can see you're upset. Why don't we discuss this with you at a later time when you're feeling better." B. "I can see that you're upset; however, you must wait at least 1 year before becoming pregnant again." C. "Let me check with your physician and get you something that will help you relax." D. "Pregnancy should be avoided until all of your testing is normal." Rationale: Clients who develop a hydatidiform mole must be instructed to wait at least 1 year before attempting another pregnancy, despite testing that shows they have returned to normal. A hydatidiform mole is a precursor to cancer, so the client must be monitored carefully for 12 months by an experienced health care provider. Discussing this situation at a later time and checking with the physician to give the client something to relax ignore the client's immediate concerns. Saying to wait until all tests are normal is vague and provides the client with little information. During a routine prenatal visit, a pregnant client reports heartburn. To minimize her discomfort, the
nurse should include which suggestion in the plan of care? A. Eat small, frequent meals. B. Limit fluid intake sharply. C. Drink more citrus juice. D. Take sodium bicarbonate. Rationale: To relieve heartburn, the nurse should advise a pregnant client to eat smaller meals at shorter intervals; drink six to eight 8-oz glasses of fluid daily to minimize regurgitation and reflux of stomach contents; and avoid citrus juice, which may act as a gastric irritant and worsen heartburn, and sodium bicarbonate, which may disrupt the body's sodium-potassium balance.
it. D. Warm milk to room temperature before adding lactase replacement tablets.
Rationale: A client with lactose intolerance must take lactase replacement drops or tablets whenever milk or a milk product is consumed. The drops must be added to a carton of milk at least 24 hours before the milk is consumed to ensure proper action. Lactase replacement drops and tablets are available without a prescription. Milk need not be warmed to room temperature before adding lactase replacement products. After an amniotomy, which client goal should take the highest priority? A. The client will express increased knowledge about amniotomy. B. The client will maintain adequate fetal tissue perfusion C. The client will display no signs of infection. D. The client will report relief of pain. Rationale: Amniotomy increases the risk of umbilical cord prolapse, which would impair the fetal blood supply and tissue perfusion. Because the fetus's life depends on the oxygen carried by that blood, maintaining fetal tissue perfusion takes priority over goals related to increased knowledge, infection prevention, and pain relief. A client calls to schedule a pregnancy test. The nurse knows that most pregnancy tests measure which hormone? A. Human chorionic gonadotropin (hCG) B. Human placental lactogen C. Human chorionic thyrotropin D. Estradiol Rationale: Widely used pregnancy tests detect hCG in the blood and urine by immunologic tests specific for the beta subunit of hCG. Human placental lactogen, human chorionic thyrotropin, and estradiol are hormones produced by the placenta; however, they aren't used to detect pregnancy. During the first 3 months, which of the following hormones is responsible for maintaining pregnancy? A. Human chorionic gonadotropin (HCG) B. Progesterone
During a prenatal visit, a pregnant client with cardiac disease and slight functional limitations reports increased fatigue. To help combat this problem, the nurse should advise her to: A. eat three well-balanced meals per day. B. exercise 1 hour before each meal. C. take a vitamin and mineral supplement D. divide daily food intake into five or six meals. Rationale: To combat fatigue, the nurse should advise the client to divide her daily food intake into five or six meals eaten throughout the day to minimize the energy expenditure associated with consuming three larger meals. Exercising before meals would increase fatigue, interfering with the client's nutritional intake. Vitamin and mineral supplements are appropriate for anyone, not specifically pregnant clients, and have little effect on fatigue. A client, 8 weeks pregnant, has a history of lactose intolerance. To prevent a nutritional deficiency as a result of lactose intolerance, the nurse teaches her about lactase replacement. Which teaching point is appropriate? A. Add lactase replacement drops to milk immediately before drinking it. B. Ask the physician for a lactase prescription that allows unlimited refills. C. Add lactase replacement drops to milk at least 24 hours before drinking
This position may trigger heart palpitations. the fetus isn't developed enough for the woman to detect movement. This position may cause gastroesophageal reflux D. Down syndrome results from a chromosomal disorder. Learning disability Rationale: Maternal alcohol use during pregnancy may cause fetal and neonatal central nervous system deficits such as learning disabilities. coping with body image and sexuality changes. A nurse is obtaining a medication history from a client who suspects she's pregnant.
. Coping with common discomforts and changes D. the client should avoid the supine position because it allows the gravid uterus to compress veins. Relaxin is an ovarian hormone that causes the mother to feel tired. a pregnant client admits she sometimes has several glasses of wine with dinner. This position promotes pregnancy-induced hypertension (PIH). blocking blood flow to the fetus. It also may lead to characteristic physical anomalies and growth retardation. The nurse is discussing posture with a client who's 18 weeks pregnant. Alcohol addiction B. the mother copes with the common discomforts and changes. Serial HCG levels are used to determine the status of the pregnancy in clients with complications.C. 2nd week C. During the first trimester. 8th week Rationale: Placental transport of substances to and from the fetus begins in the 5th week. Rationale: After the 4th month of pregnancy. Relaxin Rationale: HCG is the hormone responsible for maintaining the pregnancy until the placenta is in place and functioning. Estrogen D. C. psychosocial tasks include mother-image development. Between 16 and 20 weeks' gestation C. a key psychosocial task is to overcome fears the woman may have about the unknown. Down syndrome D. Anencephaly C. Between 10 and 12 weeks' gestation B. Anencephaly occurs when the cranial end of the neural tube fails to fuse before the 26th day of gestation. Before 16 weeks. Maternal alcohol use doesn't cause alcohol addiction in the fetus or neonate. Why should the nurse caution her to avoid the supine position? A. and myelination of the spinal cord begins. loss of control. the lungs start to produce surfactant. labor pain. thus promoting her to seek rest. the fetus continues to gain weight steadily. Overcoming fears she may have about the unknown. Progesterone and estrogen are important hormones responsible for many of the body's changes during pregnancy. loss of selfesteem. 1st week B. Developing a mother image C. Her alcohol consumption puts her fetus at risk for which condition? A. the brain is grossly formed. B. loss of control. When questioned. this condition isn't related to maternal alcohol use. After 20 weeks. What key psychosocial tasks must a woman accomplish during the third trimester? A. The nurse is developing a teaching plan for a client who's 2 months pregnant. This position impedes blood flow to the fetus. 5th week D.
Rationale: During the third trimester. During the second trimester. and death. Resolving grief over the loss of old roles B. and prenatal bonding. or promotes PIH. At which
week of gestation does placental transport of substances to and from the fetus begin? A. The nurse should tell the client that she can expect to feel the fetus move at which time? A. Between 24 and 26 weeks' gestation Rationale: A pregnant woman can usually detect fetal movements (quickening) between 16 and 20 weeks' gestation. No evidence suggests that the supine position triggers heart palpitations. Between 21 and 23 weeks' gestation D. causes esophageal reflux.
the nurse should place the fetoscope or ultrasound stethoscope in the left upper abdominal quadrant for auscultation." B. B. To slow the delivery process B. because constipation may cause contractions Rationale: The best instruction is to encourage the client to increase her intake of high-fiber foods (roughage) and to drink at least six glasses of water per day. the nurse measures
." Rationale: When dietary treatment for gestational diabetes is unsuccessful. To relieve pressure on the umbilical cord D. Straining during defecation and diarrhea can stimulate uterine contractions. A client's membranes rupture during the 36th week of pregnancy. Abdominal palpation reveals a hard. firm mass on the left side of the abdomen." D. irregular shapes in the right side of the abdomen. and a long. The nurse is teaching a client who's 28 weeks pregnant and has gestational diabetes how to control her blood glucose levels. This intervention isn't done to slow the delivery process. "I need to use insulin each day. "If I give myself an insulin injection. Because fetal heart tones are best heard through the fetus's back. Diet therapy continues to play an important role in blood glucose control in the client who requires insulin. Left upper abdominal quadrant D. postprandial. At this point. insulin therapy is started and the client will need daily doses. Based on these findings. The nurse should consider the teaching effective when the client says: A. To rupture the membranes Rationale: Manual pressure is applied to the baby's head by gently pushing up with the fingers to relieve pressure on the umbilical cord. what is the best place to auscultate fetal heart tones? A. I don't need to watch what I eat. Although placement in other locations might allow auscultation of fetal heart tones. To reinsert the umbilical cord C. but telling the client to go to the evaluation unit doesn't address her concern. The mother may also be placed in the knee-chest or Trendelenburg position to ensure blood flow to the baby.
The nurse is preparing to auscultate fetal heart tones in a pregnant client." The nurse sees a portion of the umbilical cord protruding from the vagina. Diet therapy is important to achieve appropriate weight gain and to avoid periods of hypoglycemia and hyperglycemia when taking insulin. a softer." C. "My baby is coming. Diet therapy
alone has been unsuccessful in controlling this client's blood glucose levels. Left lower abdominal quadrant Rationale: In this client. A prolapsed cord necessitates emergency cesarean section. so she has started insulin therapy. "I won't use insulin if I'm sick. Tell her to ask her caregiver for a mild laxative C. This intervention is effective if the cord begins to pulsate. "I'll monitor my blood glucose levels twice a week. the membranes are probably ruptured. but dietary changes should be tried first. the tones would be less clear.A pregnant client arrives in the emergency department and states. Suggest the use of an over-the-counter stool softener Tell her to go to the evaluation unit D. Mild laxatives and stool softeners may be needed. The client shouldn't stop using the insulin unless first obtaining an order from the physician for insulin adjustments when ill. Right upper abdominal quadrant C. small. round mass under the left side of the rib cage. and bedtime blood glucose levels need to be checked daily. Eighteen hours later. round mass just above the symphysis pubis. Encourage her to increase her intake of roughage and to drink at least six glasses of water per day. Which of the following instructions should the nurse give to a client who's 26 weeks pregnant and complains of constipation? A. Why should the nurse apply manual pressure to the baby's head? A. Fasting. The nurse shouldn't attempt to reinsert the umbilical cord because this would further compromise blood flow. Right lower abdominal quadrant B. abdominal palpation reveals that the fetus is lying in a breech position with its back facing the client's left side.
"You need to share these feelings with your partner. Discussing these feelings with a social worker or the client's partner would be inappropriate at this time. C. Increased gravidity or parity speeds carboprost's onset of action. "You may want to discuss these concerns with a social worker. her placental membranes rupture spontaneously. and oral antidiabetic agents aren't recommended for use during pregnancy because these agents may cause fetal harm. Hb is measured during the first
prenatal visit and again at 24 to 28 weeks' gestation and at 36 weeks' gestation. Obtaining pelvic measurements D.M. She tells the nurse she doesn't know whether she's ready to have a baby.to 20-week pregnancy.) Suggesting that the client consider having an abortion is a leading statement and would be inappropriate. A client makes a routine visit to the prenatal clinic. delivery. Data obtained by amniocentesis or sonography wouldn't change the decision to deliver the fetus. resolution of ambivalence is the family's key psychosocial task.the client's temperature at 101. sonography. If edema exists. However. Carboprost's onset of action is faster if gravidity is greater than parity. even though this was a planned pregnancy. including the pregnant client.. Which response should the nurse offer? A. the nurse obtains the client's weight and blood pressure and measures fundal height. 250 mcg/ml I.
. A client in the first trimester of pregnancy comes to the facility for a routine prenatal visit. "You may want to consider having an abortion. arrives in the emergency department. Increased parity slows carboprost's onset of action. the fetus must be delivered promptly. Evaluating the client for edema B. Why is this history important? A. "You're feeling ambivalent." C. Rationale: After rupture of the membranes in a client who has a fever or other signs or symptoms of infection. the nurse should assess for high blood pressure and proteinuria . 18 weeks pregnant. D. A short time later. The physician prescribes carboprost (Hemabate)." D. an empty gestational sac. The physician diagnoses gestational trophoblastic disease and orders ultrasonography.M. magnesium hydroxide. Tocolytic drugs are used to arrest preterm labor. During this trimester. During each prenatal checkup. the nurse should prepare the client for: A. Aspirin. Increased gravidity slows carboprost's onset of action." B. tocolytic therapy. The nurse expects ultrasonography to reveal: A. Magnesium hydroxide C. Although she's 14 weeks pregnant. C.other signs of PIH. B. which is normal during the first trimester. Determining the client's Rh factor Rationale: During each prenatal checkup. onset is faster with increased gravidity (number of pregnancies) or parity (number of live births) and is slower with increased fetal gestational age. grapelike clusters. The pelvis is measured and the Rh factor determined during the first prenatal visit. referral to a social worker and discussion with the partner may be appropriate. A client." Rationale: The first trimester is known as the trimester of ambivalence because the client or the couple may experience mixed feelings. What is another essential part of each prenatal checkup? A. the nurse should evaluate the client for edema. if further assessment reveals there is a problem. Rationale: Carboprost's onset of action occurs about 16 hours after I. and asks about her obstetric history. B. B. (However. Aspirin B. amniocentesis. Oral antidiabetic agents safe during
Rationale: Insulin is a required hormone for any client with diabetes mellitus. a possible sign of pregnancy-induced hypertension (PIH). the size of her uterus approximates that in an 18. Insulin D. injection. D.8° C). Which medication is considered pregnancy? A. Measuring the client's hemoglobin (Hb) level C. After initiating prescribed antibiotic therapy.8° F (38.
