Detailed Answer Key
Genetics/Antepartum_Fall2021
1. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?
A. A client who is at 38 weeks of gestation and reports a cough and fever
Rationale: This client is stable and does not require immediate assessment. Another client is the priority.
B. A client who has missed a period and reports vaginal spotting
Rationale: This client is stable and does not require immediate assessment. Another client is the priority.
C. A client who is at 14 weeks of gestation and reports nausea and vomiting
Rationale: This client is stable and does not require immediate assessment. Another client is the priority.
D. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding
Rationale: Using the urgent vs. nonurgent approach to client care, the nurse should assess this client first.
The nurse should suspect placenta previa when vaginal bleeding occurs after 24 weeks of
gestation. A pregnant woman can lose up to 40% of blood before showing signs of shock.
2. A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency
and asks if this will continue until delivery. Which of the following responses should the nurse make?
A. "It's a minor inconvenience, which you should ignore."
Rationale: This is a nontherapeutic response that disregards the client’s concern and offers unwarranted
reassurance.
B. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone."
Rationale: The presence or absence of bladder tone has no bearing on urinary frequency during
pregnancy.
C. "There is no way to predict how long it will last in each individual client."
Rationale: This is a nontherapeutic response that does not provide appropriate information to the client.
D. "It occurs during the first trimester and near the end of the pregnancy."
Rationale: Urinary frequency is due to increased bladder sensitivity during the first trimester and recurs
near the end of the pregnancy as the enlarging uterus places pressure on the bladder.
3. A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work, the nurse
notices she does not have immunity to rubella. Which of the following times should the nurse understand is
recommended for rubella immunization?
A. Shortly after giving birth
Rationale: The rubella immunization should be offered to the client following birth, preferably prior to
Created on:09/11/2021 Page 1
, Detailed Answer Key
Genetics/Antepartum_Fall2021
discharge from the hospital. This prevents the client from contracting rubella during the current
or subsequent pregnancies, which would put her fetus at risk for rubella syndrome.
B. In the third trimester
Rationale: Because the rubella vaccine contains a live virus, immunizing the client at this point in
pregnancy would put her fetus at risk for developing rubella syndrome.
C. Immediately
Rationale: Because the rubella vaccine contains a live virus, immunizing the client during the first trimester
would put the fetus at risk for developing a severe manifestations of rubella syndrome.
D. During her next attempt to get pregnant
Rationale: Rubella immunization must be given at least 28 days prior to pregnancy to assure that the
developing fetus is not exposed to the virus and put at risk for rubella syndrome.
4. A nurse is caring for an antepartum client whose laboratory findings indicate a negative rubella titer. Which of the
following is the correct interpretation of this data?
A. The client is not experiencing a rubella infection at this time.
Rationale: A negative rubella titer indicates the client is susceptible to the rubella virus. It does not indicate
the presence or absence of a rubella infection.
B. The client is immune to the rubella virus.
Rationale: A negative rubella titer indicates the client is susceptible to the rubella virus.
C. The client requires a rubella vaccination at this time.
Rationale: Rubella vaccination during pregnancy is contraindicated because of possible injury to the
developing fetus.
D. The client requires a rubella immunization following delivery.
Rationale: A negative rubella titer indicates that the client is susceptible to the rubella virus and needs
vaccination following delivery. Immunization during pregnancy is contraindicated because of
possible injury to the developing fetus. Following rubella immunization, the client should be
cautioned not to conceive for 1 month.
5. A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the
following findings should the nurse expect to observe in this client?
A. Rapid decline in human chorionic gonadotropin (hCG) levels
Rationale: A client who has a hydatidiform mole usually has an elevated serum hCG level.
B. Profuse, clear vaginal discharge
Rationale:
Created on:09/11/2021 Page 2
, Detailed Answer Key
Genetics/Antepartum_Fall2021
A client who has a hydatidiform mole often has vaginal bleeding later in the pregnancy. This
discharge can be dark brown, bright red, scant, or profuse.
C. Irregular fetal heart rate
Rationale: When a client has a hydatidiform mole, fetal heart tones are not heard since there is no
developing fetus.
