RO 2

Wich presumptive sign or symptom of pregnancy would a client experience who is approximately 10 weeks of gestation?. Amenorrhea. Hegar sign. Chadwick sign. Positive pregnancy test.

The musculoskeletal system adapts to the changes that occur throughout the pregnancy. Which musculoskeletal alteration should the client expect?. She will have increased abdominal muscle tone. She will have increased lordosis. Her center of gravity will shift backward. She will notice decreased mobility of her pelvic joints.

A 31-year-old woman believes that she may be pregnant. She took an over-the-counter (OTC) pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview, the nurse inquires about the woman’s last menstrual period and asks whether she is taking any medications. The client states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which confirms that she is not pregnant. What is the most likely cause of the false-positive pregnancy test result?. The woman has a fibroid tumor. The pregnancy test was taken too early. She has been under considerable stress and has a hormone imbalance. Anticonvulsant medications may cause the false-positive test result.

A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. Which statement best describes why this may be happening to this client?. This respiratory change is normal in pregnancy and caused by an elevated level of estrogen. The woman has been intranasally using cocaine. The woman is a victim of domestic violence and is being hit in the face by her partner. This cardiovascular change is abnormal, and the nosebleeds are an ominous sign.

Which hormone is essential for maintaining pregnancy?. Estrogen. Oxytocin. Progesterone. hCG.

he nurse is providing health education to a pregnant client regarding the cardiovascular system. Which information is correct and important to share?. Palpitations are twice as likely to occur in twin gestations. A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia, requires close medical and obstetric observation no matter how healthy she may appear otherwise. Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks of gestation to term. All of the above.

Which time-based description of a stage of development in pregnancy is correct?. Postdate—pregnancy that extends beyond 38 weeks of gestation. Term—pregnancy from the beginning of 38 weeks of gestation to the end of 42 weeks of gestation. Preterm—pregnancy from 20 to 28 weeks of gestation. Viability—22 to 37 weeks of gestation since the last menstrual period (assuming a fetal weight greater than 500 g).

What is the correct term used to describe the mucous plug that forms in the endocervical canal?. Leukorrhea. Funic souffle. Ballottement. Operculum.

Three pregnant clients may complain of changes in their voice and impaired hearing. What should the nurse explain to the client concerning these findings?. Increased blood volume causes changes in the voice. Voice changes and impaired hearing are due to the results of congestion and swelling of the upper respiratory tract. Displacement of the diaphragm results in thoracic breathing. Voice changes are caused by decreased estrogen levels.

Which renal system adaptation is an anticipated anatomic change of pregnancy?. Increased bladder sensitivity and then compression of the bladder by the enlarging uterus result in the urge to urinate even when the bladder is almost empty. Renal (kidney) function is more efficient when the woman assumes a supine position. Using diuretic agents during pregnancy can help keep kidney function regular. Increased urinary output makes pregnant women less susceptible to urinary infections.

Which gastrointestinal alteration of pregnancy is a normal finding?. Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial. Hyperthyroidism often develops (temporarily) because hormone production increases. Acid indigestion (pyrosis) begins early but declines throughout pregnancy. icient salivation (ptyalism) is caused by increases in estrogen.

What is the correct term for a woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability?. Primipara. Nulligravida. Multipara. Primigravida.

To reassure and educate their pregnant clients regarding changes in their blood pressure, nurses should be cognizant of what?. Systolic blood pressure slightly increases as the pregnancy advances; diastolic pressure remains constant. Shifting the client’s position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of a term pregnancy.

A patient in her first trimester complains of nausea and vomiting. She asks, “Why does this happen?” What is the nurse’s best response?. “Nausea and vomiting are caused by a decrease in gastric secretions.”. “Nausea and vomiting may be due to changes in hormones.”. “Nausea and vomiting are due to an increase in gastric motility.”. “Nausea and vomiting are related to an increase in glucose levels.”.

Ideally, when should prenatal care begin?. After the first missed menstrual period. After the second missed menstrual period. After the third missed menstrual period. Before the first missed menstrual period.

A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2015. What is the client’s expected date of birth (EDB)?. December 17, 2015. November 7, 2015. September 17, 2015. November 21, 2015.

Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)?. Women who have had more than one sexual partner. Woman who are monogamous with one partner. Women who have had a sexually transmitted infection (STI). All women, regardless of risk factors.

Which sign or symptom is considered a first-trimester warning sign and should be immediately reported by the pregnant woman to her health care provider?. Vaginal bleeding. Urinary frequency. Fatigue. Nausea with occasional vomiting.

Which client might be well advised to continue condom use during intercourse throughout her pregnancy?. All pregnant women. Women at risk for candidiasis. Women at risk for acquiring or transmitting STIs. Unmarried pregnant women.

