A client is at 8 weeks gestation. Which of the following findings would the nurse expect to see?
1. Multiple pillow orthopnea
2. Maternal
... [Show More] ambivalence
3. Fundus at the umbilicus
4. Pedal and ankle edema - correct answer 2. Maternal ambivalence
Ambivalence is a common finding of women during the first trimester
During a vaginal examination, the nurse palpates the back of a fetus' head 2 cm below the mother's ischial spines and facing toward the right side of the mother's back. Which of the following is consistent with this assessment?
1. ROA, -2 station
2. RSP, -2 station
3. RMA, +2 station
4. ROP, +2 station - correct answer 4. ROP, +2 station
ROP = Right occipital posterior (the back of the baby's head is facing toward the mother's right posterior), and +2 Station - the presenting part is 2 cm below the ischial spines
Incorrect
ROA = Right occipital anterior (the back of the babay's head is facing toward the mother's right anterior). -2 Station - the presenting part is 2 cm above the inschial spines
Incorrect
RSP = Risht sacral posterior (the buttocks of the baby are facing towards the mother's right posterior). -2 Station - the presenting part is 2 cm above the ischial spines
Incorrect
RMA = Right mentum anterior (the face of the baby is facing toward the mother's right anterior). +2 Station - presenting part is 2 cm below the ischial spines
The result of a pregnant woman's glucose challenge test is 145 mg/dL. Which of the following information is appropriate for the nurse to give the client at this time?
1. "You will need to inject insulin at least once a day for the rest of the pregnancy"
2. "Daily oral medicines will be prescribed for you to take"
3. "You need to have a fasting glucose tolerance test as soon as possible"
4. "The results are within normal limits so no intervention is needed" - correct answer 3. "You need to have a fasting glucose tolerance test as soon as possible"
While performing Leopold's maneuvers on a laboring woman, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following?
1. The fetal position is right occiput posterior
2. The fetal attitude is flexed
3. The fetal presentation is scapular
4. The fetal lie is vertical - correct answer 3. The fetal presentation is scapular
This is a shoulder presentation
A gravid woman and her husband inform the nurse that they have purchased a three-story home that was built in the 1930's. It is critical that the nurse counsel the couple that before moving into the home they do which of the following?
1. Remove all old carpeting
2. Check the water for heavy metals
3. Replace ll copper pipes
4. Monitor the bathrooms for signs of mildew - correct answer 2. Check the water for heavy metals
The water should be checked for lead. Lead consumption by the woman during pregnancy and/or by the baby can result in permanent central nervous system damage in the child
A nurse is working in the prenatal clinic. Which of the following findings would the nurse consider to be within normal limits for a client in the third trimester of pregnancy?
1. Diplopia
2. Epistaxis
3. Bradycardia
4. Oliguria - correct answer 2. Epistaxis
Epistaxis is commonly seen in pregnant clients. The bleeding is related to the increased vascularity of the mucous membranes. Unless the blood loss is significant, it is a normal finding.
A gravida G4 P1203, fetal heart rate 142, is 13 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct?
1. The woman is experiencing a normal pregnancy
2. The woman may be having difficulty accepting this pregnancy
3. The woman must see a nutritionist as soon as possible
4. The woman will likely miscarry the conceptus - correct answer 1. The woman is experiencing a normal pregnancy
A primigravid client is 39 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit?
1. Nausea
2. Dysuria
3. Urinary frequency
4. Intermittent diarrhea - correct answer 3. Urinary frequency
Urinary frequency recurs at the end of the third trimester. As the uterus enlarges, it again compresses the bladder, causing urinary frequency
A 36-week gestation client is being seen in the prenatal clinic. Where would the nurse expect the fundal height to be felt?
1. At the xiphoid process
2. At a point between the umbilicus and the xiphoid
3. At the umbilicus
4. At a level directly above the symphysis pubis - correct answer 1. At the xiphoid process
At 36 weeks' gestation, the fundus should be felt at the xiphoid process
At 20 weeks' gestation, the fundus should be felt at the umbilicus
At 12 weeks' gestation, the fundus should be felt directly above the symphysis pubis
A woman who has had no prenatal care was found to have hydramnios (excessive amniotic fluid) on admission to the labor unit and has since delivered a baby weighing 4500 grams. Which of the following complications of pregnancy likely contributed to these findings?
