Maternity Nursing UWORLD Complete guide, Questions, answers/ Explained

Maternity Nursing A client at 34 weeks gestation has constipation. The client has been taking 325 mg ferrous sulfate tid for anemia since the last appointment 4 weeks ago. Which instructions should the nurse recommend for this client? Select all that apply. Unordered Options Ordered Response 1. Decrease total daily dairy intake 2. Increase intake of fruits and vegetables 3. Moderate-intensity regular exercise 4. One cup of hot coffee each morning 5. One laxative twice daily for a week A 28-year-old client is admitted to the labor and delivery unit for severe preeclampsia. She is started on IV magnesium sulfate infusion. Which signs indicate that the client has developed magnesium sulfate toxicity? Select all that apply. Unordered Options Ordered Response 1. 0/4 patellar reflex 2. Blood pressure is 156/84 mm Hg 3. Client voided 600 mL in 8 hours 4. Respirations are 10/min 5. Serum magnesium level is 6 mg/dL A client is at 24 weeks gestation and preeclampsia-eclampsia syndrome is suspected. Which of the following are significant signs/symptoms criteria related to this syndrome? Select all that apply. Unordered Options Ordered Response 1. 2+ pitting pedal edema 2. 300 mg/24 hr (0.3 g/day) protein in urine 3. Frequent urination 4. Headache, blurry vision 5. Hemoglobin 10 g/dL (100 g/L) A client at 20 weeks gestation states that she started consuming an increased amount of cornstarch about 3 weeks ago. Based on this assessment, the nurse should anticipate that the health care provider will order which laboratory test(s)? Unordered Options Ordered Response 1. Hemoglobin and hematocrit levels 2. Human chorionic gonadotropin level 3. Serum folate level 4. White blood cell count A client comes to the health care provider for a checkup. The client is G5T1P2A1L2M. Which explanation(s) represent a correct understanding of this terminology? Select all that apply. Unordered Options Ordered Response 1. The client had 1 child born later than 37 weeks gestation 2. The client had 1 pregnancy that ended before 20 weeks gestation 3. The client is currently pregnant 4. The L indicates the number of live births 5. The P indicates parity, the number of deliveries after 20 weeks gestation A client at 30 weeks gestation is hospitalized for preeclampsia. Which assessment finding requires priority intervention? Unordered Options Ordered Response 1. Elevated liver enzymes 2. Lower abdominal pain and vaginal bleeding 3. Swelling of the hands, feet, and face 4. Urine output of 25 mL/hr A client who reports sudden-onset severe right lower abdominal pain and dizziness is being evaluated for suspected ectopic pregnancy. Which assessment findings should the nurse anticipate? Select all that apply. Unordered Options Ordered Response 1. Blood pressure 82/64 mm Hg 2. Crackles on auscultation 3. Distended jugular veins 4. Pulse 120/min 5. Shoulder pain A client who reports sudden-onset severe right lower abdominal pain and dizziness is being evaluated for suspected ectopic pregnancy. Which assessment findings should the nurse anticipate? Select all that apply. Unordered Options Ordered Response 1. Blood pressure 82/64 mm Hg 2. Crackles on auscultation 3. Distended jugular veins 4. Pulse 120/min 5. Shoulder pain The nurse is returning the results of a urine pregnancy test to a client currently taking several medications. Which of the following prescriptions are contraindicated in pregnancy? Select all that apply. Unordered Options Ordered Response 1. Doxycycline 2. Fluticasone 3. Insulin aspart 4. Isotretinoin 5. Lisinopril 6. Thyroxine A 36-year-old multigravida is admitted with a diagnosis of severe preeclampsia. IV magnesium sulfate is prescribed. Which nursing measures should the nurse include in this client's plan of care? Select all that apply. Unordered Options Ordered Response 1. Assess for right upper quadrant pain 2. Check deep tendon reflex frequently 3. Ensure bright lighting to prevent falls 4. Ensure calcium gluconate is available 5. Have suction equipment ready to use A client comes to the clinic indicating that a home pregnancy test was positive. The client's last menstrual period (LMP) was September 7. Today is December 7. Which of the following