Reproduction: Exemplar 33.A Antepartum Care

A client who recently learned of being pregnant tells the nurse that she stopped eating meat years ago and started eating fish daily because it is healthier. Which teaching points are appropriate for this client based on her current diet? Select all that apply.

A) Avoid shrimp, salmon, and catfish because these have higher mercury levels.

B) Eat up to 12 ounces a week of a variety of fish and shellfish.

C) Do not eat more than 6 ounces per week of albacore tuna.

D) Eat plenty of fish such as king mackerel while pregnant.

E) Follow a complete vegetarian diet while pregnant as an alternative to eating fish.

BC

A client at 16 weeks' gestation is diagnosed with tuberculosis (TB). Which statement by the nurse is appropriate when instructing the client regarding the needs for both the client and fetus?

A) "You have been prescribed isoniazid; therefore, you must also take pyridoxine (vitamin B6)."

B) "Your contact with the baby will be limited for several months after delivery."

C) "You will not be able to breastfeed your baby because of this diagnosis."

D) "You are free to have contact with anyone as TB is not contagious when diagnosed during pregnancy."

A

A client who is at 12 weeks' gestation is experiencing nausea, breast tenderness, and fatigue. She tells the nurse her husband is upset with her constant complaints. Which is the priority nursing diagnosis based on this data?

A) Ineffective Breastfeeding

B) Dysfunctional Family Processes

C) Nausea

D) Fatigue

C

The nurse is reviewing exercises with a pregnant woman to help the client maintain physical fitness and appropriate weight gain throughout the pregnancy. After the teaching session, the client tells the nurse that she was taught never to reach over the head because this will harm the baby. Based on this data, which action by the nurse is appropriate?

A) Provide dietary instruction instead to ensure the client does not gain excessive weight.

B) Tell the client to just perform the exercises that don't require her to reach over her head.

C) Provide alternative activities to do instead of exercise.

D) Assure the client that reaching over the head will not harm the baby.

D

The nurse is providing care to a pregnant client and her spouse. The client requires an amniocentesis. Which client statement indicates appropriate understanding of the information presented?

A) "The test has to be done before the 14th week of pregnancy."

B) "If the test determines our baby has Down syndrome, we will not need to take childbirth classes."

C) "It is not unusual for amniocentesis to misdiagnose a problem with the baby."

D) "The results of the amniocentesis will take up to 2 weeks."

D

The nurse is providing care to a pregnant client who is experiencing ptyalism. Which will the nurse include in the plan of care for this client?

A) Use a cool-mist vaporizer

B) Suck on hard candy

C) Avoid use of nasal sprays and decongestants

D) Use low-sodium antacids

B

The nurse is teaching childbirth exercises to a pregnant client with a history of back pain. Which is most appropriate for this client?

A) Perform the pelvic rock exercise only in the standing position.

B) Exercise in the supine position throughout the pregnancy.

C) Perform the pelvic rock exercise while in the hands and knees position.

D) Soak in a hot tub for approximately 30 minutes after exercise.

A

The nurse is providing care to a client with a history of rheumatoid arthritis (RA) who is 5 months pregnant. Which nursing actions are appropriate when providing care to this client? Select all that apply.

A) Telling the client there is an increased risk for preterm delivery because of salicylate therapy

B) Monitoring the client for anemia due to salicylate therapy

C) Suggesting the client begin supplemental pyridoxine

D) Educating the client that medication therapy may be discontinued due to remission

E) Teaching the client that RA may be contracted by the fetus during pregnancy

BD

The nurse is caring for a pregnant client who has asthma. The client has a cold and has an exacerbation of asthma symptoms, including mild wheezing. To help avoid hypoxia-related complications in the fetus, which medication prescription does the nurse anticipate?

A) IV corticosteroid (e.g., prednisone)

B) Oral pseudoephedrine (e.g., Sudafed)

C) Inhaled beta2-agonist (e.g., albuterol)

D) Oral acetylsalicylic acid (e.g., aspirin)

C

Which pregnant client would have the greatest need for a nutritional assessment and individualized meal plan?

A) A client who is lactose intolerant

B) A client who is vegetarian

C) A client who requires a Kosher diet

D) A client with anorexia nervosa

D

The nurse is caring for a 14-year-old client who is pregnant. What will the nurse need to consider that may affect this client more than older adolescents?

A) The client may be more concerned about modesty.

B) The client may be more concerned with state marriage laws.

C) The client may be more concerned about parents finding out about the pregnancy.

D) The client may be more concerned about finding a support person.

A

The nurse is caring for a 36-year-old pregnant woman. She has two children, ages 15 and 13, from a previous marriage, and this is her first child from her second marriage. The client has indicated that her two older children seem very upset by her pregnancy and have been increasingly belligerent the closer she gets to delivery. What can the nurse say to support this family?

A) "It may help to remind your older children that you will still make time for them and that you won't expect them be responsible for the baby unless they want to."

B) "You could tell your older children that the stress and anxiety that comes with a new baby will help improve your family relationships."

C) "They are probably just embarrassed because you are pregnant. They'll get over it once you have the baby."

D) "Your older children probably just want to know what their new roles will be once the baby is born. You should tell them what their re

A