OB Final Exam Prep U Questions and Answers/Rationales fall 2022/2023

OB PREP U CHP 10 An older pregnant woman has come to the clinic for her first prenatal visit. She asks the nurse about age guidelines for genetic counseling and prenatal testing. The nurse informs the client that genetic counseling and prenatal testing should be performed for all pregnant women in which age group? Which event will result in zygote formation? During the embryonic stage of pregnancy, what changes would the mother note in her body to signal that she is pregnant? A client who has one child with a genetic disorder tells the nurse, “I told my husband I was ready to have another baby and now he does not want to be intimate with me.” What is the most appropriate nursing diagnosis for this client? A recently married couple come to the prenatal clinic because they are concerned about genetic testing. The husband is of Jewish heritage. What testing should the nurse recommend to the couple? The nurse prepares a couple to have a karyotype performed. What describes a karyotype? Implantation generally occurs at which place on the uterus? Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S? In developing a plan of care for a 5-year-old child with Down syndrome, what should be a priority for the nurse in meeting the expected growth and development outcomes for this child? A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age? Cystic fibrosis is an example of which type of inheritance? Three sisters decide to have genetic testing done because their mother and their maternal grandmother died of breast cancer. Each of the sisters has the BRCA1 gene mutation. The nurse explains that just because they have the gene does not mean that they will develop breast cancer. What does the nurse explain their chances of developing breast cancer depend on? A nursing student is explaining to a newly pregnant woman what happens during each stage of fetal development. At which stage does the nurse inform the woman that the lungs are fully shaped? While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a: A nurse is describing what happens at fertilization as the zygote begins life. Which statement is most accurate? A client at a preconception screening meeting indicates to the nurse that she is a carrier of muscular dystrophy. Which statement made by the client indicates an understanding of the implications? The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information? A client comes to the clinic with concerns about her pregnancy. She is in her first trimester and is now experiencing moderate abdominal pain on the right side. What would be the nurse’s first action? A 4-year-old child is recently diagnosed with Wilms tumor. The health care provider suggests that the child's siblings have genetic testing performed. What is the best response by the nurse when explaining this to the parents? A nurse is caring for a 32-year-old Jewish client who is pregnant with a female baby. The parents are not directly related by blood. The mother reports that her husband's cousin had an infant born with Tay-Sachs disease that died two years ago and she is concerned about her baby. Which information does the nurse need to give the client to help alleviate her concerns regarding her baby having the same disease? A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take? A mutligravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embyonic stage? A pregnant client asks the nurse if the fetus can be tested for Down syndrome. Which statement by the nurse is most appropriate? A pregnant woman undergoes a triple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's estriol and alpha-fetoprotein levels are decreased with high hCG levels? Nondisjunction of a chromosome results in which diagnosis? Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S? A nurse is providing genetic counseling to a pregnant client. Which are nursing responsibilities related to counseling the client? Select all that apply. A mother has come to the clinic with her 13-year-old daughter to find out why she has not started her menses. After a thorough examination and history, genetic testing is prescribed to rule out which abnormality? The nurse is assessing a young female who just found out she is pregnant. She is is now reporting vague abdominal discomfort. After noting the client has a history of PID, the nurse predicts the health care provider will give priority to ruling out which situation? A 4-year-old child is recently diagnosed with Wilms tumor. The health care provider suggests that the child's siblings have genetic testing performed. What is the best response by the nurse when explaining this to the parents? A nurse assesses that a 7-year-old male client has a prominent lower jaw, large ears, speech deficits, and displays hyperactivity. The nurse identifies this as being most likely related to which diagnosis? During a preconception teaching session, the nurse tells participants to increase their intake of which food groups to reduce the incidence of neural tube disorders? Select all that apply. A pregnant woman has a child at home who has been diagnosed with neurofibromatosis. She asks the nurse what she should look for in the new baby that would indicate that it also has neurofibromatosis. What sign should the nurse instruct the woman to look for in the new baby? A couple has just learned that their unborn son has a chromosome disorder that results in an extra X chromosome. The primary care provider explains that secondary sex characteristics will not develop in this child at puberty and that his testes will remain small and produce ineffective sperm. The nurse recognizes that this child likely has: While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a: A nurse is discussing the importance of good nutrition to a young pregnant client. The nurse would point out that the growing fetus is getting nutrition from the mother via which structure? The nursing instructor is presenting a class on the various classifications of twins. The instructor determines the session is successful after the students correctly choose which classification that indicates twins have separate amniotic sacs and placentas? Chapter 11: Maternal Adaptation During Pregnancy The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse? - A client who has just given a blood sample for pregnancy testing in the health care provider's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy? Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to: - A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely? A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth? A 17-year-old client arrives for an annual examination and reports no changes since the last exam; however, the nurse assesses a postive Chadwick sign, slightly enlarged uterus, and subsequent positive urine pregnancy test. Which task should the nurse prioritize to assist this client who is denying any possibility that she is pregnant? The nurse is assessing a pregnant client at her 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are? The nurse is teaching a pregnant teenager the importance of proper nutrition and adequate weight gain throughout the pregnancy. What is the best response when the client refuses to eat due to fear of possible weight gain? A client who suspects she is pregnant asks the nurse about the accuracy of home pregnancy tests. The nurse would tell the client that: The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence? A pregnant client in her first trimester of pregnancy reports spontaneous, irregular, painless contractions. What does this indicate? A client in her second trimester of pregnancy reports discomfort during sexual activity. Which instruction should a nurse provide? In preparing for a prenatal class to discuss the hormonal changes during pregnancy, which information would the nurse most likely include? During a routine antepartal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse do next? The nurse is teaching a pregnant woman about breast feeding. The nurse determines that the teaching was successful when the woman identifies which hormone as being released when the newborn sucks at the breast? A pregnant client in her third trimester, lying supine on the examination table, suddently grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize? The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse? - The partner of a pregnant client in her first trimester asks the nurse about the client’s behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns? A new mother voices concerns about breast-feeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are: A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next? A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client’s blood pressure. Which intervention should the nurse implement to help alleviate this client’s condition? A client in her second trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also reports increased pigmentation on her breasts and genitalia. Which statement by the nurse is most appropriate? A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found? A 22-year-old client comes to the walk-in clinic complaining of fatigue, breast heaviness and extreme tenderness, and a clear vaginal discharge. What question would the nurse ask this client? A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week? During a prenatal visit, a client in her second trimester of pregnancy verbalizes positive feelings about the pregnancy and conceptualizes the fetus. Which is the most appropriate nursing intervention when the client expresses such feelings? During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings? . A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer? A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation and enlargement of the birth canal. What is this hormone? - The nurse is explaining the latest laboratory results to a pregnant client who is in her third trimester. After letting the client know she is anemic, which heme iron-rich foods should the nurse encourage her to add to her diet? Hormone levels of a woman indicate that the corpus luteum stopped functioning and releasing progesterone after 5 weeks. The nurse would recognize that which scenario is the expected outcome? A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem? During a routine antepartal visit, a pregnant woman reports a white, thick vaginal discharge. What would the nurse do next? The nurse is performing an assessment of a woman who has come to a health care facility for a diagnosis of pregnancy. The women is positive for breast changes, nausea, and amenorrhea. On physical exam, it is noted that the client has softening of the cervix. How should the nurse document this in her notes? The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse? A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a bloody mucous discharge noted in the toilet after an OB office visit several hours earlier. What is the best response from the triage nurse? The nurse is counseling a young woman who has just entered her second trimester, after an uneventful first trimester. She tells the nurse, "It still doesn't seem real. It's just hard to believe that I will really have a baby." Which future events should the nurse point out that will help the young woman come to believe it is real? Select all that apply. Chapter 12: Nursing Management During Pregnancy During pregnancy the cardinal