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Maternal Test 2

15-year-old nulligravida

When preparing nutritional instruction, which of the following pregnant clients would the nurse consider highest priority?

"I understand that gaining weight after such an accomplishment must not look attractive, but weight gain during pregnancy is important for proper fetal growth."

A client has achieved a 20-pound weight loss over the past year. She now is at the antepartum clinic. Her pregnancy test is positive. She is concerned about gaining the weight back, and asks the nurse if she can remain on her diet. The nurse's best response would be:

more than ideal

A client in her 20th week of pregnancy has gained 20 pounds overall. Her pattern of weight gain would be considered

25-35 lbs

A pregnant client who is of normal prepregnancy weight is now 30 weeks pregnant. She asks the nurse what appropriate weight gain would be for her. The nurse's best response is:

fish

The nurse is presenting a preconceptual counseling class. The nurse instructs the participants that niacin intake should increase during pregnancy to promote metabolic coenzyme activity. The nurse would know that teaching has been effective if a client suggests which of the following foods as a source of niacin?

Explain all aspects of the assessment in concrete terms.

The nurse is preparing to assess a pregnant 14-year-old client. Which of the following should the nurse do to support the client's psychologic development?

"Teens who have a lot of time without adult supervision are more sexually active.",
"Although the rate has dropped, teens of color are more likely to become pregnant.", and "Young teens who have a child are more likely to have another while still a teen."

The nurse is preparing an in-service presentation for a group of middle school nurses. Which statements by the nurse would indicate that the nurse understands the role of culture in adolescent pregnancy? Select all that apply.

At 28 weeks' gestation

A clinic nurse is planning when to administer Rh immune globulin (RhoGAM) to an Rh-negative pregnant client. When should the first dose of RhoGAM be administered?

Striving for gaining autonomy and independence

The 19-year-old pregnant woman begins a job to "save money for the baby." The nurse understands this statement to demonstrate what?

Urine and blood glucose

A 26-year-old multipara is at 24 weeks' gestation. Her previous births include two large-for-gestational-age babies and one unexplained stillbirth. With this history, what assessment is most important?

I might be hungry frequently because the sugar isn't getting into the tissues the way it should."

The client has just been diagnosed as diabetic. The nurse knows teaching was effective when the client says:

Increasing teens' feelings of self-worth.

A youth development program is being planned to help address the issue of teenage pregnancy in the community. The nurse advocates that the program focus on:

Ask the woman directly, "Do you use any street drugs?"

A woman's history and appearance suggest drug abuse. The nurse's best approach would be to:

25

The pharmacy sends 500 ml of NS with 40 grams of magnesium sulfate. The order is for the medication to infuse at 2 grams per hour. The nurse would set the pump at ________ ml/hour

A 100 g, 3-hour glucose tolerance test

A 26-year-old multipara is at 26 weeks' gestation. Her previous births include two large-for-gestational-age babies and one unexplained stillbirth. The nurse suspects gestational diabetes. Which tests would the nurse anticipate as being most definitive in making a diagnosis?

Measure and record her weight at each visit

To give the pregnant adolescent a role in her prenatal care, the nurse could allow her to:

Fluid volume deficit

A woman is at 7 weeks' gestation, and is diagnosed with hyperemesis gravidarum. Which nursing diagnosis would receive priority?

"You should come to the clinic in the next day or two for further evaluation."

A woman is 10 weeks pregnant. Her initial prenatal laboratory screening test for rubella showed an antibody titer of less than 1:6. The woman calls the clinic and tells the nurse that she has been exposed to measles. The nurse's best response is:

"Although condom use is growing, there is still an increasing rate of STDs among teens."

The nurse who is counseling a group of middle school girls on pregnancy avoidance should include which of the following statements?

Weekly nonstress testing beginning at 32 weeks' gestation

A woman at 32 weeks' gestation is HIV-positive but asymptomatic. What would be important in managing her pregnancy and delivery?

determine the location of placenta.

(5, 21) Wanda, G2 P1, is at 31 weeks' gestation arrives at emergency room and reports that she "woke up in a pool of blood." She denies cramping or abdominal pain. Nursing assessment findings include a moderate amount of bright red vaginal bleeding; fundal height, vital signs, and fetal heart rate within normal limits, and no contractions noted. Based on these, the nurse should anticipate that Wanda will have an ultrasound to

32-week gestation with regular uterine contractions

For which client is the physician most likely to order a cervico-vaginal fetal fibronectin test?

The test should last no longer than 30 minutes."

The client is having a nonstress test the next day. Which instruction should the nurse give to the client?

