Get Answer: Client Gravida With Question Guide
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Key Explanation
This topic involves client gravida with. A strong answer should include explanation, application, and examples.
Original Question
1. A client, gravida VI, with a history of four preterm births with fetal deaths and diabetes mellitus in her family, smokes 1 1/2 packs of cigarettes a day. Both she and her husband work full time. Based on an analysis of this client’s risk status, the nurse should: A. Suggest to the client that she and her husband be seen by a geneticist B. Explain to the client that she must stop smoking immediately for the health of the baby C.Schedule this client for cerclage placement because of her history of multiple preterm births D. Suggest to the client that she see a physician who specializes in the care of women with high risk pregnancies 2. A 36-year-old multigravid client is admitted to the hospital with possible ruptured ectopic pregnancy. When obtaining the client’s history, which of the following would be most important to identify as a predisposing factor? A. Urinary tract infection B. Marijuana use during pregnancy C. Episodes of pelvic inflammatory disease D.Use of estrogen-progestin contraceptives 3. The nurse explains the complications of pregnancy that occur with diabetes to a primigravid client at 10 weeks’ gestation who has a 5-year history of insulin-dependent diabetes. Which of the following, if stated by the client as a complication, indicates the need for additional teaching? A. Candida albicans infection B. Twin-to-twin transfer C. Polyhydramnios D. Preeclampsia 4. On arrival at the emergency department, a client tells the nurse that she suspects that she may be pregnant but has been having a small amount of bleeding and has severe pain in the lower abdomen. The client’s blood pressure is 70/50 mm Hg and her pulse rate is 120 bpm. The nurse notifies the physician immediately because of the possibility of: A. Ectopic pregnancy B. Abruptio placentae C. Gestational trophoblastic disease D. Complete abortion 5. A client, at her first visit to the prenatal clinic, states that she has missed three menstrual periods, thinks she has twins because her abdomen is so large, but has started to have a brownish vaginal discharge. Her blood pressure is elevated, indicating that she may have gestational hypertension. The nurse is aware that a further assessment is required because she may have: A. Renal faiulure B. A placenta previa C. Abruptio placenta D. A hydatidiform mole 6. A primigravid client with diabetes at 39 weeks’ gestation is seen in the high-risk clinic. The physician estimates that the fetus weighs at least 4,500 g (10 lb). The client asks, “What causes the baby to be so large?” The nurse’s response is based on the understanding that fetal macrosomia is usually related to which of the following? A. Family history of large infants B. Fetal anomalies C. Maternal hyperglycemia D. Maternal hypertension 7. Which of the following statements about a fetal biophysical profile would be incorporated into the teaching plan for a primigravid client with insulin-dependent diabetes? A. lt determines fetal lung maturity B. It is noninvasive using real-time ultrasound C. It will correlate with the newborn’s Apgar score D. It requires the client to have an empty bladder 8. At 38 weeks’ gestation, a primigravid client with poorly controlled diabetes and severe preeclampsia is admitted for a cesarean delivery. The nurse explains to the client that delivery helps to prevent which of the following? A. Neonatal hyperbilirubinemia B. Congenital anomalies C. Perinatal asphyxia D. Stillbirth 9. Before surgery to remove an ectopic pregnancy and the fallopian tube, which of the following would alert the nurse to the possibility of tubal rupture? A. Amount of vaginal bleeding and discharge B. Falling hematocrit and hemoglobin levels C. Slow, bounding pulse rate of 80 bpm D. Marked abdominal edema 10. At the end of the first trimester, the physician puts a cerclage in the client’s cervix. The client asks the nurse how long the cerclage will remain in place. The nurse correctly explains to the client that the physician will probably leave the cerclage in place until what occurs? A. The client goes into labor B. The client’s baby is delivered C. The second trimester ends D. The client is near term 11. The obstetrician sees a 31-year-old multipara client in the first trimester of pregnancy. When sharing a health history, the client tells the nurse that the last pregnancy ended in a spontaneous abortion because of an incompetent cervix. The client asks the nurse to clarify what is meant by an incompetent cervix. Which statement by the nurse best explains the meaning of an incompetent cervix? A. The cervix is not large enough for passage of the fetus B. The cervix cannot support the weight of the fetus C. The cervix has an external opening but not an internal opening D. The cervix has an internal opening but not an external opening 12. If the client develops a complete abruption, which nursing action is most appropriate? A. Obtain a written consent for an immediate cesarean birth B. Give the client an enema and prepare the abdomen C. Place the client in Trendelenburg’s position D. Prepare the client for a contraction stress test 13. A 22-year-old gravida I, para 0, has insulin-dependent diabetes mellitus and is being seen by the obstetrician for the first time. The clientwasdiagnosed with diabetes at age 6. The diabetes has been wellcontrolledsincethe initial diagnosis. While waiting to see the physician, the client asks the nurse if the pregnancy will increase the need for insulin. Which explanation by the nurse is correct concerning the client’s need for insulin during pregnancy? A. Insulin requirements will most likely increase B. Insulin requirements will most likely decrease C. Insulin requirements will most likely fluctuate D. Insulin requirements will most likely not change 14. The client’s partner verbalizes concern about how placenta previa is treated. The nurse correctly states that the physician is most likely to do which of the following if the client’s condition remains stable? A. Induce labor prematurely B. Perform an emergency cesarean birth C. Place the client on bed D. Start the client on oxytocin 15. A 38-year-old client at about 14 weeks’ gestation is admitted to the hospital with a diagnosis of complete hydatidiform mole. Soon after admission, the nurse would assess the client for signs and symptoms of which of the following? A. Pre-Eclampsia B. Gestational diabetes C. Hypothyroidism D. Polycythemia
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