Maternity - Antepartum

The nursing student is preparing to teach a prenatal class about fetal circulation. Which statement should be included in the teaching plan?
1. "One artery carries oxygenated blood from the placenta to the fetus."
2. "Two arteries carry oxygenated blood from the placenta to the fetus."
3. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta."
4. "Two veins carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta."

A pregnant client tells the clinic nurse that she wants to know the gender of her baby as soon as it can be determined. The nurse understands that the client should be able to find out the gender at 12 weeks' gestation because of which factor?
1. The appearance of the fetal external genitalia
2. The beginning of differentiation in the fetal groin
3. The fetal testes are descended into the scrotal sac
4. The internal differences in males and females become apparent

The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that the fetal heart rate is 174 beats/minute. On the basis of this finding, what is the priority nursing action?
1. Document the finding.
2. Check the mother's heart rate.
3. Notify the health care provider (HCP).
4. Tell the client that the fetal heart rate is normal.

The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's best response?
1. "It promotes the fertilized ovum's chances of survival."
2. "It promotes the fertilized ovum's exposure to estrogen and progesterone."
3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus."
4. "It promotes the fertilized ovum's exposure to luteinizing hormone and follicle-stimulating hormone."

The nursing instructor asks a nursing student to list the characteristics of the amniotic fluid. The student responds correctly by listing which as characteristics of amniotic fluid? Select all that apply.
1. Allows for fetal movement
2. Surrounds, cushions, and protects the fetus
3. Maintains the body temperature of the fetus
4. Can be used to measure fetal kidney function
5. Prevents large particles such as bacteria from passing to the fetus
6. Provides an exchange of nutrients and waste products between the mother and the fetus

A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse would determine whether this method of family planning would be most appropriate?
1. "Has either of you ever had surgery?"
2. "Do you plan to have any other children?"
3. "Do either of you have diabetes mellitus?"
4. "Do either of you have problems with high blood pressure?"

The nurse should include which statement to a pregnant client found to have a gynecoid pelvis?
1. "Your type of pelvis has a narrow pubic arch."
2. "Your type of pelvis is the most favorable for labor and birth."
3. "Your type of pelvis is a wide pelvis, but has a short diameter."
4. "You will need a cesarean section because this type of pelvis is not favorable for a vaginal delivery."

Which explanation should the nurse provide to the prenatal client about the purpose of the placenta?
1. It cushions and protects the baby.
2. It maintains the temperature of the baby.
3. It is the way the baby gets food and oxygen.
4. It prevents all antibodies and viruses from passing to the baby.

The nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse measures the fundal height in centimeters and expects which finding?
1. 22 cm
2. 30 cm
3. 36 cm
4. 40 cm

The nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Which are probable signs of pregnancy? Select all that apply.
1. Ballottement
2. Chadwick's sign
3. Uterine enlargement
4. Braxton Hicks contractions
5. Fetal heart rate detected by a nonelectronic device
6. Outline of fetus via radiography or ultrasonography

A pregnant client is seen for a regular prenatal visit and tells the nurse that she is experiencing irregular contractions. The nurse determines that she is experiencing Braxton Hicks contractions. On the basis of this finding, which nursing action is most appropriate?
1. Contact the health care provider.
2. Instruct the client to maintain bed rest for the remainder of the pregnancy.
3. Inform the client that these contractions are common and may occur throughout the pregnancy.
4. Call the maternity unit and inform them that the client will be admitted in a prelabor condition.

The nurse is providing instructions to a pregnant client with genital herpes about the measures that are needed to protect the fetus. Which instruction should the nurse provide to the client?
1. Total abstinence from sexual intercourse is necessary during the entire pregnancy.
2. Sitz baths need to be taken every 4 hours while awake if vaginal lesions are present.
3. Daily administration of acyclovir (Zovirax) is necessary during the entire pregnancy.
4. A cesarean section will be necessary if vaginal lesions are present at the time of labor.

The nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The health care provider has documented the presence of Goodell's sign. This finding is most closely associated with which characteristic?
1. A softening of the cervix
2. The presence of fetal movement
3. The presence of human chorionic gonadotropin in the urine
4. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus

A client arrives at the clinic for the first prenatal assessment. She tells the nurse that the first day of her last menstrual period was October 19, 2014. Using Nägele's rule, which expected date of delivery should the nurse document in the client's chart?
1. July 12, 2014
2. July 26, 2015
3. August 12, 2015
4. August 26, 2015

The health care provider (HCP) is assessing the client for the presence of ballottement. To make this determination, the HCP should take which action?
1. Auscultate for fetal heart sounds.
2. Assess the cervix for compressibility.
3. Palpate the abdomen for fetal movement.
4. Initiate a gentle upward tap on the cervix.

A pregnant client asks the nurse in the clinic when she will be able to begin to feel the fetus move. The nurse responds by telling the mother that fetal movements will be noted between which weeks of gestation?
1. 6 and 8
2. 8 and 10
3. 10 and 12
4. 14 and 18

The nurse is performing an assessment of a primigravida who is being evaluated in a clinic during her second trimester of pregnancy. Which finding concerns the nurse and indicates the need for follow-up?
1. Quickening
2. Braxton Hicks contractions
3. Fetal heart rate of 180 beats/minute
4. Consistent increase in fundal height

The nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. Using GTPAL, what should the nurse document in the client's chart?
1. G = 3, T = 2, P = 0, A = 0, L = 1
2. G = 2, T = 1, P = 0, A = 0, L = 1
3. G = 1, T = 1, P = 1, A = 0, L = 1
4. G = 2, T = 0, P = 0, A = 0, L = 1

The nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis. What instruction should the nurse provide?
1. Strict bed rest is required after the procedure.
2. Hospitalization is necessary for 24 hours after the procedure.
3. An informed consent needs to be signed before the procedure.
4. A fever is expected after the procedure because of the trauma to the abdomen.

A pregnant client in the first trimester calls the nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement to the client?
1. "Come to the clinic immediately."
2. "The vaginal discharge may be bothersome, but is a normal occurrence."
3. "Report to the emergency department at the maternity center immediately."
4. "Use tampons if the discharge is bothersome, but to be sure to change the tampons every 2 hours."

The nurse has performed a nonstress test on a pregnant client and is reviewing the fetal monitor strip. The nurse interprets the test as reactive. How should the nurse document this finding?
1. Normal
2. Abnormal
3. The need for further evaluation
4. That findings were difficult to interpret

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding?
1. A normal test result
2. An abnormal test result
3. A high risk for fetal demise
4. The need for a cesarean delivery

A pregnant client tells the nurse that she has been craving "unusual foods." The nurse gathers additional assessment data and discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Laboratory studies are performed and the nurse determines that which finding indicates a physiological consequence of the client's practice?
1. Hematocrit 38%
2. Glucose 86 mg/dL
3. Hemoglobin 9.1 g/dL
4. White blood cell count 12,400 cells/mm³

A pregnant client asks the nurse about the types of exercises that are allowable during pregnancy. The nurse should tell that client that which exercise is safest?
1. Swimming
2. Scuba diving
3. Low-impact gymnastics
4. Bicycling with the legs in the air

A health care provider has prescribed transvaginal ultrasonography for a client in the first trimester of pregnancy and the client asks the nurse about the procedure. How should the nurse respond to the client?
1. "The procedure takes about 2 hours."
2. "It will be necessary to drink 1 to 2 quarts of water before the examination."
3. "The probe that will be inserted into the vagina will be covered with a disposable cover and coated with a gel."
4. "Gel is spread over the abdomen, and a round disk transducer will be moved over the abdomen to obtain the picture."