"Maintain a supine position to promote rest. "What changes have you made at home to get ready for the baby?" pregnant client? D. Usually no embryo (and therefore no fetus) is present because it has been absorbed. the nurse provides discharge teaching to the client. "Drink coffee or tea to maintain hydration. "The community health nurse will help fix my meals. the nurse might ask which question? After determining that a pregnant client is RhA. "Can you tell me about the meals you typically eat each day?" A. client time to make any necessary changes." C. A client who's 24 weeks pregnant and diagnosed with preeclampsia is sent home with orders for bed rest and a referral for home health visits by a community health nurse. To detect maternal antibodies against the nurse should ask whether she has made fetal Rh-positive factor appropriate changes at home such as obtaining infant supplies and equipment. "The community health nurse will give The nurse determines that a client is in false labor. The community health nurse teaches the client to take her own medications. "Apply cold compresses to relieve discomfort. there can be no extrauterine pregnancy. an ultrasound performed after the 3rd month shows grapelike clusters of transparent vesicles rather than a fetus.C. An extrauterine pregnancy is seen with an ectopic pregnancy. The type of Rationale: The indirect Coombs' test measures the anesthesia planned doesn't reflect the client's number of antibodies against fetal Rh-positive factor preparation for parenting. "Have you begun prenatal classes?" test." Rationale: The nurse should instruct a client in false labor to return to the health care facility if she develops signs or symptoms of infection. Because there is no fetus. the physician orders an indirect Coombs' B." D. To determine the maternal blood Rh factor Rationale: During the third trimester. and adverse effects. Rationale: In a client with gestational trophoblastic disease." B. "The community health nurse will check me and my baby and talk with my physician.
me prenatal care so that I won't have to see my physician. the C. and communicating with the physician. The community health nurse doesn't replace the care provided by the client's physician. Which instruction is most appropriate at this time? A. The vesicles contain a clear fluid and may involve all or part of the decidual lining of the uterus. What is the purpose of performing this test in a C. D. dose. Which comment made by the client should indicate to the nurse that the client understands the reasons for home health visits? A. such as assessing and monitoring blood pressure. After obtaining discharge orders from the nursemidwife. To verify that this has occurred. and providing nutrition counseling. "Are you planning to have epidural anesthesia?" negative. an extrauterine pregnancy. assessing fetal heart tones. To assess the client's preparation for parenting." Rationale: Community health nurses provide skilled nursing care. "The community health nurse will give me my antihypertensive medication. frequency. determined before the indirect Coombs' test is done. The professional nurse doesn't fix meals in the home — this service may be provided by a home health aide or housekeeper. The client should have in maternal blood. a severely malformed fetus. such as a
." D. The maternal blood Rh factor is begun prenatal classes earlier in the pregnancy. To determine the fetal blood Rh factor B." C. For the prenatal client with preeclampsia this may include monitoring the therapeutic effects of antihypertensive medications. "Return to the facility if fever occurs. To detect maternal antibodies against pregnant client typically perceives the fetus as a fetal Rh-negative factor separate being. D. The nurse should have obtained dietary No maternal antibodies against fetal Rh-negative information during the first trimester to give the factor exist." B. providing treatments and education. including the proper time.
A client who's 37 weeks pregnant comes to the clinic for a prenatal checkup.
Because she's likely to experience discomforts of pregnancy. should be expected. A semiupright position with pillows placed under the client's knees promotes rest. Which action should the nurse take first? A. to stimulate uterine contractions and prevent further hemorrhage. The nurse can't assure the client that everything will be all right. as ordered. Rationale: The client's signs and symptoms indicate abruptio placentae. to increase the blood oxygen level. when the client is most strongly motivated to learn them. such as morning sickness. not epigastric pain.not applying cold compresses . Administer I.fever. D. A client has come to the clinic for her first prenatal visit. Abdominal pain. as ordered. Copious discharge of clear mucous and prolonged epigastric pain Rationale: Abdominal pain. if vaginal bleeding occurs. The nurse should suggest warm milk or herbal tea. the paper will turn which color? A. The postpartum period is the best time to teach about infant care responsibilities and neonatal nutrition if the client didn't attend prenatal classes. even
. The nurse should teach labor breathing techniques during the second half of the pregnancy. Fundal massage is used only during the postpartum period to control hemorrhage." B. Which symptoms should alert the nurse to the possibility of an ectopic pregnancy? A. Massage the client's fundus to help control the hemorrhage. 7 months pregnant. "During the first 3 months. and a positive pregnancy test are cardinal signs of an ectopic pregnancy. a pregnant client is most concerned with her own needs. is admitted to the unit with abdominal pain and bright red vaginal bleeding. Place the client on her left side and start supplemental oxygen. to maximize fetal
oxygenation. Green Rationale: Nitrazine paper turns blue on contact with alkaline substances such as amniotic fluid. Amenorrhea and a negative pregnancy test may indicate another type of metabolic disorder such as hypothyroidism. which promote relaxation and rest. Amenorrhea and a negative pregnancy test D. A client is 8 weeks pregnant. Neonatal nutrition Rationale: During the first trimester. and a positive pregnancy test B. vaginal bleeding. Breathing techniques during labor B. as ordered. oxytocin. only that everything possible will be done to help her and her fetus. Blue C. To maximize fetal oxygenation. and urinary frequency. avoid all medications except ones prescribed by your caregiver. Early detection of an ectopic pregnancy is paramount in preventing a life-threatening rupture. Taking a warm tub bath or shower . Hyperemesis and weight loss C. if her membranes rupture. The nurse uses nitrazine paper to determine whether a pregnant client's membranes have ruptured. Which teaching topic is most appropriate at this time? A. Nausea and vomiting may occur prior to rupture but significantly increase after rupture. Discharge of clear mucous isn't indicative of an ectopic pregnancy and referred shoulder pain. B. A client. instead of coffee or caffeinated tea. C. which further reduce fetal oxygenation. fatigue. Common discomforts of pregnancy C. Ease the client's anxiety by assuring her that everything will be all right. "Medications that are available over the counter are safe for you to use. Infant care responsibilities D. or if her contractions become more intense. Administering oxytocin isn't appropriate because this drug stimulates contractions. the nurse should place the client on her left side to increase placental blood flow to the fetus and administer supplemental oxygen. Otherwise.helps relieve discomfort. Pink B.V. Yellow D. infant care is taught during the third trimester and reinforced in the postpartum period. which decreases fetal oxygenation. The nurse should include which of the following statements about using drugs safely during pregnancy in her teaching? A. vaginal bleeding. Normal vaginal discharge and urine are acidic and cause nitrazine paper to turn pink. the nurse should teach her how to relieve these discomforts. If the membranes have ruptured.
Increased vaginal mucus and dyspnea on exertion are expected as pregnancy progresses. Below the symphysis pubis C. Although hemorrhoids may be a problem during pregnancy.early on. especially whole grains. and vitamin B6. dairy products. they aren't the primary diagnosis. The nurse should instruct her to notify her primary health care provider immediately if she notices A. The client needs to understand that any medication taken at any time during pregnancy can be teratogenic. "All medications are safe after you've reached the 5th month of pregnancy. Pain Rationale: If bleeding and clots are excessive. not hyperkalemia.
A client in her 15th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. Hypoglycemia B. are good sources of niacin. Deficient fluid volume C. vitamin B1. Anticipatory grieving D. telling the client to consult with her health care provider before taking any medications is the best teaching. Ritodrine may cause tachycardia. "Consult with your health care provider before taking any medications. with ritodrine. this client may become hypovolemic. Bradycardia D. cereals. Ritodrine may also cause hypokalemia. increased vaginal mucus. The nurse is caring for a client who's on ritodrine therapy to halt premature labor. Blood glucose levels may temporarily rise. D. B. fish. Rationale: Blurred vision or other visual disturbances. meat. Deficient knowledge B. Fetal heart sounds aren't heard as well in the other locations. Crackles C. leading to a diagnosis of Deficient fluid volume." D. Where is the best place for the nurse to detect fetal heart sounds for a client in the first trimester of pregnancy? A. and increased blood pressure may signal severe preeclampsia. excessive weight gain. fetal heart sounds are loudest in the area of maximum intensity. At the umbilicus Rationale: In the first trimester. C. A client is in the last trimester of pregnancy.
several clots. hemorrhoids C. Rationale: Common food sources of vitamin A include dairy products. which has potentially serious consequences for the client and fetus. She has passed
. What condition indicates an adverse reaction to ritodrine therapy? A. Fish and meat are good sources of protein. Above the symphysis pubis B. and vegetables. Above the umbilicus D. Hyperkalemia Rationale: Use of ritodrine can lead to pulmonary edema. they don't require immediate attention. the nurse should assess her diet for consumption of: A. just above the client's symphysis pubis at the midline." Rationale: Because all medications can be potentially harmful to the growing fetus. Although the other diagnoses are applicable to this client. liver. blurred vision B. To determine whether she has an adequate intake of vitamin A. D. fruits. What is the primary nursing diagnosis for this client? A. Therefore." C. not bradycardia. This condition may lead to eclampsia. edema. egg yolks. dyspnea on exertion. the nurse should assess for crackles and dyspnea. not fall. Cereals.
The nurse is reviewing a pregnant client's nutritional status.
is having a reaction to the menotropins Rationale: Characterized by abdominal swelling from ascites. weight gain. is probably pregnant. parents. 4 g in 50% solution I. the first element (0. Magnesium sulfate has no effect on labor or dopamine receptors. the nurse knows that she has been pregnant twice. abdominal pain D. hypotension. The other findings aren't typically found in women with preeclampsia. Rationale: A client's previous pregnancies are documented according to her number of Term infants. To lower blood pressure B. edema. D. Whether the pregnancy was planned or unplanned
Rationale: Many factors can influence the smoothness of a pregnant client's psychosocial transition. over 20 minutes. To inhibit labor D. Hypertension. and reduced urine output are signs of severe preeclampsia. whether the pregnancy was planned or unplanned. a client comes in for her office visit. in this case) indicates the number of term neonates. friends. To prevent seizures C. socioeconomic status. and proteinuria. C. One pregnancy resulted in a term neonate who's living and one resulted in a preterm neonate who's living.After receiving large doses of an ovulatory stimulant such as menotropins (Pergonal). One pregnancy resulted in an abortion and one resulted in a term neonate who's living. Previous health promotion activities are least likely to affect this transition. para 0111. What is the purpose of administering magnesium sulfate to this client? A. Previous health promotion activities B. Glycosuria. demonstrating signs of hyperstimulation syndrome. Support from her partner D. A client is 2 months pregnant. A client's prenatal record shows that she's a gravida 2. In the TPAL method.V. The third element (1) represents
. and previous childbirth and parenting experiences. reduced urine output C. number of Abortions. Abdominal pain. A client with pregnancy-induced hypertension (PIH) receives magnesium sulfate. number of Preterm infants. hyperstimulation syndrome from ovulatory stimulants is an unusual occurrence. Assessment reveals the following: 6-lb (3-kg) weight gain. blurry vision. exhibiting normal signs of an ovulatory stimulant. proteinuria Rationale: The typical findings of mild preeclampsia are hypertension. To block dopamine receptors Rationale: Magnesium sulfate is given to prevent and control seizures in clients with PIH. What else does this information reveal about her obstetric history? A. hypertension. The most important factors are support from her partner. and past experiences with health care facilities and professionals may also influence a client's psychosocial transition during pregnancy. The second element (1) indicates the number of preterm neonates delivered. B. This assessment indicates the client is: A. One pregnancy resulted in an abortion and one resulted in a preterm neonate who's living. D. A nurse in a prenatal clinic is assessing a 28year-old who's 24 weeks pregnant. blurry vision. labetalol. and others. From this information. seizures B. Nursing care includes emotional support to reduce anxiety and management of symptoms. Burning on urination. Betaadrenergic blockers (such as propranolol. birth stories of family members and friends. Hematuria. Which factor should the nurse anticipate as least likely to affect her psychosocial transition during pregnancy? A. and number of Living children (or TPAL). and atenolol) and centrally acting blockers (such as methyldopa) are used to lower blood pressure. C. Age. sexuality concerns. ascites. edema. B. One pregnancy resulted in a term neonate who's living and one resulted in a preterm neonate who died. These signs aren't signs of pregnancy and aren't normal reactions to ovulatory stimulants. and pedal edema. Which findings would lead this nurse to suspect that the client has mild preeclampsia? A. This client must be admitted to the hospital for management of the disorder. Previous parenting experiences C. Seizures are a sign of eclampsia. and peripheral edema.
it can lead to increased absorption of fat-soluble vitamins. Encouraging ambulation B. "Yes. Which findings best support a suspicion of ectopic pregnancy? A. and audible fetal heart tones above the symphysis pubis
Infertility in a 25-year-old couple is defined as which of the following? A. which promotes uterine contractions. infertility is defined as failure to conceive after 1 year of unprotected intercourse." D. Grapefruit-size uterine enlargement and vaginal spotting D. "No. One pregnancy that resulted in an abortion and one that resulted in a term neonate who's living would be documented as para 1011. which statement would indicate to the nurse that the client understands the information given to her? A. it produces no adverse effects. The couple's inability to conceive after 6 months of unprotected attempts B. "No. Nipple stimulation activates the release of oxytocin. "Nausea should be reported immediately. Promoting adequate hydration D. A pregnant client asks the nurse whether she can take castor oil for her constipation. it can promote sodium retention." Rationale: Castor oil can initiate premature uterine contractions in pregnant women. the time period is reduced to 6 months of unprotected intercourse.
