Antepartum Care
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Questions and Answers

During a routine prenatal examination, a client who is at 32 weeks gestation becomes dizzy, lightheaded, and pale. After placing the client in a supine position, what is the priority nursing action?

  • Ask the client to breathe deeply
  • Turn the client on her left side (correct)
  • Listen to fetal heart tones
  • Take the client's blood pressure
  • A nurse is assessing a client at 33-weeks' gestation. Leopold's maneuvers indicate that the fetus is in a breech position. Where can fetal heart tones best be heard?

  • Right lower quadrant of the abdomen
  • Midway between the symphysis pubis and the umbilicus
  • Above the level of the umbilicus (correct)
  • Right upper quadrant of the abdomen
  • In twin-to-twin transfusion syndrome, one fetus is considered the donor twin, and one becomes the recipient twin. What condition would an assessment of the recipient twin likely reveal?

  • Anemia
  • Oligohydramnios
  • Polycythemia (correct)
  • Small fetus
  • A client who reports painless vaginal bleeding at 28 weeks' gestation is diagnosed with placenta previa. The placental edge reaches the internal os. Which type of placenta previa should the nurse suspect?

    <p>Marginal placenta previa (B)</p> Signup and view all the answers

    Which procedure or treatment should the nurse anticipate for a client with a placenta implanted in the lower uterine segment?

    <p>A vaginal ultrasound examination every two to three weeks (C)</p> Signup and view all the answers

    The nurse is teaching a client with painless vaginal bleeding at 28 weeks' gestation who has just been diagnosed with placenta previa. The nurse determines that teaching has been effective when the client states:

    <p>“I need to limit my activity and rest.” (D)</p> Signup and view all the answers

    The nurse is teaching a client who has developed placenta accreta and a history of placenta previa. Which explanation of this condition would be the most correct?

    <p>The placenta attaches to the myometrium. (D)</p> Signup and view all the answers

    The nurse is caring for a client suspected of having a hydatidiform mole. Which signs and symptoms confirm this diagnosis? Select all that apply.

    <p>Snowstorm pattern on an ultrasound with no fetus or gestational sac (D), Maternal hypertension early in the second trimester. (@)</p> Signup and view all the answers

    A 21-year-old client who has just been diagnosed with having a hydatidiform mole asks the nurse about risk factors. What is the nurse's best response?

    <p>“Having a previous molar gestation” (D)</p> Signup and view all the answers

    A 21-year-old client arrives at the emergency department with a report of cramping, abdominal pain, and mild vaginal bleeding. A pelvic examination shows a left adnexal mass that is tender when palpated. Culdocentesis shows blood in the cul-de-sac. Which condition should the nurse suspect?

    <p>Ectopic pregnancy (B)</p> Signup and view all the answers

    The nurse assesses a client at 34 weeks' gestation who has arrived at the emergency department with severe abdominal pain, uterine tenderness, and increased uterine tone. The client denies vaginal bleeding. The external fetal monitor shows fetal distress with severe, variable decelerations. Which condition does this client mostly likely have?

    <p>Abruptio placentae (A)</p> Signup and view all the answers

    During a routine visit to the clinic, a client tells the nurse that she may be pregnant. The health care provider orders a pregnancy test. Which indicator would most accurately confirm this client's pregnancy?

    <p>Increase in human chorionic gonadotropin (HCG) (A)</p> Signup and view all the answers

    A nurse is assessing a pregnant client in her second trimester. The nurse understands that this client's respiratory status should show:

    <p>increased tidal volume. (A)</p> Signup and view all the answers

    A client is scheduled for amniocentesis. What priority intervention should the nurse implement?

    <p>Have the client void (B)</p> Signup and view all the answers

    The nurse is taking an initial history on a pregnant client, who asks about the chances of having dizygotic twins. The nurse correctly states:

    <p>“There's an increased risk with increased maternal age.” (C)</p> Signup and view all the answers

    A client in her fifth month of pregnancy is having a routine clinic visit. Which common condition would the nurse asses for in the client's second trimester?