The nurse has instructed a pregnant client in measures to prevent varicose veins during pregnancy. Which statement by the client indicates a need for further instructions?
1. "I should wear panty hose."
2. "I should wear support hose."
3. "I should wear flat nonslip shoes that have good support."
4. "I should wear knee-high hose, but I should not leave them on longer than 8 hours."

A pregnant client calls a clinic and tells the nurse that she is experiencing leg cramps that awaken her at night. What should the nurse tell the client to provide relief from the leg cramps?
1. "Bend your foot toward your body while flexing the knee when the cramps occur."
2. "Bend your foot toward your body while extending the knee when the cramps occur."
3. "Point your foot away from your body while flexing the knee when the cramps occur."
4. "Point your foot away from your body while extending the knee when the cramps occur."

The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instructions?
1. "I will record the number of movements or kicks."
2. "I need to lie flat on my back to perform the procedure."
3. "If I count fewer than 10 kicks in a 2-hour period I should count the kicks again over the next 2 hours."
4. "I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

The nurse is providing instructions regarding treatment of hemorrhoids to a client who is in the second trimester of pregnancy. Which statement by the client indicates a need for further instruction?
1. "I should avoid straining during bowel movements."
2. "I can gently replace the hemorrhoids into the rectum."
3. "I can apply ice packs to the hemorrhoids to reduce the swelling."
4. "I should apply heat packs to the hemorrhoids to help the hemorrhoids shrink."

The nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. Which instruction should the nurse provide?
1. Avoid wearing a bra.
2. Wash the breasts with warm water and keep them dry.
3. Wear tight-fitting blouses or dresses to provide support.
4. Wash the nipples and areolar area daily with soap, and massage the breasts with lotion.

The nurse is describing cardiovascular system changes that occur during pregnancy to a client and understands that which finding would be normal for a client in the second trimester?
1. Increase in pulse rate
2. Increase in blood pressure
3. Frequent bowel elimination
4. Decrease in red blood cell production

The clinic nurse is providing instructions to a pregnant client regarding measures that assist in alleviating heartburn. Which statement by the client indicates an understanding of the instructions?
1. "I should avoid between-meal snacks."
2. "I should lie down for an hour after eating."
3. "I should use spices for cooking rather than using salt."
4. "I should avoid eating foods that produce gas and fatty foods."

The home care nurse visits a pregnant client who has a diagnosis of mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the health care provider?
1. Urinary output has increased.
2. Dependent edema has resolved.
3. Blood pressure reading is at the prenatal baseline.
4. The client complains of a headache and blurred vision.

The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching?
1. "I should stay on the diabetic diet."
2. "I should perform glucose monitoring at home."
3. "I should avoid exercise because of the negative effects on insulin production."
4. "I should be aware of any infections and report signs of infection immediately to my health care provider."

The nurse is performing an assessment on a pregnant client with a diagnosis of severe preeclampsia. The nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis?
1. Enlargement of the breasts
2. Complaints of feeling hot when the room is cool
3. Periods of fetal movement followed by quiet periods
4. Evidence of bleeding, such as in the gums, petechiae, and purpura

The home care nurse is monitoring a pregnant client with gestational hypertension who is at risk for preeclampsia. At each home care visit, the nurse assesses the client for which classic signs of preeclampsia? Select all that apply.
1. Proteinuria
2. Hypertension
3. Low-grade fever
4. Generalized edema
5. Increased pulse rate
6. Increased respiratory rate

The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that further teaching is needed if the client makes which statement?
1. "I will need to increase my insulin dosage during the first 3 months of pregnancy."
2. "My insulin dose will likely need to be increased during the second and third trimesters."
3. "Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy."
4. "My insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding."

A pregnant client reports to a health care clinic, complaining of loss of appetite, weight loss, and fatigue. After assessment of the client, tuberculosis is suspected. A sputum culture is obtained and identifies Mycobacterium tuberculosis. Which instruction should the nurse include in the client's teaching plan?
1. Therapeutic abortion is required.
2. She will have to stay at home until treatment is completed.
3. Medication will not be started until after delivery of the fetus.
4. Isoniazid plus rifampin (Rifadin) will be required for 9 months.

The nurse is providing instructions to a maternity client with a history of cardiac disease regarding appropriate dietary measures. Which statement, if made by the client, indicates an understanding of the information provided by the nurse?
1. "I should increase my sodium intake during pregnancy."
2. "I should lower my blood volume by limiting my fluids."
3. "I should maintain a low-calorie diet to prevent any weight gain."
4. "I should drink adequate fluids and increase my intake of high-fiber foods."

The clinic nurse is performing a psychosocial assessment of a client who has been told that she is pregnant. Which assessment finding indicates to the nurse that the client is at risk for contracting human immunodeficiency virus (HIV)?
1. A client who has a history of intravenous drug use
2. A client who has a significant other who is heterosexual
3. A client who has a history of sexually transmitted infections
4. A client who has had one sexual partner for the past 10 years

A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement made by the client indicates a need for further instruction?
1. "I will watch for the evidence of the passage of tissue."
2. "I will maintain strict bed rest throughout the remainder of the pregnancy."
3. "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad."
4. "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding."

The nurse is performing an initial assessment on a client who has just been told that a pregnancy test is positive. Which assessment finding indicates that the client is at risk for preterm labor?
1. The client is a 35-year-old primigravida
2. The client has a history of cardiac disease
3. The client's hemoglobin level is 13.5 g/dL
4. The client is a 20-year-old primigravida of average weight and height

The nurse provides instructions to a malnourished pregnant client regarding iron supplementation. Which client statement indicates an understanding of the instructions?
1. "Iron supplements will give me diarrhea."
2. "Meat does not provide iron and should be avoided."
3. "The iron is best absorbed if taken on an empty stomach."
4. "On the days that I eat green leafy vegetables or calf liver I can omit taking the iron supplement."

A pregnant client at 10 weeks' gestation calls the prenatal clinic to report a recent exposure to a child with rubella. The nurse reviews the client's chart. What is the nurse's best response to the client?Refer to chart.

1. "You should avoid all school-age children during pregnancy."
2. "There is no need to be concerned if you don't have a fever or rash within the next 2 days."
3. "You were wise to call. Your rubella titer indicates that you are immune and your baby is not at risk."
4. "Be sure to tell the health care provider in 2 weeks as additional screening will be prescribed during your second trimester."

During a routine prenatal visit, a client complains of gums that bleed easily with brushing. The nurse performs an assessment and teaches the client about proper nutrition to minimize this problem. Which client statement indicates an understanding of the proper nutrition to minimize this problem?
1. "I will drink 8 oz of water with each meal."
2. "I will eat three servings of cracked wheat bread each day."
3. "I will eat two saltine crackers before I get up each morning."
4. "I will eat fresh fruits and vegetables for snacks and for dessert each day."

The nursing instructor asks the nursing student about the physiology related to the cessation of ovulation that occurs during pregnancy. Which response, if made by the student, indicates an understanding of this physiological process?
1. "Ovulation ceases during pregnancy because the circulating levels of estrogen and progesterone are high."
2. "Ovulation ceases during pregnancy because the circulating levels of estrogen and progesterone are low."
3. "The low levels of estrogen and progesterone increase the release of the follicle-stimulating hormone and luteinizing hormone."
4. "The high levels of estrogen and progesterone promote the release of the follicle-stimulating hormone and luteinizing hormone."

The nurse encourages a pregnant human immunodeficiency virus (HIV)–positive client to report any early signs of vaginal discharge or perineal tenderness to the health care provider immediately. The client asks the nurse about the importance of this action, and the nurse responds by telling the client which accurate statement?
1. "This is necessary to relieve anxiety for the pregnant client."
2. "This is necessary to eliminate the need for further uncomfortable screenings."
3. "This is necessary to minimize the financial cost of caring for an HIV-positive client."
4. "This is necessary to assist in identifying potential infections that may need to be treated."