. and slight uterine enlargement C. Nausea. How should the nurse respond? A." C. vomiting. sudden weight gain. It also can produce other adverse effects. Castor oil isn't known to increase absorption of fat-soluble vitamins. I should report it immediately. In a couple age 30 or older. The nurse is assessing a client who's 6 weeks pregnant. What nonpharmacologic intervention should the plan include to halt premature labor? A." C. "If I feel tired after resting. A nutritious diet is important in pregnancy. One pregnancy that resulted in a term neonate who's living and one that resulted in a preterm neonate who's living would be documented as para 1102. A low sperm count and decreased motility Rationale: The determination of infertility is based on age. "I'll report increased frequency of urination. Serving a nutritious diet C. but it doesn't promote sodium retention. Urinary frequency is a common problem during pregnancy caused by increased weight pressure on the bladder from the uterus. Amenorrhea. Clients generally experience fatigue and nausea during pregnancy. Performing nipple stimulation Rationale: Providing adequate hydration to the woman in premature labor may help halt contractions.
When evaluating a client's knowledge of symptoms to report during her pregnancy. but it won't halt premature labor." D." Rationale: Blurred or double vision may indicate hypertension or preeclampsia and should be reported immediately. I should call the clinic immediately. The nurse is developing a plan of care for a client in her 34th week of gestation who's experiencing premature labor. The fourth element (1) represents the number of children alive. "No. "If I have blurred or double vision. The couple's inability to sustain a pregnancy C. One pregnancy that resulted in a term neonate who's living and one that resulted in a preterm neonate who died would be documented as para 1101. it can initiate premature uterine contractions." B. The client should be placed on bed rest so that the fetus exerts less pressure on the cervix. although laxatives can decrease absorption if intestinal motility is increased.the number of spontaneous or therapeutic abortions. Amenorrhea and adnexal fullness and tenderness B. In a couple younger than 30 years old. The couple's inability to conceive after 1 year of unprotected attempts D." B.
The physician should be notified of continued blood loss. Which nursing intervention should the nurse perform? A. Allow the client to ambulate with assistance B. or vital signs indicative of shock (hypotension and tachycardia). every 4 hours. "Insulin requirements increase greatly during labor. The fetal heart sounds are normal and the client
isn't in labor. the nurse must use sterile technique to assess amniotic fluid and thus confirm membrane rupture." D. or infection. Enhance fetal growth C. The nurse should assess the fetal heart rate every 30 minutes because fetal tachycardia signals chorioamnionitis. Rationale: To prevent infection. "Insulin requirements don't change during pregnancy. D. therefore. A client tells the nurse that she suspects her amniotic membranes broke 2 hours ago. confirming membrane rupture by using a sterile speculum and cotton-tipped applicator to assess fluid. The nurse is teaching her about insulin requirements during pregnancy. Prevent infection D. but the uterus doesn't enlarge because it remains empty. and vaginal spotting may occur in ectopic pregnancy. Monitor the amount of vaginal blood loss. Vaginal examinations introduce bacteria into the vagina and should be performed only when necessary . Maternal insulin requirements fluctuate throughout pregnancy. an increase in blood flow. "Insulin requirements usually decrease during the last two trimesters. Perform a vaginal examination to check for cervical dilation C. fetal growth. A client who's 34 weeks pregnant is experiencing bleeding caused by placenta previa. assessing vital signs. Following admission and hydration." B. During labor. the physician writes an order for the nurse to give 12 mg of betamethasone I. assessing the fetal heart rate once every hour. the physician doesn't need to be notified of a fetal heart rate of 130 beats/minute. Because the goal of care for this client is to prevent infection (chorioamnionitis). Slow contractions B. Rationale: Estimate the amount of blood loss by such measures as weighing perineal pads or counting the amount of pads saturated over a period of time." Rationale: Maternal insulin requirements usually decrease during the first trimester from rapid fetal growth and maternal metabolic changes. Which guideline should the nurse provide? A. limiting vaginal examinations to once every hour. Promote fetal lung maturation Rationale: Betamethasone is given to promote fetal lung maturity by enhancing the production of surface-active lipoproteins. insulin requirements diminish from extreme maternal energy expenditure." C. vomiting. fetal heart tones aren't audible above the symphysis pubis in clients with this disorder. Weight gain may accompany ectopic pregnancy. Continue your current regimen. The nurse should assess vital signs. B.M. Which drug will the physician probably order to treat a pregnant client who is experiencing morning sickness?
. A client at 28 weeks' gestation is complaining of contractions. C. the plan of care should include: A. It has no effect on contractions. especially temperature. This medication is given to do which of the following? A. necessitating adjustment of the insulin dosage. A client with type 1 diabetes mellitus has just learned she's pregnant. A normal fetal heart rate is 120 to 160 beats/minute. "Insulin requirements usually decrease during the first trimester.for example. The woman should be placed on bed rest and not allowed to ambulate. they rise again during the second and third trimesters when fetal growth slows. before narcotic administration and to assess suspected cord prolapse. Notify the physician for a fetal heart rate of 130 beats/minute. however. Nausea. especially temperature and pulse. D. A pelvic examination should never be performed when placenta previa is suspected because manipulation of the cervix can cause hemorrhage.Rationale: Signs and symptoms of ectopic pregnancy include amenorrhea and adnexal fullness and tenderness. every 2 hours to detect early signs of infection. after decreasing during the first trimester.
5 lb per week.
A pregnant client in her second trimester visits the health care practitioner for a regular prenatal checkup. 5 to 8 weeks' gestation. C. 2 lb (. B. on average. how much weight should the client gain per week? A. hematocrit (HCT) 33% B. Which findings suggest iron deficiency anemia? A.45 kg) C. D. 0. Maternal fetal activity count B. Hb 10 g/L. Cesarean delivery isn't always necessary. the nurse reviews the client's laboratory test results. A client who's 5 weeks pregnant reports nausea and vomiting. diphenhydramine.A. it's too early to tell
Rationale: Early induction or early cesarean are possibilities if the mother has diabetes and euglycemia that hasn't been maintained during pregnancy. and reports the number of times the fetus kicks during a designated period each day. After obtaining her health history and performing a physical examination. then compares her current and previous weights. D. The client asks the nurse if her gestational diabetes will affect her delivery. the delivery must be by cesarean. The nurse reassures the client that these symptoms probably will subside by: A. D. HCT 32% C. Nonstress test Rationale: Maternal fetal activity count is the least invasive and demanding method for assessing fetal well-being. 9 to 12 weeks' gestation. 14 to 17 weeks' gestation. the Hb level is below 11 g/L and HCT drops below 32%.91 kg) Rationale: During the second and third trimesters.68 kg) D. during the second half of pregnancy. which may place extra demands on the client's time. The nurse is assessing a client who's 29 weeks pregnant. Hemoglobin (Hb) 15 g/L. 1 lb (0. Hb 9 g/L. What is the least invasive and demanding method for assessing fetal wellbeing? A. although noninvasive. recognize these as normal early pregnancy signs and symptoms. C. vomiting. urinary frequency. records. The nurse should: A. are expensive and require the use of medical facilities. A woman with a multiple-fetus pregnancy should gain about 1.5 lb (0. Ultrasonography D. During the assessment.23 kg) B. The nurse should know that: A.5 lb (0. Chorionic villi sampling is invasive and expensive and should be reserved for pregnant clients at risk for
A pregnant client comes to the facility for her first prenatal visit. Chorionic villi sampling C. and urinary urgency normally subside between 9 and 12 weeks' gestation
Rationale: The physician will probably order phosphorated carbohydrate solution for a pregnant client who is experiencing morning sickness. The nurse is providing care for a pregnant client with gestational diabetes. Rationale: Nausea. the delivery may need to be induced early. B. B. and trimethobenzamide may produce congenital anomalies and aren't recommended to treat morning sickness caused by pregnancy. Prochlorperazine. Hb 13 g/L. B. weight gain should average about 1 lb per week in a client with a single fetus. During the second trimester. question her further about these signs and
. HCT 30 Rationale: With iron deficiency anemia. 1. 18 to 22 weeks' gestation.
Prochlorperazine (Compazine) Diphenhydramine (Benadryl) Trimethobenzamide (Tigan) Phosphorated carbohydrate solution (Emetrol
genetic defects. the nurse weighs the client. C. HCT 35% D. A woman who's 10 weeks pregnant tells the nurse that she's worried about her fatigue and frequent urination. the mother will carry to term safely. the client simply counts. To use this method. Ultrasonography and nonstress testing.
Which statement about prelabor contractions is accurate? A. Unilateral calf enlargement Rationale: As the uterus grows heavier during pregnancy.
The nurse is assessing the legs of a client who's 36 weeks pregnant. a client who's 5 months pregnant tells the nurse she was exposed to rubella during the past week and asks whether she can be immunized now. which can have teratogenic effects on the fetus. may indicate thrombosis. All the other aspects are important but the administration of RhoGAM is the priority. Absent pedal pulses B. tell her that she'll need blood work and urinalysis D. also an abnormal finding. Assess uterine activity. "No because the vaccine can be given only during the first trimester. "Yes and you should consider pregnancy termination because rubella has teratogenic effects.symptoms. The other options are correct but aren't the primary nursing diagnosis. Pain C. hemoglobin 12. B." Rationale: Rubella immunization is contraindicated during pregnancy because the vaccine contains live virus." C. Pain is also present and should be addressed as warranted. B. femoral venous pressure rises. and type O-negative blood. Telling her that she may be excessively worried isn't therapeutic. Exposure to rubella virus may have teratogenic effects if the client is exposed during the first trimester. Prenatal blood work and urinalysis is routine for this situation but doesn't address the client's concerns. Check for rupture of membranes. They start in the back and radiate to the abdomen D. vital signs within normal limits. "No because the live viral vaccine is contraindicated during pregnancy. The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Unilateral calf enlargement. They're regular. C. Which of the following actions would be most important to include in the client's plan of care after the 20-minute amniocentesis has been completed? A. Absence of pedal pulses and sluggish capillary refill signal inadequate circulation to the legs — an unexpected finding during pregnancy.