are true statements for this client? Select all that apply. Unordered Options Ordered Response 1. According to Naegele's Rule, the expected date of delivery (EDD) is June 14 2. Auscultation of the fetal heart rate is possible 3. Fundal height should be 24 cm above the symphysis pubis 4. The client should be feeling fetal movement 5. Urinary frequency is a common sign A client visits the prenatal clinic for the first time. Which of the following are presumptive signs of pregnancy that the client may report during the intake assessment by the nurse? Select all that apply. Unordered Options Ordered Response 1. Breast fullness and tenderness 2. Last menstrual period 8 weeks ago 3. Nausea and vomiting that are worsening every day 4. Painless contractions at irregular intervals 5. Positive home pregnancy test 3 weeks ago A 27-year-old client at 10 weeks gestation comes to the prenatal clinic. Which vaccines can be safely given to this client during the pregnancy? Select all that apply. Unordered Options Ordered Response 1. Influenza inactivated vaccine 2. Influenza nasal spray vaccine 3. Measles-mumps-rubella vaccine (MMR) 4. Tetanus, diphtheria, and pertussis (Tdap) immunization 5. Varicella vaccine The nurse is teaching a client, gravida 1 para 0, at 8 weeks gestation about expected weight gain in pregnancy. The client's prepregnancy BMI is 21 kg/m2. Which of the following statements made by the client indicates an understanding about weight gain? Unordered Options Ordered Response 1. "I should gain 10 lb (4.5 kg) during the first trimester." 2. "I should gain about 30 lb (13.6 kg) during pregnancy." 3. "I should gain no more than 0.5 lb (0.2 kg) per week during the second and third trimesters." 4. "If I keep my weight gain to less than 20 lb (9.1 kg) during pregnancy, it will be easier to lose it after the baby is born." Which client in a prenatal clinic should the nurse assess first? Unordered Options Ordered Response 1. An 11-week gestation client with backache and 5-lb (2.26-kg) weight gain since conception 2. A 16-week gestation client with hemorrhoid pain and sinus congestion 3. A 21-week gestation client with blurred vision and increased facial edema 4. A 32-week gestation client with chloasma and urinary frequency A nurse is caring for a pregnant client who has hyperemesis gravidarum. Which assessment findings should the nurse anticipate? Select all that apply. Unordered Options Ordered Response 1. Blood pressure 160/94 mm Hg 2. Large urine protein 3. Positive urine ketones (moderate) 4. Pulse 106/min 5. Urine specific gravity 1.010 A client at 39 weeks gestation is brought to the emergency department after a motor vehicle crash. The client, who is secured supine on a backboard, suddenly becomes pale with a blood pressure of 88/50 mm Hg. What action should the nurse take first? Unordered Options Ordered Response 1. Administer normal saline fluid bolus 2. Assess cervix for presenting part 3. Obtain fetal heart rate 4. Turn client laterally A nurse is measuring a uterine fundal height for a client who is at 36 weeks gestation in supine position. The client suddenly reports dizziness and the nurse observes pallor and damp, cool skin. What should the nurse do first? Unordered Options Ordered Response 1. Assess fetal heart rate and pattern 2. Assess heart and lung sounds 3. Notify the health care provider (HCP) immediately 4. Reposition the client into a lateral position A pregnant client comes for a routine first prenatal examination. According to the last menstrual period, the estimated gestational age is 14 weeks. Where would the nurse expect to palpate the uterine fundus in this client? Unordered Options Ordered Response 1. 14 cm above the symphysis pubis 2. 14 cm above the umbilicus 3. Just above the symphysis pubis 4. Just below the umbilicus While triaging pregnant clients in the obstetrics clinic, the nurse should alert the health care provider to see which client first? Unordered Options Ordered Response 1. First-trimester client reporting frequent nausea and vomiting 2. Second-trimester client with multiple star-shaped vascular spiders 3. Second-trimester client with obesity reporting lack of fetal movement 4. Third-trimester client with epigastric pain and elevated liver enzymes