    <p>Physiologic anemia (C)</p> Signup and view all the answers

    A 21-year-old client at six weeks' gestation is diagnosed with hyperemesis gravidarum. The nurse understands that this client is most at risk of developing:

    <p>electrolyte imbalance. (B)</p> Signup and view all the answers

    A 29-year-old client has gestational diabetes. The nurse is teaching her about managing glucose levels. Which therapy would be most appropriate for this client?

    <p>Diet (A)</p> Signup and view all the answers

    A client who is pregnant has developed preeclampsia. She asks the nurse why magnesium sulfate has been prescribed for her. What is the nurse's best response?

    <p>“It prevents seizures.” (D)</p> Signup and view all the answers

    While assessing a client in her 24th week of pregnancy, the nurse learns that the client has been experiencing signs and symptoms of pregnancy-induced hypertension, or preeclampsia. Which sign or symptom helps differentiate preeclampsia from eclampsia?

    <p>Seizures (A)</p> Signup and view all the answers

    A pregnant client has a negative contraction stress test (CST). How does the nurse interpret this result?

    <p>Fetal heart rate (FHR) variability, and no decelerations from contraction in a 10-minute period in which there were three contractions. (D)</p> Signup and view all the answers

    A pregnant client with sickle cell anemia has an increased risk for having a sickle cell crisis during pregnancy. The nurse anticipates that aggressive management of a sickle cell crisis would include:

    <p>IV fluids. (C)</p> Signup and view all the answers

    The nurse is performing a cardiac assessment on a pregnant client. Which finding would the nurse recognize as normal?

    <p>Systolic murmur (D)</p> Signup and view all the answers

    A 42-year-old client presents for her first prenatal visit at 16 weeks' gestation. She has severe morning sickness and no fetal heart tones. Her blood pressure is 150/100 mmHg. Her fundal height is 24 cm. Which condition is most likely indicated by these symptoms?

    <p>Hydatidiform mole (D)</p> Signup and view all the answers

    A client with gestational hypertension is receiving magnesium sulfate to prevent seizure activity. The nurse reviews the client's magnesium level and identifies a therapeutic level as:

    <p>4 to 7 mEq/L. (A)</p> Signup and view all the answers

    A client is receiving IV magnesium sulfate for severe preeclampsia. Which is the priority assessment for this client?

    <p>Decreased urine output (B)</p> Signup and view all the answers

    The nurse is planning care for a client receiving IV magnesium sulfate for hypertension. Which medication should the nurse have available for an emergency?

    <p>Calcium gluconate (A)</p> Signup and view all the answers

    A client is screened for tuberculosis during her first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is administered by the nurse. This client is considered to have a positive test when:

    <p>an indurated wheal over 10 mm in diameter appears in 48 to 72 hours. (B)</p> Signup and view all the answers

    A 23-year-old client who is at 27 weeks' gestation arrives at her health care provider's office with reports of fever, nausea, vomiting, malaise, unilateral flank pain, and costovertebral angle tenderness. Which diagnosis is most likely?

    <p>Pyelonephritis (C)</p> Signup and view all the answers

    Clients with which condition would be appropriate for trial of labor after cesarean section (TOLAC), after a prior cesarean birth?

    <p>Premature rupture of membranes (C)</p> Signup and view all the answers

    A nurse is teaching a client who received a dose of Rho(D) immune globulin at 28 weeks' gestation to prevent Rh isoimmunization. Which statement most accurately describes isoimmunization?

    <p>Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies. (B)</p> Signup and view all the answers

    The nurse is administering Rho(D) immune globulin to a pregnant client at 28 weeks' gestation. Which dose would be appropriate for this client?

    <p>300 mcg in an unsensitized client (D)</p> Signup and view all the answers

    A client hospitalized for preterm labor tells the nurse that she's having occasional contractions. Which nursing intervention would be the most appropriate?

