Term
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Definition
| a test to see if an unborn baby has a disease or other problem, done by taking liquid from the mother's womb |
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Term
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Definition
| levels are used as a screening tool for NTDs (neural tube defects) in pregnancy. Through this technique, approximately 85% to 92% of open NTDs and almost all cases of anencephaly can be detected early (Wapner & Dugoff, 2019). Screening is recommended for all pregnant women. |
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Term
A client diagnosed with gestational diabetes is at 36 weeks of gestation. The client has had weekly reactive nonstress tests for the last 3 weeks. This week, the nonstress test was nonreactive after 40 minutes. Based on these results, the nurse would prepare the client for which intervention?
A contraction stress test
Immediate induction of labor
Hospitalization with continuous fetal monitoring
A return appointment in 2 days to repeat the nonstress test |
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Definition
| A contraction stress test |
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Term
The nurse is administering magnesium sulfate to a client experiencing severe preeclampsia. What intervention would the nurse implement during the administration of magnesium sulfate for this client?
Schedule a daily ultrasound to assess fetal movement.
Schedule a nonstress test every 4 hours to assess fetal well-being.
Assess the client's temperature every 2 hours because the client is at high risk for infection.
Assess for signs and symptoms of labor since the client's level of consciousness may be altered. |
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Definition
| Assess for signs and symptoms of labor since the client's level of consciousness may be altered. |
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Term
The nurse is caring for a client in active labor. Which intervention would the nurse implement to prevent fetal heart rate decelerations?
Discourage the client from walking.
Increase the rate of the oxytocin infusion.
Monitor the fetal heart rate every 30 minutes.
Encourage upright or side-lying maternal positions. |
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Definition
| Encourage upright or side-lying maternal positions. |
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Term
The nurse in the prenatal clinic is monitoring a client who is pregnant with twins. The nurse monitors the client closely for which priority complication that is associated with a twin pregnancy?
Hemorrhoids
Postterm labor
Maternal anemia
Costovertebral angle tenderness |
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Definition
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Term
A clinic nurse is assessing a prenatal client who has been diagnosed with heart disease. The nurse carefully assesses the client's vital signs, weight, and fluid and nutritional status to detect for complications caused by which pregnancy-related concern?
Rh incompatibility
Fetal cardiomegaly
The increase in circulating blood volume
Hypertrophy and increased contractility of the heart |
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Definition
| The increase in circulating blood volume |
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Term
The nurse is measuring the fundal height on a client who is 36 weeks of gestation when the client reports feeling lightheaded. What finding would the nurse expect to note when assessing the client?
Fear
Anemia
A full bladder
Pallor and hypotension |
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Definition
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Term
The nurse is preparing to measure the fundal height of a client whose fetus is 28 weeks of gestation. In what position would the nurse place the client to perform the procedure?
In a standing position
In the Trendelenburg position
Supine with the head of the bed elevated to 45 degrees
Supine with her head on a pillow and knees slightly flexed |
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Definition
| Supine with her head on a pillow and knees slightly flexed |
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Term
The nurse is assigned to care for a client experiencing hypertonic labor contractions. The nurse plans to conserve the client's energy and promote rest by performing which intervention?
Keeping the TV or radio on to provide distraction
Assisting the client with breathing and relaxation techniques
Keeping the room brightly lit so the client can watch her monitor
Avoiding uncomfortable procedures such as intravenous infusions or epidural anesthesia |
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Definition
| Assisting the client with breathing and relaxation techniques |
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Term
The nurse is reviewing the antenatal history of a several clients in early labor. The nurse recognizes which factor documented in the history as having the potential for causing neonatal sepsis after delivery? Select all that apply.
Of Asian heritage
Two previous miscarriages
Prenatal care began during the third trimester
History of substance abuse during pregnancy
Dietary assessment identified poor eating habits
Spontaneous rupture of membranes 24 hours ago |
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Definition
Prenatal care began during the third trimester
History of substance abuse during pregnancy
Dietary assessment identified poor eating habits
Spontaneous rupture of membranes 24 hours ago |
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Term
The nurse performing a prenatal assessment on a client in the first trimester of pregnancy discovers that the client frequently consumes beverages containing alcohol. Why would the nurse initiate interventions immediately to assist the client in avoiding alcohol consumption?
