NUR 504 EXAM 3 | QUESTIONS AND ANSWERS | NEW
2025/2026 UPDATE | WITH COMPLETE SOLUTION!!
Initial Prenatal Subjective Assessment Answer - First prenatal visit: like it to be
around 10-12 weeks or so ideally, but may not be coming in until much later...If
come in later may need to add in other things.
Current pregnancy: when LMP was, helps determine due date. Also want to
know subjective s/s if any...such as vomiting, breast tenderness, fatigue...want
to know if periods regular, Irregular bc may change how accurate due date may
be...might want to know if she was on any birth control during the time of
conception, and if planned/unplanned (unplanned doesn't necessarily mean
unwanted)...
Past pregnancies: her GTPAL status, what happened with pregnancies, if there
was any significant conditions, complications, issues with previous
pregnancies/deliveries, what type of anesthesia she used and if there was any
issues with that.
GYN history: when last pap smear was and results of that, if she has had any
abnormal GYN conditions, what they were, and what was done about
them...about any GYN surgeries and outcome of surgeries, STIs history, sexual
partner history,
Current medical history: what conditions, disorders does she have currently,
medications (prescription and OTC), allergies, prepregnancy weight. General
health including her nutrition. Current immunization status for various
immunizations we have gone over. If she has had any illnesses or exposures
since she has been pregnant (got the flu or whatever).
Past medical history: normal quesitons as we would. Both her own and her
family's. Close attention to genetic disorders that may be passed along.
,Religious/cultural history: Special religious or cultural beliefs or practices that
may impact what we do in pregnancy or delivery.
Occupational history: does she work outside the home. Is anything she does at
work harmful or concerning for pregnancy?
FOB history (father of baby): His medical history as well bc
Factors that Might Make Pregnancy High Risk Answer - Social: If she does
drugs, if she doesn't have money for prenatal care, suspect domestic abuse,
doesn't have a support system available to her, age above 35 or very young,
does she feel physically and emotionally ready? If having children very close
together,
Medical: Anything medical technically could cause issues, but might be
exceptionally concerned with suicidal tendencies, hypertension, diabetes,
cancer, any heart condition, HIV, thyroid or renal conditions, autoimmune
disorders.
OB: Miscarriages, ectopic pregnancies, many elective abortions, Rh factor if she
is negative, any previous complications like placental abruption, placental
previa, preeclampsia,
Initial Prenatal Objective Assessment Answer - • VS/Ht/Wt
• Urine specimen collection
• Head-to-toe general assessment
o Uterine/Pelvic examination last
• EDC/EDD/EDB
o If LMP unknown, may need to use objective assessment to determine due
date
• Fetal HR
o Doppler
• Can start to hear it with Dooppler around 10-12 weeks.
o Electronic fetal monitoring equipment
,• Uterine Assessment
o Fundal height: first half of pregnancy we feel for fundus and measure
distance from symphysis pubis and umbilicus, At 12 weeks we will be able to
feel it right over and above symphysis pubis. Then at 16 weeks, midway
between symmphysis pubis and umbilicus. At 20 weeks, at level of umbilicus.
• McDonald's method: Between weeks 22-34 we can use McDonald method-
we are taking tape measure and measuring from symphysis pubis to top of
uterus (fundus) and measuring in cm.
• What normal limits is considered it # of cm should equal number of weeks +
or - 2. If 28 weeks, normal limits would be 26-30cm. 32 weeks, WNL would be
30-34. Not valid if past 34 weeks. Only valid between 22-34 weeks.
• Pelvimetry (Pelvic Assessment)
o Inlet
o Pelvic cavity (midpelvis)
o Outlet
o Using fingers and feeling outlet of pelvis trying to gather relative size, shape,
whether it seems favorable for vaginal delivery...such crude data though so not
used for much other than to know that delivery may be not feasible...
• Labs
o CBC: baseline lab levels, H&H, platelets, RBCs
o VDRL/RPR/STS (reactive/nonreactive or positive/negative): tests for syphilis.
If reactive/positive we give penicillin to treat.
o GC/Chlamydia culture (negative or positive): Gonorrhea or Chamydia
o Pap smear (normal or abnormal cytology): tells us whether normal or
abnormal cytology.
o U/A: to confirm pregnancy typically at initial visit
o HbsAg (reactive/nonreactive or positive/negative): hepatitis B surface
antigen, we want it to be nonreac
Subsequent Prenatal Visits Answer - • Frequency
, o First 28 weeks: every 4 weeks
o 28-36 weeks: every 2 weeks
o After 36 weeks: every week (maybe twice a week if very close to due date)
• Vitals-consistency in taking is key-compare to baseline
• Weight (compare to first visit weight)
o First trimester: 31/2 to 5 lbs
o Second trimester: 12 to 15 lbs
o Third trimester: 12 to 15 lbs
o Overall weight gain: 25-35 lbs is standard, assuming average weight individual
to start with. If underweight may want them to gain more, or if overweight may
want them to gain a little less.
• General physical assessment
• Uterine size
• FHR
• Specimen collection as needed
o Blood
• CBC
• Regular screening as described in part 2 of unit 5 ppt
o Urine: dipstick to check for things like blood, leukocytes, protein, ketones,
that aren't supposed to be there. If are spilled into urine need to assess further.
o Cervical swabs
• Taken as indicated in part 2 of unit 5, or otherwise if patient symptomatic
• Psychological adjustment
o Mother
• 1st trimester-period of adjustment
• 2nd trimester-period of radiant health
• 3rd trimester-period of watchful waiting
2025/2026 UPDATE | WITH COMPLETE SOLUTION!!
