Teaching Mommy
A nurse is reinforcing teaching with a client who is pregnant and has a new prescription for ferrous sulfate due to iron-deficiency anemia. The nurse should instruct the client to take this medication with which of the following?
Milk, Orange Juice, Scrambled eggs, A high-fiber meal
Orange juice
Orange juice and other vitamin C-rich foods and beverages enhance iron absorption.
A nurse is preparing to palpate the uterine fundus of a client who is at 22 weeks of gestation to measure fundal height. At which of the following locations should the nurse expect to find the fundus?
3 cm above the umbilicus, Just above the umbilicus, 5cm above the umbilicus, 3 cm below the umbilicus
Just above the umbilicus
At 18 weeks and later, the gestational age should be the same number in cm while measuring the fundal height
A nurse is collecting data from a client who is in her second trimester of pregnancy. The nurse should recognize which of the following findings as an expected physiologic change during pregnancy?
An increase in lordosis, Increased abdominal muscle tone, Posterior neck flexion, Decreased mobility of pelvic joints
An increase in lordosis
Clients who are pregnant typically develop a gradual, forward curving of the spine as the growth of the fetus and uterus tilts the pelvis forward. Lordosis resolves after delivery.
A nurse is collecting data from a client who is at 35 weeks of gestation. Which of the following findings should the nurse report to the provider?
Constipation, Leukorrhea, Blurred Vision, Low back pain
Blurred Vision
The nurse should report blurred vision to the provider, as this can indicate possible preeclampsia and requires further assessment.
A nurse is collecting data from a fetal assessment of heart rate and finds a HR of 130/min. Which of the following actions should the nurse take?
Ask another nurse to verify the heart rate, Document this as an expected finding, Call the physician to assess the newborn, Reposition the client into a side lying position
Document this as an expected finding
The baseline fetal heart rate is 120 to 160/min. The nurse should document this as an expected finding.
A nurse is reinforcing teaching about quickening with a client who is at 6 weeks of gestation. Which of the following information should the nurse include?
Quickening starts soon after implantation.
Quickening occurs between the second and third months of pregnancy
Quickening occurs between the fourth and fifth months of pregnancy
Quickening starts during the last weeks of pregnancy
Quickening occurs between the fourth and fifth months of pregnancy
Quickening is defined as the first time the client is able to feel the fetus move. It usually occurs between 14 and 18 weeks of gestation.
A nurse is reinforcing teaching with a client who is at 17 weeks of gestation and is scheduled to have a maternal serum alpha-fetoprotein (MSAFP) determination. Which of the following information should the nurse include?
This test will screen for:
gestational diabetes, neural tube defects, fetal maturity, ABO incompatibility
This test will screen for neural tube defects
MSAFP measures blood levels of alpha-fetoprotein in the client's blood. Abnormal levels can indicate a neural tube defect, such as spina bifida, as well as multifetal pregnancies and fetal abdominal wall defects.
A nurse is caring for a client in the prenatal clinic who is at 7 weeks of gestation. The client reports urinary frequency and asks the nurse if this will continue throughout her pregnancy. Which of the following responses by the nurse is appropriate?
Yes, it will, but if you decrease your fluid intake, especially at bedtime, it won't be so bothersome
No, in most cases it only lasts until about the 12th week, but it will continue if you have a poor bladder tone
There is no way to predict how long it will last for each individual client, so you’ll just have to wait and see
No, it should only last until about your 12th week, but it will return near the end of the pregnancy
No, it should only last until about your 12th week, but it will return near the end of the pregnancy
Urinary frequency usually disappears at about 12 weeks of gestation but returns near term as the enlarging uterus presses on the bladder. It can also worsen following fetal descent.
A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect?
Uterine enlargement greater than expected for gestational age, Copious vaginal bleeding, Severe nausea and vomiting, Pelvic pain
Pelvic Pain
The client will experience a dull or gas-like pain at the beginning, progressing to a sharp, stabbing pain as the tube stretches.