To reduce the potential for fetal growth restriction in utero
To promote the normal psychosocial adaptation of the mother to pregnancy
To minimize the potential for placental abruptions during the intrapartum period
To reduce the risk of teratogenic effects to embryo's developing fetal organs and tissue |
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Definition
| To reduce the risk of teratogenic effects to embryo's developing fetal organs and tissue |
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Term
The nurse is caring for a client diagnosed with preeclampsia. When the client's condition progresses from preeclampsia to eclampsia, what would the nurse's first action be?
Prepare to maintain an open airway.
Prepare to administer oxygen by face mask.
Assess the maternal blood pressure and fetal heart tones.
Administer an intravenous infusion of magnesium sulfate. |
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Definition
| Prepare to maintain an open airway. |
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Term
he nurse in the newborn nursery is planning for the admission of a large for gestational age (LGA) infant whose mother is diabetic. In preparing to care for this infant, the nurse would obtain equipment to perform which diagnostic test?
Serum insulin level
Heel stick blood glucose
Rh and ABO blood typing
Indirect and direct bilirubin levels |
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Definition
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Term
The nurse is reviewing the results of the rubella screening (titer) with a pregnant client. The test results are positive, and the client asks if it is safe for her toddler to receive the vaccine. Which response by the nurse is most appropriate?
"Most children do not receive the vaccine until they are 5 years of age."
"You are still susceptible to rubella, so your toddler should receive the vaccine."
"It is not advised for children of pregnant women to be vaccinated during their mother's pregnancy."
"Your titer supports your immunity to rubella, and it is safe for your toddler to receive the vaccine." |
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Definition
| "Your titer supports your immunity to rubella, and it is safe for your toddler to receive the vaccine." |
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Term
After delivery, the postpartum nurse instructs the client with known cardiac disease to call for the nurse when she needs to get out of bed or when she plans to care for her newborn infant. Which rationale is the basis for these instructions?
Help the mother assume the parenting role.
Minimize the potential of postpartum hemorrhage.
Provide an opportunity for the nurse to teach newborn infant care techniques.
Avoid maternal or infant injury caused by the potential for syncope or overexertion. |
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Definition
| Avoid maternal or infant injury caused by the potential for syncope or overexertion. |
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Term
A pregnant client is newly diagnosed with gestational diabetes. The client cries when receiving this information and keeps repeating, "What have I done to cause this? If only I could live my life over." Considering this statement, which concern would the nurse identify for the client?
Injury to the fetus because of maternal distress
Low self-esteem because of pregnancy complications
Lack of understanding about diabetic self-care during pregnancy
Poorly perceived body image caused by complications of pregnancy |
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Definition
| Low self-esteem because of pregnancy complications |
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Term
A perinatal client is admitted to the obstetric unit during an exacerbation of a heart condition. When planning for the nutritional requirements, which dietary intervention would the nurse consult the dietitian about?
A low-calorie diet to prevent weight gain
A diet low in fluids and fiber to decrease blood volume
A diet adequate in fluids and fiber to decrease constipation
Unlimited sodium intake to increase circulating blood volume |
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Definition
| A diet adequate in fluids and fiber to decrease constipation |
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Term
A client in the second trimester of pregnancy is being assessed at the primary health care clinic. The nurse notes that the fetal heart rate (FHR) is 100 beats/min. Which nursing action would be appropriate initially?
Document the findings as normal.
Notify the primary health care provider (PHCP) of the finding.
Inform the mother that the assessment is normal and everything is fine.
Instruct the mother to return to the clinic in 8 hours for reevaluation of the FHR. |
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Definition
| Notify the primary health care provider (PHCP) of the finding. |
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Term
A pregnant client is receiving rehabilitative services for alcohol abuse. How would the nurse provide supportive care? Select all that apply.
Assist the client in identifying supportive strategies.
Initiate the possibility of placing the baby up for adoption.