. How should the nurse respond? A. What is the primary nursing diagnosis for a client with a ruptured ectopic pregnancy? A. RhoGAM must be given after any invasive procedure on an Rh-negative client. Administer RhoGAM. Recommending pregnancy termination forces the nurse's viewpoint on the client rather than allowing the client to decide for herself. Rationale: To prevent maternal sensitization. Sluggish capillary refill D. leading to bilateral dependent edema. hematocrit 35%. tell her that she may be excessively worried. The client with ruptured ectopic pregnancy may experience anticipatory grieving at the loss of her fetus. Deficient fluid volume D. Bilateral dependent edema C. Provide additional fluid.2 gm. such as sitting or standing for long periods. contribute to edema. Deficient fluid volume is the primary diagnosis. Factors interfering with venous return. C. "Yes but immunization against rubella requires a physician's order. Which finding should the nurse expect? A. Questioning her about the signs and symptoms is helpful to complete the assessment but won't reassure her. therefore. Needing a physician's order isn't a valid reason for withholding an immunization. C. D. They become more intense during walking. Initial assessment findings include the following: 16 weeks pregnant. Anticipatory grieving Rationale: Ruptured ectopic pregnancy is associated with hemorrhage and requires immediate surgical intervention. Rationale: Fatigue and frequent urination are early signs and symptoms of pregnancy that may continue through the first trimester. This client is probably experiencing anxiety because this is a surgical emergency." D. A client is admitted for an amniocentesis. They're usually felt in the abdomen." B. Anxiety B. During her fourth clinic visit.
each offspring has a one in four chance of having the trait or the disorder. C. telling her such feelings are normal in the beginning of pregnancy C. when fetal blood enters the maternal circulation. Rationale: Cystic fibrosis is a recessive trait. When should a client who's Rh(D)-negative and D-negative and who hasn't already formed Rh
antibodies receive Rh(D) human immunoglobulin (RhIg) to prevent isoimmunization? A. It doesn't necessarily mean that she requires counseling at this time. The nurse is reviewing a client's prenatal history. Which finding indicates a genetic risk factor? A. In addition to checking the client's fundal height. She may benefit by discussing her feelings with her husband. Based on this diagnosis. A 20-year-old female's pregnancy is confirmed at a clinic. edema. when the incidence of chromosomal defects increases. The client was exposed to rubella at 36 weeks' gestation. She says her husband will be excited but is concerned because she herself isn't excited. Exploring her feelings may help her understand her concerns more deeply but won't provide reassurance that her feelings are normal. fever.Rationale: Prelabor contractions are usually felt in the abdomen. vomiting. Giving RhIg within 24 hours after delivery would be too soon because maternal sensitization occurs in approximately 72 hours. a client is admitted to the facility with a diagnosis of pregnancy-induced hypertension (PIH). A client who's 19 weeks pregnant comes to the clinic for a routine prenatal visit. recommending she talk her feelings over with her husband. The client is 25 years old. Rationale: Classic signs of PIH include edema (especially of the face). Rh factor changes D. The client has a child with cystic fibrosis. D. Fever is a sign of infection. and become more intense during walking. start in the back and radiate to the abdomen. Within 72 hours after delivery only C. Although a history of preterm labor may place the client at risk for preterm labor. true labor contractions are regular. The nurse should respond by: A. increased
. the nurse should assess the client for edema because edema. Edema B. and blood pressure. B. The client has a history of preterm labor at 32 weeks' gestation. D. Rationale: Misgivings and fears are common in the beginning of pregnancy. B. and proteinuria. Giving RhIg only at 28 weeks' gestation wouldn't prevent isoimmunization from occurring after placental separation. In contrast. what should the nurse assess for at each prenatal visit? A. Giving RhIg at 32 weeks' gestation would be too late to prevent isoimmunization during pregnancy because Rh antibodies already have formed by then. At 32 weeks' gestation. At about 28 weeks' gestation and again within 72 hours after delivery D. Maternal exposure to rubella during the first trimester may cause congenital defects. B. Maternal age isn't a risk factor until age 35. Vomiting may be associated with various disorders. but the husband also needs to be reassured that these feelings are normal at this time. Hemoglobin alterations Rationale: At each prenatal visit. Giving RhIg only within 72 hours after delivery wouldn't prevent isoimmunization caused by passage of fetal blood into the maternal circulation during gestation. She fears this may mean she'll be a bad mother. C. elevated blood pressure. weight. glycosuria. exploring her feelings. At about 28 weeks' gestation only B. At about 32 weeks' gestation and again within 24 hours after delivery Rationale: A client who's Rh(D)-negative and Dnegative and who hasn't already formed Rh antibodies should receive RhIg at about 28 weeks' gestation and again within 72 hours after delivery. referring her to counseling. the nurse expects assessment to reveal: A. it doesn't correlate with genetic defects. D. Pelvic adequacy C. Glycosuria indicates hyperglycemia.
enhancing cardiac output. the client should increase her intake of high-fiber foods (such as green. through ingesting raw meat. and fruits) and fluids. "I'll increase my intake of unrefined grains. or through contact with raw meat followed by improper hand washing. The use of iron supplements can cause rather than relieve . 7 weeks B." C. During a routine prenatal visit. "I'll limit fluid intake to four 8-oz glasses. "Do you have any birds at home?" C. at 24 to 28 weeks' gestation. D. The supine position reduces sodium and water excretion because the enlarged uterus compresses the vena cava and aorta. "I'll take iron supplements regularly. Supine D. this decreases cardiac output. Which client statement indicates an accurate understanding of the nurse's instructions? A.
A client is in the 8th month of pregnancy. The right lateral and semi-Fowler positions don't alleviate pressure of the enlarged uterus on the vena cava. which can be transmitted by birds. a pregnant client reports constipation. Encourage breast-feeding because it's healthier for the baby C. To enhance cardiac output and renal function. fetal heart tones may be heard as early as the 11th week of pregnancy. which in turn impairs kidney function. and at 36 weeks' gestation. Encourage breast-feeding to facilitate bonding. Other Rubella virus. and the nurse teaches her how to relieve it. causing numerous ill effects.agents that may infect the fetus or newborn." Rationale: To increase peristalsis and relieve constipation. unrefined grains. and Herpes simplex virus . fetal heart tones may be heard between 17 and 20 weeks of gestation. Semi-Fowler's Rationale: The left lateral position shifts the enlarged uterus away from the vena cava and aorta. The nurse is using Doppler ultrasound to assess a pregnant woman. a serious bone infection. Cytomegalovirus. Discourage breast-feeding because HIV can be transmitted through breast milk. "Have you ever had osteomyelitis?" Rationale: TORCH refers to Toxoplasmosis. Encourage breast-feeding so that she can get her rest and get healthier. 11 weeks C. "Do you have any cats at home?" B. histoplasmosis. Right lateral B. 21 weeks Rationale: Using Doppler ultrasound. Osteomyelitis. When should the nurse expect to hear fetal heart tones? A. Pelvic measurements and Rh typing are determined at the first visit only because they don't change. "Have you recently had a rubeola vaccination?" D. 17 weeks D. "I'll decrease my intake of green.constipation. To help determine whether the client is at risk for a TORCH infection. kidney perfusion. leading to decreased renal blood flow. and rubeola aren't TORCH infections. and proteinuria are cardinal signs of pregnancy-induced hypertension. the nurse should ask: A." B. leafy vegetables. Toxoplasmosis is transmitted to humans through contact with the feces of infected cats (which may occur when emptying a litter box)." D. and kidney function.
The nurse is obtaining a prenatal history from a client who's 8 weeks pregnant.
. The nurse should monitor the hemoglobin level on the client's first visit. The nurse has a client at 30 weeks' gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her baby? A.blood pressure. Using a stethoscope. so breast-feeding should be discouraged in this case. Left lateral C. Rationale: Transmission of HIV can occur through breast milk. B. the nurse should advise her to use which body position? A. leafy vegetables.
The ischial spines are designated as zero station. After delivery. When the fetus's head is at the level of the ischial spines. buttocks. the nurse is correct when stating that fertilization occurs: A. In the multigravid client. A 30-year-old primiparous client at 34 weeks' gestation comes to the prenatal facility concerned about the reddish streaks she has increasingly developed on her breasts and abdomen. Tiny bright hemangiomas may occur during pregnancy as a result of estrogen release. the presenting part. they'll fade after childbirth. drug use might be appropriate. in the uterus. a diagnosis of Risk for infection related to I. they'll grow lighter after delivery. or stretch marks. combined with the action of adrenocorticosteroids. Engagement refers to entry of the fetus's head or presenting part into the superior pelvic strait. Rationale: Fertilization occurs in the first third of the fallopian tube. an ovum is released by the ovary into the abdominopelvic cavity. C. drug abuser. D. near the fimbriated end. leading to a nursing diagnosis of Imbalanced nutrition: Less than body requirements related to limited food intake. and thighs.V. Activity intolerance might be a relevant nursing diagnosis if the client were having trouble sleeping or getting adequate rest. A floating fetus hasn't yet entered the pelvic inlet. linea nigra typically appears before the 3rd month. The fertilized ovum then travels to the uterus and implants. the nurse determines that the biparietal diameter of the fetal head has reached the pelvic inlet. "These streaks are called hemangiomas. D. lead to stretching of the underlying connective tissue of the skin." B." Rationale: The client's weight gain and enlarging uterus. When teaching a group of pregnant teens about reproduction and conception. They're called vascular spiders because of the branching pattern that extends from each spot.During her first prenatal visit. Rationale: The largest part of the fetus's head. Impaired gas exchange related to respiratory effects of substance abuse Rationale: A substance abuser may spend more money on drugs than on food and other basic needs. B. in the first third of the fallopian tube. creating striae gravidarum in the second and third
trimesters. What should the nurse tell her? A.
. Better known as stretch marks. It enters the fallopian tube at the fimbriated end and moves through the tube on the way to the uterus. benign proliferations of pigment-producing cells in the skin. a pregnant client admits to the nurse that she uses cocaine at least once per day. Nevi are circumscribed. B. "These streaks are called striae gravidarum. She asks what these skin changes are and whether they're permanent. Linea nigra is a dark line that extends from the umbilicus or above to the mons pubis. Which nursing diagnosis is most appropriate for this client? A. Which statement best describes the position of the fetus at this time? A. activity intolerance wouldn't be related to decreased tissue oxygenation in this case. It's at first station. If the client were an I. however. Because the question doesn't specify how the client is using cocaine. a diagnosis of Impaired gas exchange related to respiratory effects of substance abuse is inappropriate. they're permanent changes of pregnancy. It's floating. it's at the pelvic outlet. abdomen. "These streaks are called linea nigra. when the ovum is released. C. When performing a vaginal examination on a pregnant client. Activity intolerance related to decreased tissue oxygenation B. Risk for infection related to metabolic and vascular abnormalities C. Sperm cells "swim up" the tube and meet the ovum in the first third of the fallopian tube. After ovulation. "These streaks are called nevi. they'll fade after the postpartum period.the pelvic inlet. this line develops at approximately the 3rd month of pregnancy. Imbalanced nutrition: Less than body requirements related to limited food intake D. In the primigravid client. It's at the ischial spines." C. which is marked by the pelvic inlet. The largest part of the head is accommodated by the largest part of the passage ." D. is marked by the biparietal diameter. these streaks develop most often in skin covering the breasts. they typically grow lighter. It's engaged. Nurses must know where fertilization occurs because of the risk of an ectopic pregnancy.V.
make an appointment for follow-up human chorionic gonadotropin (HCG) level monitoring at the end of 1 year. C. Tell the client to go to the hospital. Rationale: Because terbutaline can cause tachycardia. On admission to the facility Rationale: Discharge planning should begin when a client is first admitted to the facility. When should the nurse begin discharge planning? A. These signs aren't indicative of heart failure. family and home life. After listening to her concerns. the client indicates normal physiologic changes due to the growing uterus and pressure on the diaphragm. use birth control for at least 1 year. The nurse is caring for a client after evacuation of a hydatidiform molar pregnancy. Healthy eating habits D. Waiting until the day of discharge to begin planning is also likely to cause the client to become overwhelmed and anxious. functional abilities. she may be experiencing signs of heart failure from a 45% to 50% increase in blood volume. Report a heart rate greater than 120 beats/minute to the physician B. Arrange for the client to be admitted to the birth center for delivery. Take terbutaline every 4 hours. C. Age of menarche B. and finances. discharge planning requires collecting information about the client's home environment. When the client's vomiting has stopped D. On the day of discharge B. during waking hours only. Family and home life C. Level of emotional maturity Rationale: When assessing an adolescent initially. Call the physician if the fetus moves 10 times in an hour. Make an appointment because the client needs to be evaluated. Such factors as when the client stops vomiting and expresses readiness to learn shouldn't influence when the nurse begins discharge planning. calls the clinic because she's concerned about being short of breath and is unable to sleep unless she places
three pillows under her head. Explain that these are expected problems for the latter stages of pregnancy. A fetus normally moves 10 to 12 times per hour. B. the woman should be taught to monitor her radial pulse and call the physician for a heart rate greater than 120 beats/minute. support systems. C. This information is used to determine what support services will be needed. The nurse should tell the woman to: A. Initially.