1. Pyelonephritis
2. Pregnancy-induced hypertention
3. Gestational diabetes
4. Abruptio placentae - correct answer 3. Gestational diabetes
Untreated gestational diabetics often have hydramnios and often deliver macrosomic (big body) babies
A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2012. Using Naegele's rule, which of the following would the nurse determine to be the client's estimated date of delivery (EDC)?
1. January 9, 2013
2. April 13, 2013
3. April 20, 2013
4. September 6, 2013 - correct answer 2. April 13, 2013
The EDC is calculated as April 13, 2013. Naegeles rule: First, identify the first day of the last normal menstrual period. Then, subtract 3 months and add 7 days, adjust the year if needed
A pregnant woman has Marfan syndrome, n autosomal dominant disease. It has previously been determined that the woman is heterozygous for the condition. Her husband has no known genetic diseases. The nurse advises the couple that their unborn child has which of the following probabilities of having Marfan's?
1. 25% probability
2. 50% probability
3. 75% probability
4. 100% probability - correct answer 2. 50% probability
This couple has a 50% probability of having a child who has Marfan's
A 32-week gestation client was last seen in the prenatal clinic at 28 weeks' gestation. Which of the following changes should the nurse bring to the attention of the Certified Nurse's Midwife?
1. Weight change from 128 pounds to 132 pounds
2. Pulse changes from 88 bpm to 92 bpm
3. Blood pressure changes from 110/70 to 140/90
4. Respiratory change from 16 rpm to 20 rpm - correct answer 3. Blood pressure changes from 110/70 to 140/90
A blood pressure elevation to 140/90 is a sign of mild pre-eclampsia
An ultrasound of a fetus' heart shows that "normal fetal circulation is occurring." Which of the following statements is consistent with the finding?
1. A right to left shunt is seen between the atria
2. Blood is returning to the placenta via the umbilical vein
3. Blood is returning to the right atrium from the pulmonary system
4. A right to left shunt is seen between the umbilical arteries - correct answer 1. A right to left shunt is seen between the atria
The foramen ovale is a duct between the atria. In fetal circulation, there is a right to left shunt through the duct
A nurse is caring for a pregnant woman who has been diagnosed with listeriosis. The nurse monitors the woman carefully for which of the following complications of pregnancy?
1. Uterine rupture
2. Pre-eclampsia
3. Fetal death
4. Polyhydramnios - correct answer 3. Fetal death
Fetal death is one of the complications associated with listeriosis (disease caused by infection with listeria)
A woman, who is being seen in the prenatal clinic, is found to be 12 weeks pregnant. She confides to the nurse that she is afraid her baby may be permanently damaged because she takes penicillin, a pregnancy B category medication, every day to prevent rheumatic fever. Which of the following responses by the nurse would be appropriate?
1. "I would let the doctor know that if I were you"
2. "It is unlikely that the baby was affected"
3. "First-trimester abortions are very safe"
4. "An ultrasound will tell you if the baby was affected" - correct answer 2. "It is unlikely that the baby was affected"
Although o controlled human trials have been conducted, there is no evidence that category B medications cause birth defects in animals. They are, therefore, considered safe for women to take during pregnancy
A woman with ah history of congestive heart disease is 36 weeks pregnant. Which of the following findings should the nurse report to the primary healthcare practitioner?
1. Presence of chloasma
2. Presence of severe heartburn
3. 10-pound weight gain in a month
4. Patellar reflexes 1+ - correct answer 3. 10-pound weight gain in a month
The weight gain may be due to fluid retention. Fluid retention occur in clients with pregnancy-induced hypertension and in clients with congestive heart failure. The physician should be notified
A nurse is discussing diet with a pregnant woman. Which of the following foods should the nurse advise the client to avoid during her pregnancy?
1. Brie cheese
2. Bartlett pears
3. Sweet potatoes
4. Grilled lamb - correct answer 1. Brie cheese
Soft cheese may harbor Listeria. The client should avoid consuming uncooked soft cheese
A client with a 4+ protein and 4+ reflexes is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse must closely monitor the woman for which of the following?
