Chapter 9

Question 1

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?

Answer 1

“We occasionally identify a health problem that puts the current pregnancy at higher risk.”

Question 2

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?

Answer 2

Delivered two term infants

Question 3

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?

Answer 3

“Abortion is the medical term for all pregnancies that end before 28 weeks.”

Question 4

Which client should the nurse identify as being a multipara?

Answer 4

A client at 13 weeks’ gestation who previously delivered two term infants

Question 5

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

Answer 5

Full Term

Question 6

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?

Answer 6

Do genetic diseases run in the family of the baby’s father?

Question 7

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

Answer 7

It provides a baseline from which to ask questions about the client’s religious and cultural background.

Question 8

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?

Answer 8

Have the healthcare provider see the client today.

Question 9

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?

Answer 9

Respirations 30/min

Question 10

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

Answer 10

Primipara at 12 weeks with fetal heart tones heard by Doppler fetoscope

Question 11

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)?

Answer 11

January 17

Question 12

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?

Answer 12

“It will help tell whether my pelvis is big enough to deliver my baby vaginally.”

Question 13

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?

Answer 13

Diagonal conjugate

Question 14

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

Answer 14

“Because I am married, I won’t have the STI screening.”

Question 15

Which phone call should the prenatal clinic nurse return first?

Answer 15

Primipara at 32 weeks, reports headache and blurred vision

Question 16

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

Answer 16

“Because I’m in my third trimester, I should return to the clinic in a month.”

Question 17

A pregnant client’s quadruple screen shows a risk for the fetus to have Down syndrome. Which test results within the screen were used to make this determination? Select all that apply.

1. Inhibin-A
2. Alpha-fetoprotein (AFP)
3. Unconjugated estriol (UE)
4. Hemoglobin electrophoresis
5. Human chorionic gonadotropin (hCG)

Answer 17

1,2,3,5

Question 18

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.

1. Double vision
2. Epigastric pain
3. Facial swelling
4. Painful urination
5. Severe headache

Answer 18

1,2,3,5

Question 19

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.

1. Assess for nausea.
2. Refer to a dietitian.
3. Suggest amniocentesis.
4. Assess nutritional intake.
5. Discuss importance of adequate weight gain.

Answer 19

1,2,4,5

Question 20

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.

1. “A bloody show means labor will begin within 2 days.”
2. “Having uterine contractions that increase over time is a sign of labor.”
3. “Uterine contractions that do not radiate to the back are a sign of labor.”
4. “Having a spontaneous flow of water from my vagina is a sign of labor.”
5. “Expulsion of a plug of mucus means the baby has dropped into the pelvis.”

Answer 20

1,3,5