Initial Prenatal Subjective Assessment Answer - First prenatal visit: like it to be
around 10-12 weeks or so ideally, but may not be coming in until much later...If
come in later may need to add in other things.
Current pregnancy: when LMP was, helps determine due date. Also want to
know subjective s/s if any...such as vomiting, breast tenderness, fatigue...want
to know if periods regular, Irregular bc may change how accurate due date may
be...might want to know if she was on any birth control during the time of
conception, and if planned/unplanned (unplanned doesn't necessarily mean
unwanted)...
Past pregnancies: her GTPAL status, what happened with pregnancies, if there
was any significant conditions, complications, issues with previous
pregnancies/deliveries, what type of anesthesia she used and if there was any
issues with that.
GYN history: when last pap smear was and results of that, if she has had any
abnormal GYN conditions, what they were, and what was done about
them...about any GYN surgeries and outcome of surgeries, STIs history, sexual
partner history,
Current medical history: what conditions, disorders does she have currently,
medications (prescription and OTC), allergies, prepregnancy weight. General
health including her nutrition. Current immunization status for various
immunizations we have gone over. If she has had any illnesses or exposures
since she has been pregnant (got the flu or whatever).
Past medical history: normal quesitons as we would. Both her own and her
family's. Close attention to genetic disorders that may be passed along.
,Religious/cultural history: Special religious or cultural beliefs or practices that
may impact what we do in pregnancy or delivery.
Occupational history: does she work outside the home. Is anything she does at
work harmful or concerning for pregnancy?
FOB history (father of baby): His medical history as well bc
Factors that Might Make Pregnancy High Risk Answer - Social: If she does
drugs, if she doesn't have money for prenatal care, suspect domestic abuse,
doesn't have a support system available to her, age above 35 or very young,
does she feel physically and emotionally ready? If having children very close
together,
Medical: Anything medical technically could cause issues, but might be
exceptionally concerned with suicidal tendencies, hypertension, diabetes,
cancer, any heart condition, HIV, thyroid or renal conditions, autoimmune
disorders.
OB: Miscarriages, ectopic pregnancies, many elective abortions, Rh factor if she
is negative, any previous complications like placental abruption, placental
previa, preeclampsia,
Initial Prenatal Objective Assessment Answer - • VS/Ht/Wt
• Urine specimen collection
• Head-to-toe general assessment
o Uterine/Pelvic examination last
• EDC/EDD/EDB
o If LMP unknown, may need to use objective assessment to determine due
date
• Fetal HR
o Doppler
• Can start to hear it with Dooppler around 10-12 weeks.
o Electronic fetal monitoring equipment
,• Uterine Assessment
o Fundal height: first half of pregnancy we feel for fundus and measure
distance from symphysis pubis and umbilicus, At 12 weeks we will be able to
feel it right over and above symphysis pubis. Then at 16 weeks, midway
between symmphysis pubis and umbilicus. At 20 weeks, at level of umbilicus.
• McDonald's method: Between weeks 22-34 we can use McDonald method-
we are taking tape measure and measuring from symphysis pubis to top of
uterus (fundus) and measuring in cm.
• What normal limits is considered it # of cm should equal number of weeks +
or - 2. If 28 weeks, normal limits would be 26-30cm. 32 weeks, WNL would be
30-34. Not valid if past 34 weeks. Only valid between 22-34 weeks.
• Pelvimetry (Pelvic Assessment)
o Inlet
o Pelvic cavity (midpelvis)
o Outlet
o Using fingers and feeling outlet of pelvis trying to gather relative size, shape,
whether it seems favorable for vaginal delivery...such crude data though so not
used for much other than to know that delivery may be not feasible...
• Labs
o CBC: baseline lab levels, H&H, platelets, RBCs
o VDRL/RPR/STS (reactive/nonreactive or positive/negative): tests for syphilis.
If reactive/positive we give penicillin to treat.
o GC/Chlamydia culture (negative or positive): Gonorrhea or Chamydia
o Pap smear (normal or abnormal cytology): tells us whether normal or
abnormal cytology.
o U/A: to confirm pregnancy typically at initial visit
o HbsAg (reactive/nonreactive or positive/negative): hepatitis B surface
antigen, we want it to be nonreac
Subsequent Prenatal Visits Answer - • Frequency
, o First 28 weeks: every 4 weeks
o 28-36 weeks: every 2 weeks
o After 36 weeks: every week (maybe twice a week if very close to due date)
• Vitals-consistency in taking is key-compare to baseline
• Weight (compare to first visit weight)
o First trimester: 31/2 to 5 lbs
o Second trimester: 12 to 15 lbs
o Third trimester: 12 to 15 lbs
o Overall weight gain: 25-35 lbs is standard, assuming average weight individual
to start with. If underweight may want them to gain more, or if overweight may
want them to gain a little less.
• General physical assessment
• Uterine size
• FHR
• Specimen collection as needed
o Blood
• CBC
• Regular screening as described in part 2 of unit 5 ppt
o Urine: dipstick to check for things like blood, leukocytes, protein, ketones,
that aren't supposed to be there. If are spilled into urine need to assess further.
o Cervical swabs
• Taken as indicated in part 2 of unit 5, or otherwise if patient symptomatic
• Psychological adjustment
o Mother
• 1st trimester-period of adjustment
• 2nd trimester-period of radiant health
• 3rd trimester-period of watchful waiting
