Question 1

The clinic nurse is assisting with an initial prenatal assessment.The following findings are present: Spider nevi present on lower legs;dark pink,edematous nasal mucosa;mild enlargement of the thyroid gland;mottled skin and pallor of palms and nailbeds;heart rate 88 with murmur present.What is the best action for the nurse to take based on these findings?

A)Document the findings on the prenatal chart.
B)Have the physician see the client today.
C)Instruct the client to avoid direct sunlight.
D)Analyze previous thyroid hormone lab results.

Have the physician see the client today.

Accepted Answer

The findings suggest possible underlying medical conditions that may require further evaluation and management by a physician. The presence of spider nevi on the lower legs may indicate liver dysfunction, dark pink edematous nasal mucosa may indicate allergies or infections, mild enlargement of the thyroid gland may suggest thyroid dysfunction, mottled skin and pallor of palms and nail beds may indicate anemia, and the presence of a heart murmur may indicate a heart condition. Therefore, it is important for the physician to see the client today for further assessment and management. Documenting the findings on the prenatal chart is important, but the physician's assessment and management should take precedence. Avoiding direct sunlight and analyzing previous thyroid hormone lab results are not the most appropriate actions based on the findings presented.

Question 2

While completing the medical and surgical history during the initial prenatal visit,the 16-year-old primigravida interrupts with "Why are you asking me all these questions? What difference does it make?" Which of the following statements would best answer the client's questions? "We ask these questions:

A)"To detect anything that happened in your past that might affect the pregnancy."
B)"To see if you can have prenatal visits less often than most clients do."
C)"To make sure that our paperwork and records are complete and up to date."
D)"To look for any health problems in the past that might affect your parenting."

"To detect anything that happened in your past that might affect the pregnancy."

Accepted Answer

The purpose of taking medical and surgical history during the initial prenatal visit is to identify any health issues that might put the pregnancy at risk or have an impact on the health of the mother and baby during and after the pregnancy. By knowing the medical history and any past surgeries or illnesses, the healthcare provider can take necessary precautions to optimize the pregnancy outcomes.

Question 3

The primigravida at 22 weeks' gestation has a fundal height palpated slightly below the umbilicus.Which of the following statements would best describe to the client why she needs to be seen by a physician today?

A)"Your baby is growing too much and getting too big."
B)"Your uterus might have an abnormal shape."
C)"The position of your baby can't be felt."
D)"Your baby might not be growing enough."

"Your baby might not be growing enough."

Accepted Answer

At 22 weeks' gestation, the fundal height should typically be at the level of the umbilicus. A fundal height palpated slightly below the umbilicus could indicate that the baby is not growing as expected, which warrants immediate evaluation by a physician to assess fetal well-being and consider possible causes of intrauterine growth restriction (IUGR) or other complications.

Question 4

Which of the following would be part of a routine physical assessment for a second-trimester primiparous client whose prenatal care began in the first trimester and is ongoing?&#10;A)Measurement of the diagonal conjugate&#10;B)Hepatitis B screening (HBsAg)&#10;C)Fundal height measurement&#10;D)Complete blood count&#10;

Accepted Answer

Fundal height measurement is a routine physical assessment during prenatal care to assess the growth and development of the fetus. This is especially important for primiparous clients who may not be familiar with fetal movement or other signs of fetal well-being. The diagonal conjugate measurement, hepatitis B screening, and complete blood count may also be part of routine prenatal care but are not specific to a second-trimester primiparous client.

Question 5

A pregnant client asks the nurse,&#34;What is this &#34;knuckle test&#34; that is supposed to tell if my baby has a genetic problem?&#34; The nurse correctly explains that:&#10;A)&#34;The term is nuchal,and it refers to the neck.The test is a special ultrasound that measures the thickness of the back of the baby's neck.&#34;&#10;B)&#34;You will need to ask the physician for an explanation.&#34;&#10;C)&#34;It tests for Down syndrome.&#34;&#10;D)It tests for neural tube defects.&#34;&#10;

Accepted Answer

The nurse correctly explains that the term is nuchal and refers to the measurement of the thickness of the back of the baby's neck using a special ultrasound. This test can indicate the likelihood of a genetic problem, such as Down syndrome.

Question 6

The pregnant client at 16 weeks has just been told that she has a positive hepatitis B screen.She demonstrates that she understands what this means if she states:&#10;A)&#34;I have hepatitis B,which I could pass on to my baby.&#34;&#10;B)&#34;I am anemic,and should eat more iron-rich foods.&#34;&#10;C)&#34;My blood pressure is high,and it is affecting my baby.&#34;&#10;D)&#34;I have a rare blood type,and the baby could have it,too.&#34;&#10;

Accepted Answer

Choice A demonstrates that the client understands the implications of a positive hepatitis B screen, including the risk of transmitting the virus to the baby. Choices B, C, and D are unrelated to the diagnosis of hepatitis B.