    <p>Encourage the client to empty her bladder, give IV fluids, and encourage oral fluids (C)</p> Signup and view all the answers

    A client's prenatal history shows her to be a 23-year-old gravida 4, para 2. The nurse correctly interprets this history when she states:

    <p>“This client has been pregnant four times, and has had two children born after 20 weeks' gestation.” (B)</p> Signup and view all the answers

    A nurse is planning the care of a pregnant client. Which condition would require more frequent office visits?

    <p>A history of insulin-dependent diabetes mellitus (D)</p> Signup and view all the answers

    To detect life-threatening complications as early as in a client receiving a tocolytic agent, the nurse should be alert for:

    <p>bilateral crackles on lung auscultation. (C)</p> Signup and view all the answers

    A client has been in early labor, with contractions ever 10 to 12 minutes, for the past 12 hours with no progression. What medication should the nurse anticipate to help stimulate this client's uterine contractions?

    <p>Oxytocin (C)</p> Signup and view all the answers

    A client asks the nurse when maternal and fetal blood are exchanged during a pregnancy. What is the nurse's most accurate response?

    <p>Maternal and fetal blood are never exchanged (D)</p> Signup and view all the answers

    A pregnant client asks the nurse why she should lie on her left side when resting or sleeping in the later stages of pregnancy. What is the best response by the nurse?

    <p>To prevent compression of the inferior vena cava (C)</p> Signup and view all the answers

    A pregnant client voices concerns about her perceived lack of fetal movement. How should the nurse best respond to this client?

    <p>“Lie down once a day, and count the number of fetal movements for 15 to 30 minutes.” (D)</p> Signup and view all the answers

    A pregnant client reports swelling in her feet and ankles. What is the most appropriate intervention for the nurse to recommend?

    <p>Sit and elevate the feet (C)</p> Signup and view all the answers

    Which intervention should a nurse recommend to a client who has severe heartburn during her pregnancy?

    <p>Eat several small meals daily (A)</p> Signup and view all the answers

    Which maternal complication is most commonly associated with obesity in pregnancy?

    <p>Preeclampsia (C)</p> Signup and view all the answers

    A nonstress test (NST) is ordered for a client with preeclampsia. The nurse is aware that this test will be performed to assess:

    <p>fetal well-being. (B)</p> Signup and view all the answers

    The nurse is checking the blood sugar level of a client who is at 33-weeks' gestation. This client has had type 1 diabetes since she was 12 years old. Which value would indicate to the nurse that this client's disease is controlled?

    <p>85 mg/dl (4.7 mmol/L) (B)</p> Signup and view all the answers

    A client with diabetes who is late in her third trimester has a fetal non-stress test (NST) twice weekly. The 20-minute test showed three fetal heart rate accelerations that exceeded the baseline by 15 beats/min, and that lasted longer than 15 seconds. How should the nurse interpret these NST results?

    <p>Reactive test (A)</p> Signup and view all the answers

    A client is diagnosed with preterm labor at 28 weeks' gestation. At 32 weeks, this client comes to the emergency department saying, “I think I'm in labor.” Which should the nurse expect during this client's physical examination?

    <p>Regular uterine contractions with cervical dilation (B)</p> Signup and view all the answers

    The nurse is teaching a client, who, at 18 weeks' gestation, reports a fluttering sensation in her abdomen. The nurse's teaching has been successful when the client states:

    <p>“This is my baby moving.” (A)</p> Signup and view all the answers

    A pregnant client is visiting the clinic and reports tiny, blanched, slightly raised-end arterioles on her face, neck, arms, and chest. The nurse explains that these are normal during pregnancy and referred to as:

    <p>telangiectasias. (D)</p> Signup and view all the answers

    Which nursing intervention is priority for a pregnant adolescent during her first trimester?

    <p>Refer the client to a dietitian for nutritional counseling (B)</p> Signup and view all the answers

    A nurse is discussing a healthy diet with a prima gravida client. The client states that she doesn't consume much milk or other dairy, even though she knows they are important. What advice should the nurse give this client?

