Deck 12: Pregnancy in Selected Populations

Question 1

An adolescent at 20 weeks' gestation states that it is important not to have a baby that weighs too much. She has been limiting her calories so that her current weight has dropped from 110 pounds to 106 pounds. How should the nurse respond?
1) "You are causing harm to your baby."
2) "You shouldn't be worrying about your figure."
3) "Your baby needs adequate nutrition to develop."
4) "It's okay to want a small baby when you're a teen."

Answer 1

3

Question 2

A 40-year-old client, pregnant with her first child, arrives for a prenatal visit. What perinatal risk factors should the nurse keep in mind when planning this client's care? Select all that apply.
1) Miscarriage
2) Maternal death
3) Perinatal morbidity
4) Potential for multiple births
5) Maternal chronic health conditions

Answer 2

1, 2, 3, 5

Question 3

The nurse is planning a community adolescent pregnancy prevention program aimed toward parents. Which recommendation should be included in the program in order to be effective?
1) Parents should encourage steady dating.
2) Parents should not allow their son to develop an intense relationship with a girl who is much younger.
3) Rather than embarrassing an adolescent by addressing specific topics related to sex, parents should speak in broad, general terms.
4) Instead of bringing up the topic of sex, parents should allow their children to reach a point where the children initiate the discussion.

Answer 3

2

Question 4

Which statement from the mother of a pregnant 13-year-old would be an expected response?
1) "We had such high hopes for you."
2) "I told you that boy was up to no good."
3) "But she was always an easygoing child."
4) "This is just one of those things that happen."

Question 5

The nurse who is counseling a group of middle school girls about how to prevent pregnancy should include which statement?
1) "Although condom use is growing, the rate of STIs among teens is rising."
2) "It has become far less acceptable to give birth during your teenage years than it used to be."
3) "You have learned enough from your friends and families to understand how pregnancy occurs."
4) "Although sexuality is common in the media, peer pressure to have sex is not an important factor."

Question 6

The nurse is working in a teen pregnancy clinic. In order to give the pregnant adolescent a role in her prenatal care, what should the nurse encourage the teen to do?
1) Choose the schedule of her prenatal visits
2) Decide if she wants her labor to be induced
3) Measure and record her weight at each visit
4) Choose the type of prenatal vitamin she takes

Question 7

The nurse seeks to involve the adolescent father in the prenatal care of his partner. What is the reason for this strategy?
1) Improves the long-term outcome of the relationship
2) Increases the self-care behaviors of the pregnant teen
3) Avoids legal action by the adolescent father's family
4) Avoids conflict between the adolescent father and pregnant teen

Question 8

The nurse notes that the majority of clients who signed up to attend prenatal classes are over the age of 35. What should the nurse consider as reasons why these clients are this age? Select all that apply.
1) Age of marriage was later.
2) More effective birth control methods.
3) Waited until financially secure before having a family.
4) Needed to care for aging parents before having a family.
5) Wanted to become established in a career before having a family.

Question 9

The nurse is working with a group of pregnant teens. Which statement indicates that teaching has been successful?
1) "My baby could come late because I am a teenager."
2) "Because I am young, I have a low risk for preeclampsia."
3) "I am more likely to use birth control after I have this baby."
4) "Pregnant teens are more likely to quit school prior to graduation."

Question 10

A 16-year-old is making her first prenatal visit to the clinic in her fourth month of pregnancy. What is the nurse's first responsibility?
1) Contact the social worker.
2) Develop a trusting relationship.
3) Teach the patient about proper nutrition.
4) Schedule the patient for prenatal classes.

Question 11

A 38-year-old client is thrilled to learn of being pregnant with her first child. What should the nurse identify as advantages for the client having a child at this age? Select all that apply.
1) Most likely well-educated.
2) Ready to make a life change.
3) Decision was made deliberately.
4) Child care will be easier at this age.
5) Able to take on the responsibilities of a child.

Question 12

The screening results of a quadruple screening completed on a 37-year-old pregnant client were not within the normal range. For which additional testing should the nurse prepare this client? Select all that apply.
1) Ultrasound
2) Serum glucose
3) Amniocentesis
4) Serum ferritin levels
5) Fetal heart monitoring

Question 13

The nurse is working with male teens whose partners are pregnant. Which situation with a father-to-be requires nursing intervention?
1) The pregnancy does not seem real to him, and he is not sure what he should do to plan for the future.
2) Because his father was not involved in his life, he wants to be actively involved in the life of his child.
3) He is not convinced that he is the father of the baby and does not want his name on the birth certificate.
4) He is the only other person who will be present, although his girlfriend wants her mother to be with her during the birth.

Question 14

The nurse is preparing an in-service presentation about the role of culture in adolescent pregnancy. What should the nurse include in this presentation? Select all that apply.
1) "Teens with future goals tend to use birth control more consistently."
2) "Most pregnant teens do not have any relatives who had their first child as teens."
3) "Young teens who have a child are more likely to have another while still a teen."
4) "Although the rate has dropped, African American and Hispanic teens are more likely to become pregnant."
5) "Eighty-five percent of teen mothers are middle class, and give birth to gain adult status."