A pregnant client who is anemic tells the nurse that she is concerned about her infant's condition after delivery. Which nursing response would best support the client?
1. "You should not worry about your baby's condition after the delivery because complications are rare."
2. "Your baby will probably need to spend a few days in the neonatal intensive care unit after delivery."
3. "You will not have any problems if you follow all the advice the health care provider has given you."
4. "The effects of anemia on your baby are difficult to predict, but let's review your plan of care to ensure you are providing the best nutrition and growth potential."

The nurse is performing an assessment on a pregnant client at 16 weeks of gestation. On assessment, the nurse expects the fundus of the uterus to be located at which area?
1. At the umbilicus
2. Just above the symphysis pubis
3. At the level of the xiphoid process
4. Midway between the symphysis pubis and the umbilicus

The clinic nurse is performing a prenatal assessment on a pregnant client. The nurse should plan to implement teaching related to the risk of abruptio placentae if which information is obtained on assessment?
1. The client is 28 years of age.
2. This is the second pregnancy.
3. The client has a history of hypertension.
4. The client performs moderate exercise on a regular daily schedule.

During a prenatal visit, a nurse is explaining dietary management to a client with pre-existing diabetes mellitus. The nurse determines that teaching has been effective if the client makes which statement?
1. "Diet and insulin needs change during pregnancy."
2. "I will plan my diet based on the results of urine glucose testing."
3. "I will need to eat 600 more calories every day because I am pregnant."
4. "I can continue with the same diet as before pregnancy, as long as it is well balanced."

The clinic nurse has provided home care instructions to a client with a history of cardiac disease who has just been told that she is pregnant. Which statement, if made by the client, indicates a need for further instructions?
1. "It is best that I rest lying on my side to promote blood return to the heart."
2. "I need to avoid excessive weight gain to prevent increased demands on my heart."
3. "I need to try to avoid stressful situations because stress increases the workload on the heart."
4. "During the pregnancy, I need to avoid contact with other individuals as much as possible to prevent infection."

The nurse assists a pregnant client with cardiac disease to identify resources to help her care for her 18-month-old child during the last trimester of pregnancy. The nurse encourages the pregnant client to use these resources primarily for which reason?
1. Reduce excessive maternal stress and fatigue.
2. Help the mother prepare for labor and delivery.
3. Avoid exposure to potential pathogens and resulting infections.
4. Prepare the 18-month-old child for maternal separation during hospitalization.

The nurse is instructing a pregnant client regarding measures to increase iron in the diet. The nurse should tell the client to consume which food that contains the highest source of dietary iron?
1. Milk
2. Potatoes
3. Cantaloupe
4. Whole-grain cereal

The nurse is reviewing a nutritional plan of care with a pregnant client and is identifying the food items highest in folic acid. The nurse determines that the client understands the foods that supply the highest amounts of folic acid if the client states that she will include which item in the daily diet?
1. Milk
2. Yogurt
3. Bananas
4. Leafy green vegetables

A pregnant client who is at 30 weeks' gestation comes to the clinic for a routine visit, and the nurse performs an assessment on her. Which observation made by the nurse during the assessment indicates a need for further teaching?
1. The client is wearing sneakers.
2. The client is wearing knee-high hose.
3. The client is wearing flat shoes with rubber soles.
4. The client is wearing pants with an elastic waistband.

A pregnant client visits a clinic for a scheduled prenatal appointment. The client tells the nurse that she frequently has a backache, and the nurse provides instructions regarding measures that will assist in relieving the backache. Which statement by the client indicates a need for further instructions?
1. "I should wear flat-heeled shoes."
2. "I should sleep on a firm mattress."
3. "I should try to maintain good posture."
4. "I should do more exercises to strengthen my back muscles."

A nonstress test is prescribed for a pregnant client, and she asks the nurse about the procedure. How should the nurse respond?
1. "The test is a procedure that will require an informed consent to be signed."
2. "The test will take about 2 hours and will require close monitoring for 2 hours after the procedure is completed."
3. "The test is done to see if the baby can handle the stress of labor, and that medicine is given to make the uterus contract."
4. "A round, hard plastic disk called an ultrasound transducer picks up and marks the fetal heart activity on the recording paper and is secured over the abdomen."

The nurse is developing a plan of care for a pregnant client who is complaining of intermittent episodes of constipation. To help alleviate this problem, the nurse should instruct the client to take which measure?
1. Consume a low-fiber diet.
2. Drink 8 glasses of water per day.
3. Use a Fleet enema when the episodes occur.
4. Take a mild stool softener daily in the evening.

A pregnant client in the prenatal clinic is scheduled for a biophysical profile. The client asks the nurse what this test involves. The nurse should make which appropriate response?
1. "This test measures your ability to tolerate the pregnancy."
2. "This test measures amniotic fluid volume and fetal activity."
3. "This test measures your cardiac status and ability to tolerate labor."
4. "This test only measures the amount of amniotic fluid present in the uterus."

The nurse in the prenatal clinic is taking a nutritional history from a 16-year-old pregnant adolescent. Which statement, if made by the adolescent, would alert the nurse to a potential psychosocial problem?
1. "I don't like dairy products."
2. "I will continue drinking my afternoon milkshake."
3. "I'm not used to eating so much food, but I will try."
4. "I only want to gain 10 pounds because I want to have a small, petite baby."

The nurse in the prenatal clinic is conducting a session about nutrition to a group of adolescents who are pregnant. Which measure is most appropriate to teach these adolescents?
1. Eat only when hungry.
2. Eliminate snacks during the day.
3. Avoid meals in fast-food restaurants.
4. Monitor for appropriate weight gain patterns.

The clinic nurse is discussing nutrition with a pregnant client who has lactose intolerance. The nurse should instruct the client to supplement the dietary source of calcium by eating which food?
1. Hard cheese
2. Dried fruits
3. Creamed spinach
4. Fresh-squeezed orange juice

The nurse has provided instructions to a pregnant client who is preparing to take iron supplements. The nurse determines that the client understands the instructions if she states that she will take the supplements with which item?
1. Milk
2. Tea
3. Coffee
4. Orange juice

A client arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. The client tells the nurse that a home pregnancy test was positive but that she began to have mild cramps and is now having moderate vaginal bleeding. On physical examination of the client, it is noted that she has a dilated cervix. The nurse determines that the client is experiencing which type of abortion?
1. Septic
2. Inevitable
3. Incomplete
4. Threatened

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data, if noted on the client's record, would alert the nurse that the client is at risk for a spontaneous abortion?
1. Age of 35 years
2. History of syphilis
3. History of genital herpes
4. History of diabetes mellitus

The nurse is preparing to care for a client who is being admitted to the hospital with a possible diagnosis of ectopic pregnancy. The nurse develops a plan of care for the client and determines that which nursing action is the priority?
1. Checking for edema
2. Monitoring daily weight
3. Monitoring the apical pulse
4. Monitoring the temperature

The nurse reviews the laboratory results for a client with a suspected ectopic pregnancy. The nurse would expect which result of the beta subunit of human chorionic gonadotropin (β-hCG) if the client had an ectopic pregnancy?
1. Not present
2. Present in low levels
3. Present in high levels
4. Within normal limits

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data if noted on the client's record would alert the nurse that the client is at risk for developing gestational diabetes during this pregnancy?
1. The client's last baby weighed 10 pounds at birth.
2. The client's previous deliveries were by cesarean birth.
3. The client has a family history of cardiovascular disease.
4. The client is 5 feet 3 inches in height and weighs 165 pounds.