Stress the need for Alcoholics Anonymous (AA) meetings.
Encourage the client to continue counseling after the birth.
Encourage the client to participate in her rehabilitation care.
Minimize communication with codependent family members. |
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Definition
Assist the client in identifying supportive strategies.
Stress the need for Alcoholics Anonymous (AA) meetings.
Encourage the client to continue counseling after the birth.
Encourage the client to participate in her rehabilitation care. |
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Term
Which procedure would be avoided in order to help prevent the transmission of the human immunodeficiency virus (HIV) from a positive pregnant mother to her fetus during the intrapartum period?
Cesarean birth
Epidural anesthesia
External fetal heart rate monitoring
Direct (internal) fetal heart rate monitoring |
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Definition
| Direct (internal) fetal heart rate monitoring |
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Term
The nurse is planning care for a client with an intrauterine fetal demise. Which are appropriate goals for this client? Select all that apply.
The woman's grieving process will be limited to 6 months.
The woman and her family will discuss plans for going home without the infant.
The woman and her family will express their grief about the loss of their desired infant.
The woman will recognize that thoughts of worthlessness and suicide are normal after a loss.
The woman and her family will contact their pastor or grief counselor for support after discharge. |
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Definition
The woman and her family will discuss plans for going home without the infant.
The woman and her family will express their grief about the loss of their desired infant.
The woman and her family will contact their pastor or grief counselor for support after discharge. |
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Term
A client diagnosed with severe preeclampsia is admitted to the hospital. The client is a student at a local college and insists on continuing her studies while in the hospital, despite being instructed to rest. The client studies approximately 10 hours a day and has numerous visits from fellow students, family, and friends. Which intervention would the nurse use to best assist the client with promoting rest?
Ask her why she is not complying with the prescription for bed rest.
Develop a routine with the client to balance her studies and her rest needs.
Include a significant other in helping the client understand the need for bed rest.
Instruct the client that the health of the baby is more important than her studies at this time. |
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Definition
| Develop a routine with the client to balance her studies and her rest needs. |
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Term
A primigravida client who came to the clinic has been diagnosed with a urinary tract infection. She repeatedly verbalizes concern regarding the safety of the fetus. Which would the nurse address first?
Maternal and infant safety
Obtaining a sedative prescription
Instructions regarding improved hygiene
Instructions regarding medication compliance |
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Definition
| Maternal and infant safety |
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Term
The nurse is assessing a pregnant client with a diagnosis of abruptio placentae. Which manifestations of this condition would the nurse expect to note? Select all that apply.
Uterine irritability
Uterine tenderness
Painless vaginal bleeding
Abdominal and low back pain
Strong and frequent contractions
Nonreassuring fetal heart rate patterns |
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Definition
Uterine irritability
Uterine tenderness
Abdominal and low back pain
Nonreassuring fetal heart rate patterns |
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Term
Twelve hours after delivery, the nurse assesses the client for uterine involution. The nurse determines that the uterus is progressing normally toward its prepregnancy state when palpation of the client's fundus is at which level?
At the umbilicus
One finger breadth below the umbilicus
Two finger breadths below the umbilicus
Midway between the umbilicus and the symphysis pubis |
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Definition
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Term
The nurse is performing a prenatal examination on a client in the third trimester. The nurse begins an abdominal examination that includes Leopold maneuvers. What information would the nurse be able to determine after performing the assessment's first maneuver?
Fetal descent
Placenta previa
Fetal lie and presentation
Strength of uterine contractions |
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Definition
| Fetal lie and presentation |
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Term
he nurse is caring for a 33-week pregnant client who has experienced a premature rupture of the membranes (PROM). Which interventions would the nurse expect to be part of the plan of care? Select all that apply.
Perform frequent biophysical profiles.
Monitor for elevated serum creatinine.
Monitor for manifestations of infection.
Teach the client how to count fetal movements.
Use strict sterile technique for vaginal examinations.
Inform the client about the need for tocolytic therapy. |
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Definition
Perform frequent biophysical profiles
Monitor for manifestations of infection.
Teach the client how to count fetal movements.