1. High leukocyte count
2. Explosive diarrhea
3. Fractured pelvis
4. Low platelet count - correct answer 4. Low platelet count
Low platelet count is one of the signs associated with HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets)
The nurse is interviewing a gravid client during the first prenatal visit. The client confides to the nurse that she owns a number of pet animals. The nurse should advise the client to be especially careful to refrain from coming in contact with the stools of which of the pets?
1. Cat
2. Dog
3. Hamster
4. Bird - correct answer 1. Cat
The client should refrain from coming into contact with cat feces. Cats often harbor toxoplasmosis, a teratogenic illness
A nurse, who is discussing serving sizes of foods with a new prenatal client, would state that which of the following is equal to 1 (one) serving from the dairy group?
1. 1 cup chocolate milk
2. 1/2 cup vanilla yogurt
3. 2 cups cottage cheese
4. 1 ounce cream cheese - correct answer 1. 1 cup chocolate milk
I cup of any milk (e.g. whole milk, skim milk, buttermilk, chocolate milk) is equal to 1 serving size from the dairy group
A nurse is developing a standard of care plan for teen women in an obstetrical clinic. Which f the following client care outcomes would be appropriate to include in the plan of care?
1. The teen gravida will have her fetus assessed for chromosomal anomalies
2. The teen gravida will eat a diet high in calcium and iron
3. The teen gravida will deliver the baby before 37 weeks gestation
4. The teen gravida will gain no more than 25 pounds during the pregnancy - correct answer 2. The teen gravida will eat a diet high in calcium and iron
Teens tend to consume less calcium and iron than they should consume during their pregnancies; therefore. this is an appropriate patient care outcome for pregnant teens
A nurse who sees the follow tracing on an electronic fetal monitor determines that the frequency and duration of the contractions are which of the following?
1. q 2 min x 60 secs
2. q 2 min x 90 secs
3. q 3 min x 30 secs
4. q 3 min x 60 secs - correct answer 4. q 3 min x 60 secs
The nurse notes each of the following findings in a 12-week gestation client. Which of the finding would enable the nurse to tell the client that she is PROBABLY pregnant?
1. Fetal heart rate via Doppler
2. Positive pregnancy test
3. Positive ultrasound assessment
4. Absence of menstrual period - correct answer 2. Positive pregnancy test
A positive pregnancy test is a PROBABLE sign of pregnancy. It is not a POSITIVE sign since the hormone tested for - human chorionic gonadotropin (hCG) - may be produced by, for example, a hydatidiform mole
FHR is a positive sign
Positive ultrasound is a positive sign
Amenorrhea is a presumptive sign
A nurse is caring for a 30-week gestation client who is high risk for preterm labor. The nurse would expect that the client would exhibit which of the following test results?
1. Marked amniotic fluid density
2. Positive fetal fibronectin test
3, Cervix that is over 1 inch long
4. Biophysical profile of 10 - correct answer 2. Positive fetal fibronectin test
A 30-week gestation client with a positive fetal fibronectin test is high risk for preterm labor
Marked amniotic fluid density may be seen in pregnancies complicated by blood incompatibilities. It is not associated with preterm labor
A 30-week gestation client with a cervix that is SHORTER than 1 inch is high risk for preterm labor
A biophysical profile is performed to determine the well-being of the fetus. It is not related to preterm labor
The nurse is providing health teaching to a group of gravid women. One woman, who states that is a smoker, asks about its impact on her pregnancy. The nurse responds that which of the following fetal complications may develop?
1. Low neonatal birth weight
2. Excess pregnancy weight
3. Severe neonatal anemia
4. Maternal hyperbilirubinemia - correct answer 1. Low neonatal birth weight
Low neonatal birth weight is the most common complication seen in pregnancies complicated by cigarette smoking
A client is 9 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit?
1. Urinary frequency
2. Occipital headache
3. Diarrhea
4. Leg cramps - correct answer 1. Urinary frequency
Urinary frequency is a common complaint of women during their first trimester
H/A may be benign or, especially if noted after 20 weeks' gestation, may be a symptom of pregnancy-induced hypertension (PIH)
Diarrhea rarely seen in pregnancy; constipation is a common complaint
Leg cramps commonly seen in second and third trimesters
A 39-year-old, 16-week gravida woman has had an amniocentesis. Before discharge, the nurse [Show Less]