Question

A nurse is teaching a prenatal class about the role of the placenta. Which hormone produced by the placenta helps maintain the pregnancy after the first trimester?

Answer 1

Correct Answers:

Progesterone

Rationale :

💠After the first trimester, the placenta becomes the main producer of progesterone, which is vital for maintaining pregnancy.

💠Progesterone stabilizes the endometrial lining (decidua), preventing uterine contractions that could lead to miscarriage.

💠It promotes uterine relaxation and supports the growth of maternal tissues, including breast tissue, in preparation for lactation.

💠This hormone also suppresses maternal immune responses against the fetus, ensuring that the body does not reject the developing baby.

💠Without adequate progesterone, the pregnancy could not be sustained, making it a key hormone in fetal survival and uterine maintenance.

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Answer 2

Correct Answers:

Offer to schedule a meeting that includes the client, her support person, and the healthcare provider to discuss her concerns and beliefs.

Rationale :

➡️When a client’s cultural or religious beliefs influence her perception or acceptance of pregnancy and care, the nurse’s role is to promote open, respectful communication.

➡️By scheduling a meeting with the client, her support person, and the healthcare provider, the nurse encourages collaborative decision-making that honors the client’s values while ensuring safe and effective care.

➡️This approach demonstrates cultural competence, supports patient autonomy, and helps reduce anxiety or conflict between the client’s beliefs and medical recommendations.

➡️Including the client’s support person fosters trust and provides emotional reinforcement, making the client more likely to engage in prenatal care.

➡️The nurse acts as an advocate and facilitator, ensuring that care remains individualized and respectful of diverse belief systems.

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Answer 3

Correct Answers:

Urine output and urine protein level

Rationale :

💠Severe preeclampsia threatens renal perfusion, so tracking urine output (goal ≥30 mL/hr) is essential to detect evolving acute kidney injury.

💠Ongoing assessment of proteinuria (dipstick or 24-hr collection) reflects glomerular endothelial damage, a hallmark of preeclampsia severity.

💠Together, these parameters guide timely escalation (e.g., magnesium sulfate, delivery planning) and help evaluate response to antihypertensives.

💠They also provide early warning for HELLP progression and fluid shifts, informing IV fluid restriction to avoid pulmonary edema.

💠Because vital signs, weight, DTRs, and FHR are already documented, renal status and protein loss are the most critical missing routine monitors for this client.

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Answer 4

Correct Answers:

Verbalizing confidence in managing changes during pregnancy.

Rationale :

🔷An effective coping outcome is the client’s self-efficacy, demonstrated by expressing confidence in handling pregnancy-related changes.

🔷This reflects integration of education, resources, and support, indicating interventions (teaching, counseling, referrals) achieved their goal.

🔷Positive reframing and problem-focused coping typically appear as statements of capability and planfulness, which reduce anxiety.

🔷Verbalized confidence correlates with better prenatal self-care adherence (appointments, nutrition, warning sign recognition).

🔷It is a measurable behavioral indicator in nursing outcomes (e.g., Coping or Readiness for Enhanced Coping) that the care plan is effective.

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Answer 5

Correct Answers:

Prioritize folic acid intake to support neural tube development

Rationale :

🔶In the first trimester, folate is critical for neural tube closure (by week 4–6), making folic acid a top nutritional priority.

🔶Nausea/vomiting can reduce intake, so reinforcing daily folic acid (≥400–600 mcg) ensures protection despite decreased meal volume.

🔶Adequate folate lowers risk of neural tube defects (e.g., spina bifida, anencephaly), a non-negotiable preventive target in early pregnancy.

🔶Nurses should pair folate guidance with small, frequent, bland snacks to improve tolerance, ensuring the supplement is consistently absorbed.

🔶While calcium and other nutrients matter, timing-sensitive folate remains the priority during early organogenesis.

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Answer 6

Correct Answers:

Notify the client that the snack is not appropriate.

Rationale :

💎Clients with phenylketonuria (PKU) must avoid phenylalanine, found in aspartame (diet soda) and high-protein foods like turkey sticks.

💎The first nursing action is immediate client education and snack replacement to prevent teratogenic neurotoxicity from elevated maternal Phe levels.

