Question 1

The nurse is planning a seminar that focuses on the 2020 National Health Goals during pregnancy for patients who are in the first trimester of pregnancy. Which information should the nurse include in this seminar? (Select all that apply.)

Accepted Answer

The 2020 National Health Goals for pregnancy include objectives to abstain from social and binge alcohol intake, avoid smoking, receive prenatal care, and abstain from illicit drugs. Seeking alternative care approaches is not a 2020 National Health Goal for pregnancy.

Question 2

A pregnant patient is experiencing a vaginal discharge and wants to douche. What should the nurse instruct the patient about this health practice?

Accepted Answer

Douching while pregnant is contraindicated because the force of the irrigating fluid could cause the solution to enter the cervix and lead to uterine infection. In addition, douching alters the pH of the vagina, leading to an increased risk of vaginal bacterial growth. The alkalinity, purchase type, or temperature of the solution does not matter. The pregnant patient should not douche.

Question 3

The nurse is emphasizing the importance of adequate rest and sleep with a pregnant patient. Which position should the nurse suggest the patient use?

Accepted Answer

A good resting or sleeping position for a pregnant patient is a left-sided Sims' position, with the top leg forward. This position puts the weight of the fetus on the bed, not on the woman, and allows good circulation in lower extremities. Lying on the back could cause the weight of the uterus to occlude the inferior vena cava impeding blood flow to the patient and fetus. Stomach lying is not a reasonable option with the size of the uterus.

Question 4

A pregnant patient is experiencing leg cramps. What should the nurse include in the patient's teaching plan as a relief measure? (Select all that apply.)

Accepted Answer

If a pregnant woman is experiencing frequent leg cramps, she may be advised to elevate lower extremities frequently during the day to improve circulation and avoiding full leg extension. Elevating the legs on two pillows may or may not help the patient. The patient should not be instructed to perform squats or dorsiflexion to help with the leg cramps.

Question 5

A pregnant patient is concerned that orgasm will be harmful to the developing fetus. What should the nurse include when responding to this patient's concern?

Accepted Answer

Because of increased pelvic congestion from the additional uterine blood supply at midpregnancy, most women notice increased clitoral sensation and may experience orgasm for the first time during pregnancy because of this. Orgasm during pregnancy is not harmful. Pelvic congestion does not make orgasm painful.

Question 6

A pregnant patient who works as a secretary at a large corporation wants to take a leave of absence from work but is afraid of losing seniority. What should the nurse advise the patient?

Accepted Answer

Women who are unable to continue working while pregnant are protected from loss of employment benefits during pregnancy by federal law. According to federal law, an employer cannot deprive women of seniority rights because they take a maternity leave. The patient is not asking for special favors. The maternity leave can occur before the delivery because the Family Medical and Leave Act can be used once the baby is delivered. There is no time limit about how long a pregnant patient can work.

Question 7

A pregnant patient is concerned that she is allergic to something because her hands have been red and itchy since becoming pregnant. What should the nurse explain as the cause of the patient's symptoms?

Accepted Answer

Palmar erythema, or palmar pruritus, occurs in early pregnancy and is probably caused by increased estrogen levels. Constant redness or itching of the palms can make a woman believe she has developed an allergy. This type of itching in early pregnancy is normal and is not caused by an allergy to fetal protein, reduced serum protein, or chorionic gonadotropin hormone secretion.

Question 8

The nurse is reviewing the signs of labor with a patient entering the last phase of the third trimester of pregnancy. What should the nurse include as an indication that the labor is beginning?

Accepted Answer

Labor may begin with rupture of the membranes, experienced either as a sudden gush or as scanty, slow seeping of clear fluid from the vagina. Excessive fatigue, headache, abdominal pain, or increased pulse rate are not indications that labor is beginning.

Question 9

A pregnant patient enjoys exercising at a local health spa once a week. Which patient comment indicates to the nurse that additional health teaching is needed?

Accepted Answer

Pregnant women should not soak for long periods in extremely hot water or hot tubs because heat exposure for a lengthy time could lead to hyperthermia in the fetus and birth defects, specifically esophageal atresia, omphalocele, and gastroschisis. Playing table tennis, performing low-impact aerobics, and the environment of the gym are not comments that indicate the need for additional teaching.

Question 10

An adolescent asks which sport would be safe for her to learn during pregnancy. Which activity should the nurse suggest to the patient?

Accepted Answer

Swimming is a good activity for pregnant women and is not contraindicated as long as membranes are intact. It increases muscle tone but may help relieve backache.
Pregnancy is not the time to learn to ski or ride a bicycle because the lack of skill could result in many falls. Jogging is questionable because of the strain the extra weight of pregnancy places on the knees.

