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A pregnant client at 10 weeks' gestation reports nausea that is worse
immediately after waking. Which instruction should the practical nurse
provide?
A. Eat dry crackers before getting out of bed.
B. Drink a large glass of milk immediately after waking.
C. Skip breakfast until the nausea resolves.
D. Drink several glasses of water with the first meal.
Answer: A
Rationale: Eating dry crackers or another bland food before getting out
of bed can reduce morning nausea. Small, frequent meals and adequate
hydration are also helpful. Avoiding food or fluids can worsen
dehydration and nutritional deficits.
A client at 32 weeks' gestation reports painless, bright-red vaginal
bleeding. Which complication should the nurse suspect?
A. Placental abruption
B. Placenta previa
,C. Preterm labor
D. Ectopic pregnancy
Answer: B
Rationale: Placenta previa classically presents with painless, bright-red
vaginal bleeding during the second half of pregnancy. A vaginal
examination should be avoided until placenta previa has been ruled out
because manipulation may provoke severe hemorrhage.
Which finding is considered a positive sign of pregnancy?
A. Amenorrhea
B. Positive urine pregnancy test
C. Fetal heart activity detected by Doppler
D. Breast tenderness
Answer: C
Rationale: Positive signs are findings that can be directly attributed to
the fetus, such as fetal heart activity, fetal movement palpated by an
examiner, or visualization of the fetus by ultrasound. Amenorrhea,
breast changes, and nausea are presumptive signs, while a pregnancy
test is a probable sign.
The nurse is teaching a pregnant client about folic acid. Which outcome
is most directly associated with adequate folic acid intake?
,A. Prevention of neural tube defects
B. Prevention of gestational diabetes
C. Prevention of postpartum hemorrhage
D. Prevention of neonatal hypoglycemia
Answer: A
Rationale: Adequate folic acid before conception and during early
pregnancy substantially reduces the risk of neural tube defects such as
spina bifida. Prenatal supplementation is therefore an important
component of preconception and prenatal care.
Which instruction is most appropriate for a pregnant client
experiencing heartburn?
A. Eat large meals twice daily.
B. Lie flat immediately after meals.
C. Eat small, frequent meals and remain upright after eating.
D. Drink carbonated beverages with every meal.
Answer: C
Rationale: Small meals reduce gastric distention, while remaining
upright after eating decreases reflux. Large meals, lying down after
eating, and carbonated beverages may aggravate heartburn.
A pregnant client becomes dizzy and pale while lying supine. Which
action should the nurse take first?
, A. Place the client in a side-lying position.
B. Elevate both legs above the heart.
C. Place the client in Trendelenburg position.
D. Encourage the client to ambulate.
Answer: A
Rationale: In later pregnancy, the enlarged uterus can compress the
inferior vena cava when the client lies supine, reducing venous return
and cardiac output. Side-lying, particularly left lateral positioning,
improves circulation and relieves symptoms.
Which assessment finding is most concerning in a client with suspected
preeclampsia?
A. Mild ankle edema at the end of the day
B. Persistent severe headache and visual disturbances
C. Increased appetite
D. Occasional urinary frequency
Answer: B
Rationale: Severe headache, visual disturbances, epigastric or right-
upper-quadrant pain, hyperreflexia, and other neurologic symptoms
can indicate severe preeclampsia and possible progression toward
eclampsia. These findings require prompt evaluation.
A client with preeclampsia is receiving magnesium sulfate. Which
finding requires immediate intervention?