Question

A nurse at a prenatal clinic is caring for a client who is in her first trimester of pregnancy. The client expresses that she is upset because, despite planning this pregnancy with her husband, she has been having many doubts and second thoughts about the upcoming changes in her life. Which of the following is an appropriate response by the nurse?

Answer 1

Correct Answers:

"Ambivalent feelings are quite common for women early in pregnancy.".

Rationale :

✨ It is normal for women in early pregnancy to experience ambivalence about their role and upcoming responsibilities.

✨ These feelings typically reflect a process of emotional adjustment to the idea of parenthood.

✨ Recognizing and validating the client’s emotions helps establish trust and therapeutic rapport.

✨ This response provides support without judgment or unnecessary referral at this stage.

✨ It encourages the client to feel safe in expressing emotional concerns without fear of stigma.

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Answer 2

Correct Answers:

"This infection is treated with one dose of azithromycin.".

Rationale :

✅ Chlamydia is a common STI often treated with a single oral dose of azithromycin.

✅ Prompt treatment is essential to prevent complications like pelvic inflammatory disease and infertility.

✅ It is also necessary to treat sexual partners simultaneously, even if asymptomatic.

✅ Educating the client ensures compliance and reduces reinfection risk.

✅ This is in line with CDC-recommended treatment guidelines for uncomplicated chlamydia.

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Answer 3

Correct Answers:

She has a family history of thromboembolism.

Rationale :

⏺️ Estrogen-containing contraceptives are contraindicated in clients with a family history of thromboembolism.

⏺️ This increases the risk of developing venous thromboembolism, which can be life-threatening.

⏺️ A non-hormonal or progestin-only method would be a safer alternative for this client.

⏺️ Risk stratification is essential in choosing a safe and effective birth control method.

⏺️ Family history of thromboembolism is a significant red flag for estrogen-based methods.

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Answer 4

Correct Answers:

"What part of the exam makes you most nervous?"

Rationale :

♦️ This open-ended response invites the client to express specific concerns, fostering a supportive environment.

♦️ Addressing fears helps build trust and cooperation during sensitive procedures like pelvic exams.

♦️ It reflects therapeutic communication principles, which are crucial in adolescent care.

♦️ Empathy and validation reduce anxiety and improve compliance with care plans.

♦️ The nurse's goal is to empower the client through informed, compassionate dialogue.

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Answer 5

Correct Answers:

Initiate IV access.

Rationale :

💎 The client’s presentation suggests placenta previa or abruptio placentae, both of which may cause hemorrhage.

💎 The elevated heart rate and low blood pressure indicate hypovolemia and potential shock.

💎 Establishing IV access is the priority to administer fluids and blood products rapidly.

💎 Other actions like prepping for surgery or inserting a catheter are secondary to stabilizing the client.

💎 Early fluid resuscitation is critical to preserving perfusion and maternal-fetal survival.

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Answer 6

Correct Answers:

A 38-year-old patient who reports smoking one pack of cigarettes daily.

Rationale :

✍️ Smoking significantly increases the risk of thromboembolic events when using estrogen-containing oral contraceptives.

✍️ Women over age 35 who smoke should avoid combined hormonal contraceptives.

✍️ Safer alternatives include progestin-only pills or non-hormonal methods.

✍️ This patient's age and smoking status create a high-risk profile.

✍️ The nurse must assess lifestyle factors to tailor safe contraceptive counseling.

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Answer 7

Correct Answers:

"This test requires the presence of amniotic fluid.

Rationale :

✳️ Amniocentesis involves withdrawing a sample of amniotic fluid using a needle guided by ultrasound.

✳️ The procedure is done between 15–20 weeks to detect genetic or chromosomal abnormalities.

✳️ It is not used for lung maturity testing at 15 weeks; that's more relevant in the third trimester.

✳️ The nurse should clearly explain the purpose and timing relevance of the test.

✳️ Ensuring the client understands the test enhances informed consent and emotional preparedness.

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Answer 8

Correct Answers:

Intrauterine growth restriction.

Rationale :

🎀 Smoking during pregnancy leads to vasoconstriction and placental insufficiency, which limit fetal growth.

🎀 Infants born to smokers are often small for gestational age or suffer intrauterine growth restriction (IUGR).

🎀 This risk underscores the need for smoking cessation interventions during prenatal care.

🎀 Education on smoking hazards enhances maternal-fetal outcomes.

🎀 IUGR increases the likelihood of preterm birth and neonatal complications.

