Nokea
The nurse is caring for the 24-year-old client whose pregnancy history is as follows: elective termination age 18 years, spontaneous abortion age 21 years, term vaginal delivery at 22 years old, and currently pregnant again. Which documentation by the nurse of the client’s gravidity and parity is correct?
- A. G4P1
- B. G4P2
- C. G3P1
- D. G2P1
Correct Answer: A
Rationale: The client has been pregnant four times in all (gravidity). This client has delivered once (parity) and is currently pregnant, so the parity is 1. Although the client has been pregnant four times in all (gravidity), she would have had to deliver two fetuses over 20 weeks old, regardless of whether either fetus survived. The client has been pregnant four times in all, not three (gravidity). Parity of 1 is correct. The client has been pregnant four times in all, not two times (gravidity). Parity of 1 is correct.
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The nurse is caring for the pregnant client at the initial prenatal visit. Which universal screenings should the nurse complete? Select all that apply.
- A. Taking the client’s blood pressure
- B. Doing a urine dipstick test for protein
- C. Doing a urine dipstick test for glucose
- D. Asking questions about domestic violence
- E. Asking questions about use of tobacco
Correct Answer: A,D,E
Rationale: BP screening should be performed at the initial prenatal visit to establish a baseline and to evaluate for actual or potential problems. Domestic violence screening should be performed at the initial prenatal visit to determine fetal and maternal risk for harm. Screening for tobacco use should be performed at the initial prenatal visit to determine fetal and maternal risk. Smoking is associated with an increased risk for spontaneous abortion, preterm labor, and low birth weight. The use of routine urine dip assessments is unreliable in detecting proteinuria and is not always considered accurate. A urine sample should be collected and a UA completed to check for a UTI. The urine dipstick test is of insufficient sensitivity to be used as a screening tool for glycosuria and is not always considered accurate. A urine sample should be collected and a UA completed to check for the presence of glucose.
The nurse is teaching the client who is wishing to travel by airplane during the first 36 weeks of her pregnancy. Which is the primary risk of air travel for this client that the nurse should address?
- A. Risk of preterm labor
- B. Deep vein thrombosis
- C. Spontaneous abortion
- D. Nausea and vomiting
Correct Answer: B
Rationale: The primary risk with air travel during pregnancy is DVT. Pregnancy increases the risk of blood coagulation, and prolonged sitting produces venous stasis. Preterm labor is not associated with air travel. The threat of spontaneous abortion diminishes during the second trimester. Spontaneous abortion is not associated with air travel. Although nausea and vomiting can occur, they are not dangerous.
The nurse is caring for the client in preterm labor who has gestational diabetes. The nurse determines that the client has a reactive NST when which findings are noted?
- A. Two fetal heart rate (FHR) accelerations of 15 beats per minute (bpm) above baseline for at least 15 seconds in a 20-minute period
- B. An FHR acceleration of 15 bpm above baseline for at least 10 seconds in the 40-minute time period for the NST
- C. Two FHR accelerations of 20 bpm above baseline when the mother changes position during the 20-minute NST
- D. The occurrence of at least three mild repetitive variable decelerations in the 20-minute time period for the NST
Correct Answer: A
Rationale: The FHR is monitored by the placement of an electronic fetal monitor that has an ultrasound transducer to record the FHR and a tocodynamometer to detect uterine or fetal movement. The client is given a handheld marker to indicate when she feels fetal movement. Fetal movement is accompanied by an increase in the FHR in the healthy fetus. The criterion for a reactive (normal) NST is the presence of two FHR accelerations of 15 bpm above baseline lasting 15 seconds or longer in a 20-minute period. One FHR acceleration during a 40-minute period is insufficient and indicates a nonreactive (abnormal) NST. Maternal movement can cause an inconsistency in the FHR on the monitor strip and should be avoided during an NST. The occurrence of at least three mild repetitive variable decelerations in a 20-minute period describes a nonreactive (abnormal) NST and fetal intolerance.
The nurse recommends which supplement for a vegetarian pregnant client?
- A. Vitamin B12
- B. Vitamin C
- C. Calcium
- D. Magnesium
Correct Answer: A
Rationale: Vitamin B12 supplementation is crucial for vegetarian pregnant clients, as it is primarily found in animal products and supports fetal neurological development.
Which intervention is most appropriate for a client experiencing low self-esteem during pregnancy?
- A. Encourage participation in a prenatal support group
- B. Prescribe antidepressants immediately
- C. Advise avoiding social interactions
- D. Ignore the issue as it is common
Correct Answer: A
Rationale: A prenatal support group fosters peer support and boosts self-esteem, addressing the client's emotional needs.