Use strict sterile technique for vaginal examinations. |
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Term
A pregnant client at 32 weeks of gestation is admitted to the obstetrical unit for observation after a motor vehicle crash. When the client begins experiencing slight vaginal bleeding and mild cramps, which action would the nurse take to determine the viability of the fetus?
Insert an intravenous line and begin an infusion at 125 mL/hr.
Administer oxygen to the woman via a face mask at 7 to 10 L/min.
Position and connect the ultrasound transducer to the external fetal monitor.
Position and connect a spiral electrode to the fetal monitor for internal fetal monitoring. |
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Definition
| Position and connect the ultrasound transducer to the external fetal monitor. |
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Term
The nurse is instructing a pregnant client regarding measures to prevent a recurrent episode of preterm labor. Which statement by the client indicates the need for further teaching?
"I will report any feeling of pelvic pressure."
"I will not engage in sexual intercourse at this time."
"I will adhere to the limitations in activity and stay off my feet."
"I will limit my fluid intake to three 8-ounce glasses of fluid per day." |
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Definition
| "I will limit my fluid intake to three 8-ounce glasses of fluid per day." |
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Term
The nurse is preparing to care for the mother of a preterm infant. When should the nurse plan to begin discharge planning?
When the mother is in labor
When the discharge date is set
After stabilization of the infant during the early stages of hospitalization
When the parents feel comfortable with and can demonstrate adequate care of the infant |
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Definition
| After stabilization of the infant during the early stages of hospitalization |
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Term
A 30-week-gestation client admitted in preterm labor is prescribed betamethasone. What would the nurse tell the client is the purpose for this medication?
Promote fetal lung maturity.
Delay delivery for at least 48 hours.
Stop the premature uterine contractions.
Prevent premature closure of the ductus arteriosus. |
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Definition
| Promote fetal lung maturity. |
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Term
At the last vaginal exam, the client who is in the late first stage of labor was fully effaced, 8 cm dilated, vertex presentation, and station –1. Which observation would indicate that the fetus was in distress?
The fetal heart rate slowly drops to 110 beats/min during strong contractions, recovering to 138 beats/min immediately afterward.
Fresh meconium is found on the examiner's gloved fingers after a vaginal exam, and the fetal monitor pattern remains essentially unchanged.
Fresh, thick meconium is passed with a small gush of liquid, and the fetal monitor shows late decelerations with a variable descending baseline.
The vaginal exam continues to reveal some old meconium staining, and the fetal monitor demonstrates a U-shaped pattern of deceleration during contractions, recovering to a baseline of 140 beats/min. |
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Definition
| Fresh, thick meconium is passed with a small gush of liquid, and the fetal monitor shows late decelerations with a variable descending baseline. |
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Term
A client in the late, active, first stage of labor has just reported a gush of vaginal fluid. The nurse observes a fetal monitor pattern of variable decelerations during contractions followed by a brief acceleration. After that, there is a return to baseline until the next contraction, when the pattern is repeated. On the basis of these data, what is the nurse's initial intervention?
Take the client's vital signs.
Perform a Leopold's maneuver.
Perform a manual sterile vaginal exam.
Test the vaginal fluid with a Nitrazine strip. |
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Definition
| Perform a manual sterile vaginal exam |
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Term
| The nurse is reviewing the records of recently admitted clients to the postpartum unit. The nurse determines that which clients would have an increased risk for developing a puerperal infection? Select all that apply. |
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Definition
A client with a history of previous infections
A client who had numerous vaginal examinations
A client who experienced prolonged rupture of the membranes |
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Term
The nurse is caring for a 33-week pregnant client who has experienced a premature rupture of the membranes (PROM). Which interventions would the nurse expect to be part of the plan of care? Select all that apply.
Perform frequent biophysical profiles.
Monitor for elevated serum creatinine.
Monitor for manifestations of infection.
Teach the client how to count fetal movements.
Use strict sterile technique for vaginal examinations.
Inform the client about the need for tocolytic therapy. |
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Definition
Perform frequent biophysical profiles.
Monitor for manifestations of infection.
Teach the client how to count fetal movements.