The nurse is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. The nurse determines that the client understands dietary and insulin needs if the client states that the second half of pregnancy may require which treatment?
1. Increased insulin
2. Increased caloric intake
3. Decreased protein intake
4. Decreased insulin

The nurse is assessing a client with a diagnosis of gestational trophoblastic disease (hydatidiform mole). The nurse understands that which findings are associated with this condition? Select all that apply.
1. Vaginal bleeding
2. Excessive fetal activity
3. Excessive nausea and vomiting
4. Larger-than-normal uterus for gestational age
5. Elevated levels of human chorionic gonadotropin (hCG)

The nurse in the prenatal clinic is providing nutritional counseling to a pregnant client. The nurse instructs the client to increase the intake of folic acid and tells the client that which food item is highest in folic acid?
1. Pork
2. Cheese
3. Chicken
4. Green leafy vegetables

A client reports to the health care clinic and says that it has been 6 weeks since her last menstrual period. The nurse performs a pregnancy test and should expect to note the presence of which hormone in the blood test results if the client is pregnant?
1. Estrogen
2. Progesterone
3. Follicle-stimulating hormone (FSH)
4. Human chorionic gonadotropin (hCG)

A client in the prenatal clinic asks the nurse about the delivery date. The nurse notes that the client's record indicates that the client began her last menses on March 7, 2015, and ended the menses on March 14, 2015. Using Nägele's rule, the nurse should tell the client that the estimated date of delivery is which date?
1. January 14, 2014
2. January 21, 2014
3. December 21, 2015
4. December 14, 2015

The prenatal clinic nurse asks a coassigned nursing student to identify the physiological adaptations of the cardiovascular system that occur during pregnancy. The nurse determines that the student understands these physiological changes if he or she makes which statement?
1. "An increase in pulse rate occurs."
2. "A decrease in blood volume occurs."
3. "A decrease in cardiac output occurs."
4. "The systolic and diastolic blood pressures increase by 20 mm Hg."

The prenatal client asks the nurse about substances that can cross the placental barrier and potentially affect the fetus. The nurse most appropriately explains that which substances can cross this barrier? Select all that apply.
1. Viruses
2. Bacteria
3. Nutrients
4. Medications
5. Antibodies

A client who is 8 weeks pregnant calls the prenatal clinic and tells the nurse that she is experiencing nausea and vomiting every morning. The nurse should suggest which measure that will best promote relief of the symptoms?
1. Eating a high-fat diet
2. Increasing fluids with meals
3. Eating a high-carbohydrate diet
4. Eating dry crackers before arising

The home care nurse is visiting a prenatal client who has a history of heart disease. The nurse provides instructions to the client regarding home care measures to promote a healthy pregnancy. Home care for this client should include which measure?
1. Increase daily calories to ensure weight gain.
2. Maintain a supine position during rest periods.
3. Restrict visitors who may have an active infection.
4. Avoid becoming concerned about placing stress on the heart.

A home care nurse is visiting a pregnant client with a diagnosis of mild preeclampsia. What is the priority nursing intervention during the home visit?
1. Monitor for fetal movement.
2. Monitor the maternal blood glucose.
3. Instruct the client to maintain complete bed rest.
4. Instruct the client to restrict dietary sodium and any food items that contain sodium.

A maternity unit nurse is developing a plan of care for a client with severe preeclampsia who will be admitted to the nursing unit. The nurse should include which nursing intervention in the plan?
1. Restrict food and fluids.
2. Reduce external stimuli.
3. Monitor blood glucose levels.
4. Maintain the client in a supine position.

A client with severe preeclampsia is admitted to the maternity department. Which room assignment would be most appropriate for this client?
1. A private room across from the elevator
2. A semiprivate room across from the nurses' station
3. A private room two doors away from the nurses' station
4. A semiprivate room with another client who enjoys watching television

A couple is seen in the fertility clinic. After several tests, it has been determined that the husband is not sterile and that the wife has nonpatent fallopian tubes. The nurse is preparing the woman and her husband for an in vitro fertilization. Which statement by the woman or her spouse would indicate a need for further information about the procedure?
1. "Ova and sperm are collected and allowed to incubate."
2. "A fertilized ovum is transferred into the woman's uterus."
3. "The procedure is a method of medically assisted reproduction."
4. "The procedure is performed using artificial insemination of sperm instilled through the vagina."

The nurse in the gynecology clinic is reviewing the record of a pregnant client after the first prenatal visit. The nurse notes that the health care provider has documented that the woman has a platypelloid pelvis. On the basis of this documentation, the nurse plans care, knowing that this type of pelvis has which characteristic?
1. Is heart-shaped
2. Has a flat shape
3. Has an oval shape
4. Is a normal female pelvis

The nurse is counseling a pregnant woman diagnosed with gestational diabetes at 29 weeks of gestation. Which information should the nurse discuss with the client? Select all that apply.
1. Plan induction at 35 weeks.
2. Plan amniocentesis at this time.
3. Schedule biophysical profile immediately.
4. Plan for weekly non-stress test at 32 weeks.
5. Obtain nutritional counseling with a dietitian.

A nurse provides dietary instructions to a pregnant woman regarding food items that contain folic acid. Which food item should the nurse recommend as a good source of folic acid?
1. Cheese
2. Spinach
3. Potatoes
4. Bananas

The nurse is caring for a client with preeclampsia. The client is receiving an intravenous (IV) infusion of magnesium sulfate. When gathering items to be available for the client, which highest priority item should the nurse obtain?
1. Tongue blade
2. Percussion hammer
3. Potassium chloride injection
4. Calcium gluconate injection

A pregnant client has been diagnosed with a vaginal infection from the organism Candida albicans. Which finding should the nurse expect to note when assessing this client?
1. Costovertebral angle pain
2. Pain, itching, and vaginal discharge
3. Absence of any signs and symptoms
4. Proteinuria, hematuria, edema, and hypertension

The nurse is performing an assessment on a client seen in the health care clinic for a first prenatal visit. The client reports February 9 as the first day of the last menstrual period (LMP). Using Nägele's rule, what date later that same year will the nurse relay as the client's due date?
1. October 7
2. October 16
3. November 7
4. November 16

The nurse is performing a measurement of fundal height in a client whose pregnancy has reached 36 weeks of gestation. During the measurement the client begins to feel lightheaded. On the basis of knowledge of the physiological changes of pregnancy, the nurse understands that which is the cause of the lightheadedness?
1. A full bladder
2. Emotional instability
3. Insufficient iron intake
4. Compression of the vena cava

A pregnant client has been instructed on the prevention of genital tract infections. Which client statement indicates an understanding of these preventive measures?
1. "I can douche anytime I want."
2. "I can wear my tight-fitting jeans."
3. "I should avoid the use of condoms."
4. "I should wear underwear with a cotton panel liner."

The nurse is reviewing the results of the rubella screening (titer) with a pregnant client. The test results are positive, and the mother asks if it is safe for her toddler to receive the vaccine. What is the nurse's best response?
1. "Most children do not receive the vaccine until they are 5 years of age."
2. "You are still susceptible to rubella, so your toddler should receive the vaccine."
3. "It is not advised for children of pregnant women to be vaccinated during their mother's pregnancy."
4. "Your titer supports your immunity to rubella, and it is safe for your toddler to receive the vaccine at this time."

A clinic nurse is explaining the changes in the integumentary system that occur during pregnancy to a client and should tell the client that which change may persist after she gives birth?
1. Epulis
2. Chloasma
3. Telangiectasia
4. Striae gravidarum

A clinic nurse is instructing a pregnant client regarding dietary measures to promote a healthy pregnancy. The nurse tells the client about the importance of an adequate daily fluid intake. Which client statement best indicates an understanding of the daily fluid requirement?
1. "I should drink 12 glasses of fruit juices and milk every day."
2. "I should drink 8 to 10 glasses of fluid a day, and I can drink as many diet soft drinks as I want."
3. "I should drink 12 glasses of fluid a day, and I can include the coffee or tea that I drink in the count."
4. "I should drink at least 8 to 10 glasses of fluid each day, of which at least 6 glasses should be water."