Question 15

Which statement by a parent of a pregnant, unmarried 15-year-old is expected?
1) "I'm not going to get involved. She understands how her health insurance works."
2) "An abortion is the best choice for her. She can deal with our Catholic priest later."
3) "We're very happy for her. It will be easier to focus on education with a new baby."
4) "Her father told her to stop dating that boy. Now look at the trouble she's gotten into."

Question 16

The school sexual health clinic nurse has female adolescent students waiting to be seen. Which student should be seen first?
1) 17-year-old adolescent with a history of child abuse
2) 14-year-old adolescent whose 17-year-old sister is pregnant
3) 15-year-old adolescent who reports using condoms regularly
4) 16-year-old adolescent who had a chlamydial infection treated 2 weeks ago

Question 17

Which statement, if made by a pregnant adolescent, indicates that she understands her increased risk of physiologic complications during pregnancy?
1) "Smoking and using crack cocaine won't harm my baby."
2) "My anemia and eating mostly fast food are not important."
3) "It's no big deal that I started prenatal care in my seventh month."
4) "I need to take good care of myself so my baby doesn't come early."

Question 18

The nurse has been asked by a community organization to give a presentation on prevention of teen pregnancy. Which statement indicates appropriate steps toward reduction of the local teen pregnancy rate?
1) Classes on how to parent will be mandatory in high school.
2) Plans are made to create a low-cost reproductive health clinic.
3) Parents will be encouraged to avoid discussing sexual activity.
4) Abstinence-only education will be offered in the school and clinics.

Question 19

Which approach to planning educational activities is best suited to a group of pregnant adolescents?
1) Primarily using visual-based presentations during teaching
2) Combining teaching for adolescent mothers of all ages as one group
3) Respecting confidentiality and building trust by avoiding the topics of drug and alcohol abuse
4) Avoiding the inclusion of handouts with bulleted items and white space as part of the teaching

Question 20

While developing a conference for adolescents, the nurse prepares a handout describing socioeconomic and cultural factors that contribute to adolescent pregnancy. Which information should the nurse include in the handout?
1) Poverty is a major risk factor for teen pregnancy.
2) All cultures share an aversion to early pregnancy.
3) A child born to a teenage mother is at a lower risk for teen pregnancy.
4) The younger the teen when she first gets pregnant, the less likely she is to have another pregnancy in her teens.

Question 21

A 38-year-old pregnant client is reluctant to attend prenatal classes because the other participants will be much younger. What should the nurse do to encourage this client's attendance at classes? Select all that apply.
1) Support the client's strengths.
2) Find a class with participants that are older.
3) Encourage the client to read prenatal training material online.
4) Nothing, since the client most likely has already researched the birthing process.
5) Prepare a list of reasons for the late pregnancy to use as responses when others ask.

Question 22

A pregnant client with rheumatoid arthritis arrives for a prenatal examination. How should the nurse support this client's needs? Select all that apply.
1) Assist with positioning on the examination table.
2) Repeat teaching instructions slowly and succinctly.
3) Assist with changing clothing for the examination.
4) Permit the client privacy while preparing for the examination.
5) Recommend delaying an examination until later in the pregnancy.

Question 23

A 25-year-old client with a learning disability arrives for her first prenatal visit at week 24 of gestation. What should the nurse emphasize when caring for this client? Select all that apply.
1) Ask if the client has any questions.
2) Avoid rushing through the examination.
3) Provide information in small increments.
4) Ask who is going to financially assist the client.
5) Suggest discussing the pregnancy with social services.

Question 24

A client who is at 28 weeks' gestation arrives for her first prenatal examination in a wheelchair. What should the nurse include when assessing this client? Select all that apply.
1) Signs of physical abuse
2) Evidence of mental abuse
3) Teaching about cesarean birth
4) Reason why prenatal care was delayed
5) Language that would hint toward financial abuse

Question 25

The nurse is preparing a presentation on psychosocial issues of older pregnant clients. What should the nurse include in this presentation? Select all that apply.
1) Social isolation
2) Financial issues
3) Pending mortality
4) Managing adverse effects
5) Family's and friends' attitudes

Question 26

The nurse is preparing prenatal teaching material to support the learning needs of a pregnant client with a learning disability. What should the nurse keep in mind when preparing these materials? Select all that apply.
1) Provide with videotapes.
2) Provide web site addresses.
3) Allow for extra teaching time.
4) Select an easy-to-understand format.
5) Audiotape information from prenatal classes.

Question 27

The nurse is caring for a pregnant client who has scoliosis that has affected sensation below the level of the umbilicus. What should the nurse instruct the client to do, to reduce the risk of adverse effects during pregnancy? Select all that apply.
1) Walk slowly and deliberately.
2) Limit the amount of daily exercise.
3) Eat fewer calories to restrict weight gain.
4) Ingest adequate amounts of fruits, vegetables, and water.
5) Review signs of pending labor other than uterine contractions.