Deck 26: The Pregnant Female

Question 1

A pregnant client reports concern about the development of reddish marks on her abdomen and breasts.The client asks about having a cream prescribed to help them disappear.What information should be included in the teaching provided to the client regarding this inquiry?
1)The stretch marks will fade but not disappear.
2)Cream will help the skin stay supple.
3)Cocoa butter lotions and creams will clear the marks completely.
4)The marks will lighten to a silvery tone after pregnancy.
5)Wearing supportive undergarments will help to support the skin and reduce the appearance of the marks.

Answer 1

1,2,4

Question 2

The healthcare provider is using Leopold's maneuvers to assess fetal positioning.Which of the following maneuvers is being used in the figure below?
1)First Leopold's maneuver
2)Second Leopold's maneuver
3)Third Leopold's maneuver
4)Fourth Leopold's maneuver

Answer 2

3

Question 3

The nurse is assessing a postpartum client and notes the peri-pad has whitish-yellow discharge.The nurse would correctly document this vaginal discharge as which of the following?
1)Postpartal bleeding
2)Lochia rubra
3)Lochia serosa
4)Lochia alba

Answer 3

4

Question 4

The nurse is caring for a pregnant client who desires to know the estimated date of birth (EDB)for the baby.The client reports the last menstrual period (LMP)was April 10.Using Naegele's Rule,the nurse would correctly calculate the EDB as which of the following?
1)February 1
2)May 17
3)May 24
4)January 17

Question 5

The nurse is examining a client who is 37 weeks pregnant.Which of the following findings would require immediate intervention by the nurse?
1)Patellar reflex 4+/0-4+ bilaterally
2)Heart rate 104
3)Trace protein in the urine
4)Weight gain of 2 pounds in 2 months

Question 6

A client who is 38 weeks pregnant reports she has been experiencing urinary frequency.Which response by the nurse is indicated?
1)"Your reports are consistent with a urinary tract infection."
2)"I will need to check your blood sugar as excessive urination is associated with gestational diabetes."
3)"Reducing your fluid intake will be helpful to manage this problem."
4)"This is normal occurrence in the later stages of pregnancy."

Question 7

The nurse is assessing the abdomen of a client who is 20 weeks gestation.Indicate the anticipated height of the fundus.

Question 8

The nurse is preparing to assess the fetal heart tones for a client whose fetus is in the LOA position.Review the photograph below and draw an "X" to indicate the best location to assess for the heart tones.

Question 9

The healthcare provider is performing an assessment on a pregnant client.The examiner notes a softening in the area being assessed.Review the photograph below and identify the probable sign of pregnancy being assessed.
1)Goodell's sign
2)Hegar's sign
3)Chadwick's sign
4)Ladin's sign

Question 10

The nurse is interviewing a primigravida client who is 17 weeks pregnant.During the data collection the client reports she has not felt the baby move yet.The most appropriate response by the nurse would be:
1)"We will listen for the heartbeat today."
2)"You need an ultrasound."
3)"Fetal movement does not occur until the 18th week."
4)"Do you have reason to believe your baby is not ok?"

Question 11

The nurse is performing a pelvic examination on a client who is 20 weeks pregnant and notes a white,odorless discharge from the vagina.The nurse would correctly choose which of the following actions?
1)Ask the client about vaginal discomfort.
2)Inquire about recent sexual intercourse.
3)Obtain a culture of the discharge.
4)Document the findings as normal.

Question 12

The nurse is reading the history and physical on a pregnant client and reads that the cervix was noted as soft in texture and nontender during the pelvic examination.The nurse would correctly identify this as which of the following?
1)Piscacek's sign
2)Goodell's sign
3)Chadwick's sign
4)Hegar's sign

Question 13

The nurse is preparing a teaching plan for a group of pregnant clients.Which of the following should the nurse include in this teaching session?
1)Do not use soap on my nipples.
2)Sleep 8-10 hours each night.
3)Eat four servings of dairy products daily.
4)Do not take iron supplements due to constipation.
5)Avoid resting in a back lying position.

Question 14

The nurse is monitoring a pregnant client in labor and is wants to determine the length of time from the beginning of the contraction until the end of the contraction.The nurse is assessing which of the following in this client?
1)Contraction intensity
2)Contraction palpation
3)Contraction frequency
4)Contraction duration

Question 15

The nurse is interviewing a client who is 36 weeks pregnant.Which of the following statements,if made by the client,would require immediate intervention by the nurse?
1)"I have to get up during the night to void."
2)"I have not felt the baby move today."
3)"I am leaking a yellowish fluid from my breasts."
4)"I have been taking Tylenol (acetaminophen)for my backaches."

Question 16

The nurse is discussing dietary recommendations with a client who has been experiencing a larger than recommended weight gain during her pregnancy.The client reports reducing the amount of empty calories and of red meat consumed while significantly increasing intake of fish,poultry,and fresh fruits and vegetables.What response is indicated by the nurse?
1)"It looks like you have things under control.Do you have any other questions?
2)"Have you considered seeing a dietitian for nutritional counseling?"
3)"Tell me more about the meat and fish you are eating each day."
4)"I think we should discuss the risky dietary choices you are making with the healthcare provider."