A prenatal clinic nurse is providing instructions to a group of pregnant women regarding measures to prevent toxoplasmosis. Which client statement indicates a need for further instruction?
1. "I should cook meat thoroughly."
2. "I should drink unpasteurized milk only."
3. "I should avoid contact with materials that are possibly contaminated with cat feces."
4. "I should avoid touching mucous membranes of the mouth or eyes while handling raw meat."

A home care nurse is monitoring a 16-year-old primigravida who is at 36 weeks' gestation and has gestational hypertension. Her blood pressure during the past 3 weeks has been averaging in the 130/90 mm Hg range. She has had some swelling in the lower extremities and has had mild proteinuria. Which statement by the woman should alert the nurse to the worsening of gestational hypertension?
1. "My vision the past 2 days has been really fuzzy."
2. "The swelling in my hands and ankles has gone down."
3. "I had heartburn yesterday after I ate some spicy foods."
4. "I had a headache yesterday, but I took some acetaminophen (Tylenol) and it went away."

A primigravida is receiving magnesium sulfate for the treatment of gestational hypertension. The nurse who is caring for the client is performing assessments every 30 minutes. Which finding would be of most concern to the nurse?
1. Urinary output of 20 mL
2. Deep tendon reflexes of 2+
3. Fetal heart rate of 120 beats/min
4. Respiratory rate of 10 breaths per minute

The nurse is reviewing fetal development with a client who is at 36 weeks gestation. Which statements describe the characteristics that develop in a fetus at this time? Select all that apply.
1. Eyelids begin to fuse.
2. Fetal heart begins to beat.
3. The fetal skin is transparent.
4. The fetus weighs approximately 1200 g.
5. The fetus is approximately 42 to 48 cm long.
6. The lecithin-sphingomyelin (L/S) ratio is greater than 2:1

A client who has just been told that she is pregnant wants to know when the baby's heart will be completely developed and beating. The nurse reads in the client's chart that the health care provider has determined the client to be at 6 weeks' gestation. What is the nurse's best response?
1. "Your baby's heart right now consists of two parallel tubes, so we can't hear it today."
2. "Your baby's heart right now is beginning to partition into four chambers and has begun to beat, so we should be able to hear it with a Doppler."
3. "Your baby's heart right now is beginning to partition into four chambers and has begun to beat, so we should be able to hear it with a fetoscope."
4. "Your baby's heart right now has double heart chambers and has begun to beat, so we should be able to see it beat using an ultrasound machine."

During a woman's 38-week prenatal visit, the nurse assesses the fetal heart rate. Which finding would the nurse note as normal?
1. 80 beats/minute
2. 100 beats/minute
3. 150 beats/minute
4. 180 beats/minute

The clinic nurse is reviewing the medical record of a woman scheduled for her weekly prenatal appointment. The nurse notes that the woman has been diagnosed with mild preeclampsia. Of the following interventions, which should the nurse list as having the lowest priority in planning nursing care for this client?
1. Assess blood pressure.
2. Discuss the need for hospitalization.
3. Assess deep tendon reflexes and edema.
4. Teach the importance of keeping track of a daily weight.

During a woman's prenatal visit, the nurse is measuring fundal height. The nurse knows that the woman is at 20 weeks' gestation. Based on this information, the nurse expects the fundus to be found at what area of the abdomen?
1. At the umbilicus
2. At the xiphoid process
3. Midway between the umbilicus and the xiphoid process
4. Midway between the symphysis pubis and the umbilicus

The nurse is teaching a woman in her first trimester measures to alleviate nausea and vomiting. Which statement by the woman would indicate that further teaching is required?
1. "I will avoid fried foods."
2. "I will eat five or six small meals a day."
3. "I will contact the clinic if the vomiting does not subside."
4. "I will eat dry crackers after arising out of bed in the morning."

The nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant woman to describe the process of quickening. Which statement if made by the student indicates an understanding of this term?
1. "It is the thinning of the lower uterine segment."
2. "It is the fetal movement that is felt by the mother."
3. "It is the irregular, painless contractions that occur throughout pregnancy."
4. "It is the soft blowing sound that can be heard when the uterus is auscultated."

The nurse is interviewing a 16-year-old client during her initial prenatal clinic visit. The client is beginning week 18 of her first pregnancy. Which statement, if made by the client, indicates an immediate need for further investigation?
1. "I don't like my figure anymore. My clothes are all too tight."
2. "I don't like my breasts anymore. These silver lines are ugly."
3. "I don't like my stomach anymore. That brown line is disgusting."
4. "I don't like my face any more. I always look like I have been crying."

The nurse reviews the plan of care for a woman at 37 weeks' gestation who has sickle cell anemia. The nurse determines that which problem listed on the nursing care plan will receive the highest priority?
1. Pain
2. Disturbed body image
3. Insufficient fluid volume
4. Inability to tolerate activity

The nurse provides instructions to a malnourished client regarding iron supplementation during pregnancy. Which statement, if made by the client, would indicate an understanding of the instructions?
1. "Iron supplements will give me diarrhea."
2. "Meat does not provide iron and should be avoided."
3. "The iron is best absorbed if taken on an empty stomach."
4. "My body has all the iron it needs, and I don't need to take supplements."

A pregnant woman in her second trimester calls the prenatal clinic nurse to report a recent exposure to a child with rubella. Which response by the nurse would be most appropriate and supportive to the woman?
1. "You should avoid all school-age children during pregnancy."
2. "There is no need to be concerned if you don't have a fever or rash within the next 2 days."
3. "Be sure to tell the health care provider on your next prenatal visit, but there is little risk in the second trimester."
4. "You were wise to call. I will check your rubella titer screening results, and we can immediately identify whether future interventions are needed."

A pregnant woman has a positive history of genital herpes but has not had lesions during this pregnancy. What should the nurse should plan to tell the client?
1. "You will be isolated from your newborn infant after delivery."
2. "Vaginal deliveries can reduce neonatal infection risks, even if you have an active lesion at the time."
3. "There is little risk to your newborn infant during this pregnancy, during the birth, and after delivery."
4. "You will be evaluated at the time of delivery for herpetic genital tract lesions, and if any are present, a cesarean delivery will be needed."

A pregnant woman is seen in the health care clinic and asks the nurse what causes the breasts to change in size and appearance during pregnancy. The nurse plans to base the response on which facts?
1. The breasts become stretched because of the weight gain.
2. The increased metabolic rate causes the breasts to become larger.
3. The breast changes occur because of the secretion of estrogen and progesterone.
4. Cortisol secreted by the adrenal glands plays a role in increasing the size and appearance of the breasts.

The nurse is conducting a prepared childbirth class and is instructing pregnant women about the method of effleurage. The nurse instructs the women to perform the procedure by doing which action?
1. Contracting and then consciously relaxing different muscle groups
2. Massaging the abdomen during contractions, using both hands in a circular motion
3. Instructing her partner to stroke or massage a tightened muscle by the use of touch
4. Contracting an area of the body, such as an arm or leg, and then concentrating on letting tension go from the rest of the body

During a routine prenatal visit, a client complains of gums that bleed easily with brushing. The nurse performs an assessment and then teaches the client about proper nutrition to minimize this problem. Which statement, if made by the client, would indicate an understanding of the proper nutritional measures to minimize this problem?
1. "I will drink 8 ounces of water with each meal."
2. "I will eat three servings of cracked wheat bread each day."
3. "I will eat two saltine crackers before I get up each morning."
4. "I will eat fresh fruits and vegetables for snacks and for dessert each day."

