128 Antepartum NCLEX Exam Questions with Answers Latest Updated, Rated A

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128 Antepartum NCLEX Exam Questions with Answers Latest Updated The nurse is caring for a prenatal client who is at risk for placental abruption. Which risk factor documented in the client's record... supports this risk factor? -Ans- Maternal hypertension The nurse working in a prenatal clinic reviews a client's chart and notes that the primary health care provider documents that the client has a gynecoid pelvis. The nurse plans care understanding that which findings are characteristic of this type of pelvis? Select all that apply. -Ans- 1.Round shape 4.Diagonal conjugate measures 12.5 cm to 13 cm 5.Blunt, somewhat widely separated ischial spines A nursing student is assigned to a client in labor. The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. The instructor determines that the student understands the structure of the ductus venosus if the student states which about the ductus venosus? -Ans- Connects the umbilical vein to the inferior vena cava The nurse is collecting data from a client who is pregnant with triplets. The client also has a 3-year-old child who was born at 39 weeks' gestation. The nurse should document which gravida and para status on this client? -Ans- Gravida II, para I The nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse notes that the health care provider has documented the presence of Goodell's sign. The nurse determines that this sign is indicative of which change that occurs with pregnancy? -Ans- A softening of the cervix A primipara is being evaluated in the clinic during her second trimester of pregnancy. Which occurrence indicates an abnormal physical finding that necessitates further testing? -Ans- Fetal heart rate of 180 beats per minute The nurse is collecting data from a pregnant client who is currently at 28 weeks' gestation. At her prior prenatal visit, her fundal height measured 22 cm. The nurse measures the fundal height at this visit in centimeters and should expect which finding? -Ans- 26cm The nurse is checking a client's record for probable signs of pregnancy. Which are the probable signs of pregnancy that the nurse should note? Select all that apply. -Ans- 1.Ballottement 2.Chadwick's sign 3.Uterine enlargement 4.Braxton Hicks contractionsThe nursing instructor asks a nursing student to describe the process of quickening. Which statement indicates an understanding of this term? -Ans- "It is the fetal movement that is felt by the mother." The client at 28 weeks' gestation is Rh negative and Coombs antibody negative. The nurse determines that the client understands what the nurse has taught her about Rh sensitization when the client makes which statement? -Ans- "I will tell the nurse at the hospital that I had an Rh shot during pregnancy." While assisting with the measurement of fundal height, the client at 36 weeks' gestation states that she is feeling lightheaded. On the basis of the nurse's knowledge of pregnancy, the nurse determines that this is most likely a result of which reason? -AnsCompression of the vena cava The perinatal client is admitted to the obstetrical unit during an exacerbation of a heart condition. When planning for the nutritional requirements of the client, the nurse should consult with the dietitian to ensure which dietary measure? -Ans- A diet that is high in fluids and fiber to decrease constipation The nurse caring for a client with abruptio placentae is monitoring the client for signs of disseminated intravascular coagulopathy (DIC). The nurse should suspect DIC if which is observed? -Ans- Petechiae, oozing from injection sites, and hematuria The client is in her second trimester of pregnancy. She complains of frequent low back pain and ankle edema at the end of the day. The nurse should recommend which measure to help relieve both discomforts? -Ans- Lie on the floor with the legs elevated onto a couch or padded chair, with the hips and knees at a right angle. The nurse is reinforcing instructions to a pregnant client regarding measures to prevent heartburn. The nurse should instruct the client to take which best measure? -Ans- Drink decaffeinated coffee and tea. The nurse is monitoring a pregnant client with gestational hypertension (GH) who is at risk for preeclampsia. The nurse should check the client for which signs of preeclampsia? Select all that apply. -Ans- 1.Proteinuria 2.Hypertension The nurse is assisting with caring for a client who has a placenta previa. The nurse understands that a cervical examination should not be performed on the client primarily because it could have which consequence? -Ans- Cause hemorrhage The nurse is reviewing the health record of a pregnant client at 16 weeks' gestation. The nurse should expect to document that the fundus of the uterus is located at which area? -Ans- Midway between the symphysis pubis and the umbilicusA pregnant client in the second trimester of pregnancy is admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding should the nurse expect to note if this condition is present? -Ans- Abdominal pain A pregnant client in the third trimester of