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The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi present on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings?


A) Have the healthcare provider see the client today.
B) Instruct the client to avoid direct sunlight.
C) Document the findings on the prenatal chart.
D) Analyze previous thyroid hormone laboratory results.

E) All of the above
F) C) and D)

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During a prenatal examination the healthcare provider is going to estimate the adequacy of the client's pelvis for birth. Which measurement will the physician perform vaginally?


A) True conjugate
B) Diagonal conjugate
C) Obstetric conjugate
D) Transverse outlet diameter

E) B) and C)
F) A) and B)

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The pregnant client has completed the prenatal questionnaire and asks the nurse why this form had to be filled out. Which response is the most appropriate?


A) "We occasionally identify a health problem that puts the current pregnancy at higher risk."
B) "This form is designed to predict who will develop problems with their pregnancy or delivery."
C) "The doctor wants all of the pregnant clients to fill out the form so that our records are complete."
D) "Some people have things that have happened in the past that could impact their current pregnancy."

E) A) and B)
F) C) and D)

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The nurse receives a phone call from a client who thinks she is pregnant. The client reports that she has regular menses that occur every 28 days and last 5 days. The first day of her last menses was April 10) What is the client's estimated date of delivery (EDD) ?


A) January 10
B) January 17
C) December 3
D) November 13

E) B) and C)
F) C) and D)

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During a phone call to the clinic the nurse suspects that a pregnant client is experiencing preeclampsia. What manifestations did this client report that caused the nurse to make this clinical determination? Select all that apply.


A) Double vision
B) Epigastric pain
C) Facial swelling
D) Painful urination
E) Severe headache

F) B) and D)
G) All of the above

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During a prenatal visit the nurse notes that a client entering the third trimester has gained a total of 8 lb. What action should the nurse take at this time? Select all that apply.


A) Assess for nausea.
B) Refer to a dietitian.
C) Suggest amniocentesis.
D) Assess nutritional intake.
E) Discuss importance of adequate weight gain.

F) A) and E)
G) B) and E)

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The nurse provides teaching on the signs of impending labor with a client at week 37 of gestation. Which client statements indicate that additional teaching would be beneficial? Select all that apply.


A) "A bloody show means labor will begin within 2 days."
B) "Having uterine contractions that increase over time is a sign of labor."
C) "Uterine contractions that do not radiate to the back are a sign of labor."
D) "Having a spontaneous flow of water from my vagina is a sign of labor."
E) "Expulsion of a plug of mucus means the baby has dropped into the pelvis."

F) C) and E)
G) D) and E)

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A pregnant client is having pelvimetry measurements made. Which diagram should the nurse use to demonstrate the technique for determining the anteroposterior diameter?


A) A pregnant client is having pelvimetry measurements made. Which diagram should the nurse use to demonstrate the technique for determining the anteroposterior diameter?  A)    B)    C)    D)
B) A pregnant client is having pelvimetry measurements made. Which diagram should the nurse use to demonstrate the technique for determining the anteroposterior diameter?  A)    B)    C)    D)
C) A pregnant client is having pelvimetry measurements made. Which diagram should the nurse use to demonstrate the technique for determining the anteroposterior diameter?  A)    B)    C)    D)
D) A pregnant client is having pelvimetry measurements made. Which diagram should the nurse use to demonstrate the technique for determining the anteroposterior diameter?  A)    B)    C)    D)

E) A) and D)
F) All of the above

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The nurse is seeing prenatal clients in the clinic. Which client is exhibiting expected findings?


A) Primipara at 26 weeks with fundal height of 30 cm
B) Multipara at 12 weeks who reports bright red vaginal bleeding
C) Multipara at 22 weeks who reports no fetal movement felt yet
D) Primipara at 12 weeks with fetal heart tones heard by Doppler fetoscope

E) A) and B)
F) All of the above

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The nurse explains to a pregnant woman that her antepartum assessment will include assessment of clinical pelvimetry. Which client response reflects understanding of the reason for this test?