A prenatal woman with a history of heart disease has been instructed on care at home. Which statement, if made by the woman, would indicate that she understands her needs?
1. "My weight gain is not important."
2. "I should avoid stressful situations."
3. "I should rest by lying on my back."
4. "There is no restriction on people who visit me."

The nurse is reviewing the record of a pregnant woman and notes that the health care provider has documented the presence of Chadwick's sign. The nurse understands that which hormone is responsible for the development of this sign?
1. Prolactin
2. Estrogen
3. Progesterone
4. Human chorionic gonadotropin

A contraction stress test is scheduled for a pregnant woman, and she asks the nurse to describe the test. What should the nurse tell the woman?
1. Uterine contractions are stimulated by Leopold's maneuvers.
2. An external fetal monitor is attached, and the woman ambulates on a treadmill until contractions begin.
3. The uterus is stimulated to contract by the administration of small amounts of oxytocin (Pitocin) or by nipple stimulation.
4. Small amounts of oxytocin (Pitocin) are administered during internal fetal monitoring to stimulate uterine contractions.

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The health care provider (HCP) prescribes a contraction stress test. The test is performed, and the nurse notes that the HCP has documented the results as negative. How should the nurse interpret this finding?
1. A normal test result
2. An abnormal test result
3. A high risk for fetal demise
4. The need for a cesarean delivery

A pregnant woman seen in the health care clinic has tested positive for human immunodeficiency virus (HIV). What can the nurse determine based on this information?
1. The woman has the herpes simplex virus (HSV).
2. This woman has contracted an airborne disease.
3. The neonate will definitely develop this disease after birth.
4. HIV antibodies are detected by the enzyme-linked immunosorbent assay (ELISA) test.

In the prenatal clinic, the nurse is interviewing a new client and obtaining health history information. Which action should the nurse plan to do to elicit the most accurate responses to the questions that refer to sexually transmitted infections?
1. Establish a therapeutic relationship.
2. Use specific closed-ended questions.
3. Omit these types of questions because they are highly personal.
4. Apologize for the embarrassment that these questions will cause the client.

The clinic nurse is teaching a pregnant woman about the warning signs in pregnancy. Which, if identified as a warning sign by the woman, would indicate a need for further education?
1. Rapid weight gain
2. Visual disturbances
3. Generalized or facial edema
4. Presence of irregular painless contractions

The nurse is performing a physical assessment on a client during her first prenatal visit to the clinic. The nurse takes the client's temperature and notes that the temperature is 99.2° F. Based on this finding, which nursing action is most appropriate?
1. Document the temperature.
2. Notify the health care provider.
3. Retake the temperature by the rectal route.
4. Inform the client that the temperature is elevated and antibiotics may be required.

A 39-week-gestation pregnant client calls the maternity unit stating, "My baby has not moved very much in the past few days. Should I be concerned?" Which would be the best response made by the nurse?
1. "Six to eight fetal movements in a 24-hour period are adequate to determine that the fetus is healthy."
2. "Fetal movement is a sign of fetal health. Even if the amount has decreased, the fetus is still healthy."
3. "Continue to count fetal movements for the next 24 hours and call your health care provider if the number of movements continues to decrease."
4. "Fetal movements do not decrease as a woman nears term; therefore you should be seen by your health care provider for further evaluation."

A 25-year-old woman arrives on the maternity unit on February 2. She states that her estimated date of delivery (EDD) is March 22. She is verbalizing complaints of dull lower back pain, pelvic heaviness, and diarrhea for the past few days. On admission for observation, the client's blood pressure is 128/80 mm Hg, pulse is 100 beats/minute, respirations are 16 breaths per minute, and temperature is 99° F. The nurse plans care based on which interpretation?
1. The woman requires further evaluation for preterm labor.
2. The woman is suffering from an intestinal bacterial infection.
3. The woman is exhibiting signs and symptoms of gestational hypertension.
4. The woman needs instruction on pelvic tilts to decrease her lower back pain.

The nurse in an obstetrical clinic is reviewing current prenatal laboratory results of a pregnant client who is being seen for a routine prenatal visit. The nurse discovers the client's 1-hour oral glucose tolerance test (OGTT) result to be 163 mg/dL. Which would be the nurse's best response to the client?
1. "Your OGTT results indicate that your baby is at high risk for macrosomia and special considerations may be necessary at delivery."
2. "Your OGTT results are within normal limits, but continuing your prenatal visits remains essential to monitor fetal growth and development."
3. "The OGTT is a screening tool for gestational diabetes, and you will need further testing to confirm a diagnosis owing to your results being elevated."
4. "Your OGTT results indicate that you are positive for gestational diabetes. You will be scheduled for a dietitian consultation to plan your daily dietary intake."

A 35-week-gestation pregnant woman is transferred to the maternity unit from the emergency department, where she was treated for minor injuries sustained in a motor vehicle crash. The maternal nurse's priority will be to assess for which complication?
1. Placenta previa
2. Polyhydramnios
3. Abruptio placentae
4. Gestational hypertension

The result of a biophysical profile (BPP) of a 28-year-old client at 36 weeks' gestation after the ultrasound components is 8. Based on this result, the nurse should take which action?
1. Notify the health care provider.
2. Prepare the client for labor induction.
3. Place the fetal heart monitor on the client in order to do a nonstress test (NST).
4. Provide the client with information regarding warning signs and symptoms of pregnancy and discharge her to home.

A client in week 35 of her pregnancy is placed on the fetal heart monitor (FHM) for a nonstress test (NST) as a result of her complaints of decreased fetal movement. Twenty minutes after placing the client on the monitor, the nurse sees the following monitor strip and makes what conclusion regarding the NST?

1. The fetal heart rate (FHR) is positive, with a baseline of 130 beats/min, moderate variability, and no decelerations.
2. The FHR is reactive, with a baseline of 130 beats/min, moderate variability, and no decelerations.
3. The FHR is nonreactive, with a baseline of 130 beats/min, moderate variability, and small episodic decelerations.
4. The FHR is negative, with a baseline of 130 beats/min, moderate variability, and no decelerations.

The charge nurse on a labor and delivery unit has numerous admissions of laboring clients and must transfer one of the clients to the postpartum/gynecological unit, where the nurse-to-client ratio will be 1:4. Which antepartum client would be the most appropriate one to transfer?
1. The 36-year-old, gravida I, para 0 client who is at 24 weeks' gestation and is being monitored for preterm labor
2. The 26-year-old, gravida I, para 0 client who is at 10 weeks' gestation and is experiencing vaginal bleeding
3. The 40-year-old, gravida III, para 0 client who is at 38 weeks' gestation and is complaining of decreased fetal movement
4. The 29-year-old, gravida I, para 0 client who is at 42 weeks' gestation and had a biophysical profile score of 5 earlier today

A nurse working in an infertility clinic reviews the medical history of a 35-year-old woman who is currently taking fertility medications and is planning a pregnancy. Which medication, if present in the client's history, would indicate a need for teaching related to the woman's potential risk for carrying a fetus with a congenital cleft lip or cleft palate?
1. Methyldopa
2. Folic acid (Folvite)
3. Phenytoin (Dilantin)
4. Bupropion (Wellbutrin SR)

A nurse is caring for a client with a diagnosis of placenta previa. The nurse collects data knowing that which is a characteristic of placenta previa?
1. A tender and rigid uterus
2. Painless, bright red vaginal bleeding
3. Greenish discoloration of the amniotic fluid
4. Vaginal bleeding accompanied by abdominal pain

A nulliparous woman asks the nurse when she will begin to feel fetal movements. The nurse responds by telling the woman that the first recognition of fetal movement will occur at approximately how many weeks of gestation?
1. 5 weeks
2. 9 weeks
3. 13 weeks
4. 18 weeks

A nurse is assessing a woman in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which finding would the nurse expect to note if abruptio placentae is present?
1. Soft uterus
2. Abdominal pain
3. Nontender uterus
4. Painless vaginal bleeding

A woman in the third trimester of pregnancy with a diagnosis of mild preeclampsia is being monitored at home. The home care nurse teaches the woman about the signs that need to be reported to the health care provider. The nurse should tell the woman to call the health care provider if which occurs?
1. Urine tests negative for protein.
2. Fetal movements are more than four per hour.
3. Weight increases by more than 1 pound in a week.
4. The blood pressure reading is ranging between 122/80 and 132/88 mm Hg.