pregnancy with a diagnosis of mild preeclampsia is being monitored at home for progression of the disease process. The home care nurse reinforces teaching the client about the signs that need to be reported to the primary health care provider (PHCP) and tells the client to call the PHCP if which occurs? -Ans- Weight increases by more than 1 pound in a week. A client in the third trimester of pregnancy visits the clinic for a scheduled prenatal appointment. The client tells the nurse that she frequently has leg cramps, primarily when she is reclining. On the basis of the client's complaint which should the nurse do first? -Ans- Check for signs of thrombophlebitis. The nurse is preparing a pregnant client for a transvaginal ultrasound exam. The nurse should tell the client that which will occur? -Ans- The client will feel some pressure when the vaginal probe is moved. A client who has just been told that she is pregnant asks a clinic nurse when the fetus's heart will be developed and beating. The nurse tells the client that the fetal heart is beating at what gestational week? -Ans- week 5 The nurse-midwife is conducting a session on the process of conception with a group of nursing students. Which statements reflect that the nursing students understand the process of conception? Select all that apply. -Ans- 1."Fertilization occurs in the outer third of the fallopian tube." 2."Only 1 sperm will penetrate the ovum to produce fertilization." 4."Implantation occurs in the anterior or posterior fundal region of the uterus." 5."The ovary produces hormones to maintain the pregnancy before placental development." The nurse is providing information to a pregnant woman about food items high in folic acid. Which mid-afternoon snack should be recommended to supply folic acid? -AnsNuts and green, leafy vegetables A client beginning week 30 of gestation comes to the clinic for a routine visit. Which observation by the nurse indicates a need for further teaching? -Ans- The client is wearing knee-high hose. A nursing student is conducting a clinical conference regarding the hormones related to pregnancy. The instructor asks the student about the function of thyroxine. Which statements by the student indicate an understanding of this hormone? Select all that apply. -Ans- 4."It may play a role in the neural development of the fetus." 5."It increases during pregnancy to stimulate basal metabolic rate."The nurse is reading the primary health care provider's (PHCP) documentation regarding a pregnant client and notes that the PHCP has documented that the client has an android pelvic shape. The nurse understands that which characteristics are included with this pelvic shape? Select all that apply. -Ans- 2.Heart shaped 4.Convergent sidewalls 6.narrow interspinous diameter The nurse is measuring the fundal height of a client who is at 30 weeks of gestation. In preparing to perform the procedure the nurse should take which action? -Ans- Place the client in a supine position and place a wedge under the right hip. A pregnant woman visiting a health care clinic for the first prenatal visit hears the primary health care provider discuss the preembryonic period of development with the nurse. The woman asks the nurse what this means. What information should the nurse share related to this stage of development? Select all that apply. -Ans- 3."The preembryonic period is the first 2 weeks of fetal development following conception." 6."The preembryonic period includes initial development of the embryonic membranes and establishment of the primary germ layers." The nurse is reviewing the record of a pregnant client and notes that the primary health care provider has documented the presence of Chadwick's sign. Which clinical finding supports the documentation of Chadwick's sign? -Ans- Violet bluish color of vaginal mucosa and cervix The nurse is collecting data on a pregnant client and is preparing to take the client's blood pressure. In which position should the nurse place the client? -Ans- In a sitting position The nurse is reading the primary health care provider's (PHCP) documentation regarding a pregnant client and notes that the PHCP has documented that the client has a platypelloid pelvic shape. The nurse recognizes which characteristics to be present in the platypelloid pelvis? Select all that apply. -Ans- 1.Shallow depth 2.Wide suprapubic arch 4.Compatible with vaginal delivery 5.Flattened anteroposteriorly and wide transversely The nurse is reinforcing instructions to a pregnant client regarding dietary measures to promote a healthy pregnancy. The nurse instructs the client to consume an adequate intake of fluid on a daily basis. Which statement by the client indicates an understanding of the daily fluid requirement? -Ans- "I should drink 8 to 12 glasses of liquid in addition to my daily milk requirement." The nurse is reinforcing instructions to a maternity client on how to keep a fetal activity diary. Which instruction should the nurse provide the client? -Ans- Contact the primary health care provider if the baby's movements are fewer than 10 times in 2 hours.A woman at 20 weeks of gestation calls the primary health care provider's office and speaks to the nurse. The client states that she is having subtle but persistent changes in her vaginal discharge, menstrual-like cramps, and diarrhea. Which is the least helpful response to the client? -Ans- "This is an emergency; you should come to the clinic within the hour." The nurse reviews the client's health record and notes that based on Leopold's maneuvers, the fetus is in a cephalic presentation. Which findings while performing Leopold's maneuvers support the identification of a cephalic presentation? Select all that apply. -Ans- 1.Small parts are located on the left side of the uterus. 