Which condition is likely to be identified by the quadruple marker screen?. Diaphragmatic hernia. Down syndrome. Congenital cardiac abnormality. Anencephaly.

A pregnant woman at 18 weeks of gestation calls the clinic to report that she has been experiencing occasional backaches of mild-to-moderate intensity. Which intervention should the nurse recommend?. Bed rest for 24 hours. Kegel exercises. Pelvic rock exercises. Softer mattress.

What should the nurse be cognizant of concerning the client’s reordering of personal relationships during pregnancy?. Women usually express two major relationship needs during pregnancy: feeling loved and valued and having the child accepted by the father. The woman’s sexual desire is likely to be highest in the first trimester because of the excitement and because intercourse is physically easier. Nurses need not get involved in any sexual issues the couple has during pregnancy, particularly if they have trouble communicating them to each other. Because of the special motherhood bond, a woman’s relationship with her mother is even more important than with the father of the child.

During the initial visit with a client who is beginning prenatal care, which action should be the highest priority for the nurse?. The first interview is a relaxed, get-acquainted affair during which the nurse gathers some general impressions of his or her new client. Because of legal complications, the nurse should not ask about illegal drug use; that is left to the physician. The nurse should be alert to the appearance of potential parenting problems, such as depression or lack of family support. If the nurse observed handicapping conditions, he or she should be sensitive and not inquire about them because the client will do that in her own time.

The client is instructed to place her thumb and forefinger on the areola and gently press inward. What is the purpose of this exercise?. To see whether the fetus has become inactive. To calculate the adipose buildup in the abdomen. To check the sensitivity of the nipples. To determine whether the nipple is everted or inverted.

Dental care during pregnancy is an important component of good prenatal care. Which instruction regarding dental health should the nurse provide?. If dental treatment is necessary, then the woman will be most comfortable with it in the second trimester. Regular brushing and flossing may not be necessary during early pregnancy because it may stimulate the woman who is already nauseated to vomit. A cleaning is all that is necessary. Dental surgery, in particular, is contraindicated during pregnancy and should be delayed until after delivery. If a woman has dental anxiety, then dental care may interfere with the expectant mother’s need to practice conscious relaxation and to prepare for labor.

The nurse working with pregnant clients must seek to gain understanding of the process whereby women accept their pregnancy. Which statement regarding this process is mostaccurate?. Nonacceptance of the pregnancy very often equates to a rejection of the child. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes. Ambivalent feelings during pregnancy are usually only expressed in emotionally immature or very young mothers. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will naturally resolve themselves after birth.

Which consideration is essential for the nurse to understand regarding follow-up prenatal care visits? (1pts). Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester. For pregnant women, a systolic BP of 130 mm Hg and a diastolic BP of 80 mm Hg is sufficient to be considered hypertensive. During the abdominal examination, the nurse should be alert for supine hypotension. The interview portions become more intensive as the visits become more frequent over the course of the pregnancy.

A pregnant woman complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate? (1pts). Have the patient stand up, and then retake her BP. Have the patient lie supine for 5 minutes, and then recheck her BP on both arms. Have the patient sit down, and then hold her arm in a dependent position. Have the patient turn to her left side, and then recheck her BP in 5 minutes.

A pregnant woman’s diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about?. Vitamin B12. Protein. Calcium. Folic acid.

A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant. Which guidance should she expect to receive?. “Discontinue all contraception now.”. “Lose weight so that you can gain more during pregnancy.”. “You may take any medications you have been regularly taking.”. “Make sure you include adequate folic acid in your diet.”.

To prevent gastrointestinal (GI) upset, when should a pregnant client be instructed to take the recommended iron supplements?. After eating a meal. With milk. On a full stomach. At bedtime.

Pregnant adolescents are at greater risk for decreased BMI and “fad” dieting with which condition? (1pts). Obesity. Gestational diabetes. High-birth-weight babies. Low-birth-weight babies.

Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy. Why is this the case? (1pts). Adequate nutrition is an important preventive measure for a variety of problems. A woman’s preconception weight becomes irrelevant. Maternal nutritional status is extremely difficult to adjust because of an individual’s ingrained eating habits. Women love obsessing about their weight and diets.

Which nutritional recommendation regarding fluids is accurate? (1pts). Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worry. Water with fluoride is especially encouraged because it reduces the child’s risk of tooth decay. Of the artificial sweeteners, only aspartame has not been associated with any maternity health concerns. A woman’s daily intake should be six to eight glasses of water, milk, and/or juice.

Which minerals and vitamins are usually recommended as a supplement in a pregnant client’s diet? (1pts). Iron and folate. Calcium and zinc. Fat-soluble vitamins A and D. Water-soluble vitamins C and B6.