A nurse is collecting data from a client who is at 18 weeks of gestation and tells the nurse that she felt light fluttering in her stomach the previous day. The nurse should use which of the following terms to document this finding?
Ballottement, Lightening, Quickening, Chloasma
Quickening
Clients often describe quickening as a fluttering sensation they first perceive as early as the 14th week of gestation. It reflects fetal movement.
A nurse is caring for client who is at 20 weeks of gestation and tells the nurse that she is concerned that exercising might pose risks to her pregnancy. Which of the following statements should the nurse make?
Be careful about exercises that include stretching, Moderate exercise can help improve your circulation, It is a good idea to increase your weight-bearing exercises, You should rest for 5 minutes following the exercise
Moderate exercise can help improve your circulation
Improving circulation is one of many benefits of moderate exercise during pregnancy. It can also enhance well-being and promote rest and relaxation. It also improves muscle tone, which might shorten the duration of labor. The recommendation is to rest for 10 min after exercising. Resting in a side-lying position promotes optimal circulation in the later stages of pregnancy.
A nurse is caring for a client who is at 38 weeks of gestation and has a score of 10 on her biophysical profile. Which of the following actions should the nurse take?
Assure the client that the score is within the expected range.
Administer oxygen and notify the provider.
Assist the client into a side-lying position
Offer the client orange juice and repeat the assessment in 1hr
Assure the client that the score is within the expected range.
The biophysical profile yields a score based on fetal breathing, movement, tone, amniotic fluid volume, and fetal heart rate reactivity. A score of 2 is assigned to each expected finding. A score of 10 indicates expected findings in all five areas.
A nurse is reinforcing teaching about common discomforts of pregnancy during the first trimester with a client who is pregnant. Which of the following manifestations should the nurse include in the teaching?
Urinary urgency, Constipation, Supine hypotension, Heartburn
Urinary urgency
Urinary urgency and frequency are common discomforts occurring during the first trimester. Hormones cause vascular engorgement and altered bladder function. Education should also include regular emptying of the bladder, performing Kegel exercises, and limiting fluid intake prior to bedtime.
A nurse is reinforcing teaching with a client who is at 23 weeks of gestation and will return to the facility the following week for an amniocentesis. Which of the following instructions should the nurse include?
Refrain from eating breakfast the day of the procedure
Give herself a hypertonic enema the day before the procedure
Empty her bladder immediately prior to the procedure
Wash her abdomen with soap and water the morning of the procedure
Empty her bladder immediately prior to the procedure
Emptying her bladder before amniocentesis prevents possible puncture of the bladder and displacement of the uterus and fetus.
A nurse in a prenatal clinic is reviewing the medical record of a client who is at 28 weeks of gestation. The client’s history reveals one pregnancy terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks of gestation. The nurse should document which of the following as the client's present parity?
5, 4, 3, 2
2
Parity describes the number of pregnancies that have reach a term of 20 weeks.
A nurse is speaking on the phone to a client on the phone who is pregnant and taking iron supplements for iron-deficiency anemia. The client reports that her stools are black but she has no abdominal pain or cramping. Which of the following responses by the nurse is appropriate?
"Come to the office and we will check things out."
“Go to the emergency room and your provider will meet you there.”
“This is expected because of the iron is broken down during digestion.”
“What else have you been eating?”
This is expected because of the iron is broken down during digestion
Iron supplements turn a client's stools black. In the absence of cramping and abdominal pain, this is an expected finding. The client should be instructed to expect black stools.
A nurse is assisting with the care of a client who is experiencing preterm labor and is scheduled to undergo amniocentesis. The client needs an amniocentesis to determine which of the following findings?
Maturity of lungs, Weeks of gestation, Gender of the fetus, Anatomic abnormalities
Maturity of lungs
Amniocentesis is the best means for determining fetal lung maturity. The lecithin/sphingomyelin ratio (L/S) helps measure the amount of lung enzyme surfactant. A ratio of 2:1 or greater means the lungs are mature enough to withstand extrauterine life.