rule regarding on taking medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy? The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which signs and symptoms would the nurse include? Select all that apply. A nurse is educating a pregnant client about physical changes that can occur in pregnancy. Which conditions are associated with physical changes in pregnancy? Select all that apply. A client in her third month of pregnancy arrives at the health care facility for a regular follow-up visit. The client reports discomfort due to increased urinary frequency. Which instruction should the nurse offer the client to reduce the client’s discomfort? A nurse is conducting a class geared toward changes in early pregnancy and self-care items like perineal hygiene. A woman shares that she douches at least once a day since she has "so much discharge" from her vagina. Which response by the nurse is most appropriate at this time? A 31-year-old client at 28 weeks' gestation reports frequent low back pain and ankle edema by the end of the day. Which suggestion should the nurse prioritize for this client? The nurse is assessing a client at her first prenatal visit and reports her LMP started December 1. Which date will the nurse predict for the EDD? Which client immunization titer is most important to assess and document in the prenatal record of the pregnant woman? At 34 weeks' gestation a client is diagnosed with preeclampsia and sent home on bed rest. The nurse teaches the client to contact the provider immediately if she experiences which change? A client in her second trimester of pregnancy visits a health care facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which precaution should the nurse instruct the pregnant client to take when practicing aerobic exercises? A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information? A client at 27 weeks' gestation still walks daily but reports "terrible" heartburn at night. Which action should the nurse point out will best address this situation? The nurse discovers a new prescription for RhoGAM for a client who is about to undergo a diagnostic procedure. The nurse will administer the RhoGAM after which procedure? The client at her 32 week gestation appointment expresses concern regarding lower extremity edema and bulging leg veins. Which suggestions by the nurse are helpful? Select all that apply A woman asks the nurse if she can take an over-the-counter vitamin during pregnancy rather than her prescription prenatal vitamin. A chief ingredient in prenatal vitamins that makes them important for pregnancy nutrition is: A nurse is giving a prenatal class on teratogens that have an affinity for specific body tissues. Which teratogen is accurately paired with the specific body tissue affected? • in pregnancy, is now prescribed for cancer therapy, and it may cause limb defects Which pregnant woman should consult with her obstetric provider before continuing an exercise program? A pregnant client is planning a vacation to a different state and questions the nurse concerning precautions. Which suggestion should the nurse prioritize for this client who will be traveling by automobile? A client at 32 weeks' gestation is admitted to labor and delivery with vaginal bleeding and contractions. The physician orders a course of two steroid injections. The client asks why she needs steroids. What is the best explanation by the nurse? Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation. A nurse is educating a prenatal client at her second visit. The client is worried about “blotchy brown spots" on her forehead. The nurse reassures the client about this change by giving which appropriate response? - The health care provider has prescribed an over-the-counter antacid for a pregnant client in her first trimester who is having ongoing nausea, vomiting, and heartburn. Which instruction concerning the antacid should the nurse prioritize after noting the client is also prescribed a multivitamin supplement? The nurse is reviewing client data following a regular monthly appointment at 6 months' gestation. Which fundal height requires no further intervention? A pregnant client at 18 weeks' gestation has arrived for her routine prenatal visit. Which assessment findings should the nurse prepare to document at this time? Select all that apply. • Fundal height of approximately 18 cm • Quickening A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which symptom is an indicator of true labor? The nurse is planning a class for nurses learning to teach early prenatal classes. Which statement indicates that teaching has been effective? A client in her third trimester of pregnancy wishes to formula feed her baby. What instruction should the nurse provide? A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history? The client states that the first day of her last menstrual period is March 23. The nurse is most correct to calculate using Naegele rule that the estimated date of delivery is: Chapter 19: Nursing Management of Pregnancy at Risk: Pregnancy- Related Complications A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting? The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this? A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements? A pregnant client with hyperemesis gravidarum needs advice on how to minimize nausea and vomiting. Which instruction should the nurse give this client? The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client? A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion? A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV? The nurse is comforting and listening to a young couple who just suffered a miscarriage. When asked why this happened, which reason should the nurse share as a common