NCLEX Prep: PN Maternal and Newborn Latest Update.

NCLEX Prep: PN Maternal and Newborn Latest Update. 1. Nonstress test A method for evaluating fetal status during the antepartum period by observing the response of the fetal heart rate to fetal movement. 2. A nurse is admit- ting a client at 42 weeks gesta- tion to the la- bor and delivery Correct Answer: A. Bishop score of 10 The Bishop score is a system for the assessment and rating of cervical favorability and readiness for induction of labor. The cervix is scored (0-3) on consistency, position, dilation, ettacement, and station of the fetal presenting part. A higher unit for induction Bishop score indicates an increased likelihood of successful induction that results of labor. What is a predictor of a successful induc- tion? A. Bishop score of 10 B. Firm and pos- terior cervix C. History of pre- cipitous labor D. Reactive non- stress test in vaginal birth. For nulliparous women, a score 6e-8 usually indicates that induc- tion will be successful. Incorrect Answers: [B. Firm and posterior cervix] A cervix that is firm and posterior is associated with a low Bishop score, which reflects a low likelihood of successful labor induction. [C. History of precipitous labor] A history of precipitous labor (3 hours from onset of contractions to birth) may indicate that the client will again experience precipitous labor once labor is established. However, such a history is not an independent predictor of successful induction. [D. Reactive nonstress test] A reactive nonstress test indicates that the fetus is well oxygenated and establishes fetal well-being. It does not provide information about the likely success or failure of labor induction. Educational objective:The Bishop score is a system for the assessment and rating of cervical favorability and readiness for induction of labor. A score 6e-8 in nulli- parous women is associated with successful induction and subsequent vaginal birth. 3. The nurse is re- inforcing teach- ing to a client, gravida 1 para 0, at 8 weeks gestation about expected weight gain during pregnancy. The client's prepreg- nancy BMI is 21 kg/m2. Which statement made by the client in- dicates an ap- propriate under- standing about weight gain? A. "I should gain 10 pounds dur- ing the first trimester." B. "I should gain about 30 pounds during the entire pregnancy." C. "I should gain Correct Answer: B. "I should gain about 30 pounds during the entire pregnancy." Appropriate weight gain during pregnancy decreases risks to the client and fetus. Optimal weight gain is determined by prepregnancy BMI. Underweight clients need to gain more weight (1 lb [0.5 kg] per week) during the second and third trimesters of pregnancy than obese clients (0.5 lb [0.2 kg] per week). However, weight gain in the first trimester should be 1.1-4.4 lb (0.5-2.0 kg), regardless of BMI. With a prepregnancy BMI of 21 kg/m2, this client has an appropriate weight and should gain 25-35 lb (11.3-15.9 kg) over the course of the pregnancy. Incorrect Answers: [A. "I should gain 10 pounds during the first trimester."] Weight gain during the first trimester should be approximately 1.1-4.4 lb (0.5-2.0 kg). A 10-lb (4.5-kg) weight gain during the first 3 months of pregnancy would be excessive for any client. [C. "I should gain no more than half a pound per week during the third trimester."] A client of appropriate weight should gain approximately 1 lb (0.5 kg) per week during the second and third trimesters of pregnancy. A weight gain of only 0.5 lb (0.2 kg) per week is recommended for obese clients. [D. "If I gain no more than 20 pounds during pregnancy, it will be easier to lose weight postpartum."] A weight gain of 20 lb (9.1 kg) during pregnancy is inadequate for a client of appropriate weight. Restricting weight gain increases the risk of low fetal birth weight (5.5 lb [2500 g]) and preterm birth. Educational objective:Appropriate weight gain during pregnancy decreases risks no more than half a pound per week during the third trimester." D. "If I gain no more than 20 pounds dur- ing pregnancy, it will be easier to lose weight post- partum." 4. A client comes to the clinic in- dicating that a home pregnancy test was positive. The client's last to the client and fetus. Weight gain in the first trimester should be 1.1-4.4 lb (0.5-2.0 kg), regardless of BMI. The optimal total weight gain during pregnancy is determined by the client's prepregnancy BMI. Correct Answer: A, B, and E Naegele's rule, which is the last menstrual period minus 3 months plus 7 days, can be used to calculate a client's expected date of delivery. The accuracy of this method may be influenced by the regularity and length of the client's menstrual cycle. September 7 minus 3 months is June 7, plus 7 days is June 14. menstrual period Detection of a fetal heart rate is possible using a Doppler by 10-12 weeks gesta- was September 7. Today is De- cember 7. Which are true state- ments for this client? Select all that apply. A. According to Naegele's rule, the expected tion. Urinary frequency, a presumptive sign of pregnancy common in the first trimester, occurs primarily due to hormonal changes and anatomical changes in the renal system. However, clients also reporting dysuria, fever/chills, or back pain should be evaluated for a urinary tract infection. Incorrect Answers: [C. Fundal height should be 24 cm above the symphysis pubis] Uterine growth is assessed by measuring fundal height using a measuring tape. After 20 weeks date of delivery is gestation, the fundal height measurement in centimeters should correlate closely June 14 with the number of weeks pregnant (eg, 24 cm = 24 weeks). The client should empty the bladder before having fundal height measured, as a full bladder can B. Detection of the fetal heart rate via Doppler is possible C. Fundal height should be 24 cm above the sym- physis pubis D. The client should be feeling fetal movement E. Urinary fre- quency is a com- mon symptom 5. A nurse aus- cultates a loud cardiac murmur on a newborn with suspected displace the uterus and attect measurement accuracy. [D. The client should be feeling fetal movement] Quickening, the awareness of fetal movements, occurs around 18-20 weeks gestation in primigravidas and at 14-16 weeks in multigravidas. Educational objective:Naegele's rule for estimating date of delivery is the last menstrual period minus 3 months plus 7 days. Fetal heart rate is detectable by Doppler at 10-12 weeks gestation. Urinary frequency is a presumptive sign of pregnancy in the first trimester. Correct Answer: B. Document the finding