OB: Chapter 20 PrepU

A client who is 10 weeks' pregnant reports during a social assessment interview that they have two indoor cats, live alone, fix their own meals, and enjoy gardening. What precautions would the nurse recommend the client take to prevent the possibility of contracting toxoplasmosis? Select all that apply.

A. Use gloves when planting their vegetable garden.

B. Hire someone to empty the litter box in the house.

C. Make sure meats are cooked to 152ºF (66.7℃); do not eat raw or rare meats.

D. Wash all fruits and vegetables in hot, soapy water before eating.

E. Receive the vaccination as soon as possible to prevent contracting the disease.

A. Use gloves when planting their vegetable garden.

B. Hire someone to empty the litter box in the house.

C. Make sure meats are cooked to 152ºF (66.7℃); do not eat raw or rare meats.

A 20-year-old pregnant client is positive for hemoglobin S. The nurse explains to the client that the client will need perform which actions during their pregnancy? Select all that apply.

A. Drink lots of fluids.

B. Eat high-protein meals.

C. Be on bed rest.

D. Avoid conditions of low oxygen tension, such as high altitudes.

A. Drink lots of fluids.

D. Avoid conditions of low oxygen tension, such as high altitudes.

A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? Select all that apply.

A. client age less than 18 years

B. genitourinary tract abnormalities

C. obesity

D. hypertension

E. previous large-for-gestational-age (LGA) infant

C. obesity

D. hypertension

E. previous large-for-gestational-age (LGA) infant

A pregnant client is screened for tuberculosis during their first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. Which sign would indicate a positive test result?

A. An indurated wheal under 10 mm in diameter appears in 6-12 hours

B. An indurated wheal over 10 mm in diameter appears in 48-72 hours

C. A flat, circumscribed area under 10 mm in diameter appears in 6-12 hours

D. A flat, circumscribed area over 10 mm in diameter appears in 48-72 hours

B. An indurated wheal over 10 mm in diameter appears in 48-72 hours

At 24 weeks' gestation, a client's 1-hour glucose tolerance test is elevated. The nurse explains that, based on this finding, the client will need to take which action?

A. A 3-hour glucose tolerance test for follow-up

B. Daily insulin injections for GD

C. Monthly hemoglobin A1C levels to rule out diabetes

D. Daily fingersticks for a fasting blood glucose level

A. A 3-hour glucose tolerance test for follow-up

A client who has sickle cell anemia asks the nurse if their infant will develop sickle cell disease. The nurse would base the answer on which information?

A. Sickle cell anemia is recessively inherited

B. Sickle cell anemia has more than one polygenic inheritance pattern

C. Sickle cell anemia is dominantly inherited

D. Sickle cell anemia is not inherited; it occurs following a malaria infection

A. Sickle cell anemia is recessively inherited

A nurse is performing an assessment on a new client. The client estimates that they are approximately 16 weeks pregnant. While assessing the client, the nurse asks about apparent scratch marks on the client's hands, and the client tells the nurse that they have three cats at home. What screening would be prescribed for this client?

A. Cytomegalovirus

B. Toxoplasmosis

C. Hep C

D. Herpes simplex virus

B. Toxoplasmosis

A pregnant client with sickle cell anemia is very concerned their infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse?

A. Both parents have to carry the trait

B. There is a good chance the infant will inherit the disease from the birthing parent

C. The infant inherits the disease from the male parent

D. If the birthing parent goes into a crisis while pregnant, the infant will develop sickle cell anemia

A. Both parents have to carry the trait

A client with cardiac disease at 32 weeks' gestation reports they have been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize?

A. Decrease activity and rest more often

B. Increase fluids and take more vitamins

C. Bed rest and bathroom privileges only until birth

D. Discuss induction of labor with the health care provider

A. Decrease activity and rest more often

A nursing instructor is teaching students about anemia during pregnancy. Which type of anemia does the instructor teach students is most prevalent during pregnancy?

A. Sickle-Cell Anemia

B. Pernicious Anemia

C. Iron-deficiency Anemia

D. Folic acid Anemia

C. Iron-deficiency Anemia

A nurse is caring for a pregnant adolescent client, who is in the first trimester, during a visit to the clinic. Which important area should the nurse address during assessment of the client?

A. sexual development of the client

B. options for birth control in the future

C. Whether sex was consensual

D. Knowledge of child development

D. Knowledge of child development

The nurse is teaching a pregnant client about how to prevent contracting cytomegalovirus (CMV) during pregnancy. What tips would the nurse share with this client? Select all that apply.

A. Do not share food or drinks with young children, especially if they are in day care.

B. If you develop any flu-like symptoms, notify your pratitioner immediately to be evaluated for CMV.

C. Wash your hands thoroughly with soap and water after touching saliva or urine.

D. If you have CMV, it is suggested that you not breastfeed your infant

E. If you contract CMV, your practitioner will give you some oral medicine to treat it.

A. Do not share food or drinks with young children, especially if they are in day care.

B. If you develop any flu-like symptoms, notify your pratitioner immediately to be evaluated for CMV.

C. Wash your hands thoroughly with soap and water after touching saliva or urine.

In preparing a class for pregnant couples, the nurse includes information about possible newborn complications associated with smoking during pregnancy. Which complication(s) will the nurse include? Select all that apply.