A woman in the third trimester of pregnancy visits the clinic for a scheduled prenatal appointment. The woman tells the nurse that she frequently has leg cramps, primarily when she is reclining. Once thrombophlebitis has been ruled out, the nurse should tell the woman to implement which measure to alleviate the leg cramps?
1. Apply heat to the affected area.
2. Take acetaminophen (Tylenol) every 4 hours.
3. Self-administer calcium carbonate tablets three times daily.
4. Purchase a chewable antacid that contains calcium and take a tablet with each meal.

A nurse is preparing a pregnant woman for a transvaginal ultrasound examination. The nurse should tell the woman that which will occur?
1. She will feel some pain during the procedure.
2. She will be placed in a supine left side-lying position.
3. She will feel some pressure when the vaginal probe is moved.
4. She will need to drink 2 quarts of water to attain a full bladder.

A nurse is assisting in conducting a prenatal session with a group of expectant parents. One of the expectant parents asks, "How does the milk get secreted from the breast?" What is the nurse's best response?
1. "Prolactin stimulates the secretion of milk, which is called lactogenesis."
2. "Oxytocin stimulates the secretion of milk, which is called lactogenesis."
3. "Progesterone stimulates the secretion of milk, which is called lactogenesis."
4. "Testosterone stimulates the secretion of milk, which is called lactogenesis."

A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement by the client indicates a need for further teaching?
1. "I need to stay on the diabetic diet."
2. "I will perform glucose monitoring at home."
3. "I cannot exercise because of the negative effects on insulin production."
4. "I will report signs of infection immediately to my health care provider."

The nurse is caring for a client with a diagnosis of endometriosis. The client asks the nurse to describe this condition. What is the best response by the nurse?
1. "It causes the cessation of menstruation."
2. "It is pain that occurs during ovulation."
3. "It is the presence of tissue outside the uterus that resembles the endometrium."
4. "It is also known as primary dysmenorrhea and causes lower abdominal discomfort."

A client calls the health care provider's office to schedule an appointment because a home pregnancy test was performed and the results were positive. The nurse should expect which hormone to be present in the urine?
1. Estrogen
2. Progesterone
3. Follicle-stimulating hormone (FSH)
4. Human chorionic gonadotropin (hCG)

The nurse is teaching a pregnant client about the physiological effects and hormonal changes that occur during pregnancy. The client asks the nurse about the purpose of estrogen. Which response should the nurse give the client for the purpose of estrogen?
1. It maintains and relaxes the uterine lining for implantation.
2. It stimulates metabolism of glucose and converts the glucose to fat.
3. It prevents the involution of the corpus luteum and maintains the production of progesterone until the placenta is formed.
4. It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.

The nurse is collecting data from a client during the first prenatal visit. The client is anxious to know the gender of the fetus and asks the nurse when she will be able to know. The nurse should respond to the client knowing that the gender of the fetus is determined by which weeks?
1. 6 to 8
2. 8 to 10
3. 13 to 16
4. 20 to 22

The nurse is collecting data from a client seen in the health care clinic for a first prenatal visit. The nurse asks the client when the first day of her last menstrual period was and the client reports February 9, 2015. Using Nägele's rule, the nurse determines what is the estimated date of confinement (delivery)?
1. October 7, 2015
2. October 16, 2015
3. November 7, 2015
4. November 16, 2015

A pregnant client is seen in the health care clinic. During the prenatal visit, the client informs the nurse that she is experiencing pain in her calf when she walks. Which is the most appropriate nursing action?
1. Instruct the client to avoid walking.
2. Assess for signs of venous thrombosis.
3. Instruct to elevate the legs throughout the day.
4. Tell the client that this is normal during pregnancy.

A client in her second trimester of pregnancy is seen at the health care clinic. The nurse collects data from the client and notes that the fetal heart rate is 90 beats/min. Which nursing action is appropriate?
1. Document the findings.
2. Notify the health care provider (HCP).
3. Inform the client that everything is normal and fine.
4. Instruct the client to return to the clinic in 1 week for reevaluation of the fetal heart rate.

A nurse is caring for a pregnant woman who has herpes genitalis. The nurse provides instructions to the woman about treatment modalities that may be necessary for this condition. Which statement made by the woman indicates an understanding of these treatment measures?
1. "I do not need to abstain from sexual intercourse."
2. "I need to use vaginal creams after I douche every day."
3. "I need to douche and perform a sitz bath three times a day."
4. "It may be necessary to have a cesarean section for delivery."

A pregnant woman tests positive for the hepatitis B virus (HBV). The woman asks the nurse if she will be able to breast-feed the baby as planned after delivery. Which response by the nurse is most appropriate?
1. "You will not be able to breast-feed the baby until 6 months after delivery."
2. "Breast-feeding is allowed after the baby has been vaccinated with immune globulin."
3. "Breast-feeding is not advised, and you should seriously consider bottle-feeding the baby."
4. "Breast-feeding is not a problem, and you will be able to breast-feed immediately after delivery."

A nurse is collecting data from a client who is at 32 weeks gestation. The nurse measures the fundal height in centimeters and expects the findings to be how many centimeters (cm)?
1. 22 cm
2. 28 cm
3. 32 cm
4. 40 cm

A pregnant client is seen in the health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions. The nurse determines that the client is experiencing Braxton Hicks contractions. Which nursing action should the nurse implement?
1. Contact the health care provider.
2. Instruct the client to maintain bed rest for the remainder of the pregnancy.
3. Instruct the client that these are common and may occur throughout the pregnancy.
4. Call the maternity unit and inform them that the client will be admitted in a prelabor condition.

A nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The health care provider has documented the presence of Goodell's sign. What should the nurse determine that this sign indicates?
1. A softening of the cervix
2. The presence of fetal movement
3. The presence of human chorionic gonadotropin (hCG) in the urine
4. A soft blowing sound that corresponds to the maternal pulse while auscultating the uterus

A nursing instructor asks a nursing student to describe the process of quickening. Which statement by the student indicates an understanding of this term?
1. "It is the thinning of the lower uterine segment."
2. "It is the fetal movement that is felt by the mother."
3. "It is irregular painless contractions that occur throughout pregnancy."
4. "It is the soft blowing sound that can be heard when the uterus is auscultated."

A pregnant client asks the nurse in the clinic, "When will I begin to feel fetal movement?" Which response should the nurse make?
1. Between 6 and 8 weeks
2. Between 8 and 10 weeks
3. Between 12 and 14 weeks
4. Between 16 and 20 weeks

A rubella titer is performed on a client who has just been told that she is pregnant. The results of the titer indicate that the client is not immune to rubella. Which should the nurse anticipate to be prescribed for this client?
1. Immunization with rubella
2. Retesting rubella titer during pregnancy
3. Antibiotics to be taken throughout the pregnancy
4. Counseling the mother regarding therapeutic abortion

A nursing student is preparing to instruct a pregnant client in performing Kegel exercises. The nursing instructor asks the student the purpose of Kegel exercises. Which response made by the student indicates an understanding of the purpose?
1. "The exercises will help reduce backaches."
2. "The exercises will help prevent ankle edema."
3. "The exercises will help prevent urinary tract infections."
4. "The exercises will help strengthen the pelvic floor in preparation for delivery."

