Nokea
On the first prenatal visit, an examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as:
- A. Chadwick's sign
- B. Goodell's sign
- C. Hegar's sign
- D. Homan's sign
Correct Answer: A
Rationale: Chadwick's sign is bluish discoloration of the cervix and vagina from increased blood flow, seen early in pregnancy. Goodell's is cervical softening, Hegar's is uterine softening, and Homan's indicates thrombosis, not pregnancy.
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A pregnant woman undergoes a triple/quadruple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's alpha-fetoprotein (AFP) level is decreased?
- A. Sickle-cell anemia
- B. Cardiac defects
- C. Down syndrome
- D. Respiratory disorders
Correct Answer: C
Rationale: Decreased AFP, with altered hCG and estriol, suggests Down syndrome (trisomy 21). Sickle-cell anemia, cardiac defects, and respiratory disorders don't typically lower AFP; cardiac defects may raise it.
A pregnant woman in the 36th week of gestation reports that her feet are quite swollen at the end of the day. After careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. Which intervention is appropriate for the nurse to suggest?
- A. Wear spandex-type full-length pants
- B. Try elevating your legs when you sit
- C. Limit your intake of fluids
- D. Eliminate salt from your diet
Correct Answer: B
Rationale: Elevating legs reduces swelling by aiding venous return, a safe intervention for late-pregnancy edema. Tight pants worsen swelling, limiting fluids risks dehydration, and eliminating salt disrupts electrolytes.
Which compound would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?
- A. Ferrous sulfate
- B. Potassium chloride
- C. Calcium carbonate
- D. Calcium gluconate
Correct Answer: D
Rationale: Calcium gluconate reverses magnesium toxicity (e.g., respiratory depression), a risk with magnesium sulfate used for preeclampsia. Ferrous sulfate treats anemia, potassium chloride corrects hypokalemia, and calcium carbonate is an antacid, none addressing toxicity.
A client comes to the prenatal clinic for her first visit. When determining the client's estimated due date, the nurse understands which method is the most accurate.
- A. Nagele's rule
- B. Ultrasound
- C. Gestation wheel
- D. Birth calculator
Correct Answer: B
Rationale: Ultrasound in the first trimester measures fetal size accurately for due date estimation, unlike Nagele's rule, gestation wheel, or calculators, which rely on less precise menstrual data or assumptions.
Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy?
- A. Recurrent pelvic infections
- B. Ovarian cyst 2 years ago
- C. Use of oral contraceptives for 8 years
- D. Heavy, irregular periods
Correct Answer: A
Rationale: Recurrent pelvic infections (e.g., PID) scar fallopian tubes, increasing ectopic pregnancy risk by hindering egg transport. Ovarian cysts, oral contraceptives (which reduce risk), and irregular periods don't directly contribute.