Use strict sterile technique for vaginal examinations. |
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Term
The nurse is reviewing the antenatal history of a several clients in early labor. The nurse recognizes which factor documented in the history as having the potential for causing neonatal sepsis after delivery? Select all that apply.
Of Asian heritage
Two previous miscarriages
Prenatal care began during the third trimester
History of substance abuse during pregnancy
Dietary assessment identified poor eating habits
Spontaneous rupture of membranes 24 hours ago |
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Definition
Prenatal care began during the third trimester
History of substance abuse during pregnancy
Dietary assessment identified poor eating habits |
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Term
The nurse caring for a client in labor who has been diagnosed with gestational diabetes would plan to assess the fetal heart rate (FHR) at which specific times? Select all that apply.
Before ambulation
After vaginal examination
After rupture of the membranes
Before turning the client on her side
Before the administration of oxytocin |
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Definition
Before ambulation
After vaginal examination
After rupture of the membranes
Before the administration of oxytocin |
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Term
A client at 35 weeks' gestation reports a sudden discharge of fluid from the vagina. Based on the data provided, which condition would the nurse suspect?
Miscarriage
Preterm labor
Intrauterine fetal demise
Premature rupture of the membranes |
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Definition
| Premature rupture of the membranes |
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Term
A prenatal client is being evaluated for possible gestational diabetes. Which data identified and documented after the nursing assessment would support that diagnosis?
22 years old
A gravida 4, para 0, aborta 3
5' 6" tall, weighs 130 pounds
Stated, "I get really tired after working all day" |
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Definition
| A gravida 4, para 0, aborta 3 |
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Term
The nurse caring for a client in labor who has been diagnosed with gestational diabetes would plan to assess the fetal heart rate (FHR) at which specific times? Select all that apply.
Before ambulation
After vaginal examination
After rupture of the membranes
Before turning the client on her side
Before the administration of oxytocin |
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Definition
Before ambulation
After vaginal examination
After rupture of the membranes
Before the administration of oxytocin |
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Term
A postpartum client with a diagnosis of gestational diabetes is scheduled for discharge. During the discharge teaching, the client asks the nurse, "Do I have to worry about this diabetes anymore?" Which is the most appropriate response by the nurse?
"Your blood glucose level is within normal limits now, so you will be all right."
"You will have to worry about the diabetes only if you become pregnant again."
"You will be at risk for developing gestational diabetes with your next pregnancy and also for developing diabetes mellitus."
"When you have gestational diabetes, you have diabetes forever, and you must be treated with medication for the rest of your life." |
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Definition
| "You will be at risk for developing gestational diabetes with your next pregnancy and also for developing diabetes mellitus." |
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Term
The nurse is performing an assessment on a client who is at 38 weeks’ gestation and notes that the fetal heart rate (FHR) is 174 beats per 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 obstetrician (OB).
4. Tell the client that the fetal heart rate is normal. |
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Definition
| Notify the obstetrician (OB). |
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Term
A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse should determine whether this method of family planning would be most appropriate?
1. “Have 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?” |
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Definition
| “Do you plan to have any other children?” |
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Term
The nurse should make 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 it has a short diameter.”
4. “You will need a cesarean section because this type of pelvis is not favorable for a vaginal delivery.” |
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Definition
| “Your type of pelvis is the most favorable for labor and birth.” |
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Term
A 55-year-old male client confides in the nurse that he is concerned about his sexual function. What is the nurse’s best response?
1. “How often do you have sexual relations?”
2. “Please share with me more about your concerns.”
3. “You are still young and have nothing to be concerned about.”
4. “You should not have a decline in testosterone until you are in your 80s.” |
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Definition
| “Please share with me more about your concerns.” |
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Term
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. |
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Definition
| An informed consent needs to be signed before the procedure. |
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Term
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 be sure to change the tampons every 2 hours.” |
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Definition
| “The vaginal discharge may be bothersome, but is a normal occurrence.” |
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Term
A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The primary 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 section |
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Definition
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Term
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 instruction?
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.” |
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Definition
| “I need to lie flat on my back to perform the procedure.” |
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