While caring for pregnant adolescents. Terbutaline must be taken every 4 to 6 hours around-the-clock to maintain an effective serum level that will suppress labor. Increase activity daily if not fatigued. B. D. This forms the basis for the nursing plan of care. Age of menarche. D. C. Rationale: After experiencing a hydatidiform molar pregnancy. though important. now 37 weeks pregnant. D. The nurse is caring for a client with hyperemesis gravidarum who will need close monitoring at home. Notifying support services on the day of discharge won't be sufficient to ensure meeting the client's needs in a timely fashion. The client doesn't need to be seen or admitted for delivery. In this case. Rationale: The nurse must distinguish between normal physiologic complaints of the latter stages of pregnancy and those that need referral to the health care provider. aren't as significant as determining the emotional maturity of the client. wait 1 month before trying to become pregnant again. the client should be counseled to use a
. When the client expresses readiness to leave the hospital. discuss options for sterilization with the physician. Which instruction should the nurse include in the discharge teaching plan? A. The client experiencing premature labor must maintain bed rest at home. the nurse should try to determine the client's level of emotional maturity. the nurse should take which action? A.A client treated with terbutaline for premature labor is ready for discharge. A client. and healthy eating habits. the nurse should develop a plan of care that incorporates which health concern? A.
pressure on the bladder by the presenting part of the fetus again causes urinary frequency and urgency. Family history of spina bifida in a sister B. However. B. as term approaches. Fluids shouldn't be limited during pregnancy. is admitted to the facility with hyperemesis gravidarum. Which maternal history finding best explains the need for this test? A. a client is scheduled for a serum alpha-fetoprotein (AFP) test. No evidence suggests that hyperemesis gravidarum results from a neurologic disorder. Because of the risk of choriocarcinoma. or hemolysis of fetal RBCs. A client is in the 38th week of her first pregnancy. This symptom is abnormal and should subside after the presenting part of the fetus is engaged. Rationale: Because the client is describing two premonitory signs of labor. Urinalysis wouldn't be indicated unless the client reported symptoms of bladder inflammation. The nurse should take which action? A. What should the nurse tell her? A. such as burning and pain. the nurse should review these normal signs and reassure the client. C. At 15 weeks' gestation. Rationale: The cause of hyperemesis gravidarum isn't known. She tells the nurse she has never known anyone who had such severe morning sickness. B. hormonal changes and uterine pressure on the bladder cause urinary frequency and urgency. which she says seems lower than usual. fetal bradycardia is present. No known correlation exists between gestational diabetes or early vaginal spotting and a certain AFP level at 15 to 20 weeks' gestation. Urinary frequency doesn't subside after the presenting part is engaged. Because the client's findings are normal. an unknown cause. Instead.12. Prepare for cesarean delivery
. C. Administer amnioinfusion B. would be inappropriate unless the client reported changes in fetal activity. urinary symptoms abate. However. History of gestational diabetes during a previous pregnancy D.reliable method of birth control for at least 1 year. The risk of recurrence of a hydatidiform mole is low. when the uterus rises out of the
pelvis. Although a low AFP level has been correlated with Down syndrome. An NST. The nurse understands that hyperemesis gravidarum results from: A. B. If HCG levels remain low. Ask the client to bring in a urine specimen for urinalysis D. D. This symptom is abnormal during the third trimester and may indicate a urinary tract infection. Braxton Hicks contractions and tightening. A client. a neurologic disorder. etiologic theories implicate hormonal alterations and allergic or psychosomatic conditions. Rationale: During the first trimester. She calls the prenatal facility to report occasional tightening sensations in the lower abdomen and pressure on the bladder from the fetus. C. such as dysuria or urinary frequency or urgency. Instruct the client to go the health care facility for a nonstress test (NST). she need not see the physician other than at her regular weekly appointment. Make an appointment for the client to see the physician today. inadequate nutrition. Based on these findings. A pregnant client in her third trimester asks why she needs to urinate frequently again. History of spotting during the 1st month of the current pregnancy Rationale: An abnormally high AFP level in the client's serum or amniotic fluid suggests a neural tube defect such as spina bifida. her HCG levels need to be monitored monthly for 1 to 2 years. Urinary frequency isn't abnormal unless accompanied by other urinary symptoms. This symptom is a normal variation and is easily managed by limiting fluid intake. a woman may try to become pregnant after 1 year. used to assess fetal well-being. as she did during the first trimester. A client has meconium-stained amniotic fluid. 11 weeks pregnant. This symptom is normal and results from the fetus exerting pressure on the bladder. it isn't the most accurate indicator. Fetal scalp sampling indicates a blood pH of 7. hemolysis of fetal red blood cells (RBCs). During the second trimester. Family history of Down syndrome on the father's side C. Review premonitory signs of labor with the client. the nurse should take which action? A. A family history of such defects increases the risk of carrying a fetus with a neural tube defect. inadequate nutrition. D. Sterilization isn't necessary after hydatidiform mole. the presenting part exerts pressure on the bladder.
Between 28 and 31 weeks' gestation D. D. Written information would be effective only in conjunction with teaching sessions. meconium-stained amniotic fluid and bradycardia are further signs of fetal distress that warrant cesarean delivery. liver.V. causes 1% of
Rationale: A clear liquid diet consists of foods that are clear liquids at room temperature or body temperature. the nurse should advise her to eat: A. Between 32 and 35 weeks' gestation Rationale: Braxton Hicks contractions typically begin between 23 and 27 weeks' gestation. Reposition the client. When do these contractions typically begin? A. and clear juices. C. the nurse tells the client that she's likely to first experience Braxton Hicks contractions. eggs. Doing nothing won't address the client's needs. spinach and beef. A pregnant client asks the nurse about the percentage of congenital anomalies caused by drug exposure. grains and milk. milk and ice pops. legumes. B. Tomatoes and citrus fruits are high in vitamins A and C. tea and gelatin dessert. 10% C. broccoli. such as ice pops. but the nurse still needs to teach the client about giving birth. To help meet the client's iron needs. Adolescents are prone to which complication during pregnancy? A. Introducing her to another pregnant client may be helpful.
. and oatmeal are part of a full liquid diet. Provide her with the information and teach her the skills she'll need to understand and cope during birth. Iron deficiency anemia
A client with hyperemesis gravidarum is on a clear liquid diet. gelatin desserts. pasteurized eggs. The nurse is planning care for a 16-year-old client in the prenatal clinic. prunes. carbonated beverages. B. Provide her with written information about the birthing process. egg substitutes. Between 18 and 22 weeks' gestation B. exacerbating fetal stress. eggs and citrus fruit. 20% D. The nurse should serve this client: A. regular or decaffeinated coffee and tea. Braxton Hicks contractions increase in frequency and intensity between 32 and 35 weeks. Which intervention by the nurse is most appropriate for this client? A. and fish. and milk are high in protein. Do nothing in hopes that she'll begin coping as the pregnancy progresses. Grains are good sources of carbohydrates. Assessment of a pregnant client reveals that she feels very anxious because of a lack of knowledge about giving birth. B. Rationale: Common food sources of iron include spinach. oxytocin infusion as prescribed Rationale: Fetal blood pH of 7. Start I. Oxytocin administration increases contractions. The client is in her second trimester. Rationale: Because the client is in her second trimester. beef. Have a more experienced pregnant woman assist her. Client repositioning may improve uteroplacental perfusion but only serve as a temporary measure because the risk of fetal asphyxia is imminent. milk is high in vitamin D. D. The nurse is providing dietary teaching to a pregnant client. The fetal heartbeat typically can be heard and fetal rebound is possible between 18 and 22 weeks. Amnioinfusion is indicated when the only abnormal fetal finding is meconium-stained amniotic fluid. tomatoes and fish. C. The fetal outline becomes palpable and the fetus is highly mobile between 28 and 31 weeks. 60% Rationale: Drug exposure congenital anomalies. and whole wheat breads and cereals. C. apple juice and oatmeal. Milk. the nurse has ample time to establish a trusting relationship with her and to teach her in a style that fits her needs. How should the nurse respond? A. pork. Between 23 and 27 weeks' gestation C. 1% B.19 or lower signals severe fetal acidosis. decaffeinated coffee and scrambled eggs. When providing health teaching to a primigravid client. D. D.C.
and exchanges nutrients and electrolytes. "I'll need to lie perfectly still. Gestational diabetes Rationale: Iron deficiency anemia is a common complication of adolescent pregnancies. Because an external monitor isn't invasive and is worn around the abdomen." B. detoxifies some drugs and chemicals. The nurse obtains the antepartum history of a client who's 6 weeks pregnant. they aren't the primary cause. As a client progresses through pregnancy. Eating frequent. Exchange site for food. Inadequate fluid intake C. Detoxification of some drugs and chemicals C." D. inadequate fluid intake. Although decreased appetite. it doesn't increase the risk of uterine infection. she may continue to engage in low-impact aerobics during pregnancy. "I can lie in any comfortable position. The nurse still needs to frequently assess and provide emotional support to a woman in labor who's wearing an external monitor. When assessing her. small meals helps maintain the client's energy level by keeping the blood glucose level relatively constant. The nurse is caring for a client in her 34th week of pregnancy who wears an external monitor. compounds the anemia even further. She's 32 weeks pregnant. the nurse should stay especially alert for signs and symptoms of: A." Rationale: A woman with an external monitor should lie in the position that is most comfortable to her. "You won't need to come in and check on me while I'm wearing this monitor. Which finding should the nurse discuss with the client first? A." C. Her consumption of six to eight cans of beer on weekends C. If the client is accustomed to moderate exercise. visits the nurse practitioner for a regular prenatal check-up. Thus. The need for iron during pregnancy. Prolonged gastric emptying D. A woman should be encouraged to change her position as often as necessary. Varicosities C. Her participation in low-impact aerobics three times per week B. but I should stay off my back. which the mother's body considers a foreign protein. and waste D. Varicosities are a complication of pregnancy more likely seen in women over age 35. but the maternal immune system is actually suppressed during pregnancy to prevent maternal rejection of the fetus. however. she develops constipation. the placenta isn't responsible for the production of maternal antibodies. age 39. Which statement by the client would indicate an understanding of the nurse's teaching? A. Decreased appetite B. The placenta produces estrogen and progesterone. gases. Production of estrogen and progesterone B. Reduced intestinal motility Rationale: During pregnancy. Production of maternal antibodies Rationale: Fetal immunities are transferred through the placenta. Which of the following functions would the nurse expect to be unrelated to the placenta? A. and prolonged gastric emptying may contribute to constipation. although the supine position should be discouraged. for fetal growth and an increased blood supply. An adolescent pregnancy doesn't increase the risk of nausea and vomiting or gestational diabetes. Nausea and vomiting D. the monitor may need to be repositioned after a position change. hormonal changes and mechanical pressure reduce motility in the small intestine. Adolescent girls may already be anemic. enhancing water absorption and promoting constipation.
A client. Her practice of taking a multivitamin supplement daily
Rationale: Consuming any amount or type of alcohol isn't recommended during pregnancy because it increases the risk of fetal alcohol syndrome or fetal alcohol effect.B. pregnancy-induced hypertension (PIH). Her consumption of four to six small meals daily D. "I know that the external monitor increases my risk of a uterine infection. Taking a multivitamin supplement daily and eating a balanced diet are recommended during pregnancy. What is the primary cause of this problem during pregnancy? A.
especially temperature and pulse. the nurse's highest priority is to evaluate: A. A glass of milk B. A cup of hot tea C. The nurse prepares a client who's 28 weeks pregnant for a nonstress test (NST)."
Rationale: With each pregnancy. The nurse is caring for a client whose membranes ruptured prematurely 12 hours ago. Brushing a hand over a nipple or
. The nurse should anticipate that the client will need to: A. Having the client drink orange juice B. A client is expecting her second child in 6 months. Iron deficiency anemia. such as orange juice. maternal vital signs and FHR. may suggest maternal infection caused by PROM. and STDs may occur in any client regardless of age. their fetuses and neonates have a higher mortality and a higher incidence of trisomies. start using insulin. FHR is the most accurate indicator of fetal status after PROM and may suggest sepsis caused by ascending pathogens.B. or an antacid reduces the absorption of iron. "Each pregnancy has a unique psychosocial meaning. she says. sexually transmitted diseases (STDs). not the mother. A glass of orange juice Rationale: Increasing vitamin C enhances the absorption of iron supplements. Maternal vital signs. start taking an oral antidiabetic drug. "A client can develop couvade with any pregnancy. The WBC count may suggest maternal infection. Urine sugars aren't an accurate indication of blood glucose levels. cephalopelvic disproportion. B. monitor her urine for glucose. monitoring maternal vital signs and FHR takes priority. The other options don't address the client's feelings. During the psychosocial assessment. iron deficiency anemia. D. What should this client drink to increase the absorption of iron? A. Glucose tolerance test results show a blood glucose level of 160 mg/dl. C. To stimulate fetal movement. The nurse is providing care for a pregnant client in her second trimester. Rationale: After premature rupture of the membranes (PROM). Rationale: The client's blood glucose level should be controlled initially by diet and exercise. When assessing this client. A liquid antacid D. Also. be taught about diet. Assessing cervical effacement and dilation should be avoided in this client because it requires a pelvic examination. however. Taking an iron supplement with milk. The nurse is caring for a 16-year-old pregnant client. The client is taking an iron supplement." B. Instructing the client to brush her hand over a nipple C. C. a woman explores a new aspect of the mother role and must reformulate her self-image as a pregnant woman and a mother. "The facility requires these answers of all pregnant clients. Oral antidiabetic drugs aren't used in pregnant females. the nurse may instruct the client to drink a liquid. "I've been through this before. tea. D." D. rather than insulin. Which intervention is most likely to stimulate fetal movements during this test? A. C. The client will need to watch her overall diet intake to control her blood glucose level. which may introduce pathogens into the birth canal. frequency and duration of contractions. Positioning the client on her left side Rationale: The NST measures fetal movement and the fetal heart rate. D. or to touch or rock her abdomen to move the fetus. cephalopelvic disproportion. cervical effacement and dilation. it can't be measured as often as maternal vital signs and FHR can and therefore provides less current information. "A second pregnancy may require more psychosocial adjustment. white blood cell (WBC) count. No evidence suggests that a second pregnancy requires more adjustment. Evaluating the frequency and duration of contractions doesn't provide insight into fetal status. Why are you asking me these questions?" What is the nurse's best response? A. Advising the client not to eat for 12 hours before the test D. Couvade symptoms occur in the father. Rationale: Mature pregnant clients are at increased risk for PIH and are more likely to require cesarean delivery. B." C.