2.Small parts are located on the right side of the uterus. 5.A soft, irregular non-ballottable shape is located just above the symphysis pubis. Which statements made by a nursing student indicate that the student has an appropriate knowledge base regarding the pregnancy hormone human chorionic gonadotropin (hCG)? Select all that apply. -Ans- 2."Human chorionic gonadotropin is the hormone responsible for a positive pregnancy test." 3."Human chorionic gonadotropin may be present as early as 8 to 10 days following conception." 4."Human chorionic gonadotropin is produced by the trophoblastic cells that surround the developing embryo." 5."Human chorionic gonadotropin preserves the function of the ovarian corpus luteum so that estrogen and progesterone are produced before placental functioning." A nursing instructor instructs the nursing students that surfactant is a substance needed to facilitate neonatal breathing. Which statements made by the nursing students indicate understanding regarding the presence of surfactant? Select all that apply. -Ans- 3."Surfactant, which is needed for lung expansion, is present beginning at 28 weeks." 4."With decreased surfactant, more pressure must be generated to produce inspiration." 5."Surfactant lowers surface tension, reducing the pressure required to keep the alveoli expanded." A pregnant client tests positive for hepatitis B virus (HBV). The nurse determines that the client understands this infection when the client makes which statement? -Ans- "I am so glad that I can breastfeed my baby after she has been vaccinated." A pregnant woman who is at 38 weeks' gestation arrives at the emergency department. She reports the presence of bright red vaginal bleeding and denies the presence of any pain. Based on this information, what does the nurse determine the client may be experiencing? -Ans- Placenta previa During a routine prenatal visit, a client complains of gingivitis and gums that bleed easily with brushing. When assisting to plan the care for the client, the nurse includes a goal that addresses proper nutrition to minimize this problem. The nurse determines that the goal has been achieved when the client makes which statement? -Ans- "I am eating fresh fruits and vegetables for snacks and for dessert each day."The nurse is assigned to care for a pregnant client with a diagnosis of sickle cell anemia. The nurse plans care, knowing that which problem should receive highest priority? -Ans- Dehydration The nurse is preparing a 36-year-old gravida II, para I pregnant client for an amniocentesis. She is at 16 weeks of gestation. Which action should the nurse take before the procedure to ensure fetal safety? -Ans- Test the ultrasound equipment to ensure proper functioning. A pregnant client is a gravida III, para 0, abortus II. She is placed on bed rest at home because of preterm labor. The nurse provides information to the husband, knowing that which instruction will assist in promoting family adaptation? -Ans- Teaching the husband to perform passive range of motion and provide back rubs for his wife A client who is in the second trimester of pregnancy develops melasma during pregnancy. Which statements made by the client indicates an understanding of this condition? Select all that apply. -Ans- 1."Melasma may reoccur in a subsequent pregnancy. 4."These brown, splotchy patches will most likely disappear after I deliver my baby." 5."The dark patches that are on my nose, cheeks and forehead will most likely darken until the baby is delivered." A pregnant client tells the nurse that she has been craving "unusual foods." On further data collection, the nurse discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Which laboratory result indicates a physiological consequence of a result of this practice? -Ans- Hemoglobin 9.1 g/dL A nonstress test is performed on a client, and the results are documented in the chart. The results are documented as a reactive nonstress test. Which interpretation should the nurse make of these results? -Ans- A negative test The nurse is collecting data from a client who is pregnant with twins. The nurse understands that which complications are more likely to occur with a twin pregnancy? Select all that apply. -Ans- 1.Preterm labor 3.Maternal anemia The nurse is reinforcing instructions to a client about preterm labor. Which method of teaching should the nurse use? -Ans- Palpate for uterine contractions at the same time as the client. A prenatal client has acquired the sexually transmitted infection, condyloma acuminatum (human papillomavirus). When