cause? A nurse is preparing a nursing care plan for a client who is admitted at 22 weeks' gestation with advanced cervical dilatation to 5 cm, cervical insufficiency, and a visible amniotic sac at the cervical opening. Which primary goal should the nurse prioritize at this point? A woman at 34 weeks' gestation presents to labor and delivery with vaginal bleeding. Which finding from the obstetric examination would lead to a diagnosis of placental abruption? A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission? A woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that: A 44-year-old client has lost several pregnancies over the last 10 years. For the past 3 months, she has had fatigue, nausea, and vomiting. She visits the clinic and takes a pregnancy test; the results are positive. Physical examination confirms a uterus enlarged to 13 weeks' gestation; fetal heart tones are heard. Ultrasound reveals that the client is experiencing some bleeding. Considering the client’s prenatal history and age, what does the nurse recognize as the greatest risk for the client at this time? A client at 11 weeks’ gestation experiences pregnancy loss. The client asks the nurse if the bleeding and cramping that occurred during the miscarriage were caused by working long hours in a stressful environment. What is the most appropriate response from the nurse? A client with a history of cervical insufficiency is seen for reports of pink-tinged discharge and pelvic pressure. The primary care provider decides to perform a cervical cerclage. The nurse teaches the client about the procedure. Which client response indicates that the teaching has been effective? A 16-year-old client gave birth to a 12 weeks' gestation fetus last week. The client has come to the office for follow-up and while waiting in an examination room notices that on the schedule is written her name and "follow-up of spontaneous abortion." The client is upset about what is written on the schedule. How can the nurse best explain this terminology? A nurse is caring for a client undergoing treatment for ectopic pregnancy. Which symptom is observed in a client if rupture or hemorrhaging occurs before the ectopic pregnancy is successfully treated? The nurse is required to assess a pregnant client who is reporting vaginal bleeding. Which nursing action is the priority? A client has come to the office for a prenatal visit during her 24th week of gestation. On examination, it is noted that her blood pressure has increased to 146/94 mm Hg. Her urine is negative for proteinuria. Blood pressure assessment at 20 weeks' gestation was 142/92 mm Hg and urine was negative for protein. Blood pressure readings at previous visits ranged from 120/76 mm Hg to 126/80 mm Hg. The nurse suspects which condition? A pregnant 36-year-old woman has presented to the emergency department with vaginal bleeding. While reviewing the client's history, the nurse suspects placenta previa when which risk factors are found in her record? Select all that apply. A young mother gives birth to twin boys who shared the same placenta. What serious complication are they at risk for? A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy? A woman of 16 weeks' gestation telephones the nurse because she has passed some “berry-like” blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do? A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect? The nurse is caring for a pregnant client with severe preeclampsia. Which nursing intervention should a nurse perform to institute and maintain seizure precautions in this client? A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client? A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as: A 24-year-old client presents in labor. The nurse notes there is an order to administer RhoGAM after the birth of her infant. When asked by the client the reason for this injection, which reason should the nurse point out? A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure? A nurse is caring for a client who just experienced a miscarriage in her first trimester. When asked by the client why this happened, which is the best response from the nurse? A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm/Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next? A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP? A woman in her 20s has experienced a miscarriage at 10 weeks' gestation and asks the nurse at the hospital what went wrong. She is concerned that she did something that caused her to lose her baby. The nurse can reassure the woman by explaining that the most common cause of spontaneous miscarriage in the first trimester is related to which factor? A pregnant woman with preeclampsia is to receive magnesium sulfate IV. Which assessment should the nurse prioritize before administering a new dose? Which measure would the nurse include in the plan of care for a woman with prelabor rupture of membranes if her fetus's lungs are mature? After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between abruptio placentae and placenta previa. Which statement should the nurse include in the teaching? A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage. The client looks frightened and confused and states that she does not believe in abortion. Which statement by the nurse is best? A woman at 34 weeks' gestation presents to labor and delivery with vaginal bleeding. Which finding from the obstetric examination would lead to a diagnosis of placental abruption? A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate? A woman has presented to the emergency department with symptoms that suggest an ectopic pregnancy. Which finding would lead the nurse to suspect that the fallopian tube has ruptured? A client at 27 