💎Early correction protects fetal brain development, as high maternal Phe is linked to microcephaly, developmental delay, and congenital anomalies.

💎After correcting the choice, the nurse can collaborate with the dietitian to reinforce a low-Phe, medically supervised diet.

💎Prompt, clear feedback builds dietary adherence, crucial throughout pregnancy to maintain safe maternal Phe ranges.

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Answer 7

Correct Answers:

Blood pressure of 124/68 mmHg

Rationale :

🟣In gestational hypertension, the therapeutic goal of nifedipine (vasodilation) and low-dose aspirin (anti-platelet placental benefit) is BP control.

🟣A reading of 124/68 mmHg indicates effective reduction of afterload and decreased risk of preeclampsia and placental complications.

🟣Controlled BP reduces the likelihood of end-organ injury, fetal growth restriction, and preterm birth.

🟣Aspirin 81 mg particularly helps mitigate abnormal placentation and preeclampsia progression in at-risk pregnancies.

🟣This value demonstrates the medications are achieving the desired hemodynamic targets without hypotension.

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Answer 8

Correct Answers:

"Standard precautions are used for all clients, including those with HIV. Isolation is not required after delivery."

Rationale :

🔵HIV is managed with standard precautions (hand hygiene, gloves as needed); routine isolation is not indicated postpartum.

🔵Transmission risks are addressed by antiretroviral therapy, delivery plan, and neonatal prophylaxis, not by maternal isolation.

🔵Placing an HIV-positive client in isolation without indication may contribute to stigma and does not enhance safety.

🔵The same infection-prevention principles apply as for any postpartum client—appropriate PPE for blood/body fluids only.

🔵Clear education reduces misconceptions, supports psychological safety, and promotes trust in the care plan.

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Answer 9

Correct Answers:

Early pregnancy loss
Threatened abortion

Rationale :

Early pregnancy loss:

🟢Low progesterone compromises endometrial support, increasing likelihood of failed implantation/placental maintenance despite positive hCG.

🟢Insufficient progesterone reduces uterine quiescence and decidual stability, precipitating pregnancy failure.

🟢Clinically, low levels correlate with nonviable gestation or ectopic, but in the context given, the classic association is early loss.

🟢Monitoring trends with serial hCG and ultrasound confirms viability and guides management.

🟢Progesterone supplementation may be considered in select cases per provider protocol, but low levels signal risk.

Threatened abortion:

🟢Threatened abortion involves first-trimester bleeding with a closed cervix where progesterone may be low, jeopardizing pregnancy continuation.

🟢The hormone’s role in maintaining the endometrium and relaxing uterine muscle means deficiency can present with symptoms of threatened loss.

🟢Identifying low progesterone prompts close follow-up, possible progesterone support, and activity/bleeding precautions.

🟢Ultrasound is used to assess intrauterine location and cardiac activity, while labs track hormonal trends.

🟢Early, targeted intervention may improve the chance of ongoing viability in select scenarios.

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Answer 10

Correct Answers:

"I understand that amniocentesis is a procedure to obtain a sample of amniotic fluid for genetic testing."

Rationale :

🔷Amniocentesis at 15–20 weeks involves inserting a needle through the maternal abdomen into the amniotic sac to withdraw amniotic fluid for genetic and chromosomal testing.

🔷The sample allows assessment for genetic abnormalities such as Down syndrome, neural tube defects, or metabolic disorders.

🔷The nurse must ensure the client knows that fasting is not required and that this test is primarily diagnostic, not for fetal monitoring.

🔷Ultrasound guidance is used during the procedure to avoid injury to the fetus and placenta.

🔷Understanding the purpose of the test indicates accurate knowledge and readiness for the procedure.

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QLexNursing

1 :
A nurse is teaching a prenatal class about the role of the placenta. Which hormone produced by the placenta helps maintain the pregnancy after the first trimester?

2 :
A client who is pregnant has cultural and religious beliefs that are affecting the acceptance of her pregnancy and prenatal plan of care. What can the nurse suggest to help the client cope and move forward with acceptance?

4 :
Which client behavior indicates to the nurse that the interventions to improve coping have been effective for a client who is pregnant?

5 :
A nurse is providing nutritional education to a client who is experiencing nausea and vomiting during the first trimester of pregnancy. Which of the following nutritional priorities should the nurse emphasize?