so immediate delivery is unnecessary. Her BPP score is 8. fetal tone. gross body movements. This fetus has successfully demonstrated that the intrauterine environment is still favorable.
techniques near the end of pregnancy. C. A score between 8 and 10 is considered normal. Tests to evaluate for high-risk pregnancy
Rationale: No matter how far the client's pregnancy has progressed by the time of her first prenatal visit. For example. reactive fetal heart rate. The fetus isn't in distress at this time. The BPP may or may not be repeated if the score isn't within normal limits. Notify the physician and transfer the mother to labor and delivery for imminent delivery. Rationale: Fetal well-being is determined during a nonstress test by two accelerations occurring within 20 minutes that demonstrate a rise in heart rate of at least 15 beats. When providing teaching. "Perform gentle back-lying exercises for 30 minutes daily. "Exercise to raise the heart rate above 140 beats/minute for 20 minutes daily." D. Starting from the 4th month of pregnancy. this score warrants detailed investigation. and gradually increase this time. but limit sessions to 15 minutes daily. the nurse should be sure to cover which topic? A. A normal response for each variable receives 2 points. In research studies. What should the nurse do next? A. signs and symptoms of pregnancy. "Walk briskly for 10 to 15 minutes daily. After 20 minutes of monitoring. indicating that the fetus has a low risk of oxygen deprivation and isn't in distress. D." B." C. A pregnant client comes to the facility for her first prenatal visit. the nurse should teach about danger signs during pregnancy so the client can identify and report them early. The client should repeat the test in 1 week. The client should begin by walking slowly for 10 to 15 minutes per day and increase gradually to a comfortable speed and a duration of 30 to 45 minutes per day. and qualitative amniotic fluid volume. the nurse should teach about labor
. Signs and symptoms of pregnancy D. What does this score indicate? A. The client should repeat the test in 24 hours. based on the number of weeks' gestation. is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. D. this client has a reassuring strip. Danger signs during pregnancy C. eating foods or drinking fluids hasn't been shown to influence the outcome of a nonstress test. Labor techniques B. an abnormal response receives 0 points. helping to avoid complications. Continue to monitor the baby for fetal distress. Rationale: The BPP evaluates fetal health by assessing five variables: fetal breathing movements. pregnancy itself not only increases oxygen consumption but reduces oxygen reserve. the nurse reviews the strip and finds two 15-beat accelerations that lasted for 15 seconds. Inform the physician and prepare for discharge. shortly before they're anticipated." Rationale: Taking brisk walks is one of the easiest ways to exercise during pregnancy. A fetus with a score of 6 or lower is at risk for asphyxia and premature birth. and any tests. C. "Try high-intensity aerobics.positioning the client on her left side wouldn't stimulate fetal movement. How should the nurse counsel her? A. 30 weeks pregnant. Ask the mother to eat something and return for a repeat test. The client should have a snack before the test to help ensure readable fetal movements. A client. B. A client who's 4 months pregnant asks the nurse how much and what type of exercise she should get during pregnancy. the client should
A client is told that she needs to have a nonstress test to determine fetal well-being. The nurse should discuss other topics just before they're expected to occur. The fetus should be delivered within 24 hours. The test results don't suggest fetal distress. a few weeks before they're scheduled. The pregnant client should avoid high-intensity aerobics because these greatly increase oxygen consumption. B. the results are inconclusive.
Report the client's concerns to her caregiver D. "You practice good health habits. It's also important for the nurse to determine whether the client has any complicating problems such as an eating disorder. and strenuous activity. a client expresses concern about gaining weight. her fetus will develop: A. When planning the client's care. C." D. D. just follow them and you'll be fine. These findings signify: A. 400 mcg. then assess the client's response to that information. Rationale: The risk of intrauterine growth retardation may increase with the number of cigarettes a pregnant woman smokes. C. "There is nothing you can do to have a healthy pregnancy. the nurse anticipates informing her that if she doesn't stop smoking. Telling the client not to worry ignores the client's needs. When preparing the plan of care. trauma. Ask her to come back to the clinic every 2 weeks for a weight check. Rationale: Weight gain during pregnancy is a normal concern for most women. umbilical cord prolapse." C. Be alert for a possible eating problem and do a further in-depth assessment. Sedative use. an EFM may show large variable decelerations during
During her first prenatal visit. and renal
. B. A client who's planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. Tachycardia Rationale: Factors that may precipitate a sickle cell crisis during pregnancy include dehydration.
disorders are associated with multifactorial genetic inheritance. fever. the nurse should discuss the role of folic acid in preventing neural tube defects.avoid back-lying exercises because in this position the enlarged uterus may reduce blood flow through the vena cava. stress. the nurse detects large variable decelerations in the fetal heart rate (FHR) on the external electronic fetal monitor (EFM). The nurse must first teach the client about normal weight gain and diet in pregnancy. The nurse should provide information but not prescribe the drug. the start of the second stage of labor. Dehydration C. improves pregnancy outcomes by preventing certain complications. B. infection. the nurse should identify which factor as a potential trigger for a sickle cell crisis during pregnancy? A. it's all up to nature. an infection. Shortly afterward. Telling the client that it's up to nature is inaccurate. Reporting the client's concern about weight gain to the health care provider isn't necessary at this time. Practicing good health habits is important for any person. a significant change in the FHR may indicate umbilical cord prolapse. The client should avoid exercises that raise the heart rate over 140 beats/minute because the cardiovascular system already is stressed by increased blood volume during pregnancy. intrauterine growth retardation. C. a renal disorder. a cardiac abnormality. Which of the following would be the nurse's best action? A. She reports smoking 20 to 25 cigarettes per day. Which of the following would be the nurse's best response? A. A weight check every 2 weeks also is unnecessary. Hypertension D." Rationale: When counseling a client who's planning to become pregnant. A client undergoes an amniotomy. a neural tube defect. "Folic acid. D. hypertension. A client who's 7 weeks pregnant comes to the clinic for her first prenatal visit. not maternal cigarette smoking A client who's 24 weeks pregnant has sickle cell anemia. Sedative use B." B. It's the client's responsibility to ask the health care provider about a prescription. "Pregnancy is a human process. fatigue. Rationale: After an amniotomy. the need for labor induction. Neural tube defects. and tachycardia aren't known to precipitate a sickle cell crisis. Ask the client how she feels about gaining weight and provide instructions about expected weight gain and diet. you don't have to worry. cardiac abnormalities. B.
double vision. The fetal outline may be palpated after 24 weeks. D. ballottement. A client is admitted to the facility with a suspected ectopic pregnancy. the nurse may assess Hegar's sign (softening of the uterine isthmus) between the 6th and 8th weeks of pregnancy. absence of fetal heart tones. Pain may be caused by a ruptured or distended fallopian tube or blood in the peritoneal cavity. and sudden weight gain. use of an oral contraceptive for 5 years. Impaired gas exchange may result from the loss of oxygen-carrying hemoglobin through blood loss. Rationale: When performing a vaginal or rectovaginal examination. Because the client exhibits most of these signs. and double vision D. Pain. Gestational trophoblastic disease Rationale: Gestational trophoblastic disease causes increased nausea and vomiting. quickening. Absence of fetal heart tones is a sign of
A client who's 12 weeks pregnant is complaining of severe left lower quadrant pain and vaginal spotting. C. B. When reviewing the client's health history for risk factors for this abnormal condition. Risk for deficient fluid volume B. she requires further evaluation. double vision. a history of pelvic inflammatory disease B. fluids are needed to restore intravascular volume until the bleeding is surgically controlled. Proteinuria. Headaches. the primary cause of ectopic pregnancy. but fluid volume loss through hemorrhage is the greatest threat to her physiological integrity and must be stopped. Rationale: A ruptured ectopic pregnancy is a medical emergency due to the large quantity of blood that may be lost in the pelvic and abdominal cavities. the client's fundal height of 20 cm at 3 months' gestation is too large to indicate fetal demise. Nursing assessment reveals a fundal height of 20 cm and no audible fetal heart tones. Proteinuria. Hegar's sign. Hyperemesis gravidarum D. and vaginal bleeding C. and vaginal bleeding B. Impaired gas exchange. fetal outline. A urine specimen reveals proteinuria. Ballottement isn't elicited until the 4th or 5th month of pregnancy.
The nurse is performing a physical examination of a primigravid client who's 8 weeks pregnant. Shock may develop from blood loss. and vaginal spotting. headaches. C. Vaginal bleeding and uterine contractions aren't associated with PIH. Proteinuria. and uterine contractions Rationale: A client with PIH complains of headache. the nurse expects to find: A. and large quantities of I. Of the following nursing diagnoses. In fetal demise. double vision. D. C.cord compressions. At this time. uterine size decreases. uterine enlargement beyond that expected for the number of weeks' gestation. grand multiparity (five or more births). All the other nursing diagnoses are relevant for a woman with an ectopic pregnancy. Rationale: Pelvic inflammatory disease with accompanying salpingitis is commonly implicated in cases of tubal obstruction. Labor induction is indicated if the client's labor fails to progress. Ectopic pregnancy isn't associated A client who's 3 months pregnant with her first child reports that she has had increasing morning sickness for the past month. Ectopic pregnancy C. the nurse expects to assess: A. A client with pregnancy-induced hypertension (PIH) probably exhibits which of the following symptoms? A. Anxiety. Quickening typically is reported after 16 to 20 weeks. the nurse should give the highest priority to: A. She's admitted for treatment of an ectopic pregnancy. The other options aren't associated with FHR changes. An infection causes temperature elevation. Anxiety may be due to such factors as the risk of dying and the fear of future infertility.
. Fetal demise B. The nurse should suspect which complication of pregnancy? A. headaches. use of an intrauterine device for 1 year D.V. The second stage of labor starts with complete cervical dilation.
C. they're most noticeable during the last 6 weeks of gestation in primigravid clients and the last 3 to 4 months in multiparous clients. compromising venous return and causing blood pressure to drop. fetal distress. Back labor refers to pain that typically starts in the back. These changes may cause cardiac stress. During the third trimester. Measure the client's blood pressure. Because she has just entered her 36th week of pregnancy. D. a client who's 32 weeks pregnant becomes pale. Rationale: Before planning any intervention with a client who smokes. although it may cause sharp abdominal pain. and lightheaded while supine. back labor. Vaginal examination discloses a closed. it's essential to determine whether or not the client is willing or ready to stop smoking. A client who's pregnant with her second child comes to the clinic complaining of a pulling and tightening sensation over her pubic bone every 15 minutes. B.
. age 19. B. assess the client's readiness to stop. A client who's 30 weeks pregnant has a corrected atrial septal defect and minor functional limitations. a fundal height of 20 cm doesn't support that diagnosis. This gives the nurse an opportunity to work with her over time to help with permanent smoking cessation. especially during the second trimester. Pain from true labor contractions typically starts in the back and moves to the front of the fundus as a band of pressure that peaks and subsides in a regular pattern. D. however. thick. C. true labor contractions. Deep breathing wouldn't relieve this client's symptoms. Decreased or absent fetal movements. Decreased heart rate B. a pregnant
woman will agree to stop for the duration of the pregnancy. the client's enlarged uterus suggests a different problem. restoring normal venous return and blood pressure. B. a third-degree laceration. A client. In the course of the assessment. Listen to fetal heart tones D. D. the nurse learns that this woman smokes one pack of cigarettes a day. Rationale: Braxton Hicks contractions cause pulling or tightening sensations. has an episiotomy to widen her birth canal. These findings suggest that the client is experiencing: A. This complication is called: A. Increased blood pressure Rationale: Pregnancy increases plasma volume and expands the uterine vascular bed. During a physical examination. Listening to fetal heart tones and measuring the client's blood pressure wouldn't provide relevant information nor would they treat the client's symptoms. pressure on the inferior vena cava increases. or port-wine-colored fluid may also indicate fetal distress. This may lead to syncope and accompanying symptoms when the client is supine. Although hyperemesis gravidarum causes increased nausea and vomiting. Which pregnancy-related physiologic change places her at greatest risk for more severe cardiac problems? A. Blood pressure during early pregnancy may decrease 5 to 10 mm Hg. Rationale: As the uterus enlarges. help the client develop a plan to stop. Turn the client on her left side B. provide the client with the telephone number of a formal smoking cessation program. posterior cervix. Braxton Hicks contractions. Increased plasma volume C. She reports no vaginal fluid leakage. C. reaching its lowest point during the second half of the second trimester. Ask the client to breathe deeply C. Decreased cardiac output D. The nurse is assessing a pregnant woman in the clinic. green-tinged or yellowish green– tinged fluid. possibly increasing the heart rate and boosting cardiac output. Although these contractions may occur throughout pregnancy. primarily over the pubic bone. a fourth-degree laceration. Fetal distress doesn't cause contractions. The first step the nurse should take to help the woman stop smoking is to: A. it gradually returns to first-trimester levels. Which action should the nurse immediately take? A. she's apprehensive about her symptoms.ectopic pregnancy. suggest that the client reduce the daily number of cigarettes smoked by one-half. Delivery extends the incision into the anal sphincter. a second-degree laceration. a first-degree laceration. Commonly. dizzy. Turning the client on her left side relieves pressure on the vena cava.