D. Excessive uterine enlargement
Rationale: A hydatidiform mole is a rare tumor that forms inside the uterus at the beginning of a pregnancy
and results in the over-production of tissue that would normally develop into the placenta. This
tissue consists of fluid-filled vesicles. A rapidly enlarging uterus is a classic finding in clients who
have a molar pregnancy. It is often accompanied by severe nausea and vomiting, elevated
human chorionic gonadotropin levels, signs of hyperthyroidism, and early onset of preeclampsia.
6. A nurse is caring for a client who is having a nonstress test performed. The fetal heart rate (FHR) is 130 to 150/min,
but there has been no fetal movement for 15 min. Which of the following actions should the nurse perform?
A. Immediately report the situation to the client's provider and prepare the client for induction of labor.
Rationale: The fetus might not be moving because it is asleep, or there might be another benign reason.
B. Encourage the client to walk around without the monitoring unit for 10 min, then resume monitoring.
Rationale: Having the client walk is not likely to promote fetal movement.
C. Offer the client a snack of orange juice and crackers.
Rationale: A nonstress test depends upon fetal movement, and this fetus is most likely asleep. Most
fetuses are more active after meals due to the increase in the mother's blood sugar. Giving the
mother a snack will promote fetal movement.
D. Turn the client onto her left side.
Rationale: Turning the client onto her left side increases the placental perfusion of oxygen to the fetus, but
the FHR of 130 to 150/min is not indicative of fetal distress.
7. A nurse is instructing a woman who is contemplating pregnancy about nutritional needs. To reduce the risk of giving
birth to a newborn who has a neural tube defect, which of the following information should the nurse include in the
teaching?
A. Limit alcohol consumption.
Rationale: Alcohol consumption has no effect on the incidence of neural tube defects. It is related to the
incidence of other congenital defects and fetal alcohol syndrome (FAS) in newborns of clients
who consume alcohol during pregnancy.
B. Increase intake of iron-rich foods.
Rationale: Iron intake has no effect on the incidence of neural tube defects. A diet low in iron places a client
Created on:09/11/2021 Page 3
Genetics/Antepartum_Fall2021
1. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?
A. A client who is at 38 weeks of gestation and reports a cough and fever
Rationale: This client is stable and does not require immediate assessment. Another client is the priority.
B. A client who has missed a period and reports vaginal spotting
Rationale: This client is stable and does not require immediate assessment. Another client is the priority.
C. A client who is at 14 weeks of gestation and reports nausea and vomiting
Rationale: This client is stable and does not require immediate assessment. Another client is the priority.
D. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding
Rationale: Using the urgent vs. nonurgent approach to client care, the nurse should assess this client first.
The nurse should suspect placenta previa when vaginal bleeding occurs after 24 weeks of
gestation. A pregnant woman can lose up to 40% of blood before showing signs of shock.
2. A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency
and asks if this will continue until delivery. Which of the following responses should the nurse make?
A. "It's a minor inconvenience, which you should ignore."
Rationale: This is a nontherapeutic response that disregards the client’s concern and offers unwarranted
reassurance.
B. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone."
Rationale: The presence or absence of bladder tone has no bearing on urinary frequency during
pregnancy.
C. "There is no way to predict how long it will last in each individual client."
Rationale: This is a nontherapeutic response that does not provide appropriate information to the client.
D. "It occurs during the first trimester and near the end of the pregnancy."
Rationale: Urinary frequency is due to increased bladder sensitivity during the first trimester and recurs
near the end of the pregnancy as the enlarging uterus places pressure on the bladder.
3. A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work, the nurse
notices she does not have immunity to rubella. Which of the following times should the nurse understand is
recommended for rubella immunization?
A. Shortly after giving birth
Rationale: The rubella immunization should be offered to the client following birth, preferably prior to
Created on:09/11/2021 Page 1
, Detailed Answer Key
Genetics/Antepartum_Fall2021
discharge from the hospital. This prevents the client from contracting rubella during the current
or subsequent pregnancies, which would put her fetus at risk for rubella syndrome.