A nurse in a prenatal clinic is caring for a client who is at 12 weeks of gestation. The client asks about the cause of her heartburn. Which of the following responses should the nurse make?
Increased pancreatic activity results in intolerance of fat in the diet, Increased estrogen production causes increased secretion of hydrochloric acid, Pressure from the growing uterus displaces the stomach, Increased progesterone production causes decreased motility of smooth muscle
Increased progesterone production causes decreased motility of smooth muscle
Increased progesterone production causes a relaxation of the cardiac sphincter and delayed gastric emptying, which can result in heartburn.
A nurse is caring for a client who has just learned that she is pregnant. The nurse should reinforce with the client to call her provider if she experiences which of the following manifestations?
Decreased energy, Urinary frequency, Facial edema , Mood swings
Facial Edema
Facial edema is an indication of pregnancy-induced hypertension, which should be reported to the client's provider.
A nurse in a prenatal clinic is determining a client’s estimated date of delivery using Naegele’s rule. The first day of her last menstrual period was May 4. Which of the following dates should the nurse tell the client is her estimated date of delivery?
February 11
February 27
April 27
April 11
February 11
Subtract 3 calendar months and add 7 days to the client’s first day of her last menstrual period.
A nurse is reinforcing teaching about immunizations with a woman in her first trimester of pregnancy whose diagnostic testing indicates she does not have an immunity to rubella. The nurse should recommend that the client receive a measles, mumps, rubella (MMR) vaccine at which of the following times?
When she does not desire future pregnancies, Prior to discharge from the hospital after giving birth, Prior to giving birth, Two weeks before attempting pregnancy again
Prior to discharge from the hospital after giving birth
It is recommend that the client receive the MMR vaccine following delivery, so she is protected from contracting rubella, and during future pregnancies.
MMR vaccine must be given at least 3 months prior to pregnancy to ensure that the developing fetus is not exposed to the rubella virus.
A nurse is reinforcing teaching with a client who is at 15 weeks of gestation and is about to undergo an amniocentesis. The nurse should reinforce that this test can identify which of the following traits or problems? (Select all that apply.)
Fetal Lung maturity, Cephalopelvic disproportion, Neural tube defects, Fetal gender
Fetal Lung maturity
Neural tube defects
Fetal gender
Cephalopelvic disproportion is incorrect. Abdominal US screens for this problem
A nurse is reinforcing teaching about expected gestational changes with a client who is at 12 weeks of gestation. Which of the following statements by the client indicates a need for further teaching?
I am going to reduce my stress level
I will consult with my doctor before using home remedies for nausea
I should monitor my weight gain during the following months
I will use only nonprescription medications while pregnant
I will use only nonprescription medications while pregnant
Both prescription and nonprescription medications can be harmful to the fetus. The client needs to understand the importance of disclosing all medications, supplements, and vitamins to the provider prior to use during pregnancy
A nurse is reinforcing teaching with a client who is at 6 weeks of gestation. The client tells the nurse that she smokes one pack of cigarettes per day. The nurse should instruct the client that her newborn is at increased risk for which of the following clinical manifestations?
Craniofacial abnormalities, Low birth weight, Hyperactivity, Hypersensitivity to noise
Low birth weight
Women who smoke are at risk for many complications, including placental abruption, placenta previa, preterm delivery, fetal death, and newborns who have low birth weight
A nurse is reinforcing teaching about a biophysical profile with a client who is at 40 weeks of gestation. The nurse should explain that this profile focuses on which of the following parameters? (Select all that apply.)
Fetal breathing, Fetal motion, Nuchal translucency, Amniotic fluid volume
Fetal breathing, Fetal motion, Amniotic fluid volume
Nuchal transparency is incorrect. This screening technique measures fluid in the nape of the fetal neck via ultrasound, but it is not a parameter of the biophysical profile.