pulmonary edema.. If the client doesn't accept that she's pregnant. She also takes prednisone (Orasone). hypertensive crisis Rationale: When administered concomitantly with prednisone or another corticosteroid. 5 mg by mouth twice per day. A client. a client states. multiparity.V. July 5. is receiving the tocolytic agent terbutaline (Bricanyl). D. D. I've missed two periods now. A first-degree laceration involves the fourchette. to halt uterine contractions.Rationale: Delivery may extend an episiotomy incision to the anal sphincter (a third-degree laceration) or the anal canal (a fourth-degree laceration). June 19. The nurse calculates the estimated date of delivery (EDD) as: A. This results in an EDD of July 19. C. June 5. increased uterine contractions B. D. On her second visit to the prenatal facility. C. the nurse should monitor the client for: A. Other cardiac rhythm disturbances also may occur during pregnancy and don't require treatment unless the client has concurrent heart disease. July 19. Preparing to relinquish the
When auscultating the heart sounds of a client who's 34 weeks pregnant. Poor diet Rationale: Typically. the nurse calculates the client's EDD by adding 7 days to the 1st day of the last menstrual period (12 + 7 = 19) and subtracting 3 months from the month of the last menstrual period (October – 3 months = July). Low self-esteem C. B. asthma exacerbation. the nurse detects a systolic ejection murmur. Accepting the biological fact of pregnancy Rationale: The first maternal psychological task of pregnancy is to accept the pregnancy as a biological fact. Document the finding. and poor diet aren't direct risk factors for committing child abuse. to control asthma. terbutaline may cause pulmonary edema. Typically. the abusive parent has low self-esteem along with many unmet needs. Preparing to relinquish the neonate through labor D. Identifying the fetus as a separate being usually occurs after the client feels fetal movements. Consult with a cardiologist. C. the nurse determines that the client has accomplished which psychological task of pregnancy? A. a systolic ejection murmur over the pulmonic area is a common finding. Rationale: During pregnancy. A pregnant client's last menstrual period began on October 12. Multiparity D. Explain that this finding may indicate
. and vaginal mucous membranes. Identifying the fetus as a separate being B. 7 months pregnant. During the first trimester. Lack of nurturing experience and inadequate knowledge of childhood growth and development may also contribute to the potential for child abuse. perineal skin.5 mcg/minute I. or hypertensive crisis. A second-degree laceration extends to the fasciae and muscle of the perineal body." Based on this statement. The nurse need not consult a cardiologist or the primary care health provider and shouldn't tell the client that this finding indicates a cardiac disorder. The nurse should document the finding and check for the murmur during the next visit. the nurse evaluates a pregnant client for factors that suggest she might abuse a child. A low educational level. Concomitant administration of a corticosteroid and terbutaline doesn't cause increased uterine contractions.
a cardiac disorder. asthma exacerbation. which is normal during pregnancy. Assuming caretaking responsibility for the neonate C. To detect an adverse interaction between these drugs. Contact the client's primary health care provider. 17. she's unlikely to seek prenatal care. B. Which parental characteristic is a risk factor for committing child abuse? A. "I guess I really am pregnant. Which action should the nurse take? A. Rationale: Using Nägele's rule. along with changes in heart size and position. Assuming caretaking responsibility for the neonate should occur during the postpartum period. Low educational level B. it results from increases in blood volume and cardiac output.
Signs of facial or digital edema Rationale: Postural hypotension doesn't occur until late in the pregnancy and is easily correctable. scheduling an ultrasound test to confirm the pregnancy. D. To help confirm that she's in true labor. Fetal heart rate and activity C. A client. each lasting 20 seconds. discomfort that moves from the
. changes in cervical effacement and dilation after 1 to 2 hours D. Genetic testing isn't necessary for a low-risk client. leg cramps cause shortening of the gastrocnemius muscle in the calf. such as fetal heart rate and activity. arrives in the emergency department complaining of contractions. scheduling genetic testing for the client. B. Instructing her to increase milk and cheese intake to 8 to 10 servings per day Rationale: Common during late pregnancy. not ultrasonography. which of the following assessments is least important? A. each lasting 15 seconds or more and occurring with fetal movement. C. D. The fetus is nonreactive and hypoxic. C. The client undergoes ultrasonography to evaluate fetal growth and wellbeing. During a nonstress test (NST). The fetus isn't in distress at this time. reactive (favorable) results include two to three FHR increases of 15 beats/minute or more. A low-risk client who's 6 weeks pregnant comes to the clinic for her first prenatal visit. Rationale: True labor is characterized by progressive cervical effacement and dilation after 1 to 2 hours. regular contractions. Although moderate exercise promotes circulation. The client should undergo an oxytocin challenge test B.
When determining maternal and fetal well-being. should be started early in the pregnancy because abnormalities can put the mother or the fetus at risk for significant physiologic and psychological problems. the nurse notes three fetal heart rate (FHR) increases of 20 beats/minute. the physician must evaluate the client's need for calcium supplements. Which nursing action would be most effective in helping her cope with these cramps? A. Excessive calcium intake may cause hypercalcemia. Collection of other assessment data. establishing a schedule of prenatal visits B. An oxytocin challenge test is performed to stimulate uterine contractions and evaluate the FHR. Advising her to take over-the-counter calcium supplements twice per day C. 38 weeks pregnant. the nurse should establish a regular schedule of prenatal visits. Signs of postural hypotension B. contractions that feel like pressure in the abdomen and groin. a nonreactive result may indicate fetal hypoxia. The test is inconclusive and must be repeated. enrolling the client in a childbirth class. increased fetal movement. Suggesting that she walk for 1 hour twice per day B. this procedure yields different information from one trimester to the next. Childbirth education classes can start at any time during pregnancy. A nonreactive result occurs when the FHR doesn't rise 15 beats/minute or more over the specified time. Rationale: In an NST. the client decides when to enroll. a nipple stimulation contraction test may be ordered. At this time. calcium supplements and additional servings of high-calcium foods may be unnecessary. Rationale: To promote the health of the client and her fetus. promoting leg cramps. If the client eats a well-balanced diet. A client who's 7 months pregnant reports severe leg cramps at night. The mother's acceptance of growing fetus D. Dorsiflexing or standing on the affected leg extends that muscle and relieves the cramp. walking 2 hours daily during the third trimester is excessive.neonate through labor normally occurs during the third trimester. Teaching her to dorsiflex her foot during the cramp D. and signs of edema. the nurse should assess for: A. C. the nurse should assign highest priority to: A. irregular contractions. Pregnancy is confirmed by serum human chorionic gonadotropin levels. the mother's acceptance of the growing fetus. These increases occur only with fetal movement. Although the nurse may encourage enrollment. If results are inconclusive. What does this finding suggest? A.
" C. if the pregnancy is normal" Rationale: During a normal pregnancy. depending on body weight. Excessive alcohol intake has serious harmful effects on the fetus. and maxillary hypoplasia. The client says that she's concerned she may gain too much weight and wants to start dieting. Alcohol intake may also affect the client's nutrition and may predispose her to complications in early pregnancy. increased fetal movement. Uterine enlargement C. which includes microcephaly.back to the front of the abdomen and. 2 months pregnant." B. the goal of nursing care is to achieve optimal fetal growth. The nurse should expect to collect which assessment findings? A." Rationale: Depriving the developing fetus of nutrients can cause serious problems and the nurse should discuss this with the client. "Until the end of the third trimester" D. "Client will remain hospitalized for the duration of pregnancy to relieve stress. "Client will gain weight according to the expected pattern for pregnancy." D. "The client consumes 2 to 6 oz of alcohol daily. "Now isn't a good time to begin dieting because you are eating for two. Which client outcome identifies a safe level of alcohol intake for this client? A. growth retardation. Fetal heart tones Rationale: Breast sensitivity is the only sign assessed within the first 4 weeks of pregnancy. The nurse is caring for a client in the first 4 weeks of pregnancy. short palpebral fissures. "Nutrition is important because depriving your baby of nutrients can cause developmental and growth problems. A client who's 4 weeks pregnant comes to the clinic for her first prenatal visit. The nurse should respond by saying: A. alcohol. the client and her partner need not discontinue sexual activity. False labor causes irregular contractions that are felt primarily in the abdomen and groin and commonly decrease with walking. which can be evaluated by monitoring uterine growth through fundal height assessment. Amenorrhea is expected during this time. and cigarettes. "The client consumes no more than 2 oz of alcohol daily. "Client will exhibit uterine growth within the expected norms for gestational age. Breast sensitivity D. has hyperemesis gravidarum. A client. If the client develops complications that could lead to preterm labor. and lack of change in cervical effacement or dilation even after 1 or 2 hours. "The client consumes no more than 4 oz of alcohol daily. the nurse explores her use of drugs. "As long as you wish. The client isn't eating for two. possibly. The vitamins are supplements and don't contain everything a mother or baby needs. Exploring feelings helps the client understand her concerns. "Client will accept the pregnancy and stop vomiting. Which expected outcome is most appropriate for her? A. this is a misconception. A client asks how long she and her husband can safely continue sexual activity during pregnancy."
Rationale: A safe level of alcohol intake during pregnancy hasn't been established. When obtaining her health history. but she needs to be aware of the risks at this time. Therefore. they work in congruence with a balanced diet. The nurse is providing care for a pregnant 16-yearold client. The nurse shouldn't assume that excessive vomiting
. "Until the end of the second trimester" C." B. especially between the 16th and 18th weeks of pregnancy." Rationale: For a client with hyperemesis gravidarum." D. authorities recommend that pregnant women abstain from alcohol entirely. she and her partner should consult with a health practitioner for advice on the safety of sexual activity." B." D. Presence of menses B." C. "The client consumes no alcohol. bloody show. How should the nurse respond? A. The other assessment findings don't occur until after the first 4 weeks of pregnancy." C. "Let's explore your feelings further. "Until the end of the first trimester" B. "The prenatal vitamins should ensure the baby gets all the necessary nutrients. Affected neonates exhibit fetal alcohol syndrome.
increasing levels of estrogen . leading to such problems as earaches.for example. impaired hearing. Still. 16 to 18 weeks C. "You should check with your surgeon to determine whether breast-feeding would be possible. and a constant feeling of fullness in the ears. What information should the nurse give to this mother regarding breast-feeding success? A. Positive signs and objective indicators such as fetal outline on ultrasound confirm pregnancy At what gestational age would a primigravida expect to feel quickening? A. By the end of the 26th week
Rationale: It's important for the nurse to distinguish between a client who's having her first baby and one who has already had a baby. Uterine enlargement and Chadwick's sign C. A high-calorie diet helps control the mother's disease and doesn't contribute to neonatal size. Therefore. Neither excess sugar nor excess insulin reduces placental functioning. 12 weeks B. An ear infection Rationale: During pregnancy. There is the possibility that reduction surgery may have decreased the mother's ability to meet all of her baby's nutritional needs. you may have to supplement each feeding with formula. it's good to check with the surgeon to determine what breast reduction procedure was done. "It's contraindicated for you to breast-feed following this type of surgery. "I support your commitment. so breastfeeding after surgery is possible. 20 to 22 weeks D. When assessing a client during her first prenatal visit. The mother indicates she wants to breast-feed. Which of the following would the nurse expect to assess as presumptive signs of pregnancy A. They may be hospitalized briefly to regulate fluid and electrolyte status. usually around 18 to 20 weeks." Rationale: Recent breast reduction surgeries are done in a way to protect the milk sacs and ducts. and some supplemental feeding may be required. Maternal dietary intake of high calories D." B. Eustachian tube vascularization C. During the 6th month of pregnancy. What is the most likely cause of these symptoms? A. A positive pregnancy test and a fetal outline D. Large babies are prone to complications and may have to be delivered by cesarean section. Probable signs are objective but nonconclusive indicators . Braxton Hicks contractions and Hegar's sign Rationale: Presumptive signs. "You should be able to breast-feed without difficulty. Insulin acting as a growth hormone on the fetus C. Clients with hyperemesis gravidarum rarely gain weight according to the expected pattern. Women who have had children will feel quickening earlier. but they don't require hospitalization for the duration of pregnancy. the nurse discovers that the client had a reduction mammoplasty. Nothing in the question implies that the client has a serious neurologic disorder or an ear infection. A pregnant client who's diabetic is at risk for having a large-for-gestational-age infant because of which of the following? A. hospitalization may add to the stress of pregnancy by causing family separation and financial concerns. however.signifies the client doesn't accept the pregnancy.not progesterone . are mostly subjective and may be indicative of other conditions or illnesses. For the client who's pregnant for the first time." C. quickening occurs around 20 to 22 weeks. a positive pregnancy test. because they recognize the sensations. and Braxton Hicks contractions. Increasing progesterone levels D. Chadwick's sign. In fact. A serious neurologic disorder B. Excess insulin reducing placental functioning Rationale: Insulin acts as a growth hormone on the fetus. uterine enlargement. Preparing the mother for this
.cause vascularization of the eustachian tubes. Excess sugar causing reduced placental functioning B. Hegar's sign. pregnant diabetic clients must maintain good glucose control. a client reports intermittent earaches and a constant feeling of fullness in the ears. Amenorrhea and quickening B. such as amenorrhea and quickening." D.
