Maternity Newborn And Women Health Nursing-Case Based
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Chapter 15: Pregnancy; O'Meara: Maternity, Newborn, and Wome
Health PREPU Level 5
1. A pregnant client reports chewing on ice throughout the day. Which
laboratory value would the nurse evaluate?
a. serum iron level
b. serum potassium level
c. serum glucose level
d. serum sodium level: a. serum iron level
Pregnant clients who crave ice often have an iron deficiency. A low serum iron level
needs to be checked. The client's electrolyte values are not associated with cravings
for ice.
2. The fluid-filled, inner membrane sac surrounding the fetus is which
structure?
a. amnion
b. chorion
c. endometrium
d. decidua: a. amnion
The fluid-filled, inner membrane sac surrounding the fetus is the amnion. The
chorion is the outer membrane surrounding the fetus. The endometrium is the inner
lining of the uterus. The decidua is the name used for the endometrium during
pregnancy.
3. A pregnant client at 32 weeks' gestation remarks during a routine prenatal
visit, "Sex is becoming difficult for us." Which would be the best response
by the nurse?
a. "If you and your partner are having problems, maybe decreasing the fre-
quency of sex would be helpful."
b. "Intercourse this late in pregnancy can be difficult. Do you think that
abstaining is possible?"
c. "Sex during pregnancy is a common concern. What do you mean by diffi-
cult?"
d. "You should expect to have discomfort with sex because of the
pregnancy. Discuss this with your obstetrician.": c. "Sex during pregnancy is a
common concern. What do you mean by difficult?"
, Chapter 15: Pregnancy; O'Meara: Maternity, Newborn, and Wome
Health PREPU Level 5
Frank discussion about how sexual feelings and behaviors may change during
pregnancy can help prevent and alleviate problems. The nurse should seek more
information from the pregnant client regarding the difficulties that are encountered.
Decreasing the frequency of sex or telling the client to abstain until after the birth
does not address the cause of the difficulty. Discomfort should not be an issue, and
if present should be investigated.
4. A client in her 29th week of gestation reports dizziness and clamminess
when assuming a supine position. During the assessment, the nurse
observes there is a marked decrease in the client's blood pressure. Which
intervention should the nurse implement to help alleviate this client's
condition?
a. Keep the client's legs slightly elevated.
b. Place the client in an orthopneic position.
c. Keep the head of the client's bed slightly elevated.
d. Place the client in the left lateral position.: d. Place the client in the left lateral
position.
The symptoms experienced by the client indicate supine hypotension syndrome.
When the pregnant woman assumes a supine position, the expanding uterus exerts
pressure on the inferior vena. The nurse should place the client in the left lateral
position to correct this syndrome and optimize cardiac output and uterine perfusion.
Elevating the client's legs, placing the client in an orthopneic position, or keeping
the head of the bed elevated will not help alleviate the client's condition.
5. A pregnant client at 34 weeks' gestation reports a burning sensation in the
lower esophagus. What action would the nurse recommend to increase her
comfort? Select all that apply.
a. Eat five to six small meals per day.
b. Do not eat fried, fatty foods.
c. Do not lie down immediately after eating.
d. Eat a large amount of carbohydrates.
e. Do not drink liquids with meals.: a. Eat five to six small meals per day. b. Do
not eat fried, fatty foods.
c. Do not lie down immediately after eating.
, Chapter 15: Pregnancy; O'Meara: Maternity, Newborn, and Wome
Health PREPU Level 5
The client is experiencing pyrosis. Eating small frequent meals, avoiding fried foods,
and not laying down immediately after eating will minimize the discomfort. Large
quantities of carbohydrates and not taking liquids with meals will not change the
discomfort being experienced.
6. The nurse teaches a primigravida client that lightening occurs about 2
weeks before the onset of labor. What will the mother likely experience at that
time?
a. dysuria
b. dyspnea
c. constipation
d. urinary frequency: d. urinary frequency
Lightening refers to the descent of the fetal head into the pelvis and engagement.
With this descent, pressure on the diaphragm decreases, easing breathing, but
pressure on the bladder increases, leading to urinary frequency. Dysuria might
indicate a urinary tract infection. Constipation may occur throughout pregnancy due
to decreased peristalsis, but it is unrelated to lightening.
7. How many weeks into her pregnancy should a woman who is Rho(D)-
negative be screened for antibodies and given Rho(D) immune globulin?: 28
weeks
For women who are Rh-negative, Rho(D) immune globulin is given at 28 weeks to
prevent isoimmunization.
8. The nurse is planning a seminar that focuses on the 2030 National Health
Goals during pregnancy for clients who are in the first trimester of pregnancy.
Which information should the nurse include in this seminar? Select all that
apply.
a. refusing alcohol
b. importance to stop smoking
c. maintaining health appointments
d. seeking alternative care approaches
e. abstaining from drugs and substances: a. refusing alcohol
b. importance to stop smoking
c. maintaining health appointments
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