6 :
A nurse is caring for a client who is pregnant and has phenylketonuria (PKU). The client has been given a diet soda and a turkey stick as a snack. Which of the following actions should the nurse take first?

7 :
A client who is pregnant and has gestational hypertension is prescribed low-dose aspirin 81 mg and nifedipine 30 mg by mouth daily. Which of the following findings indicates the medications' desired therapeutic effects?

8 :
A nurse is caring for a client who is pregnant and HIV-positive and scheduled for a cesarean birth the next day. The client asks, "Why do I need to be placed in isolation after delivery?" Which of the following responses should the nurse provide?

9 :
A nurse is caring for a client who has positive pregnancy tests (hCG detected in urine and blood) but low progesterone levels. Which of the following conditions could this indicate? (Select All that Apply.)

10 :
A nurse reinforces education to a pregnant client about the amniocentesis she is to undergo at 17 weeks of gestation. Which of these statements, if made by the client, indicates that the client has the correct understanding of the instruction?

QLexNursing

1 : A nurse is teaching a prenatal class about the role of the placenta. Which hormone produced by the placenta helps maintain the pregnancy after the first trimester?

2 : A client who is pregnant has cultural and religious beliefs that are affecting the acceptance of her pregnancy and prenatal plan of care. What can the nurse suggest to help the client cope and move forward with acceptance?

4 : Which client behavior indicates to the nurse that the interventions to improve coping have been effective for a client who is pregnant?

5 : A nurse is providing nutritional education to a client who is experiencing nausea and vomiting during the first trimester of pregnancy. Which of the following nutritional priorities should the nurse emphasize?

6 : A nurse is caring for a client who is pregnant and has phenylketonuria (PKU). The client has been given a diet soda and a turkey stick as a snack. Which of the following actions should the nurse take first?

7 : A client who is pregnant and has gestational hypertension is prescribed low-dose aspirin 81 mg and nifedipine 30 mg by mouth daily. Which of the following findings indicates the medications' desired therapeutic effects?

8 : A nurse is caring for a client who is pregnant and HIV-positive and scheduled for a cesarean birth the next day. The client asks, "Why do I need to be placed in isolation after delivery?" Which of the following responses should the nurse provide?

9 : A nurse is caring for a client who has positive pregnancy tests (hCG detected in urine and blood) but low progesterone levels. Which of the following conditions could this indicate? (Select All that Apply.)

10 : A nurse reinforces education to a pregnant client about the amniocentesis she is to undergo at 17 weeks of gestation. Which of these statements, if made by the client, indicates that the client has the correct understanding of the instruction?

1 :
A nurse is teaching a prenatal class about the role of the placenta. Which hormone produced by the placenta helps maintain the pregnancy after the first trimester?

2 :
A client who is pregnant has cultural and religious beliefs that are affecting the acceptance of her pregnancy and prenatal plan of care. What can the nurse suggest to help the client cope and move forward with acceptance?

4 :
Which client behavior indicates to the nurse that the interventions to improve coping have been effective for a client who is pregnant?

5 :
A nurse is providing nutritional education to a client who is experiencing nausea and vomiting during the first trimester of pregnancy. Which of the following nutritional priorities should the nurse emphasize?

6 :
A nurse is caring for a client who is pregnant and has phenylketonuria (PKU). The client has been given a diet soda and a turkey stick as a snack. Which of the following actions should the nurse take first?

7 :
A client who is pregnant and has gestational hypertension is prescribed low-dose aspirin 81 mg and nifedipine 30 mg by mouth daily. Which of the following findings indicates the medications' desired therapeutic effects?

8 :
A nurse is caring for a client who is pregnant and HIV-positive and scheduled for a cesarean birth the next day. The client asks, "Why do I need to be placed in isolation after delivery?" Which of the following responses should the nurse provide?

9 :
A nurse is caring for a client who has positive pregnancy tests (hCG detected in urine and blood) but low progesterone levels. Which of the following conditions could this indicate? (Select All that Apply.)

10 :
A nurse reinforces education to a pregnant client about the amniocentesis she is to undergo at 17 weeks of gestation. Which of these statements, if made by the client, indicates that the client has the correct understanding of the instruction?