Assist the woman into a supine position on the examining table

The nurse is assisting with a transabdominal ultrasound procedure to determine fetal age. The nurse should:

"I might go into labor early."

Which response would indicate that a client clearly understands the risks of an amniocentesis?

They can be stored in the body, leading to toxic effects

Why might fat-soluble vitamins be harmful if taken in large quantities during pregnancy?

A daily supplement of 4 mg of vitamin B12 is important.

A pregnant client who is a vegetarian asks the nurse for assistance with her diet. What instruction would the nurse give?

4-6

n early-pregnancy class, the nurse emphasizes the importance of 8-10 glasses of fluid per day. How many of these should be water?

less than ideal

A client with a normal prepregnant weight is in her 28th week of pregnancy and has gained 13 pounds overall. Her pattern of weight gain would be considered

32-week gestation with regular uterine contractions

For which client is the physician most likely to order a cervico-vaginal fetal fibronectin test?

Gravida 2, para 1, 36 weeks, with hypertension disorder of pregnancy

Which client's indications most warrant fetal monitoring in the third trimester?

You need to come to the clinic right away for further evaluation."

A woman at 28 weeks' gestation is asked to keep a fetal activity diary and to bring the results with her to her next clinic visit. One week later, she calls the clinic and anxiously tells the nurse that she has been at work and has not noted any fetal movement in the past 4 hours. What would be the most appropriate initial comment by the nurse?

oxygen

The nurse is caring for a laboring client with sickle cell anemia. Which therepy should the nurse anticipate the doctor ordering?

diaphoresis and disorientation

The nurse is caring for a laboring client with type 1 diabetes. What are the signs and symptoms of hypoglycemia for which the nurse should assess?

"I will take my Zidovudine (ZVD) at the same time every day." ,
"During labor and delivery, I can expect the Zidovudine (ZVD) to be given in my IV." and, "My baby will be started on Zidovudine (ZVD) within 12 hours of delivery."

A client admits to being HIV-positive, and that she is at about 16 weeks' gestation. Which statements made by the client indicate an understanding of the plan of care both during the pregnancy and postpartally? Select all that apply.

"Your cervix is beginning to dilate. That is a serious sign. We will continue to monitor you and the baby for now."

A woman is 16 weeks pregnant. She has had cramping, backache, and mild bleeding for the past 3 days. Her physician determines that her cervix is dilated to 2 centimeters, with 10% effacement, but membranes are still intact. She is crying, and says to the nurse, "Is my baby going to be okay?" In addition to acknowledging the client's fear, the nurse should also say:

Motor vehicle accidents

What form of trauma is the leading cause of fetal and maternal death?

Urinary output 20 ml/hour

The following are assessment findings for a client with pre-eclampsia: blood pressure 158/100; urinary output 50 mL/hour; lungs clear to auscultation; urine protein 11 on dipstick; edema of the hands, ankles, and feet. On the next hourly assessment, which new assessment finding would be an indication of worsening of the pre-eclampsia?

Not become pregnant for at least 1 year.

A woman has a hydatidiform mole (molar pregnancy) evacuated, and is prepared for discharge. The nurse should make certain that the client understands that it is essential that she:

Pregnancy-induced hypertension

A 20-year-old woman is at 28 weeks' gestation. Her prenatal history reveals previous drug abuse, and urine screening indicates that she has recently used heroin. The nurse should recognize that the woman is at increased risk for:

Measure and record her weight at each visit.

To give the pregnant adolescent a role in her prenatal care, the nurse could allow her to

Develop a trusting relationship

A 16-year-old is making her first prenatal visit to the clinic in her fourth month of pregnancy. The nurse's first responsibility would be to:

Altered Nutrition: less than body requirements related to poor eating habits

A pregnant adolescent client states that it is important not to have a baby who weighs too much. She states this has been her rationale for limiting calories. Her weight has decreased from 110 pounds to 106 pounds. Which of the following nursing diagnoses would have priority?

Suggest she have a hemoglobin done because of the association between pica and iron deficiency anemia.

At a prenatal appointment, a woman who is 3 months pregnant confides to you that she ingests starch due to a craving she has had since adolescence. She is now 26 years old. What would be your most appropriate response?

An additional 300 calories per day

What calorie intake is recommended during pregnancy

Ask her to describe her intake for the last 24 hours

When meeting with a family at the prenatal clinic, what is the most effective way to assess the woman's usual food intake during her pregnancy?

Orange juice

The school nurse is planning a class about nutrition for pregnant teens. The nurse knows that several of the pregnant teenage clients have been diagnosed with iron-deficiency anemia. Which should the nurse encourage the teens to consume more of in order to increase iron absorption?

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