assisting in planning care, which treatment should the nurse consider to be safe for this client? -Ans- Laser therapyWhen caring for the pregnant client with human immunodeficiency virus (HIV), which goal is appropriate? -Ans- The client will not develop an opportunistic infection during the remainder of pregnancy. A prenatal client diagnosed with anemia has come to the clinic. After reviewing the client's health record, the nurse notes that the laboratory values indicate low hemoglobin and hematocrit levels. Which problem do the data best support? -Ans- High risk for infection The nurse is planning interventions for counseling a maternity client newly diagnosed with sickle cell anemia. The nurse understands that the important psychosocial intervention at this time is which action? -Ans- Provide emotional support. A client who is 6 months pregnant is attending her first prenatal visit. On the first prenatal visit, the nurse notes that the client is gravida 4, para 0, abortion 3. The client is 5 feet, 6 inches tall, weighs 130 pounds, and is 25 years old. She states, "I get really tired after working all day and can't keep up with my housework." Which factor in the above data should lead the nurse to suspect gestational diabetes? -Ans- Fetal demise The nurse reinforces instructions to a client with mild preeclampsia on home care. Which comment by the client indicates that teaching is effective? -Ans- "I need to check my urine with a dipstick every day for protein and call my health care provider if it is 2+ or more." A pregnant client has just been admitted to the hospital with severe preeclampsia. The nurse knows it is important to monitor for additional complications at this time. Which assessment should be part of the plan of care? -Ans- Any bleeding, such as in the gums, petechiae, and purpura When collecting data from a pregnant client at risk for disseminated intravascular coagulation (DIC), which factors should the nurse consider significant? -Ans- A client who is gravida II who has just been diagnosed with dead fetus syndrome; fetal demise occurred 2 months ago The nurse is collecting data from a client and is reviewing the client's health record to determine the risk for preterm labor. Which finding places the client at risk for preterm labor? -Ans- A urinary tract infection The nurse assigned to care for a client with mild preeclampsia should anticipate which specific nursing intervention for this client? -Ans- Monitoring fetal movement The nurse is assigned to care for a client admitted with severe preeclampsia. Which is the priority nursing intervention for this client? -Ans- Minimizing the client's exposur The nurse is caring for a prenatal client who is at risk for placental abruption. Which risk factor documented in the client's record supports this risk factor? -Ans- Maternal hypertension The nurse working in a prenatal clinic reviews a client's chart and notes that the primary health care provider documents that the client has a gynecoid pelvis. The nurse plans care understanding that which findings are characteristic of this type of pelvis? Select all that apply. -Ans- 1.Round shape 4.Diagonal conjugate measures 12.5 cm to 13 cm 5.Blunt, somewhat widely separated ischial spines A nursing student is assigned to a client in labor. The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. The instructor determines that the student understands the structure of the ductus venosus if the student states which about the ductus venosus? -Ans- Connects the umbilical vein to the inferior vena cava The nurse is collecting data from a client who is pregnant with triplets. The client also has a 3-year-old child who was born at 39 weeks' gestation. The nurse should document which gravida and para status on this client? -Ans- Gravida II, para I The nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse notes that the health care provider has documented the presence of Goodell's sign. The nurse determines that this sign is indicative of which change that occurs with pregnancy? -Ans- A softening of the cervix A primipara is being evaluated in the clinic during her second trimester of pregnancy. Which occurrence indicates an abnormal physical finding that necessitates further testing? -Ans- Fetal heart rate of 180 beats per minute The nurse is collecting data from a pregnant client who is currently at 28 weeks' gestation. At her prior prenatal visit, her fundal height measured 22 cm. The nurse measures the fundal height at this visit in centimeters and should expect which finding? -Ans- 26cm The nurse is checking a client's record for probable signs of pregnancy. Which are the probable signs of pregnancy that the nurse should note? Select all that apply. -Ans- 1.Ballottement 2.Chadwick's sign 3.Uterine enlargement 4.Braxton Hicks contractionsThe nursing instructor asks a nursing student to describe the process of quickening. Which statement indicates an understanding of this term? -Ans- "It is the fetal movement that is felt by the mother." The client at 28 weeks' gestation is Rh negative and Coombs antibody negative. The nurse determines that the client understands what the nurse has taught her about Rh