weeks' gestation is admitted to the obstetric unit afer reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magneisum sulfate to accomplish which primary goal? The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity? A client has been admitted with placental abruption. She has lost 1,200 mL of blood, is normotensive, and ultrasound indicates approximately 30% separation. The nurse documents this as which classification of abruptio placentae? A nurse is describing the use of Rho(D) immune globulin as the therapy of choice for isoimmunization in Rh-negative women and for other conditions to a group of nurses working at the women's health clinic. The nurse determines that additional teaching is needed when the group identifies which situation as an indication for Rho(D) immune globulin? A client tells that nurse in the doctor’s office that her friend developed high blood pressure on her last pregnancy. She is concerned that she will have the same problem. What is the standard of care for preeclampsia? The nurse is caring for a multigravid who experienced a placental abruption 4 hours ago. For which potential situation will the nurse prioritize assessment? The nurse is caring for a woman at 32 weeks gestation with severe preeclampsia. Which assessment finding should the nurse prioritize after the administration of hydralazine to this client? A 35-year-old client is seen for her 2-week postoperative appointment after a suction curettage was performed to evacuate a hydatidiform mole. The nurse explains that the human chorionic gonadotropin (hCG) levels will be reviewed every 2 weeks and teaches about the need for reliable contraception for the next 6 months to a year. The client states, "I'm 35 already. Why do I have to wait that long to get pregnant again?" What is the nurse's best response? A nurse is caring for a pregnant client with eclamptic seizure. Which is a characteristic of eclampsia? A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize? A pregnant women calls the clinic to report a small amount of painless vaginal bleeding. What response by the nurse is best? A woman in week 35 of her pregnancy with severe hydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client? A high-risk pregnant client is determined to have gestational hypertension. The nurse suspects that the client has developed preeclampsia with severe features based on which finding? A 24-year-old woman presents with vague abdominal pains, nausea, and vomiting. An urine hCG is positive after the client mentioned that her last menstrual period was 2 months ago. The nurse should prepare the client for which intervention if the transvaginal ultrasound indicates a gestation sac is found in the right lower quadrant? A woman at 10 weeks gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize? A woman at 12 weeks' gestation comes to the clinic with vaginal bleeding. When assessing the woman further, the nurse would suspect a threatened abortion based on which finding? Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Between her regularly scheduled visits, a woman in her first trimester of pregnancy who is taking iron supplements for anemia calls the nurse at her obstetrician's office reporting constipation. She reports that she has never had this problem before and asks for some advice about how to get relief. What is the best advice the nurse can give her? A woman with an artificial mitral valve develops heart failure at the 20th week of pregnancy. Which measure would the nurse stress with her during the remainder of the pregnancy? A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection? A pregnant client is screened for tuberculosis during her first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. Which sign would indicate a positive test result? A pregnant client has developed iron-deficiency anemia and has been prescribed 200 mg of elemental iron per day. The nurse should encourage the client to take this medication with which substance? What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension? A woman at 26 weeks' gestation is undergoing screening for diabetes with a 1-hour oral glucose challenge test. On the client's return visit, the nurse anticipates the need to schedule a 3-hour glucose challenge test based on which result of the previous test? An infant is born to a mother with gestational diabetes. Which long-term maternal complication is associated with this diagnosis? A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize? The nurse is caring for a pregnant woman is determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame? A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for? A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client? A nursing instructor is teaching students about preexisting illnesses and how they can complicate a pregnancy. The instructor recognizes a need for further education when one of the students makes which statement? A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum? What important instruction should the nurse give a pregnant client with tuberculosis? The nurse is providing care to a neonate. Review of the maternal history reveals that the mother is suspected of having a heroin use disorder. The nurse would be alert for which finding when assessing the neonate? The nurse is assessing a mother who just delivered a 7 lb (3136 g) baby via cesarean delivery. Which assessment finding should the nurse prioritize if the mother has a history of controlled atrial fibrillation? A pregnant client is diagnosed with syphilis. Which interviewing question would demonstrate respect for the client and therapeutic communication? A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse’s teaching indicates that the woman needs