Normal and High Risk Antepartum NCLEX Questions

Normal and High Risk Antepartum NCLEX Questions 5.0 (1 review) Students also studied Terms in this set (34) Save ATI Quiz #3 30 terms ryan_hunt86Preview ATI quiz 15 terms lilypad117Preview

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25 terms Google_Us_1234 Preview ATI Qu 27 terms rya A nurse is caring for an antepartum client whose lab findings indicate a negative rubella titer. Which of the following is the correct interpretation of this data?

• The client is not experiencing a rubella infection at this

time

• The client is immune to the rubella virus
• The client requires a rubella vaccination at this time
• The client requires a rubella immunization following

delivery D A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?

• A client who is at 38 weeks gestation and reports a

cough and fever

• A client who has missed a period and reports vaginal

spotting

• A client who is at 14 weeks gestation and reports

nausea and vomiting

• A client who is at 28 weeks gestation and reports

painless vaginal bleeding D A nurse in the antepartum unit is caring for a client who is at 36 weeks of gestation and has pregnancy-induced hypertension. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following complications?

• Placenta previa
• Prolapsed cord
• Incompetent cervix
• Abruptio placentae

D

A nurse in a prenatal clinic is teaching a client who is in her 2nd trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?

• "I should limit my carbohydrates to 50% of caloric

intake"

• "I will reduce my exercise schedule to 3 days a week"
• "I will take my glyburide daily with breakfast"
• "I know I am at increased risk to develop type 2 DM"

B A nurse is caring for an adolescent client who is G1 and P0. The client was admitted at 38 weeks gestation for preeclampsia. Which of the following findings should the nurse identify as inconsistent with preeclampsia?

• 1+ pitting sacral edema
• 3+ protein in urine

C. BP 148/98

• Deep tendon reflexes +1

D A nurse is caring for a client who has preeclampsia and is being treated with magnesium sulfate IV. The client's RR is 10/min and DTR are absent. Which of the following actions should the nurse take?

• Discontinue medication infusion
• Prepare for an emergency c-section
• Assess maternal blood glucose
• Place the client in Trendelenburg position

A A nurse is admitting a client who has severe preeclampsia at 35 weeks gestation and is reviewing the provider's orders. Which of the following orders requires clarification?

• Assess DTR every hour
• Obtain a daily weight
• Continuous fetal monitoring
• Ambulate twice daily

D A nurse is completing the admission assessment of a client who is at 38 weeks gestation and has severe preeclampsia. Which of the following is an expected finding?

• Tachycardia
• Absence of clonus
• Polyuria
• Report of headache

D

A nurse is caring for a client who is receiving magnesium sulfate to treat preeclampsia. She asks "Is the medication working". Which of the following responses should the nurse make?

• "The medication is working because there are no

contractions"

• "The medication is working, because there is no seizure

activity"

• "The medication is working, because all your lung

fields are clear"

• "The medication is working, because your blood

pressure is normal" B A nurse is admitting a client who is at 33 weeks of gestation and has a diagnosis of placenta previa. Which of the following is the priority nursing action?

• Monitor vaginal bleeding
• Administer glucocorticoids
• Inset an IV catheter
• Apply an external fetal monitor

D A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

• "There is an increased risk of introducing infection"
• "This could initiate preterm labor"
• "This could result in profound bleeding"
• "There is an increased risk of rupture of the

membranes" C A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy, terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client's current status?

A. 4-0-1-2-2

B. 3-0-2-0-2

C. 2-0-0-2-0

D. 4-2-0-2-2

A A nurse in a prenatal clinic is caring for a client who is pregnant and asks the nurse for her estimated date of birth (EDB). The client's last menstrual period began on July 27. What is the client's EDB?May 4th

A nurse in a prenatal clinic is caring for a client who believes that she might be pregnant because she feels the baby moving. Which of the following statements should the nurse make?

• "This is a presumptive sign of pregnancy"
• "This is a probable sign of pregnancy"
• "This is a possible sign of pregnancy"
• "This is a positive sign of pregnancy"

A A nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy. Which of the following client statements indicates understanding of the teaching?

• "It is normal to have a white vaginal discharge"
• "I should recognize fetal movement by 12 weeks"
• "I will take fluid pills if my ankles begin to swell"
• "My nipples and areolae will become pale as my

breasts enlarge" A A nurse in labor and delivery is caring for a client.Following delivery of the placenta, the nurse examines the umbilical cord. Which of the following vessels should the nurse expect to observe in the umbilical cord?

• Two veins and one artery
• One artery and one vein
• Two arteries and one vein
• Two arteries and two veins

C A nurse in a hospital is caring for a client who is at 38 weeks of gestation and has a large amount of painless, bright red vaginal bleeding. The client is placed on a fetal monitor indicating a regular fetal heart rate of 138/min

and no uterine contractions. The client's vital signs are:

blood pressure 98/52 mm Hg, heart rate 118/min, respiratory rate 24/min, and temperature 36.4° C (97.6° F).Which of the following is the priority nursing action?

• Insert an indwelling urinary catheter
• Initiate IV access
• Witness the signature for informed consent for surgery
• Prepare the abdominal and perineal areas

B 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?

• Limit alcohol consumption
• Increase intake of iron-rich foods
• Consume foods fortified with folic acid
• Avoid foods containing aspartame

C