83. Another nurse is caring for a 29-weeks-pregnant woman who presents with decreased fetal movement

83. Another nurse is caring for a 29-weeks-pregnant woman who presents with decreased fetal movement. Her initial blood pressure (BP) reading is 140/90 mm Hg. She states she “doesn’t feel well” and her vision is “blurry.” Additional assessment data include +3 reflexes, +2 proteinuria, +2 pedal edema, and puffy face and hands. What is the most important information that the nurse should obtain from the client’s prenatal record? a. Urine dip stick from last visit b. BP at 20 weeks c. BP at her first prenatal visit d. Weight gain pattern 84. A client is attempting to deliver vaginally despite the fact that her previous delivery was by cesarean birth. Her contractions are 2 to 3 minutes apart, lasting from 75 to 100 seconds. Suddenly, the client complains of intense abdominal pain, and the fetal monitor stops picking up contractions. The nurse recognizes that which of the following has occurred? a. Abruptio placentae b. Prolapsed cord c. Partial placenta previa d. Complete uterine rupture 85. A woman presents with vaginal bleeding at 7 weeks. What is the primary nursing intervention for a woman who is bleeding during the first trimester? a. Have oxygen available b. Assess family’s response to the situation c. Monitor vital signs d. Prepare equipment for examination 86. A client is receiving magnesium sulfate to help suppress preterm labor. The nurse should watch for which sign of magnesium toxicity? a. Palpitations b. Headache c. Loss of deep tendon reflexes d. Dyspepsia 87. A 38-year-old pregnant woman has just been told she has hydramnios after undergoing a sonogram for size greater than dates. For which conditions, associated with hydramnios, should the nurse assess? SELECT ALL THAT APPLY. i. Presence of major congenital anomaly ii. Chronic hypertension iii. Infections iv. Gestational diabetes v. Preeclampsia a. I, II, IV b. II, IV, V c. I, II, III d. I, III, IV 88. A pregnant client presents with vaginal bleeding and increasing cramping. Her exam reveals that the cervical os is open. Which term should the nurse expect to see in the client’s chart notation to most accurately describe the client’s condition? a. Complete abortion b. Imminent abortion c. Ectopic pregnancy d. Incomplete abortion 89. A nurse admits a woman with a diagnosis of placenta previa. Which symptom is the nurse most likely to assess in a woman with this diagnosis? a. Painful vaginal bleeding b. Painless vaginal bleeding c. Contractions d. Absence of fetal movement 90. A pregnant client (G7P5) presents after being advised she has a missed abortion. She tells a nurse that she wants to wait and let the pregnancy pass “naturally.” Which length of time should the nurse tell the client is the longest she can wait before having a dilatation and curettage (D&C) after being diagnosed with a missed abortion? a. 4-6 weeks b. 72 hours c. 6-8 weeks d. 24 hours 91. A pregnant client is concerned because she is now 14 days over her due date. A nurse should monitor the client for which most concerning problem for a post-term fetus? a. Meconium-stained amniotic fluid b. Birth trauma c. Fetal demise d. Macrosomia 92. A nurse caring for a 30-weeks-pregnant client is having contraction every 2 minutes with spontaneous rupture of membranes about 2 hours ago. Her cervix is dilated at 8cm and 100% effaced. The nurse knows that this is an imminent delivery and should perform which most important action? a. Providing teaching information on premature infant care b. Administering a tocolytic agent c. Preparing for a cesarean birth d. Notifying neonatology of the impending birth 93. Which complications should the nurse identify as being associated with gestational diabetes? SELECT ALL THAT APPLY. i. Congenital anomalies ii. Seizures iii. Low birth weight infant iv. Preterm labor v. Large for gestational age infant a. I, II, IV, V b. I, V c. I, IV, V d. I, IV 94. A client who is 20 days postpartum calls the perinatal clinic nurse to report that she has been having heavy bright red bleeding since leaving the hospital 18 days ago. What should the nurse instruct the client to do? a. Stop being concerned because this is expected after birth b. Call again next week if the bleeding has not stopped by then c. Come to the clinic immediately d. Decrease physical activity until the bleeding stops 95. A multigravida client with mild preeclampsia should have which of the following diets? a. Low-sodium diet b. Regular diet c. High-protein diet d. High-residue diet 96. After instructing a primigravid client at 38 weeks’ gestation about how preeclampsia can affect the client and the growing fetus, the nurse realizes that the client needs additional instruction when she says that preeclampsia can lead to which of the following? a. Abruptio placentae b. Hydrocephalic infant c. Intrauterine growth retardation d. Poor placental transfusion 97. A 18-year-old client at 32 weeks’ gestation with mild preeclampsia is treated as an outpatient. The nurse instructs the client to contact the health care provider immediately if she experiences which of the following? a. Ankle edema b. Increased energy levels c. Blurred vision d. Mild backache 98. A primigravid client at 38 weeks’ gestation diagnosed with severe preeclampsia is prescribed with magnesium sulfate. Which of the following medications should the nurse have readily available at the client’s bedside? a. Calcium gluconate b. Phenytoin c. Diazepam d. Hydralazine 99. Which of the following should the nurse do FIRST if the client with sever preeclampsia begins to experience a seizure? (18) a. Insert an airway to improve oxygenation b. Note the time when the seizure begins and ends c. Call for immediate assistance d. Turn the client to her left side 100. A nurse has been given a report on a postpartum client that includes the information that the client suffered a fourth-degree perineal laceration during her vaginal birth. In response to this information, which intervention should the nurse add to the client’s plan of care? a. Monitor the uterus for firmness every 2 hours. b. Instruct the client on a high-fiber diet and administer stool softeners. c. Limit ambulation to bathroom privileges only. d. Decrease fluid intake to 1,000 mL every 24 hours. 101. A multigravid client at 34 weeks’ gestation visits the hospital because she suspects that her water has broken. After testing the leaking fluid with nitrazine paper, the nurse confirms that the client’s membranes have ruptured when the paper turns which of the following colors? a. Yellow b. Green c. Blue d. Red 102. A primigravid client at 34 weeks’ gestation is experiencing contractions every 3 to 4 minutes lasting for 35 seconds. Her cervix is 2 cm dilated and 50% effaced. While the nurse is assessing the client’s vital signs, the client says, “I think my bag of water just broke.” Which of the following would the nurse do first? a. Check the status of the fetal heart rate. b. Turn the client to her right side. c. Test the leaking fluid with nitrazine paper. d. Perform a sterile vaginal examination. 103. A client in sickle cell crisis was admitted during her pregnancy. Which statement by the client requires intervention from the nurse? a. “At the earliest signs of a crisis, I need to seek treatment.” b. “I have this disease because I don’t eat enough food with iron.” c. “I will need more frequent appointments during the remainder of the pregnancy.” d.”Signs of any type of infection must be reported immediately.” 104. The nurse assessed a positive Homan sign in a multiparous client who delivered 24 hours ago. What should the nurse do? a. Ask the client to ambulate around the room. b. Place a cold pack on the client’s perineal area. c. Place the client in semi-Fowler’s position. d. Notify the client’s physician immediately. 105. A postpartum client is diagnosed with cystitis. The nurse should plan for which priority nursing action in the care of the client? a. Placing ice on the perineum b. Providing sitz baths c. Encouraging fluid intake d. Monitoring hemoglobin and hematocrit levels

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