sensitization when the client makes which statement? -Ans- "I will tell the nurse at the hospital that I had an Rh shot during pregnancy." While assisting with the measurement of fundal height, the client at 36 weeks' gestation states that she is feeling lightheaded. On the basis of the nurse's knowledge of pregnancy, the nurse determines that this is most likely a result of which reason? -AnsCompression of the vena cava The perinatal client is admitted to the obstetrical unit during an exacerbation of a heart condition. When planning for the nutritional requirements of the client, the nurse should consult with the dietitian to ensure which dietary measure? -Ans- A diet that is high in fluids and fiber to decrease constipation The nurse caring for a client with abruptio placentae is monitoring the client for signs of disseminated intravascular coagulopathy (DIC). The nurse should suspect DIC if which is observed? -Ans- Petechiae, oozing from injection sites, and hematuria The client is in her second trimester of pregnancy. She complains of frequent low back pain and ankle edema at the end of the day. The nurse should recommend which measure to help relieve both discomforts? -Ans- Lie on the floor with the legs elevated onto a couch or padded chair, with the hips and knees at a right angle. The nurse is reinforcing instructions to a pregnant client regarding measures to prevent heartburn. The nurse should instruct the client to take which best measure? -Ans- Drink decaffeinated coffee and tea. The nurse is monitoring a pregnant client with gestational hypertension (GH) who is at risk for preeclampsia. The nurse should check the client for which signs of preeclampsia? Select all that apply. -Ans- 1.Proteinuria 2.Hypertension The nurse is assisting with caring for a client who has a placenta previa. The nurse understands that a cervical examination should not be performed on the client primarily because it could have which consequence? -Ans- Cause hemorrhage The nurse is reviewing the health record of a pregnant client at 16 weeks' gestation. The nurse should expect to document that the fundus of the uterus is located at which area? -Ans- Midway between the symphysis pubis and the umbilicusA pregnant client in the second trimester of pregnancy is admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding should the nurse expect to note if this condition is present? -Ans- Abdominal pain A pregnant client in the third trimester of pregnancy with a diagnosis of mild preeclampsia is being monitored at home for progression of the disease process. The home care nurse reinforces teaching the client about the signs that need to be reported to the primary health care provider (PHCP) and tells the client to call the PHCP if which occurs? -Ans- Weight increases by more than 1 pound in a week. A client in the third trimester of pregnancy visits the clinic for a scheduled prenatal appointment. The client tells the nurse that she frequently has leg cramps, primarily when she is reclining. On the basis of the client's complaint which should the nurse do first? -Ans- Check for signs of thrombophlebitis. The nurse is preparing a pregnant client for a transvaginal ultrasound exam. The nurse should tell the client that which will occur? -Ans- The client will feel some pressure when the vaginal probe is moved. A client who has just been told that she is pregnant asks a clinic nurse when the fetus's heart will be developed and beating. The nurse tells the client that the fetal heart is beating at what gestational week? -Ans- week 5 The nurse-midwife is conducting a session on the process of conception with a group of nursing students. Which statements reflect that the nursing students understand the process of conception? Select all that apply. -Ans- 1."Fertilization occurs in the outer third of the fallopian tube." 2."Only 1 sperm will penetrate the ovum to produce fertilization." 4."Implantation occurs in the anterior or posterior fundal region of the uterus." 5."The ovary produces hormones to maintain the pregnancy before placental development." The nurse is providing information to a pregnant woman about food items high in folic acid. Which mid-afternoon snack should be recommended to supply folic acid? -AnsNuts and green, leafy vegetables A client beginning week 30 of gestation comes to the clinic for a routine visit. Which observation by the nurse indicates a need for further teaching? -Ans- The client is wearing knee-high hose. A nursing student is conducting a clinical conference regarding the hormones related to pregnancy. The instructor asks the student about the function of thyroxine. Which statements by the student indicate an understanding of this hormone? Select all that apply. -Ans- 4."It may play a role in the neural development of the fetus." 