A) "It will help me understand how big a baby I can have."
B) "It will be used to screen for gestational diabetes."
C) "It will be used to find out whether my baby has a chromosomal abnormality."
D) "It will help tell whether my pelvis is big enough to deliver my baby vaginally."

E) A) and C)
F) B) and C)

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The nurse learns that a pregnant client's religion is Judaism. Why is this information important?


A) Religious and cultural background can impact what a client eats during pregnancy.
B) Knowing the client's beliefs and behaviors regarding pregnancy is important.
C) Clients sometimes encounter problems in their pregnancies based on what religion they practice.
D) It provides a baseline from which to ask questions about the client's religious and cultural background.

E) All of the above
F) None of the above

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The client has delivered her first child at 39 weeks. How should the nurse document this type of delivery?


A) Preterm
B) Postterm
C) Full Term
D) Near term

E) B) and C)
F) None of the above

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The prenatal clinic nurse is designing a new prenatal intake information form for pregnant clients. Which question is the most important to include on this form?


A) What is the name of the baby's father?
B) Where was the father of the baby born?
C) Are you married to the father of the baby?
D) Do genetic diseases run in the family of the baby's father?

E) None of the above
F) C) and D)

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The nurse is working with a prenatal client. Which statement indicates that additional teaching about prenatal screening tests is necessary?


A) "My blood will be checked for hemoglobin level."
B) "Because I am married, I won't have the STI screening."
C) "My vagina will be cultured at 36 weeks for group B strep."
D) "I will have Rh testing, even though this is my first pregnancy."

E) None of the above
F) B) and C)

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The nurse is completing an assessment for a prenatal visit. Which client statement indicates that further teaching is necessary?


A) "Now that I've felt fetal movement, I should feel movement regularly."
B) "Because I'm in my third trimester, I should return to the clinic in a month."
C) "Alcohol is possibly harmful to my baby, even at the end of my pregnancy."
D) "Before I take any over-the-counter medications, I should contact my doctor."

E) A) and B)
F) B) and C)

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The pregnant client's prenatal record indicates that she is a gravida 4 para 2022. How should the nurse interpret these data about the client?


A) Is pro-abortion
B) Has four living children
C) Delivered two term infants
D) Delivered two infants preterm

E) A) and B)
F) B) and D)

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C

Which phone call should the prenatal clinic nurse return first?


A) Primipara at 32 weeks, reports headache and blurred vision
B) Primipara at 16 weeks, reports increased urinary frequency
C) Multipara at 18 weeks, reports no fetal movement this pregnancy
D) Multipara at 40 weeks, reports sudden gush of fluid and contractions

E) A) and B)
F) All of the above

Correct Answer

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A multigravida gave birth to an 18-week fetus last week. During her follow-up she sees that it is documented in her medical record that she had one abortion and becomes upset over the use of this word. How can the nurse best explain this terminology to the client?


A) "Abortion is what we call all babies who are stillborn."
B) "Abortion is the word we use when someone has miscarried."
C) "Abortion is how we label pregnancies that end in the second trimester."
D) "Abortion is the medical term for all pregnancies that end before 28 weeks."

E) A) and D)
F) B) and C)

Correct Answer

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Which client should the nurse identify as being a multipara?


A) A client at 28 weeks' gestation with no previous pregnancies
B) A client at 32 weeks' gestation who previously delivered one term infant
C) A client at 13 weeks' gestation who previously delivered two term infants
D) A client at 34 weeks' gestation who previously had one spontaneous abortion

E) All of the above
F) A) and B)

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C

The nurse is assessing a 25-year-old primigravida who is 20 weeks pregnant. Which vital signs finding should the nurse report immediately to the physician?


A) Pulse 88/min
B) Respirations 30/min
C) Blood pressure 134/82
D) Temperature 37.4°C (99.3°F)

E) B) and C)
F) None of the above

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B

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