1. A female client has been treated since childhood for mitral valve prolapse. The antibiotic of choice for her during pregnancy would be:
A) Sulfa B) Tetracycline C) Hydralazine D) Erythromycin
2. A pregnant client complains of varicosities in the third trimester. Which of the following activities should she be advised to avoid?
A) Sitting with legs crossed at ankles B) Wearing thromboembolic disease (TED) stockings C) Wearing support pantyhose D) Wearing knee-high stockings
3. A client at 9 weeks gestation comes for an initial prenatal visit. On assessment, the nurse discovers this is her second pregnancy. Her first pregnancy resulted in a spontaneous abortion. She is 28 years old, in good health, and works full-time as an elementary school teacher. This information alerts the nurse to which of the following:
A) An increased risk in maternal adaptation to pregnancy B) The need for anticipatory guidance regarding the pregnancy C) The need for teaching regarding family planning D) An increased risk for subsequent abortions
4. A client is pleased about being pregnant, yet states, 'It is really not the best time, but I guess it will be OK.' The nurse - s assessment of this response is:
A) Initial maternal-infant bonding may be poor. B) Client may have a poor relationship with her husband. C) This response is normal in the first trimester. D) This response is abnormal, to be re-evaluated at the next visit.
5. A client at 6 months gestation complains of tiredness and dizziness. Her hemoglobin level is 10 g/dL, and her hematocrit value is 32%. Her nutritional intake is assessed as sufficient. The most likely diagnosis is:
A) Iron-deficiency anemia B) Physiological anemia C) Fatigue due to stress D) No problem indicated
1. Right Answer: D Explanation: (A) Sulfa is a teratogen and will cause kernicterus. (B) Tetracycline is a teratogen and will effect tooth development. (C) Hydralazine is not an antibiotic but a calcium channel blocker. (D) Erythromycin is safe during pregnancy and can be used when the client is allergic to penicillin.
2. Right Answer: D Explanation: (A) Sitting with the legs crossed at the ankles does not interfere with circulation or create pressure points. (B) TED stockings will help to reduce the varicosity by supporting the vein. Stockings must be applied with legs elevated. (C) Support pantyhose help to reduce the varicosity by supporting the vein. They also provide support to the uterus and allow for better return circulation. Hose must be applied like TED stockings. (D) Knee-high stockings create constriction and pressure points that interfere with circulation in the lower extremities.
3. Right Answer: B Explanation: (A, D) There are no data to support this. (B) Anticipatory guidance and health maintenance is a first-line defense in the promotion of healthy mothers and healthy babies. (C) There are no data to support this at this time. This will be a concern later.
4. Right Answer: C Explanation: (A) Ambivalence is normal during the first trimester. Reva Rubin addresses the issue of 'not now' in the first trimester. The statement still leaves room for exploration. (B) There are no data to support this. This statement by the mother still leaves room for exploration. (C) Ambivalenceis normal during the first trimester. Reva Rubin addresses the issue of 'not now.' This fact should be shared with the mother during further exploration of the comment. (D) It is not abnormal. If it were, another month would also be too long to wait.
5. Right Answer: A Explanation: (A) This clinical situation is indicative of iron-deficiency anemia because the client has inadequate nutritional intake. Her blood volume is increasing faster than her red blood cell volume. Anemia is present in the second trimester when the hemoglobin level is <10.5 and the hematocrit value falls below 35%. She needs increased iron supplements with follow-up. (B) The clients values are below levels for physiological anemia. (C) The client is fatigued because of a low hemoglobin level. (D) Her hemoglobin level is low and will probably decrease even more when the blood volume peaks at 28 weeks.
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