5."It increases during pregnancy to stimulate basal metabolic rate."The nurse is reading the primary health care provider's (PHCP) documentation regarding a pregnant client and notes that the PHCP has documented that the client has an android pelvic shape. The nurse understands that which characteristics are included with this pelvic shape? Select all that apply. -Ans- 2.Heart shaped 4.Convergent sidewalls 6.narrow interspinous diameter The nurse is measuring the fundal height of a client who is at 30 weeks of gestation. In preparing to perform the procedure the nurse should take which action? -Ans- Place the client in a supine position and place a wedge under the right hip. A pregnant woman visiting a health care clinic for the first prenatal visit hears the primary health care provider discuss the preembryonic period of development with the nurse. The woman asks the nurse what this means. What information should the nurse share related to this stage of development? Select all that apply. -Ans- 3."The preembryonic period is the first 2 weeks of fetal development following conception." 6."The preembryonic period includes initial development of the embryonic membranes and establishment of the primary germ layers." The nurse is reviewing the record of a pregnant client and notes that the primary health care provider has documented the presence of Chadwick's sign. Which clinical finding supports the documentation of Chadwick's sign? -Ans- Violet bluish color of vaginal mucosa and cervix The nurse is collecting data on a pregnant client and is preparing to take the client's blood pressure. In which position should the nurse place the client? -Ans- In a sitting position The nurse is reading the primary health care provider's (PHCP) documentation regarding a pregnant client and notes that the PHCP has documented that the client has a platypelloid pelvic shape. The nurse recognizes which characteristics to be present in the platypelloid pelvis? Select all that apply. -Ans- 1.Shallow depth 2.Wide suprapubic arch 4.Compatible with vaginal delivery 5.Flattened anteroposteriorly and wide transversely The nurse is reinforcing instructions to a pregnant client regarding dietary measures to promote a healthy pregnancy. The nurse instructs the client to consume an adequate intake of fluid on a daily basis. Which statement by the client indicates an understanding of the daily fluid requirement? -Ans- "I should drink 8 to 12 glasses of liquid in addition to my daily milk requirement." The nurse is reinforcing instructions to a maternity client on how to keep a fetal activity diary. Which instruction should the nurse provide the client? -Ans- Contact the primary health care provider if the baby's movements are fewer than 10 times in 2 hours.A woman at 20 weeks of gestation calls the primary health care provider's office and speaks to the nurse. The client states that she is having subtle but persistent changes in her vaginal discharge, menstrual-like cramps, and diarrhea. Which is the least helpful response to the client? -Ans- "This is an emergency; you should come to the clinic within the hour." The nurse reviews the client's health record and notes that based on Leopold's maneuvers, the fetus is in a cephalic presentation. Which findings while performing Leopold's maneuvers support the identification of a cephalic presentation? Select all that apply. -Ans- 1.Small parts are located on the left side of the uterus. 2.Small parts are located on the right side of the uterus. 5.A soft, irregular non-ballottable shape is located just above the symphysis pubis. Which statements made by a nursing student indicate that the student has an appropriate knowledge base regarding the pregnancy hormone human chorionic gonadotropin (hCG)? Select all that apply. -Ans- 2."Human chorionic gonadotropin is the hormone responsible for a positive pregnancy test." 3."Human chorionic gonadotropin may be present as early as 8 to 10 days following conception." 4."Human chorionic gonadotropin is produced by the trophoblastic cells that surround the developing embryo." 5."Human chorionic gonadotropin preserves the function of the ovarian corpus luteum so that estrogen and progesterone are produced before placental functioning." A nursing instructor instructs the nursing students that surfactant is a substance needed to facilitate neonatal breathing. Which statements made by the nursing students indicate understanding regarding the presence of surfactant? Select all that apply. -Ans- 3."Surfactant, which is needed for lung expansion, is present beginning at 28 weeks." 4."With decreased surfactant, more pressure must be generated to produce inspiration." 5."Surfactant lowers surface tension, reducing the pressure required to keep the alveoli expanded." A pregnant client tests positive for hepatitis B virus (HBV). The nurse determines that the client understands this infection when the client makes which statement? -Ans- "I am so glad that I can breastfeed my baby after she has been vaccinated." A pregnant woman who is at 38 weeks' gestation arrives at the emergency department. She reports the presence of bright red vaginal bleeding and denies the presence of any pain. Based on this information, what does the nurse determine the client may be experiencing? -Ans- Placenta previa During a routine prenatal visit, a client complains of gingivitis and gums that bleed easily with brushing. When assisting to plan the care for the client, the nurse includes a goal that addresses proper nutrition to minimize this problem. The nurse