Chapter 2: Expected physiological changes during Pregnancy
Chapter 3: Prenatal Care
Chapter 4: Nutrition during pregnancy
Chapter 5: Determination of fetal well being
Naegele's Rule
100
A nurse is caring for a client who is pregnant and states that their last menstrual period was on April 1, 2023. What is the client's estimated due date of delivery?
A: January 8, 2024
B: April 15, 2024
C: September 24, 2023
D: January 1, 2024
A: January 8, 2024
Rationale: To get the estimated due date, you subtract 3 months and 7 days from April 1st, and then add one year.
100
A nurse is providing reinforcement to a group of clients who are pregnant about measures to relieve backache during pregnancy. Which of the following measures should the nurse include?
A: Avoid any heavy lifting.
B: Perform Kegel exercises twice per day.
C: Perform pelvic rock exercises everyday. ( pelvic rock exercises stretches the muscles of the lower back and helps relieve lower back pain. )
D: Use proper body mechanics.
E. Avoid constrictive clothing.
C: Perform pelvic rock exercises everyday. ( pelvic rock exercises stretches the muscles of the lower back and helps relieve lower back pain. )
D: Use proper body mechanics.
100
A nurse in a prenatal clinic is reinforcing education to a client who is at 8 weeks of gestation. The client states " I don't like milk." Which of the following foods should the nurse recommend as a good source of calcium?
A: Dark leafy green vegetables
B: Deep red or orange vegetables
C: White breads and rice
D: Meat, poultry and fish.
Dark leafy green vegetables ( kale, artichokes, turnip greens are examples of low oxalate foods good for teeth and bone formation - along with other foods that are rich in calcium. )
100
A nurse is reviewing the findings of a client's biophysical profile. The nurse should expect which of the following variables to be included during the test? Select all that apply.
A: fetal height
B: fetal breathing movement
C: fetal tone
D: fetal position
E: amniotic fluid volume
B: Fetal breathing movement
C: Fetal tone
D: Amniotic fetal volume
100
During a prenatal visit a patient tells you her last menstrual period was May 21, 2016. Based on the Naegele's Rule, when is the estimated due date of her baby?
- A. February 27, 2016
- B. March 19. 2017
- C. February 28, 2017
- D. April 16, 2016
- C. February 28, 2017
200
A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy. The health record indicates this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? Select all that apply:
A: Child has delivered one newborn at term.
B: Client has experienced no pre-term labor.
C: Client has been through active labor
D: Client has had two prior pregnancies.
E: Client has one living child.
A: Child has delivered one newborn at term.
B: Client has experienced no pre-term labor.
C: Client has had two prior pregnancies.
D: Client has one living child.
200
A nurse is reinforcing teaching with a client who is pregnant about manifestations of complications to promptly report to the provider. Which of the following complications should the nurse reinforce to the client?
A: Vaginal bleeding
B: Swelling of the ankles
C: Heartburn after eating
D: Lightheadedness when lying on the back
Vaginal bleeding. ( Vaginal bleeding indicates a complication of the placenta - known as placenta previa. Instruct the client to notify the provider immediately.
200
A nurse in a prenatal clinic is assisting with caring for four clients. Which of the client's weight gain should the nurse report to the provider?
A: 1.8kg (4lb) weight gain and is in the first trimester.
B: 3.6kg (8lb) weight gain and is in the first trimester.
C: 6.8kg (15 lb) weight gain and is in the second trimester.
D: 11.3kg (25 lb) weight gain and is in the third trimester.
3.6 kg ( 8lb ) weight gain and is in the first trimester.
Rationale: The expected weight gain within the first trimester is 3-4 lbs.
200
A nurse is assisting with the care of a client who is in preterm labor and is scheduled to undergo an amniocenteses. The nurse should review which of the following tests to check for fetal lung maturity?
A: Alpha-fetoprotein (AFP)
B: Lecithin / spingomyelin ( L/S ) RATIO
C: Kleihauer-Bletke test
D: Indirect Coombs' test
B: Lecithin / Splingomyelin ( L/S ) ratio
Rationale: A test of the L/S ratio is done as a part of amniocentesis to determine fetal lung maturity.
200
2. During a prenatal visit a patient tells you her last menstrual period was November 25, 2016. Based on the Naegele's Rule, when is the estimated due date of her baby?
- A. October 1, 2017
- B. September 10, 2017
- C. August 28, 2016
- D. September 1, 2017
- D. September 1, 2017
300
A nurse is reviewing the health record of a client who's pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following should the nurse expect? Select all that apply.
A: Montgomery's glands
B: Goodell's sign
C: Ballottment ( returning of the fetus (ex: bouncing back of the fetus) against the fingers when the uterus is pushed during palpation )
D: Chadwick's sign
E: Quickening
B: Goodell's sign
C: Ballottment
D: Chadwick's sign
300
A client who is 7 weeks of gestation is experiencing nausea and vomiting in the morning. Which of the following information should the nurse include?
A: Eat crackers or plain toast before getting out of bed.
B: Awaken during the night to eat a snack.
C: Skip breakfast and eat lunch after nausea has subsided.
D: Eat a large evening meal.
A: Eat crackers or plain toast before getting out of bed. ( Nausea and vomiting during the first trimester of pregnancy might be relieved by eating crackers or plain toast prior to rising in the morning. )
300
A nurse in a clinic is reinforcing teaching with a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency?