Which vitamins or minerals may lead to congenital malformations of the fetus if taken in excess by the mother?. Zinc. Vitamin A. Folic acid. Vitamin D.

While obtaining a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. Which nutritional problem does this behavior indicate? (1pts). Pyrosis. Preeclampsia. Purging. Pica.

A client states that she plans to breastfeed her newborn infant. What guidance would be useful for this new mother?. Lactating women can go back to their prepregnant caloric intake. Critical iron and folic acid levels must be maintained. The mother’s intake of vitamin C, zinc, and protein can now be lower than during pregnancy. Caffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful.

The nurse has formulated a diagnosis of Imbalanced nutrition: Less than body requirements for the client. Which goal is most appropriate for this client to obtain?. Suggest that she not eat at fast-food restaurants to avoid foods of poor nutritional value. Realize that most adolescents are unwilling to make dietary changes during pregnancy. Emphasize the need to eliminate common teenage snack foods because they are high in fat and sodium. Determine the weight gain needed to meet adolescent growth, and add 35 pounds.

Which action is the highest priority for the nurse when educating a pregnant adolescent?. Determine the weight gain needed to meet adolescent growth, and add 35 pounds. Realize that most adolescents are unwilling to make dietary changes during pregnancy. Emphasize the need to eliminate common teenage snack foods because they are high in fat and sodium. Suggest that she not eat at fast-food restaurants to avoid foods of poor nutritional value.

A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine “several times” during the past year and occasionally drinks alcohol. Her blood pressure is 108/70 mm Hg. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics places this client in a high-risk category?. Family history, blood pressure (BP), BMI. Blood pressure, age, BMI. Drug and alcohol use, age, family history. Family history, BMI, drug and alcohol abuse.

A 39-year-old primigravida woman believes that she is approximately 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day; however, she tells the nurse that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique would be useful at this time?. Nonstress test (NST). Ultrasound examination. Amniocentesis. Maternal serum alpha-fetoprotein (MSAFP) screening.

At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytic medications are administered and she is placed on bed rest, she continues to experience regular uterine contractions and her cervix is beginning to dilate and efface. What is an important test for fetal well-being at this time?. Amniocentesis for fetal lung maturity. PUBS. Ultrasound for fetal size. NST.

A client asks her nurse, “My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean?” What is the nurse’s best response?. “Don’t worry about it. Everything is fine.”. “Your placenta isn’t working properly, and your baby is in danger.”. “Your placenta changes as your pregnancy progresses, and it is given a score that indicates how well it is functioning.”. “We need to perform an amniocentesis to detect if you have any placental damage.”.

Which information should nurses provide to expectant mothers when teaching them how to evaluate daily fetal movement counts (DFMCs)?. Alcohol or cigarette smoke can irritate the fetus into greater activity. A count of less than four fetal movements in 1 hour warrants future evaluation. Kick counts should be taken every hour and averaged every 6 hours, with every other 6-hour stretch off. The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.

In comparing the abdominal and transvaginal methods of ultrasound examination, which information should the nurse provide to the client?. Initially, the transvaginal examination can be painful. The abdominal examination is more useful in the first trimester. Both require the woman to have a full bladder. The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.

The nurse is planning the care for a laboring client with diabetes mellitus. This client is at greater risk for which clinical finding?. Postterm pregnancy. Polyhydramnios. Chromosomal abnormalities. Oligohydramnios.

A pregnant woman’s BPP score is 8. She asks the nurse to explain the results. How should the nurse respond at this time?. “The test results are within normal limits.”. “Further testing will be performed to determine the meaning of this score.”. “Immediate delivery by cesarean birth is being considered.”. “An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery.”.

The indirect Coombs’ test is a screening tool for Rh incompatibility. If the titer is greater than ______, amniocentesis may be a necessary next step. 1:12. 1:4. 1:2. 1:8.

A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is ofgreatest concern to the nurse?. Weight gain of 0.5 kg during the past 2 weeks. Dipstick value of 3+ for protein in her urine. Blood pressure (BP) increase to 138/86 mm Hg. Pitting pedal edema at the end of the day.

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the woman’s latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate aminotransaminase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition?. Eclampsia. Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome. Idiopathic thrombocytopenia. Disseminated intravascular coagulation (DIC) syndrome.

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal bleeding, and a tense, painful abdomen. Which clinical change does the nurse anticipate?. Abruptio placentae. Rupture of the uterus. Placenta previa. Eclamptic seizure.