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Answer 9

Correct Answers:

Amenorrhea.

Rationale :

🎭 Presumptive signs of pregnancy are subjective experiences reported by the woman, like amenorrhea.

🎭 While not definitive, missed periods are often the earliest indication of pregnancy.

🎭 Other presumptive signs include nausea, fatigue, and breast tenderness.

🎭 Objective signs (e.g., positive test, cervical changes) fall under probable signs.

🎭 Only ultrasound or fetal heart tones confirm pregnancy definitively.

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Answer 10

Correct Answers:

"You will need to double your intake of iron during pregnancy.".

Rationale :

✨ Pregnancy increases the need for iron to support fetal growth and increased maternal blood volume.

✨ Iron supplementation helps prevent maternal anemia and low birth weight.

✨ The daily iron requirement doubles from 18 mg to about 30–60 mg during pregnancy.

✨ Iron-rich foods and prenatal vitamins both play a role in meeting these needs.

✨ Patient education ensures compliance and improved maternal-fetal outcomes.

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QLexNursing

2 :
A nurse in a community clinic is counseling a client who received a positive test result for chlamydia. Which of the following statements should the nurse provide?

3 :
A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

4 :
A nurse in a family planning clinic is caring for a 17-year-old female client who is requesting oral contraceptives. The client states that she is nervous because she has never had a pelvic examination. Which of the following responses should the nurse make?

6 :
A nurse is considering contraceptive options for four patients. Which patient should the nurse identify as having a contraindication for oral contraceptives?

7 :
A nurse in a prenatal clinic is instructing a client about an amniocentesis, which is scheduled at 15 weeks of gestation. Which of the following should be included in the teaching?

8 :
A nurse is completing a health history for a patient who is 6 weeks pregnant. The patient informs the nurse that she smokes one pack of cigarettes per day. The nurse should inform the patient that smoking puts her newborn at risk for which of the following complications?

9 :
A patient makes an appointment at the prenatal clinic because she believes she might be pregnant. Which assessment should the nurse identify as a presumptive sign of pregnancy?

10 :
A nurse is providing nutritional education to a patient at her first prenatal visit. Which of the following statements should the nurse include in the teaching?

QLexNursing

2 : A nurse in a community clinic is counseling a client who received a positive test result for chlamydia. Which of the following statements should the nurse provide?

3 : A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

4 : A nurse in a family planning clinic is caring for a 17-year-old female client who is requesting oral contraceptives. The client states that she is nervous because she has never had a pelvic examination. Which of the following responses should the nurse make?

6 : A nurse is considering contraceptive options for four patients. Which patient should the nurse identify as having a contraindication for oral contraceptives?

7 : A nurse in a prenatal clinic is instructing a client about an amniocentesis, which is scheduled at 15 weeks of gestation. Which of the following should be included in the teaching?

8 : A nurse is completing a health history for a patient who is 6 weeks pregnant. The patient informs the nurse that she smokes one pack of cigarettes per day. The nurse should inform the patient that smoking puts her newborn at risk for which of the following complications?

9 : A patient makes an appointment at the prenatal clinic because she believes she might be pregnant. Which assessment should the nurse identify as a presumptive sign of pregnancy?

10 : A nurse is providing nutritional education to a patient at her first prenatal visit. Which of the following statements should the nurse include in the teaching?

2 :
A nurse in a community clinic is counseling a client who received a positive test result for chlamydia. Which of the following statements should the nurse provide?

3 :
A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

4 :
A nurse in a family planning clinic is caring for a 17-year-old female client who is requesting oral contraceptives. The client states that she is nervous because she has never had a pelvic examination. Which of the following responses should the nurse make?

6 :
A nurse is considering contraceptive options for four patients. Which patient should the nurse identify as having a contraindication for oral contraceptives?

7 :
A nurse in a prenatal clinic is instructing a client about an amniocentesis, which is scheduled at 15 weeks of gestation. Which of the following should be included in the teaching?

8 :
A nurse is completing a health history for a patient who is 6 weeks pregnant. The patient informs the nurse that she smokes one pack of cigarettes per day. The nurse should inform the patient that smoking puts her newborn at risk for which of the following complications?

9 :
A patient makes an appointment at the prenatal clinic because she believes she might be pregnant. Which assessment should the nurse identify as a presumptive sign of pregnancy?

10 :
A nurse is providing nutritional education to a patient at her first prenatal visit. Which of the following statements should the nurse include in the teaching?