Question 17

The nurse is assessing a client in the third trimester of pregnancy and notes a yellowish discharge from both breasts.The nurse would correctly choose which of the following actions?
1)Ask the client if she is preparing for breastfeeding.
2)Notify the healthcare provider.
3)Document the findings as normal.
4)Obtain a culture of the discharge immediately.

Question 18

A client at 33 weeks gestation calls the healthcare provider's office and reports she was attempting to nap when she became dizzy and felt faint.What assessment data should be collected by the nurse first?
1)The position the client was in during the nap period
2)Dietary intake prior to the episode
3)History of hyperemesis
4)No additional data as this appears to be an isolated incident

Question 19

The nurse is assisting the healthcare provider during a vaginal examination.The healthcare provider notes the cervix has a bluish-purple change in coloration.The nurse would recognize this condition is known as:
1)Goodell's sign
2)Leukorrhea
3)Chadwick's sign
4)Mucous plug

Question 20

The nurse is interviewing a female client who reports no menstrual periods for 2 months and breast soreness.The nurse would document this data as which classification of signs of pregnancy?
1)Objective
2)Probable
3)Presumptive
4)Positive

Question 21

The nurse is examining a client in the third trimester of pregnancy.Which of the following findings would require immediate intervention by the nurse?
1)Pulse of 98 beats per minute
2)Weight gain of 1.5 pounds in a month
3)Blood pressure of 148/94
4)Respiratory rate of 26 per minute

Question 22

The nurse is reviewing the tests planned for a pregnant client.Traditionally testing done for gestational diabetes will be performed between 24 and 28 weeks gestation.Which of the following findings in the client's history will prompt the test to be performed earlier in the pregnancy?
1)The client is a multigravida.
2)The client has a history of a previous stillbirth.
3)The client has a strong family history of diabetes.
4)The client experienced infertility prior to becoming pregnant.
5)The client's last baby was large for gestational age.

Question 23

A client has been diagnosed with Group B Streptococcus at 33 weeks gestation.The client becomes tearful when the diagnosis is discussed.She asks what will be done next.What information should be provided to the client?
1)The client will receive oral antibiotics to be taken over the next 7 weeks.
2)The infection will be managed with IV antibiotics when the client is in active labor.
3)Due to the limited risk of transmission,the client will begin treatment during the postpartum period.
4)The client will require IM antibiotic treatment to facilitate a rapid cure.

Question 24

A client at 15 weeks gestation has just been advised she has tested positive for syphilis.The client is tearful and inquires about the risk to her infant.Which of the elements will be included in the management of the condition?
1)The client will be treated with IV antibiotic therapy during the prenatal period.
2)The sexual partners of the client will require notification and testing.
3)The client will begin antibiotic therapy at this time.
4)The client will begin antibiotic therapy after birth of the baby.
5)The infant will require intrauterine management for the condition.

Question 25

During a prenatal counseling session a client indicates concern about her potential HIV positive status.The client states she does not want to "jinx" the pregnancy by getting tested because if she is positive,so is the baby.Which statement by the nurse is indicated?
1)"You are right to avoid the stress of finding out you are HIV positive during the pregnancy."
2)"If you are HIV positive,your baby will also have HIV."
3)"Even if you do test HIV positive,preventive treatments have a good chance of providing protection for your baby."
4)"As long as you do not breastfeed and have a cesarean section,your baby will be protected."

Question 26

While performing data collection for a client who has recently had her pregnancy confirmed,the client reports taking daily herbal supplements.What action by the nurse is of the highest priority?
1)Instruct the client to increase the supplements to promote nutritional well-being.
2)Advise the client to reduce the amount of supplements taken to allow for the prescribed prenatal vitamins being taken.
3)Encourage the client to speak with the healthcare provider about the herbal supplements.
4)Record the client's reports on the permanent medical record.

Question 27

The client who is at 5 weeks gestation is seen in the Emergency Department with complaints of severe abdominal and pelvic pain.A vaginal examination reveals tenderness and a palpable mass near the uterus.Based upon your knowledge,which of the following can the nurse anticipate will take place first?
1)The client will be sent home on bed rest.
2)The client will be admitted to the acute care facility for observation.
3)The client will be evaluated in the labor and delivery department with a nonstress test.
4)An ultrasound will be ordered.

Question 28

A client at 33 weeks gestation has a complete blood cell count drawn.When the client hears that her hemoglobin level was higher before her pregnancy,she asks if this will increase the risk to her unborn baby.What information should be provided to the client?
1)If the client increases the number of prenatal vitamins taken,the risk to the fetus will be eliminated.
2)The fetus is at an increased risk of prematurity.
3)Dietary management will eliminate the risk to the fetus.
4)The fetus will likely suffer from anemia as well.

Question 29

The nurse is planning a prenatal education class for a group of women who are in their second trimester of pregnancy.Regarding the gestation of the pregnancy,which of the following topics are considered most appropriate?
1)Preparation of breasts for breastfeeding
2)Fetal development
3)Warning signs to report
4)Psychologic concerns associated with becoming pregnant
5)Preterm labor signs