    <p>“You should consume other non-dairy foods that are high in calcium.” (C)</p> Signup and view all the answers

    Which drug should a nurse choose as an antagonist for magnesium sulfate?

    <p>Calcium gluconate (C)</p> Signup and view all the answers

    A nurse receives an order to start an infusion of blood for a client who is hemorrhaging due to a placenta previa. Which equipment will the nurse need to initiate the infusion? Select all that apply.

    <p>Y tubing (A), 18-gauge catheter (B), Normal saline solution (C)</p> Signup and view all the answers

    A nurse is assessing a client who is experiencing a normal pregnancy. Which assessment would the nurse find in a normal pregnancy?

    <p>A 2-breath/min increase in respiratory rate (B)</p> Signup and view all the answers

    The nurse is teaching a student nurse about the GTPAL system. GTPAL documents a client's previous pregnancies. Which statement most accurately describes this system?

    <p>Term neonates, Preterm neonates, Abortions, and Living children (D)</p> Signup and view all the answers

    The nurse is reviewing the glucose tolerance test results of a client who is at 26 weeks' gestation. The nurse determines further intervention is necessary when the results identify:

    <p>a two-hour glucose level of 180 mg/dl (10.0 mmol/L) during a three-hour glucose tolerance test. (C)</p> Signup and view all the answers

    A 32-year-old woman is at 15 weeks' gestation when she's admitted to the labor unit. According to the GTPAL system, she is a G5 P1212. Which description best describes this client?

    <p>Total of five pregnancies, one full-term pregnancy, two pre-term pregnancies, one abortion, and two living children (C)</p> Signup and view all the answers

    The nurse is assessing a 32-year-old woman who is 15 weeks' gestation and has a history of hypertension. The nurse is aware that the client is most at risk for:

    <p>abruptio placentae. (A)</p> Signup and view all the answers

    A 32-year-old client has her first prenatal visit at 15 weeks' gestation. Her pre-pregnancy weight was 135 lb (61.2 kg). Which finding is abnormal during this visit?

    <p>Fundal height of 18 cm (A)</p> Signup and view all the answers

    A 25-year-old primiparous client arrives for her first prenatal visit at 10 weeks' gestation. She seems nervous and has many questions. What is the most important intervention by the nurse?

    <p>Reassure the client that all her questions will be answered during the visit (C)</p> Signup and view all the answers

    Accompanied by her father, a primiparous 15-year-old client arrives for her first prenatal visit at 30 weeks' gestation. Her father refuses to leave the room. He tells the nurse that the girl is shy, and that he will answer the questions for her. What should concern the nurse the most about this situation?

    <p>Possible child abuse or domestic violence (C)</p> Signup and view all the answers

    What is the best way for a nurse to determine if a pregnant client is the victim of domestic abuse or violence?

    <p>Interview the client alone in a nonjudgmental way (C)</p> Signup and view all the answers

    A client with gestational hypertension is experiencing abdominal pain and vaginal bleeding. Which assessment should the nurse perform first?

    <p>Fetal heart tones (A)</p> Signup and view all the answers

    Which assessment findings should the nurse expect to find in client, during the second and third trimesters of pregnancy? Select all that apply.

    <p>Ankle edema (A), Shortness of breath (B)</p> Signup and view all the answers

    A client with mild preeclampsia is being prepared for discharge from the hospital. The client understands the discharge instructions when she states:

    <p>“I will lie on my left side.” (A)</p> Signup and view all the answers

    The nurse describes the cardinal mechanisms of labor while teaching an antepartum client about the passage of the fetus through the birth canal during labor. Select the events that are in the proper sequence as they would occur.

    <ol> <li>Descent</li> <li>Flexion</li> <li>Internal rotation</li> <li>Extension</li> <li>External rotation</li> <li>Expulsion (B)</li> </ol> Signup and view all the answers

    A nurse is palpating the uterus of a client who is at 20 weeks' gestation to measure fundal height. Identify the area of the abdomen where the nurse should expect to feel the uterine fundus.

    <p>should be at about the umbilicus (A)</p> Signup and view all the answers

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