The client is being induced in response to worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active, despite several hours of oxytocin administration. She asks the nurse, “Why is this taking so long?” What is the nurse’smost appropriate response?. “The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor.”. “The length of labor varies for different women.”. “I don’t know why it is taking so long.”. "Your baby is just being stubborn.”.

What nursing diagnosis is the most appropriate for a woman experiencing severe preeclampsia?. Risk for deficient fluid volume, related to increased sodium retention secondary to the administration of magnesium sulfate. Risk for injury to mother and fetus, related to central nervous system (CNS) irritability. Risk for increased cardiac output, related to the use of antihypertensive drugs. Risk for altered gas exchange.

Which intervention is most important when planning care for a client with severe gestational hypertension?. Induction of labor is likely, as near term as possible. If at home, the woman should be confined to her bed, even with mild gestational hypertension. Special diet low in protein and salt should be initiated. Vaginal birth is still an option, even in severe cases.

Women with mild gestational hypertension and mild preeclampsia can be safely managed at home with frequent maternal and fetal evaluation. Complete or partial bed rest is still frequently ordered by some providers. Which complication is rarely the result of prolonged bed rest?. Cardiovascular deconditioning. Psychologic stress. Thrombophlebitis. Fluid retention.

What is the most common medical complication of pregnancy?. Hemorrhagic complications. Hypertension. Hyperemesis gravidarum. Infections.

Which statement most accurately describes the HELLP syndrome?. Mild form of preeclampsia. Associated with preterm labor but not perinatal mortality. Characterized by hemolysis, elevated liver enzymes, and low platelets. Diagnosed by a nurse alert to its symptoms.

With regard to hemorrhagic complications that may occur during pregnancy, what information is most accurate?. Gestational trophoblastic neoplasia (GTN) is one of the persistently incurable gynecologic malignancies. One ectopic pregnancy does not affect a woman’s fertility or her likelihood of having a normal pregnancy the next time. Incidences of ectopic pregnancy are declining as a result of improved diagnostic techniques. An incompetent cervix is usually not diagnosed until the woman has lost one or two pregnancies.

Which laboratory marker is indicative of DIC?. Thrombocytopenia. Bleeding time of 10 minutes. Hypofibrinogenemia. Presence of fibrin split products.

In caring for the woman with DIC, which order should the nurse anticipate?. Preparation of the client for invasive hemodynamic monitoring. Restriction of intravascular fluids. Administration of steroids. Administration of blood.

In contrast to placenta previa, what is the most prevalent clinical manifestation of abruptio placentae?. Cramping. Intense abdominal pain. Uterine activity. Bleeding.

What is the correct definition of a spontaneous termination of a pregnancy (abortion)?. Fetus weighs less than 1000 g. Products of conception are passed intact. No evidence exists of intrauterine infection. Pregnancy is less than 20 weeks.

Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole?. Blood pressure of 120/80 mm Hg. History of bright red spotting for 1 day, weeks ago. Fundal height measurement of 18 cm. Complaint of frequent mild nausea.

A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Which information assists the nurse in developing the plan of care?. She will be unable to conceive in the future. Hemorrhage is the primary concern. A D&C will be performed to remove the products of conception. Bed rest and analgesics are the recommended treatment.

Which order should the nurse expect for a client admitted with a threatened abortion?. Bed rest. Narcotic analgesia every 3 hours, as needed. Administration of ritodrine IV. Nothing by mouth (nil per os [NPO]).

Preconception counseling is critical in the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?. Congenital anomalies in the fetus. Hydramnios. Hyperemesis gravidarum. Frequent episodes of maternal hypoglycemia.

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. This fetus is at the greatest risk for which condition?. Low birth weight. Macrosomia. Congenital anomalies of the central nervous system. Preterm birth.

A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks. She appears thin and somewhat nervous. She reports that she eats a well-balanced diet, although her weight is 5 pounds less than it was at her last visit. The results of laboratory studies confirm that she has a hyperthyroid condition. Based on the available data, the nurse formulates a plan of care. Which nursing diagnosis is most appropriate for the client at this time?. Imbalanced nutrition: more than body requirements. Imbalanced nutrition: less than body requirements. Deficient fluid volume. Disturbed sleep pattern.

A number of metabolic changes occur throughout pregnancy. Which physiologic adaptation of pregnancy will influence the nurse’s plan of care?. During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus. Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar. Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own. Maternal insulin requirements steadily decline during pregnancy.

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. The client shows the nurse her readings for the past few days. Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates?. 115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time. 75 mg/dl before lunch. This is low; better eat now. 115 mg/dl 2 hours after lunch. This is too high; it is time for insulin. 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.

To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet?. Reduce the carbohydrates in her diet. Eat six small equal meals per day. Eat her meals and snacks on a fixed schedule. Increase her consumption of protein.