further instruction? A woman is pregnant and has asthma. Her primary care provider has told her to continue taking prednisone during pregnancy, but she is concerned the drug may be teratogenic. What advice would be best to give her regarding this? A pregnant woman with diabetes is having a glycosylated hemoglobin (HbA1C) level drawn. Which result would require the nurse to revise the client's plan of care? The nurse is preparing information for a client who has just been diagnosed with gestational diabetes. Which instruction should the nurse prioritize in this information? The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or at delivery for her baby. Which statement by the mother indicates that further teaching is needed by the nurse? The parent of an 11-year-old girl with an inoperable brain tumor confides to the nurse that her daughter's physician is "pushing them" to convince their daughter to participate in a controversial treatment that has a high risk for side effects. She further states that she told him twice that they were not interested. What would be the nurse's best response to this situation? In an effort to improve the health status of women and their children, several national campaigns have been implemented. The campaign that reduced the incidence of Sudden Infant Death Syndrome (SIDS) by 50% was the: A program designed to decrease the infant mortality rate in the United States would probably make the greatest impact if it focused on which aspect of care? To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent? The nurse is assessing a 9-year-old boy with pneumonia. Which finding is a factor for this child's morbidity? The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role? An expectant mother has arranged for her massage therapist to provide gentle hand, arm, and neck massage for the client while she is in labor in the hospital. Which trend in today's health care environment is most related to this arrangement? A nurse is caring for a critically ill female client who has recently been diagnosed with advanced lung cancer. The family asks the nurse why their mother's cancer is so advanced and was not detected earlier. Which response would be most accurate and appropriate? A group of women are attending a community presentation regarding the leading health concerns of women. Which interventions should the nurse recommend to have the greatest impact on the leading cause of death? The nurse is updating the records of a 10-year-old girl who had her appendix removed. Which action could jeopardize the privacy of the child’s medical records? A nurse is preparing a presentation on current American trends in maternal morbidity and mortality in order to lobby for program funding. Which statements would the nurse include? Select all that apply. A nurse is admitting a female client to the cardiac unit diagnosed with a possible myocardial infarction. During the admission assessment, which symptoms would the nurse expect to find? Select all that apply. After completing an assessment, the nurse examines the information to develop a wellness diagnosis for the client to identify which potential goal? The nurse is organizing health information to teach a client basic principles that will help maintain wellness in the family. Which actions should the nurse prioritize in this teaching? A 15-year-old client has just given birth and states that she does not want her infant to receive any newborn vaccines. What is the appropriate action for the nurse to take? A nurse witnesses a peer tell a client, “You are a mother now and you have to do what is best for you baby. You have to breastfeed her!” Which is the best action by the nurse? A client learns she is 6 weeks' pregnant and asks the nurse for the name of the local abortion clinic. What is the most appropriate response by the nurse? The nurse is working with the parents of an infant and a toddler in the clinical setting. What statement by the parent would alert the nurse to assess the children further? he nurse is providing education to the parents of a school-aged child. Which information would the nurse include in the teaching plan? Chapter 2 PrepU The nurse is asked to present an educational event to the local Junior League. While planning for the event, what is most important for the nurse to do? To assess the sociocultural aspects of the family of an adolescent being seen in an ambulatory clinic, the nurse would try to find out more about: Which information is true of home care as a whole? The nurse evaluates a family to see if they are a good candidate for home care for a sick child. Which factor would be most important to see in the prospective family's home? The nurse is caring for a pregnant woman and her family who are immigrants. Which intervention would be the priority for helping to achieve a successful outcome? A 40-year-old pregnant client tells her nurse that she would like to give birth in a birthing center because she wants several friends and family members to be there and will have more freedom at the center. What would be the most important factor for the nurse to point out when discussing this option with the client? The nurse is participating in a poisoning prevention program. This activity is an example of which type of community-based nursing intervention? The nurse notes that a 5-year-old boy is approaching obesity. Which is the priority intervention? The nurse is caring for a 7-year-old boy and his family, who are immigrants. Which intervention will most significantly affect the success of the care provided? Personal space and distance is a cultural perspective that can impact nurse- client interactions. What is the best way for the nurse to interact with a client who has a different