determines that the goal has been achieved when the client makes which statement? -Ans- "I am eating fresh fruits and vegetables for snacks and for dessert each day."The nurse is assigned to care for a pregnant client with a diagnosis of sickle cell anemia. The nurse plans care, knowing that which problem should receive highest priority? -Ans- Dehydration The nurse is preparing a 36-year-old gravida II, para I pregnant client for an amniocentesis. She is at 16 weeks of gestation. Which action should the nurse take before the procedure to ensure fetal safety? -Ans- Test the ultrasound equipment to ensure proper functioning. A pregnant client is a gravida III, para 0, abortus II. She is placed on bed rest at home because of preterm labor. The nurse provides information to the husband, knowing that which instruction will assist in promoting family adaptation? -Ans- Teaching the husband to perform passive range of motion and provide back rubs for his wife A client who is in the second trimester of pregnancy develops melasma during pregnancy. Which statements made by the client indicates an understanding of this condition? Select all that apply. -Ans- 1."Melasma may reoccur in a subsequent pregnancy. 4."These brown, splotchy patches will most likely disappear after I deliver my baby." 5."The dark patches that are on my nose, cheeks and forehead will most likely darken until the baby is delivered." A pregnant client tells the nurse that she has been craving "unusual foods." On further data collection, the nurse discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Which laboratory result indicates a physiological consequence of a result of this practice? -Ans- Hemoglobin 9.1 g/dL A nonstress test is performed on a client, and the results are documented in the chart. The results are documented as a reactive nonstress test. Which interpretation should the nurse make of these results? -Ans- A negative test The nurse is collecting data from a client who is pregnant with twins. The nurse understands that which complications are more likely to occur with a twin pregnancy? Select all that apply. -Ans- 1.Preterm labor 3.Maternal anemia The nurse is reinforcing instructions to a client about preterm labor. Which method of teaching should the nurse use? -Ans- Palpate for uterine contractions at the same time as the client. A prenatal client has acquired the sexually transmitted infection, condyloma acuminatum (human papillomavirus). When assisting in planning care, which treatment should the nurse consider to be safe for this client? -Ans- Laser therapyWhen caring for the pregnant client with human immunodeficiency virus (HIV), which goal is appropriate? -Ans- The client will not develop an opportunistic infection during the remainder of pregnancy. A prenatal client diagnosed with anemia has come to the clinic. After reviewing the client's health record, the nurse notes that the laboratory values indicate low hemoglobin and hematocrit levels. Which problem do the data best support? -Ans- High risk for infection The nurse is planning interventions for counseling a maternity client newly diagnosed with sickle cell anemia. The nurse understands that the important psychosocial intervention at this time is which action? -Ans- Provide emotional support. A client who is 6 months pregnant is attending her first prenatal visit. On the first prenatal visit, the nurse notes that the client is gravida 4, para 0, abortion 3. The client is 5 feet, 6 inches tall, weighs 130 pounds, and is 25 years old. She states, "I get really tired after working all day and can't keep up with my housework." Which factor in the above data should lead the nurse to suspect gestational diabetes? -Ans- Fetal demise The nurse reinforces instructions to a client with mild preeclampsia on home care. Which comment by the client indicates that teaching is effective? -Ans- "I need to check my urine with a dipstick every day for protein and call my health care provider if it is 2+ or more." A pregnant client has just been admitted to the hospital with severe preeclampsia. The nurse knows it is important to monitor for additional complications at this time. Which assessment should be part of the plan of care? -Ans- Any bleeding, such as in the gums, petechiae, and purpura When collecting data from a pregnant client at risk for disseminated intravascular coagulation (DIC), which factors should the nurse consider significant? -Ans- A client who is gravida II who has just been diagnosed with dead fetus syndrome; fetal demise occurred 2 months ago The nurse is collecting data from a client and is reviewing the client's health record to determine the risk for preterm labor. Which finding places the client at risk for preterm labor? -Ans- A urinary tract infection The nurse assigned to care for a client with mild preeclampsia should anticipate which specific nursing intervention for this client? -Ans- Monitoring fetal movement The nurse is assigned to care for a client admitted with severe preeclampsia. Which is the priority nursing intervention for this client? -Ans- Minimizing the client's exposur [Show More]

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