Vaginal bleeding C. During a nonstress test (NST). At the end of fetal movement Rationale: An NST assesses the FHR during fetal movement. determined by palpation. Based on the history above. may not take care of herself. 10 days D. may not be fit to take care of a child. What is the most common finding associated with this antepartum complication? A. By pushing the control button when a fetal movement starts. Her uterus is soft. Nausea and vomiting D. Placenta previa D. and she's experiencing no pain. and nausea and vomiting are less commonly associated with ectopic pregnancy. Health care can be costly but it doesn't necessarily mean that the client has no interest in caring for herself or her child. When evaluating a pregnant client's fundal height. Taking up a second job doesn't necessarily solve this situation. the placenta tears away from the wall of the uterus before delivery. the nurse should suspect which of the following conditions? A. Which of the following is the approximate time that the blastocyst spends traveling to the uterus for implantation? A. The nurse assesses a client for signs and symptoms of ectopic pregnancy. not fundal height. vaginal bleeding. Threatened abortion Rationale: Placenta previa is associated with painless vaginal bleeding that occurs when the placenta or a portion of the placenta covers the cervical os. At the beginning of each fetal movement B. the client marks the strip to allow easy correlation of fetal movement with
. At the beginning of each contraction C. the nurse should stretch a measuring tape over the client's enlarged abdomen and measure from the symphysis pubis notch to the highest level of the fundus. Rationale: The client needs to know that resources are available to her. 7 days C.
An 18-year-old pregnant woman tells the nurse that she's concerned that she may not be able to take care of herself during her pregnancy. B. From the symphysis pubis notch to the umbilicus C. needs to take up a second job. Temperature elevation. the nurse should measure in which way? A. D. should be referred to community resources available for pregnant women. Measuring across the abdomen and measuring from the symphysis pubis to the umbilicus are incorrect procedures for measuring fundal height. 14 weeks Rationale: The blastocyst takes approximately 1 week to travel to the uterus for implantation. Fetal heart rate is 120 beats/minute. In abruptio placentae. A pelvimeter is used to evaluate the size of the maternal pelvis for delivery. Preterm labor C. She states that prenatal care is expensive and her job doesn't provide insurance. 2 days B. To mark the strip. the FHR accelerates with each movement. occurring in over 90% of women with this antepartum complication. threatened abortion occurs during the first 20 weeks' gestation. In a healthy fetus. Across the abdomen laterally B. the client usually has pain and a boardlike uterus. the electronic tracing displays a relatively flat line for fetal movement. With a pelvimeter designed to measure fundal height D. By definition. The nurse should recognize that she: A. making it difficult to evaluate the fetal heart rate (FHR). A woman in her 34th week of pregnancy presents with sudden onset of bright red vaginal bleeding. Preterm labor is associated with contractions and shouldn't involve bright red bleeding. The other options are incorrect. Temperature elevation B. Abruptio placentae B. the nurse should instruct the client to push the control button at which time? A.possibility is extremely important because the client's psychological adaptation to mothering may be dependent on how successfully she breast-feeds. From the symphysis pubis notch to the highest level of the fundus Rationale: To measure fundal height. After every three fetal movements D. C. Abdominal pain Rationale: Abdominal pain is the most common finding in ectopic pregnancy. and the nurse should help her to find those resources.
If the client has a placental abruption. A vaginal examination is contraindicated in the presence of bleeding. rather than in the morning. Assess the location and consistency of the uterus C. Pushing the control button after every three fetal movements or at the end of fetal movement wouldn't allow accurate comparison of fetal movement and FHR changes. so the nurse must determine the level of the uterus and mark that level on the client's abdomen. take the vitamin on a full stomach. A client who's 16 weeks pregnant comes to the emergency department complaining of vaginal bleeding. Both estrogen and progesterone levels are rising B.the FHR. Rapid fetal heart tones B. Both estrogen and progesterone levels are declining. Between the 7th and 9th months. No fetal heart tones are heard because there is no viable fetus. The estrogen level is much higher than the progesterone level. Between 18 and 40 weeks' gestation. She must also check the consistency of the uterus. a woman with hydatidiform mole often has marked nausea and vomiting. Which statement accurately describes estrogen and progesterone levels during this client's stage of pregnancy? A. B. Rationale: Until the 7th month of pregnancy. the uterus grows fast and is larger than expected for a given gestational date. This increasing estrogen-progesterone ratio promotes the onset of uterine contractions. (Fifty percent of all clients with hypertension will develop abruptio placenta. and fetal heart tones 160 beats/minute. Switching brands may not be helpful and may be more costly. Abnormally high human chorionic gonadotropin (HCG) levels C.) In this case. Which signs or symptoms indicate a hydatidiform mole? A. In addition to telling the client how important taking the vitamins are. switch brands. C. The nurse is assessing a pregnant woman. Slow uterine growth D. Prepare for immediate delivery. to reduce nausea. Lack of symptoms of pregnancy Rationale: In a pregnant woman with a hydatidiform mole.
Rationale: The nurse must determine whether placenta previa or abruptio placentae is the problem. Bleeding from a placental previa is usually painless. the trophoblast villi proliferate and then degenerate. heart rate 95 beats/minute. respiratory rate 25 breaths/minute. A client at 35 weeks' gestation complains of severe abdominal pain and passing clots. During a prenatal visit at 20 weeks' gestation. both estrogen and progesterone are secreted in progressively greater amounts. Rationale: Prenatal vitamins commonly cause nausea and taking them on a full stomach may curb this. birth will most likely be by cesarean section. Orange juice tends to make pregnant women nauseated. B. Because of the greatly elevated HCG levels. take the vitamin first thing in the morning. Because there is rapid proliferation of the trophoblast cells. Proliferating trophoblast cells produce abnormally high HCG levels. Examine the vagina to determine whether her client is in labor. Perform an ultrasound to determine placental placement. The client's vital signs are blood pressure 150/100 mm Hg. take the vitamin with orange juice for better absorption. a uterus that is filling with blood because the placenta has detached early is rigid. A newly pregnant woman tells the nurse that she hasn't been taking her prenatal vitamins because they make her nauseated. which procedure is used to detect fetal anomalies?
. estrogen secretion continues to increase while progesterone secretion drops slightly. not the NST. D. D. C. a pregnant client asks whether tests can be done to identify fetal abnormalities. Most nurses haven't been taught how to perform an ultrasound. The admitting nurse must determine the cause of the bleeding and respond appropriately to this emergency. The vitamins may be taken at night. Which of the following should the nurse do first? A. D. The estrogen level is much lower than the progesterone level. The FHR is assessed during uterine contractions in the oxytocin contraction test. the nurse should advise her to:
A. the presenting symptoms are highly suggestive of an abruption.
Levels of hCG rise rapidly until about the 20th week of gestation. such as human placental lactogen. and progesterone. By the 20th week. and cell layers develop.A. "Tell your son about the childbirth about 1 month before your due date. C." Rationale: Being involved in the pregnancy helps reinforce a child's position in the family and minimizes feelings of neglect and abandonment.
Amniocentesis Chorionic villi sampling Fetoscopy Ultrasound
Rationale: Ultrasound is used between 18 and 40 weeks' gestation to identify normal fetal growth and detect fetal anomalies and other problems. A client who's 32 weeks pregnant is hospitalized with preterm labor. the parents should discuss which aspects of family life will be changed by the upcoming birth and which will remain the same. Early during the 4th week (28 days after implantation). "2 to 3 weeks after fertilization" D." C. Amniocentesis is done during the third trimester to determine fetal lung maturity. During the 2nd week (14 days after implantation). notochord. "8 days after conception" B. During a health-teaching session. she's
During routine preconception counseling. Telling the child about the childbirth only 1 month before the due date wouldn't allow enough time to prepare him for the sibling and would prevent him from conceptualizing the passage of time. The eyes are open at approximately 28 weeks' gestation. and three new structures . "Involve your son in planning and preparing for a sibling. "Reassure your son that nothing is going to change. C. The nurse anticipates that at 16 weeks' gestation. Sensitive and specific pregnancy tests can detect hCG in the blood and urine even before the first missed menstrual period. 14 days after fertilization C. such as poor nutrition. D. cellular differentiation and organization occur. During the 3rd week of development (21 days after implantation). a client asks how early a pregnancy can be diagnosed. strenuous athletic activity. 28 days after fertilization Rationale: Implantation occurs at the end of the 1st week after fertilization. Fetoscopy is done at approximately 18 weeks' gestation to observe the fetus directly and obtain a skin or blood sample
Rationale: Fetal heart tones are usually audible with a fetoscope between 16 and 20 weeks' gestation. the client's fetus will: A. open the eyes. 7 days after fertilization B. cavities." D. After preterm labor is arrested.form. Parents should reward mature behavior and ignore immature behavior. a pregnant client asks the nurse how soon the fertilized ovum becomes implanted in the endometrium. and allantois . The nostrils are open at about 21 to 28 weeks' gestation. Which answer should the nurse supply? A. The fetus can suck and swallow at about 20 weeks' gestation. The nurse should make which suggestion? A. estrogen. B. pregnancy can be diagnosed as early as 8 days after conception. 21 days after fertilization D. be able to suck and swallow B. Chorionic villi sampling is performed at 8 to 12 weeks' gestation to detect genetic disease. they decline gradually and stay low for the remainder of gestation. A client who's 12 weeks pregnant attends a class on fetal development as part of a childbirth education program. implantation progresses and two germ layers. "When the woman misses a menstrual period" C. have audible heart sounds. the embryonic disk evolves into three layers.the primitive streak. when the blastocyst attaches to the endometrium. A pregnant client asks how she can best prepare her 3-year-old son for the upcoming birth of a sibling. have open nostrils. "Reprimand your son if he displays immature behavior. A missed period may also be related to other factors. D." B. increase during pregnancy. when the syncytiotrophoblast produces hCG. instead. Other hormones. What is the nurse's best response? A. and certain drugs. Reassuring him that nothing will change would be misleading.
. "As soon as hormone levels decline" Rationale: Based on human chorionic gonadotropin (hCG) levels in the blood and urine.
and false and true labor are discussed in later classes." D. 28 cm. The nurse is assisting in developing a teaching plan for a client who's about to enter the third trimester of pregnancy. During a prenatal visit. Hemorrhoids B. "You can return to your job as a hairdresser in 2 weeks. This measurement indicates that the fetus has reached approximately which gestational age? A. Blurred vision C.
A client in the first trimester of pregnancy joins a childbirth education class. quickening and fetal movements. Although hemorrhoids may occur during pregnancy. A client receiving ritodrine should return to the clinic in 1 to 2 weeks for a regular checkup and evaluation for preterm labor.is contraindicated immediately after preterm labor. 24 weeks D." C.especially to a job that involves much standing . they don't require immediate attention. Which instruction should the nurse provide during discharge teaching? A. Quickening and fetal movements C. "Take the medication as needed whenever contractions occur. 12 weeks B. blurred vision may be a danger sign of preeclampsia or eclampsia. 24 cm. 28 weeks Rationale: The fundal height measurement in centimeters equals the approximate gestational age in weeks. Thus. 19 weeks C. until week 32. Signs and symptoms of labor. and at 28 weeks." B. Warning signs of complications D.
. False labor and true labor Rationale: In early childbirth education classes. Dyspnea on exertion and increased vaginal mucus are common discomforts caused by the physiologic changes of pregnancy. "Return to the clinic for a checkup in 6 weeks. Ritodrine must be taken regularly to prevent recurrence of preterm labor. nutrition. the nurse measures a client's fundal height at 19 cm. at 24 weeks. Dyspnea on exertion D.discharged with a prescription for oral ritodrine (Yutopar). Increased vaginal mucus Rationale: During pregnancy. the anatomy and physiology of pregnancy. Signs and symptoms of labor B. fundal height at 12 weeks is 12 cm. The teaching plan should include identification of which danger sign that must be reported immediately? A." Rationale: A client who's predisposed to preterm labor should abstain from sexual intercourse unless she uses a condom because semen contains prostaglandins that stimulate uterine contractions. instruction on the physiologic aspects of pregnancy may include warning signs of complications. and fetal development. complications that require immediate attention because they can cause severe maternal
and fetal consequences. During this trimester. Returning to work . "Abstain from sexual intercourse unless you use a condom. the class is most likely to cover which physiologic aspect of pregnancy? A.