A. low birth weight

B. trisomy 21

C. sudden unexpected infant death

D. cerebral palsy

E. cleft lip and palate

A. low birth weight

C. sudden unexpected infant death

D. cerebral palsy

E. cleft lip and palate

The nurse encourages a client with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise them to take which action?

A. eat a sustaining-carbohydrate snack

B. inject a bolus of insulin

C. eat a high-carbohydrate snack

D. add a bolus of long-acting insulin

A. eat a sustaining-carbohydrate snack

A pregnant client is talking to the nurse and is concerned about managing their asthma while they are pregnant. Which response to the nurse's teaching indicates that the client needs further instruction?

A. "It is fine for me to use my albuterol inhaler if I begin to feel tight."

B. "I need to be aware of my triggers and avoid them as much as possible."

C. "I will monitor my peak expiratory flow rate regularly to help me predict when an asthma attack is coming on."

D. "I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring."

D. "I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring."

A 29-year-old client has gestational diabetes. The nurse is teaching the client about managing their glucose levels. Which therapy would be most appropriate for this client?

A. glucagon

B. oral hypoglycemic drugs

C. long-acting insulin

D. diet

D. diet

The nurse explains to a pregnant client that they will need to take iron during pregnancy after being diagnosed with iron-deficiency anemia. The nurse suggests that absorption of the supplemental iron can be increased by taking it with which substance?

A. legumes

B. meals high in iron

C. milk

D. orange juice

D. orange juice

The nurse is assessing a pregnant client with a known history of congestive heart failure who is in the third trimester. Which assessment findings should the nurse prioritize?

A. shortness of breath, bradycardia, and hypertension

B. increased urinary output, tachycardia, and dry cough

C. regular heart rate and hypertension

D. dyspnea, crackles, and irregular weak pulse

D. dyspnea, crackles, and irregular weak pulse

A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize?

A. diuretic drugs

B. IV fluids

C. antihypertensive drugs

D. antibiotics

B. IV fluids

A new parent has tested positive for HIV. When discussing the situation with the client, the nurse should advise the client that they should avoid which activity?

A. breastfeeding

B. handling the infant with open sores

C. future pregnancies

D. cesarean birth

A. breastfeeding

A nurse is providing education to a client at 28 weeks' gestation who has tested positive for gestational diabetes mellitus (GDM). What would be important for the nurse to include in the client teaching?

A. The infant is at increased risk for neonatal diabetes mellitus.

B. The infant is at increased risk for type 1 diabetes mellitus.

C. The client is at increased risk for type 1 diabetes mellitus after the infant is born.

D. The client is at increased risk for type 2 diabetes mellitus after the infant is born.

D. The client is at increased risk for type 2 diabetes mellitus after the infant is born.

A nurse is teaching a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority?

A. administration of immunoglobulins

B. consumption of a low-fat diet

C. avoidance of infection

D. constipation prevention

C. avoidance of infection

A client is diagnosed with peripartum cardiomyopathy (PPCM). Which therapy should the nurse expect to administer to the client?

A. restricted sodium intake

B. monoamine oxidase inhibitors (MAOIs)

C. ginger therapy

D. methadone therapy

A. restricted sodium intake

A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum?

A. assessing for cardiac decompensation

B. limiting sodium intake

C. inspecting the extremities for edema

D. ensuring that the client consumes a high fiber diet

A. assessing for cardiac decompensation

A pregnant client with diabetes is having a glycosylated hemoglobin (HgbA1C) level drawn. Which result would require the nurse to revise the client's plan of care?

A. 7%

B. 8.5%

C. 0.6%

D. 5.5%

B. 8.5%

Which neonate is at highest risk for developing neonatal herpes following birth?

A. A newborn who was a vaginal delivery to a client with no active lesions but a history of herpes.

B. A newborn who was a vaginal delivery to a client who had their initial outbreak during the third trimester of pregnancy and has active lesions

C. A newborn who was delivered by cesarean section following prolonged rupture of membranes to a herpes positive client with no active lesions

D. A newborn who was delivered by cesarean section to a client with genital herpes

B. A newborn who was a vaginal delivery to a client who had their initial outbreak during the third trimester of pregnancy and has active lesions

A pregnant client with diabetes is having their hemoglobin (glycosylated) level evaluated. The nurse determines that the client's glucose is under control and continues the client's plan of care based on which result?

A. 6.5%

B. 7.5%

C. 8.5%

D. 8.0%

A. 6.5%

The health nurse is caring for a pregnant client with a history of asthma who requires maintenance medication for the management of the disease. Which action by the nurse best reinforces information provided to the client regarding maintenance of their health?

A. Observe the client taking their inhaler.

B. Ask the client to show the nurse deep breathing techniques.

C. .Review the client's peak flow meter readings.

D. Teach the client how to use a spacer with an inhaler.

A. Observe the client taking their inhaler.