Assessment of High Risk Pregnancy NCLEX Questions

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Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one infant at 32 weeks' gestation, and one infant at 38 weeks' gestation.

  • A. G5 T1 P2 A2 L 2
  • B. G5 T1 P1 A1 L2
  • C. G5 T0 P2 A2 L2
  • D. G5 T1 P1 A2 L2
Correct Answer: D

Rationale: Rationale for Answer D (G5 T1 P1 A2 L2):
- G (Gravida): The patient is in her fifth pregnancy
- T (Term births): She has had one infant at 38 weeks' gestation
- P (Preterm births): She has had one infant at 32 weeks' gestation
- A (Abortions): She has had two spontaneous abortions in the first trimester
- L (Living children): She has 2 living children

Summary of other choices:
- A: Incorrect as it states 2 living children, which is not accurate
- B: Incorrect as it only accounts for one abortion and one living child
- C: Incorrect as it indicates no living children, which is not true based on the given information

Therefore, Answer D is the correct option based on the patient's obstetric history.

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A nurse has provided a young woman with preconception counseling. Which of the statements by the woman indicates that the teaching was successful? Select all that apply.

  • A. “As soon as I think I may be pregnant, I should stop drinking alcohol.”
  • B. “It is important for me to see my medical doctor for a complete physical.”
  • C. “I should make sure that my daily multivitamin contains folic acid.”
  • D. “When I go to my dentist for a checkup I should state that I may be pregnant.”
Correct Answer: A

Rationale: All the statements indicate successful preconception counseling, covering topics such as alcohol cessation, medical checkups, folic acid intake, dental care, and dietary precautions.

At the first prenatal visit, the patient informs the nurse that the first day of her last menstrual period (LMP) was February 18, 2024. Using Naegle's Rule, calculate the patient's EDD.

  • A. 11-Nov-24
  • B. 11-Nov-25
  • C. 25-Nov-24
  • D. 25-Nov-25
Correct Answer: C

Rationale: The correct answer is C: 25-Nov-24. Naegle's Rule is to add 7 days to the first day of the last menstrual period (LMP), then subtract 3 months, and finally add 1 year. In this case, LMP was February 18, 2024. Adding 7 days gives February 25, 2024. Subtracting 3 months gives November 25, 2024. Adding 1 year gives the estimated due date (EDD) of November 25, 2024. Choices A, B, and D are incorrect because they do not follow the correct calculation steps of Naegle's Rule.

The nurse is working with a pregnant woman who states that she is a vegan. Which of the following actions by the nurse is appropriate?

  • A. Advise the mother that she must eat some animal protein during her pregnancy.
  • B. Refer the woman to a nutritionist for diet counseling.
  • C. Remind the mother that cashews and coconut are excellent sources of calcium.
  • D. Congratulate the woman on agreeing to eat eggs and milk.
Correct Answer: B

Rationale: A nutritionist can help ensure the vegan mother receives adequate nutrients, such as B12, iron, and protein, during pregnancy.

What patient symptom at 10 weeks of gestation requires further investigation by the nurse?

  • A. breast tenderness
  • B. infrequent nausea
  • C. change in appetite
  • D. weight loss
Correct Answer: D

Rationale: The correct answer is D: weight loss. At 10 weeks of gestation, weight loss is concerning as it may indicate potential issues like hyperemesis gravidarum or inadequate nutrition, posing risks to both the mother and fetus. Breast tenderness (A), infrequent nausea (B), and changes in appetite (C) are common symptoms during early pregnancy and may not necessarily indicate serious problems. Weight loss (D) should be investigated promptly to ensure the well-being of both the mother and the developing baby.

The nurse is completing the family assessment on a patient at 10 weeks of gestation. What data are included in the family assessment? Select all that apply.

  • A. annual income
  • B. total number of cousins
  • C. number of people living in the household
  • D. person in the household who makes the major decisions for the family
Correct Answer: A

Rationale: The correct answer is A: annual income. This data is crucial for assessing the family's financial resources and potential impact on the patient's health and well-being during pregnancy. Annual income can help identify possible financial stressors that may affect access to healthcare, nutrition, and overall prenatal care.

B: Total number of cousins is not typically part of a family assessment during pregnancy and does not directly impact the patient's prenatal care.

C: Number of people living in the household is important for understanding the household dynamics, but it may not be directly related to the patient's prenatal care needs.

D: Identifying the person in the household who makes major decisions is important for understanding family dynamics, but it may not directly impact the patient's prenatal care.

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