Question 7

Which of the following pieces of information that the nurse obtains from a pregnant client would indicate this client is at risk for preterm labor?&#10;A)The client smokes two packs of cigarettes per day and delivered her last child at 34 weeks.&#10;B)The client has group B streptococcus in her urine,and is primiparous.&#10;C)The client had congenital hip dysplasia as a child and is 15 pounds overweight.&#10;D)The client lives in a second-floor apartment without stairs,and walks to work.&#10;

Accepted Answer

The fact that the client smokes heavily and has a history of delivering early (at 34 weeks) puts her at a higher risk for preterm labor in this pregnancy. The other options do not provide significant risk factors for preterm labor.

Question 8

The primiparous client has completed her first prenatal clinic appointment.She is asking how often prenatal visits will be done if everything remains normal and she develops no complications.Which of the following statements best answers her question? "Prenatal visits are scheduled:

A)"Every 2 weeks for the first 28 weeks,then every week."
B)'Every 4 weeks until 30 weeks,every 3 weeks until 36 weeks,then every week."
C)'Every 4 weeks until 28 weeks,every 2 weeks until 36 weeks,then every week."
D)"Every 4 weeks until 30 weeks,then every other week."

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Accepted Answer

The American College of Obstetricians and Gynecologists (ACOG) recommends prenatal visits every 4 weeks up to 28 weeks, every 2 weeks from 28-36 weeks, and then weekly after 36 weeks for women with uncomplicated pregnancies. Therefore, option C is the correct answer. Option A is incorrect because it only mentions visits up to 28 weeks, but does not include the later part of pregnancy, when visits should be more frequent. Option B is incorrect because it includes a 3-week interval, which is not standard in prenatal care. Option D is incorrect because it skips the 2-week interval recommended by ACOG.

Question 9

The nurse is preparing a class for couples who are planning pregnancy.Which statement should the nurse include? &#34;Before becoming pregnant,you should talk with your health care provider if:&#10;A)&#34;The baby's father has any medical problems.&#34;&#10;B)&#34;The baby's father has other children from a previous relationship.&#34;&#10;C)&#34;You are going to move or change jobs.&#34;&#10;D)&#34;Anyone in your family has had surgery.&#34;&#10;

Accepted Answer

The nurse should include information about discussing any medical problems of the baby's father with a healthcare provider before becoming pregnant, as these could have genetic implications or affect the health of the mother and baby.

Question 10

A woman gave birth to her first pregnancy,a fetus at 18 weeks' gestation,last week.She is in the clinic for follow-up,and notices that her chart states she has had 1 abortion.The client is upset over the use of this word.How can the nurse best explain this terminology to the client?

A)"Abortion is the medical term for all pregnancies that end before 20 weeks."
B)"Abortion is the word we use when someone has miscarried."
C)"Abortion is how we label babies born in the second trimester."
D)"Abortion is what we call all babies who are born dead."

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Accepted Answer

Abortion is a medical term used to describe all pregnancies that end before 20 weeks, regardless of whether it was a spontaneous miscarriage or an induced termination. The nurse can explain to the client that the term does not necessarily imply a deliberate act and is simply a medical jargon used to describe all non-viable pregnancies.

Question 11

A nurse examining a prenatal client recognizes that a lag in progression of measurements of fundal height from month to month and week to week could signal:&#10;A)Intrauterine growth restriction.&#10;B)Twin pregnancy.&#10;C)Polyhydramnios.&#10;D)Breech position.&#10;

Accepted Answer

The answer of A nurse examining a prenatal client recognizes...

Question 12

The nurse is assessing a newly pregnant client.Which of the following findings does the nurse note as a normal psychosocial stage in this client's first trimester?&#10;A)An unlisted telephone number&#10;B)Reluctance to tell the partner of the pregnancy&#10;C)Parental disapproval of the woman's partner&#10;D)Ambivalence about the pregnancy&#10;

Accepted Answer

The answer of The nurse is assessing a newly pregnant...

Question 13

The clinic nurse is compiling informational data for a yearly report.Which of the following clients would be classified as a primigravida?&#10;A)A client at 18 weeks' gestation who had a spontaneous loss at 12 weeks&#10;B)A client at 13 weeks' gestation who had an ectopic pregnancy at 8 weeks&#10;C)A client at 14 weeks' gestation who has a 3-year-old daughter at home&#10;D)A client at 15 weeks' gestation who has never been pregnant before&#10;

Accepted Answer

The answer of The clinic nurse is compiling informational data...

Question 14

A 25-year-old primigravida is 20 weeks pregnant.At the clinic,her nurse obtains the following vital signs.Which of these findings would necessitate notifying a doctor immediately?&#10;A)Pulse regular at 88/minute&#10;B)Rhonchi in both bases&#10;C)Temperature 37.4&#176;C (99.3&#176;F)&#10;D)Blood pressure 130/78&#10;

Accepted Answer

The answer of A 25-year-old primigravida is 20 weeks pregnant.At...

Deck 10: Antepartal Nursing Assessment