B. In the third trimester
Rationale: Because the rubella vaccine contains a live virus, immunizing the client at this point in
pregnancy would put her fetus at risk for developing rubella syndrome.
C. Immediately
Rationale: Because the rubella vaccine contains a live virus, immunizing the client during the first trimester
would put the fetus at risk for developing a severe manifestations of rubella syndrome.
D. During her next attempt to get pregnant
Rationale: Rubella immunization must be given at least 28 days prior to pregnancy to assure that the
developing fetus is not exposed to the virus and put at risk for rubella syndrome.
4. A nurse is caring for an antepartum client whose laboratory findings indicate a negative rubella titer. Which of the
following is the correct interpretation of this data?
A. The client is not experiencing a rubella infection at this time.
Rationale: A negative rubella titer indicates the client is susceptible to the rubella virus. It does not indicate
the presence or absence of a rubella infection.
B. The client is immune to the rubella virus.
Rationale: A negative rubella titer indicates the client is susceptible to the rubella virus.
C. The client requires a rubella vaccination at this time.
Rationale: Rubella vaccination during pregnancy is contraindicated because of possible injury to the
developing fetus.
D. The client requires a rubella immunization following delivery.
Rationale: A negative rubella titer indicates that the client is susceptible to the rubella virus and needs
vaccination following delivery. Immunization during pregnancy is contraindicated because of
possible injury to the developing fetus. Following rubella immunization, the client should be
cautioned not to conceive for 1 month.
5. A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the
following findings should the nurse expect to observe in this client?
A. Rapid decline in human chorionic gonadotropin (hCG) levels
Rationale: A client who has a hydatidiform mole usually has an elevated serum hCG level.
B. Profuse, clear vaginal discharge
Rationale:
Created on:09/11/2021 Page 2
, Detailed Answer Key
Genetics/Antepartum_Fall2021
A client who has a hydatidiform mole often has vaginal bleeding later in the pregnancy. This
discharge can be dark brown, bright red, scant, or profuse.
C. Irregular fetal heart rate
Rationale: When a client has a hydatidiform mole, fetal heart tones are not heard since there is no
developing fetus.
D. Excessive uterine enlargement
Rationale: A hydatidiform mole is a rare tumor that forms inside the uterus at the beginning of a pregnancy
and results in the over-production of tissue that would normally develop into the placenta. This
tissue consists of fluid-filled vesicles. A rapidly enlarging uterus is a classic finding in clients who
have a molar pregnancy. It is often accompanied by severe nausea and vomiting, elevated
human chorionic gonadotropin levels, signs of hyperthyroidism, and early onset of preeclampsia.
6. A nurse is caring for a client who is having a nonstress test performed. The fetal heart rate (FHR) is 130 to 150/min,
but there has been no fetal movement for 15 min. Which of the following actions should the nurse perform?
A. Immediately report the situation to the client's provider and prepare the client for induction of labor.
Rationale: The fetus might not be moving because it is asleep, or there might be another benign reason.
B. Encourage the client to walk around without the monitoring unit for 10 min, then resume monitoring.
Rationale: Having the client walk is not likely to promote fetal movement.
C. Offer the client a snack of orange juice and crackers.
Rationale: A nonstress test depends upon fetal movement, and this fetus is most likely asleep. Most
fetuses are more active after meals due to the increase in the mother's blood sugar. Giving the
mother a snack will promote fetal movement.
D. Turn the client onto her left side.
Rationale: Turning the client onto her left side increases the placental perfusion of oxygen to the fetus, but
the FHR of 130 to 150/min is not indicative of fetal distress.
7. A nurse is instructing a woman who is contemplating pregnancy about nutritional needs. To reduce the risk of giving
birth to a newborn who has a neural tube defect, which of the following information should the nurse include in the
teaching?
A. Limit alcohol consumption.
Rationale: Alcohol consumption has no effect on the incidence of neural tube defects. It is related to the
incidence of other congenital defects and fetal alcohol syndrome (FAS) in newborns of clients
who consume alcohol during pregnancy.
B. Increase intake of iron-rich foods.
Rationale: Iron intake has no effect on the incidence of neural tube defects. A diet low in iron places a client
Created on:09/11/2021 Page 3