The nurse in a health care clinic is instructing a client how to perform kick counts. Which statement made by the client indicates a need for further teaching?
1. "I should lie on my back to perform the procedure."
2. "I will use a clock or a timer and record the number of movements or kicks."
3. "I should count the fetal movements for 30 to 60 minutes three times a day."
4. "I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

A pregnant client asks the nurse, "What should I expect during a nonstress test?" Which information should the nurse provide to the client?
1. "The test is an invasive procedure and requires that you sign an informed consent."
2. "The fetus is challenged by uterine contractions to obtain the necessary information."
3. "The test will take about 2 hours and will require close monitoring for 2 hours after the procedure is completed."
4. "An ultrasound transducer that records fetal heart activity is secured over the abdomen where the fetal heart is heard most clearly."

A nurse provides teaching regarding how to relieve discomfort to a client in her second trimester of pregnancy that is having frequent low back pain and ankle edema at the end of the day. Which statement made by the client indicates an understanding of the teaching?
1. "When I get home I should lie on my left side, with my feet in a dorsiflexed position."
2. "I should soak in a tub bath of hot water when I get home and then perform pelvic tilt exercises."
3. "When I get home I should lie on my right side, with my feet elevated on a pillow, and put a heating pad on my back."
4. "When I get home I should lie on the floor, with my legs elevated onto a couch, and turn my hips and knees at right angles."

A pregnant client calls the nurse at the health care provider's office and reports that she has noticed a thin, colorless, vaginal drainage. Which information is most appropriate for the nurse to provide to the client?
1. Come to the clinic immediately.
2. The vaginal discharge may be bothersome, but is a normal occurrence.
3. Report to the emergency department at the maternity center immediately.
4. Use tampons if the discharge is bothersome but be sure to change the tampons every 2 hours.

The nurse has assisted in performing a nonstress test on a pregnant client and is reviewing the documentation related to the results of the test. The nurse notes that the health care provider has documented the test results as reactive. How should the nurse interpret this result?
1. Normal findings
2. Abnormal findings
3. The need for further evaluation
4. That the findings on the monitor were difficult to interpret

A pregnant client calls the clinic and tells the nurse that she is experiencing leg cramps and is awakened by the cramps at night. Which activity should the nurse tell the client to perform when the cramps occur?
1. Dorsiflex the foot while flexing
2. Dorsiflex the foot while extending
3. Plantar flex the foot while flexing
4. Plantar flex the foot while extending

The nurse is providing instructions about treatment for hemorrhoids to a client in the second trimester of pregnancy. Which statement made by the client indicates a need for further teaching?
1. "Cool sitz baths will help in relieving the discomfort."
2. "I should perform Kegel exercises as you have instructed."
3. "I should apply heat packs to the hemorrhoids to help them shrink."
4. "I can apply ice packs to the hemorrhoids to assist in relieving discomfort."

The clinic nurse is discussing nutrition with a pregnant client who has lactose intolerance. Which food should the nurse instruct the client to eat to supplement the dietary source of calcium?
1. Dried fruits
2. Hard cheese
3. Creamed spinach
4. Fresh squeezed orange juice

A nurse is providing instructions to a pregnant client visiting the antenatal clinic about foods that are rich in folic acid. Which food should the nurse encourage the client to consume because it is highest in folic acid?
1. Rice
2. Cheese
3. Chicken
4. Green leafy vegetables

A pregnant client asks the nurse about the type of exercises that are allowable during pregnancy. Which exercise should the nurse instruct the client to engage in?
1. Swimming
2. Water skiing
3. Downhill skiing
4. Aerobic exercising

A pregnant client reports to the health care clinic complaining of loss of appetite, weight loss, and fatigue. A sputum culture is obtained, andMycobacterium tuberculosis is identified in the sputum. Which instruction should the nurse provide to the client regarding therapeutic management of tuberculosis?
1. The need for therapeutic abortion is required.
2. Medication will not be started until after delivery of the fetus.
3. Isoniazid plus rifampin (Rifadin) will be required for a total of 9 months.
4. The newborn must receive medication therapy immediately following birth.

The nurse provides home care instructions to a pregnant client with a history of cardiac disease. Which statement made by the client indicates a need for further teaching?
1. "It is best that I rest on my left side to promote blood return to the heart."
2. "I need to avoid excessive weight gain to prevent increased demands on my heart."
3. "I need to try to avoid stressful situations because stress increases the workload on the heart."
4. "During the pregnancy, I need to avoid contact with other individuals as much as possible to prevent infection."

A nurse is collecting data on a pregnant client in the first trimester of pregnancy diagnosed with iron deficiency anemia. The nurse should monitor the client to detect which sign/symptom indicating that this problem has not yet resolved?
1. Pink mucous membranes
2. Increased vaginal secretions
3. Complaints of daily headaches and fatigue
4. Complaints of increased frequency of voiding

The nurse is conducting a routine screening to detect a client's risk for toxoplasmosis parasite infection during pregnancy. Which factor should the nurse ask the client about to determine this risk?
1. Presence of cats in the home
2. Number of sexual partners during pregnancy
3. Exposure to children with rashes or gastrointestinal symptoms
4. History of high fevers or unusual rashes during the first 6 weeks of pregnancy

A nurse is preparing to care for a client being admitted to the hospital with a possible diagnosis of ectopic pregnancy. The nurse develops a plan of care for the client and determines that which is the priority nursing action?
1. Assessing for edema
2. Monitoring daily weight
3. Monitoring the apical pulse
4. Monitoring the temperature

A nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data should alert the nurse that the client is at risk for developing gestational diabetes during this pregnancy?
1. The client's last baby weighed 10 lb at birth.
2. The client has a family history of type 1 diabetes.
3. The client is 5 feet, 3 inches tall and weighs 165 lb.
4. The client's previous deliveries were by cesarean section.

A nurse is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. The nurse determines that the client understands dietary and insulin needs if the client states that which may be required during the second half of pregnancy?
1. Increased insulin
2. Decreased insulin
3. Increased caloric intake
4. Decreased caloric intake

A nurse is providing instructions about taking iron supplements to a pregnant client. The nurse determines that the client understands the instructions if the client states she will take the supplements with which drink?
1. Tea
2. Milk
3. Coffee
4. Orange juice

A nurse is assisting the health care provider to perform Leopold's maneuvers on a pregnant client. Which action should the nurse perform before the procedure?
1. Ask the client to urinate.
2. Ask the client to drink 8 oz of water.
3. Locate the fetal heart tones with a fetoscope.
4. Warm the sonogram gel before placing it on the client's abdomen.

A nurse is collecting data on clients who are in their first trimester of pregnancy. The nurse is concerned with identifying clients who may be at risk for the development of postpartum complications. Which client would be least likely at risk for the development of thrombophlebitis in the postpartum period?
1. A 35-year-old client who reports that she smokes
2. A 26-year-old client with a family history of thrombophlebitis
3. A 37-year-old client in her fourth pregnancy who is overweight
4. A 22-year-old client in her first pregnancy who states that oral contraceptives taken in the past have caused thrombophlebitis

The clinic nurse is instructing a pregnant client in her first trimester about nutrition. The nurse should determine that the client needs further teaching if the client believes which is true about nutrition during pregnancy?
1. Iron supplements should be taken throughout pregnancy.
2. Calcium intake should be increased for the duration of the pregnancy.
3. Pregnancy greatly increases the risk of malnourishment for the mother.
4. The maternal diet significantly influences fetal growth and development.