cultural perspective on space and distance? While interviewing a Chinese man about his son's health, the nurse notices that the man keeps his eyes focused on the floor. What is the best action by the nurse? A nurse doing an admission assessment on a new Chinese American client notices that the client will not make eye contact. The most likely reason for this is that it: A primary care provider tells a pregnant woman with slightly elevated blood pressure to return home on bed rest until her next scheduled checkup. This is an example of which type of care? Which action should a nurse perform to avoid disrupting family routine when visiting to provide home care? The nurse instructs a pregnant client who is at home on bed rest to drink at least eight glasses of fluid each day. What would be the best method to encourage the client to drink this amount? The pediatric nurse assists the parents of a 26-month-old child newly diagnosed with childhood diabetes. Which statements and questions by the nurse would be appropriate to help the parents grasp the necessary care information? Select all that apply. The emergency nurse is providing care for a pregnant woman admitted with a broken femur, blackened eye, and multiple contusions. She admits her partner is abusive. Which activity would be considered at the tertiary level of prevention? You Selected: The community health nurse is seeing a mother and newborn for the first home visit. Which information best indicates an understanding of visiting clients in their home? When caring for woman who speaks a different language than one's own, the nurse must ask for an interpreter before having the client sign which forms to ensure clarity can be confirmed? Select all that apply. A 19-year-old pregnant adolescent who experienced a rape has arrive in the emergency department in active labor with no prenatal care. The nurse caring for the client should assess for which potential adverse health problem? • Chapter 3 PrepU Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male, where are the sex hormones produced? The vagina is at risk for infection because of its location and because it opens to the outside of the body. What is a protective mechanism of the vagina to keep it from becoming infected? A woman experiencing menopausal symptoms asks the nurse about herbal remedies for managing her symptoms. Which response by the nurse would be most appropriate? The nurse is reviewing with a group of high school students that the hypothalamus, pituitary gland, and gonads all contribute to hormonal regulation of the female reproductive system. What would be the best information for the nurse to include in the education session about the main effects of the gonadotropic hormones? The nurse is reviewing the structure and function of various organs in the female reproductive system. Which information should the nurse include about the ovum in the review with the client? The mother of a 9-year-old girl is concerned because her daughter has already begun menstruating. The daughter is of normal height for her age and weighs 150 lbs (68 kg). The mother is concerned that this is not normal and asks about the factors that could be involved. Which response by the nurse would be best? A nurse is teaching a sex education class and is discussing sexual response. She describes a 30-minute period during which external and internal genital organs return to an unaroused state. What is this phase of sexual response known as? A client is trying to have a baby and wants to know the best time to have intercourse to increase the chances of pregnancy. Which time for intercourse is ideal to help her chances of conceiving? Which hormone is called the hormone of pregnancy because it reduces uterine contractions during pregnancy? A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs: Which client should the nurse flag for the health care provider to assess first? A mother brings her 10-year-old daughter to the clinic for a routine visit. The mother tells the nurse that she has noticed her daughter beginning to develop and asks the nurse about when her daughter may begin menstruating. The nurse understands that many factors are involved in determining the age at which menstruation begins. Which factor would the nurse include in the response as most important? A nurse is reviewing the medical record of a woman who has given birth vaginally. The record reveals that the client required a right mediolateral episiotomy during birth. When assessing the client, the nurse would inspect which area to evaluate the status of the episiotomy? A nurse is obtaining a health history from a female client who reports that she started menstruating at age 11 years. The nurse would document this as: The nurse is answering questions from a newborn's parents concerning a circumcision. Which structure will the nurse point out is removed during the procedure? A mother comes to the clinic nurse concerned about whether her adolescent daughter is sexually active. She requests a physical examination of the daughter’s hymen. Which statement by the nurse accurately addresses this issue? A school nurse is talking to an adolescent, who asks her about why she has monthly menstrual cycles. The best explanation that the nurse can offer the adolescent regarding the menstrual phase is to tell her that: In the resolution phase of sexual response, which response would be most commonly noted in the male? An adult client currently has low levels of estrogen and progesterone. At this point in the menstrual cycle, the client will likely: • The nurse is educating a pregnant woman regarding expectations immediatley after the birth of her baby. Which would the nurse include in the teaching plan regarding colostrum?