A: Iron deficiency anemia
B: Poor bone formation
C: Macrosomic fetus
D: Neural tube defects
D: Neural tube defects.
Rationale: Neural tube defects are caused by folic acid deficiency. Food sources of folic acid include fresh leafy green vegetables, liver, peanuts, cereals, and whole grain breads.
300
A nurse is assisting with the care of a client who is pregnant and is undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. Which of the following responses should the nurse make?
A: It is used to stimulate uterine contractions.
B: it will decrease the incidence of uterine contractions.
C: It lulls the fetus to sleep.
D: It awakens a sleeping fetus.
D: It awakens a sleeping fetus.
Rationale: The acoustic vibration device is activated for 3 seconds on the maternal abdomen over the fetal head to awaken a sleeping fetus.
300
During a prenatal visit a patient tells you her last menstrual period was January 20, 2016. Based on the Naegele's Rule, when is the estimated due date of her baby?
- A. October 27, 2016
- B. September 5, 2017
- C. October 28, 2016
- D. November 1, 2016
- A. October 27, 2016
400
A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypertension. The client asks the nurse what causes these episodes. Which of the following statements should the nurse make?
A: " This is due to increase in blood volume."
B: "This is due to pressure from the uterus on the diaphragm."
C: " This is due to the weight of the uterus on the vena cava."
D: "This is due to increased cardiac output."
C: " This is due to the weight of the uterus on the vena cava."
Rationale: Maternal hypertension occurs when the client is lying in the supine position and the weight of the gravid uterus places pressure on the vena cava, decreasing venous blood flow to the heart.
400
A nurse is providing reinforcement to a client who is at 6 weeks of gestation about common discomforts of pregnancy. Which of the following findings should the nurse include? Select all that apply.
A: Breast tenderness
B: Urinary frequency
C: Epistaxis
D: Dysuria
A: Breast tenderness
B: Urinary frequency
C: Epistaxis
400
A nurse is reviewing a new prescription for iron supplements with a client who is at 8 weeks of gestation and has iron deficiency anemia. Which of the following beverages should the new reinforce the client to take the iron supplement with?
A: Ice water
B: Low fat or whole milk
C: Tea or coffee
D: Orange Juice
D: Orange Juice
Rationale: Orange juice contains vitamin C - which aids in the absorption of iron.
400
A nurse is reinforcing teaching with a client who is of 22 weeks gestation about the amniocentesis procedure. Which of the following statements should the nurse make?
A: You will lay on your right side during the procedure.
B: You should not eat anything for 24 hours prior to the procedure.
C: You should empty your bladder prior to the procedure.
D: The test is done to determine gestational age.
C: "You should empty your bladder prior to the procedure."
Rationale: The client's bladder should be empty to avoid inadvertent puncture during the procedure.
400
During a prenatal visit a patient tells you her last menstrual period was March 14, 2016. Based on the Naegele's Rule, when is the estimated due date of her baby?
- A. January 27, 2017
- B. December 21, 2016
- C. December 28, 2016
- D. January 1, 2016
December 21, 2016
500
A nurse receives a phone call from a client who would like information about pregnancy testing. Which of the following information should the nurse provide to the client?
A: " You should wait until 4 weeks after conception to be tested."
B: " You should be off any medications for 24 hours prior to the pregnancy test."
C: You should not eat or drink for at least 8 hours prior to the pregnancy test."
D: " You should use your first morning urination specimen to provide the most accurate results."
D: " You should use your first morning urination specimen for a home pregnancy test."
Rationale: Urine pregnancy tests should be done on a first voided specimen to provide the most accurate results.
500
A client who is at 8 weeks of gestation tells the nurse, " I am not sure I am happy about being pregnant." Which of the following responses should the nurse make?
A: I will inform the provider that you are having these feelings."
B: " It is normal to have these feelings during the first few months of pregnancy."
C: " You should be happy that you are going to bring new life into the world."
D: "I am going to make an appointment with the counselor for you to discuss these thoughts."
" It is normal to have these feelings during the first few months of pregnancy."
Rationale: Feelings of ambivalence about pregnancy are normal during the first trimester.
500
A nurse is assisting the charge nurse with reviewing postpartum nutrition needs with a group of clients who have begun breastfeeding their newborns. Which of the following statements by a member of group indicates an understanding of the teaching?
A: "I am glad i can have my morning coffee."
B: "I should take folic acid to increase my milk supply."
C: " I will continue adding 330 calories per day to my diet."
D: "I will continue my calcium supplements because I don't like milk."
D: "I will continue my calcium supplements because I don't like milk."
500
A nurse is assisting with the care ofa client who is pregnant and is to undergo a contraction stress test ( CST.) Which of the following findings are indications for this procedure? Select all that apply.
A: Decreased fetal movement
B: Intrauterine growth restriction
C: Post-maturity
D: Placenta previa
E: Amniotic fluid emboli
B: Intrauterine growth restriction
C: Post-maturity
500
During a prenatal visit a patient tells you her last menstrual period was August 28, 2016. Based on the Naegele's Rule, when is the estimated due date of her baby?
- A. July 4, 2017
- B. June 3, 2017
- During a prenatal visit a patient tells you her last menstrual period was August 28, 2016. Based on the Naegele's Rule, when is the estimated due date of her baby?
- A. July 4, 2017
- B. June 3, 2017
- C. June 4, 2017
- D. July 1, 2016
- D. July 1, 2016
- C. June 4, 2017