Question 11

What advice should the nurse provide to a patient who is 4 months pregnant and owns a cat?

Accepted Answer

Toxoplasmosis, a protozoan infection, may be contracted through handling cat stool in soil or cat litter. Removing a cat from the home during pregnancy as a means of prevention is not necessary as long as the cat is healthy. The pregnant woman should be instructed not to change a cat litter box or garden in soil in an area where cats may defecate to avoid exposure to the disease. Cleaning the cat's dish is acceptable.
Scratches do not cause the disease.

Question 12

A woman who is 4 months pregnant asks what can be done to alleviate frequent heart palpitations and leg cramps. Which nursing diagnosis would be applicable to the patient at this time?

Accepted Answer

The patient is asking for information to reduce the symptoms of heart palpitations and leg cramps caused by pregnancy. This is health-seeking behavior. Heart palpitations and leg cramps are not severe complications of pregnancy. There is no evidence to suggest that the patient is at risk for an ineffective breathing pattern. There is also no evidence to support that the patient is experiencing impaired urinary elimination.

Question 13

During the previous prenatal visit, the nurse instructed a pregnant patient on ways to reduce the impact of varicosities. Which patient statement indicates that additional teaching is needed?

Accepted Answer

For varicosities, the patient should be instructed to avoid constrictive knee-high hose. Fluid intake, avoiding prolonged positions, and dorsiflexion of the feet are ways to reduce the impact of varicosities and would not require additional teaching.

Question 14

A nurse is 5 weeks pregnant and works on a care area where chemotherapy is administered to patients. Which statement indicates that this nurse needs additional health teaching about avoiding teratogens during pregnancy?

Accepted Answer

The nurse is not using latex gloves and is exposed to chemotherapeutic agents, which are known teratogens during pregnancy. This nurse needs additional instruction to reduce exposure from the chemotherapy agents. Caring for five patients a day does not necessarily increase the nurse's exposure to teratogens. Emotional support does not increase the nurse's exposure to teratogens. Avoiding X-rays is a positive action to avoid teratogens.

Question 15

What advice should the nurse provide to a pregnant patient who admits to continuing to drink alcohol one to two times a week?

Accepted Answer

There is evidence to confirm that women who consume large quantities of alcohol during pregnancy can have babies with congenital craniofacial deformities. It is impossible to define a safe level of alcohol consumption. Women should be screened for alcohol use at a first prenatal visit and advised to abstain from alcohol completely for the remainder of their pregnancy. Refer pregnant women with alcohol addiction to an alcohol treatment program as early in pregnancy as possible to help them reduce their alcohol intake.

Question 16

A patient enjoys exercising and wants to know if it can continue to be done while pregnant. What should the nurse instruct the patient about exercising at this time? (Select all that apply.)

Accepted Answer

The nurse should instruct the patient to drink liquids to prevent dehydration, limit strenuous exercise to 20 minutes, warm up before beginning an exercise session, and avoid exercises that can jar the body. The patient should be instructed to eat a protein and complex carbohydrate snack before exercise to maintain the serum glucose level.

Question 17

A pregnant patient is planning travel to a foreign country as part of a work assignment and needs immunizations. What should the nurse instruct the patient about immunizations while pregnant?

Accepted Answer

All live virus vaccines are contraindicated during pregnancy and should not be administered unless the risk of the disease outweighs the risk to the pregnancy because live virus vaccines can cross the placenta and infect the fetus. The influenza vaccine is recommended if it is flu season when visiting crowded locations.

Question 18

A pregnant patient reports feeling pain similar to menstrual cramps. What should the nurse explain about this patient's symptoms?

Accepted Answer

Beginning as early as the 8th to 12th week of pregnancy, the uterus periodically contracts and then relaxes again. These sensations are Braxton Hicks contractions and can be similar to a forceful menstrual cramp. These contractions are not usually a sign of beginning labor but should be reported for evaluation. A rhythmic pattern of even very light but persistent contractions could be a beginning sign of preterm labor.
Exercise or rest does not reduce the frequency of Braxton Hicks contractions.

Question 19

A pregnant patient has a history of genital herpes lesions and has experienced outbreaks periodically throughout the pregnancy. What should the nurse instruct the patient regarding this virus if lesions are present at the time of delivery?

Accepted Answer

If genital lesions are present at the time of birth, a fetus may contract the virus from direct exposure. A woman who has existing genital lesions at the time of birth will be advised to have a cesarean birth to reduce the risk of infecting the baby. There are precautions that need to be undertaken if lesions are present at the time of birth. The use of medication will depend on the patient's and infant's exposure to the virus.

Quiz 12: Nursing Care to Promote Fetal and Maternal Health