Pregnancy Assessment Questions

Pregnancy Assessment Questions Related

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The nurse is admitting a client, who reports, 'My water broke yesterday, and I haven't felt my baby move any today.' She is 38 weeks with a history of gestational diabetes. Which assessment data is of most concern to the nurse on admission?

  • A. Maternal vital signs: T 100.2, HR 104, RR 20, BP 136/82
  • B. Pain score 6/10
  • C. Minimal variability and variable decelerations
  • D. 5 cm/80% effaced/0 station
Correct Answer: C

Rationale: The correct answer is C because minimal variability and variable decelerations on fetal heart monitoring indicate fetal distress, which is a critical concern. Minimal variability suggests the baby's nervous system is compromised, and decelerations can indicate umbilical cord compression or placental insufficiency, possibly leading to fetal hypoxia. This situation requires immediate intervention to prevent potential harm to the baby.

Choice A is incorrect as the vital signs are slightly elevated but not as concerning as fetal distress. Choice B is incorrect as pain score is subjective and not as critical as fetal well-being. Choice D is incorrect as cervical dilation/effacement/station is important for labor progress but not as concerning as fetal distress in this scenario.

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Which laboratory result would be a cause for concern if exhibited by a patient at her first prenatal visit during the second month of her pregnancy?

  • A. Rubella titer, 1:6
  • B. Platelets, 300,000/mm3
  • C. White blood cell count, 6000/mm3
  • D. Hematocrit 38%, hemoglobin 13 g/dL
Correct Answer: A

Rationale: The correct answer is A: Rubella titer, 1:6. A low rubella titer indicates susceptibility to rubella infection, which can be harmful during pregnancy. Rubella can lead to birth defects or miscarriage. Platelets, WBC count, and hematocrit/hemoglobin levels are within normal range and not typically concerning during the early stages of pregnancy.

Which finding indicates the best quality improvement process?

  • A. Staff identifies the wait time in the emergency department is too long.
  • B. Administration identifies the design of the facility’s lobby increases patient stress.
  • C. Director of the hospital identifies the payment schedule does not pay enough for overtime.
  • D. Health care providers identify the inconsistencies of some of the facility’s policy and procedures.
Correct Answer: A

Rationale: The quality improvement process begins at the staff level, where problems are defined by the staff. It is not identified by administration, the hospital director, or health care providers.

The nurse is discussing the methods of confirming the pregnancy with a patient at the first prenatal visit. What method is used to confirm cardiac activity of the fetus?

  • A. bimanual exam
  • B. pelvic ultrasound
  • C. serum pregnancy test
  • D. urine pregnancy test
Correct Answer: B

Rationale: The correct answer is B: pelvic ultrasound. Pelvic ultrasound is used to confirm the presence of cardiac activity in the fetus by visualizing the fetal heartbeat. This method is the most accurate and reliable way to confirm the viability of the pregnancy. A bimanual exam (choice A) is a physical examination technique that assesses the size and shape of the uterus but does not confirm fetal cardiac activity. Serum pregnancy test (choice C) and urine pregnancy test (choice D) detect the presence of human chorionic gonadotropin (hCG) hormone in the blood or urine, indicating pregnancy, but do not confirm fetal cardiac activity.

The triage nurse in an obstetric clinic received the following four messages during the lunch hour. Which of the women should the nurse telephone first?

  • A. My section incision from last week is leaking a whitish yellow discharge and I have a fever. What should I do?'
  • B. I am 39 weeks pregnant with my first baby. I am having contractions about every ten minutes.'
  • C. My boyfriend and I had intercourse this morning and our condom broke. What should we do?'
  • D. I started my period yesterday. I need some medicine for these terrible menstrual cramps.'
Correct Answer: A

Rationale: A fever and discharge from a surgical incision could indicate an infection, which requires immediate attention. The other situations, while important, are less urgent.

A client, 6 cm and 80% effaced, has just received Demerol (meperidine) 50 mg IV for pain. Which of the following fetal heart changes would the nurse expect to observe on the internal fetal monitor tracing?

  • A. Drop in baseline heart rate.
  • B. Increase in number of variable decelerations.
  • C. Decrease in variability.
  • D. Rise in number of early decelerations.
Correct Answer: C

Rationale: Demerol can cross the placenta and cause decreased variability in the fetal heart rate.

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