A pregnant client calls the clinic and tells a nurse that she is experiencing leg cramps and is awakened by

the cramps at night. To provide relief from the leg cramps, the nurse tells the client to:

Answer: Dorsiflex the foot while extending the knee when the cramps occur.

Explanation: Legs cramps occur when the pregnant woman stretches the leg and plantar flexes the foot.
Dorsiflexion of the foot while extending the knee stretches the affected muscle, prevents the muscle
from contracting, and stops the cramping.

A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension
(PIH). The nurse who is caring for the client is performing assessments every 30 minutes. Which
assessment finding would be of most concern to the nurse?

A. Urinary output of 20 ml since the previous assessment

B. Deep tendon reflexes of 2+

C. Respiratory rate of 10 BPM

D. Fetal heart rate of 120 BPM

Explanation: Magnesium sulfate depresses the respiratory rate. If the respiratory rate is less than 12
breaths per minute, the physician or other health care provider needs to be notified, and continuation of
the medication needs to be reassessed. A urinary output of 20 ml in a 30 minute period is adequate; less
than 30 ml in one hour needs to be reported. Deep tendon reflexes of 2+ are normal. The fetal heart rate
is WNL for a resting fetus.

A nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to
assist in reducing breast tenderness. The nurse tells the client to:

A. Avoid wearing a bra

B. Wash the nipples and areola area daily with soap, and massage the breasts with lotion.

C. Wear tight-fitting blouses or dresses to provide support

D. Wash the breasts with warm water and keep them dry

The pregnant woman should be instructed to wash the breasts with warm water and keep them dry. The
woman should be instructed to avoid using soap on the nipples and areola area to prevent the drying of
tissues. Wearing a supportive bra with wide adjustable straps can decrease breast tenderness. Tight-
fitting blouses or dresses will cause discomfort.

Q: After the first four months of pregnancy, the chief source of estrogen and progesterone is the:
Answer: Placenta

When placental formation is complete, around the 16th week of pregnancy; it produces estrogen and
progesterone.

The antagonist for magnesium sulfate. Drugs antidote for magnesium toxicity or magnesium sulfate
overdose. (Magnesium sulfate is an anticonvulsant, not an antihypertensive agent)

Answer: Calcium Gluconate

Calcium gluconate is the antidote for magnesium toxicity. Ten ml of 10% calcium gluconate is given IV
push over 3-5 minutes.

Pregnancy outcomes can be described with the acronym GTPAL.“G” is Gravidity, the number of
pregnancies. “T” is term births, the number of born at term (38 to 41 weeks). “P” is preterm births, the
number born before 38 weeks gestation. “A” is abortions or miscarriages, included in “G” if before 20
weeks gestation, included in parity if past 20 weeks AOE. “L” is live births, the number of births of living
children.

A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe
preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client
for:

Answer: Any bleeding, such as in the gums, petechiae, and purpura.

Explanation: Severe Preeclampsia can trigger disseminated intravascular coagulation because of the
widespread damage to vascular integrity. Bleeding is an early sign of DIC and should be reported to the
M.D.

The nurse teaches a pregnant woman to avoid lying on her back. The nurse has based this statement on
the knowledge that the supine position can:

Answer: Cause decreased placental perfusion.

Explanation: This is because impedance of venous return by the gravid uterus, which causes hypotension
and decreased systemic perfusion.

Q: Nutritional planning for a newly pregnant woman of average height and weighing 145 pounds should
include:

Answer: An increase of 300 calories a day.

Explanation: This is the recommended caloric increase for adult women to meet the increased metabolic
demands of pregnancy.

Q: A nurse is caring for a pregnant client with Preeclampsia. The nurse prepares a plan of care for the
client and documents in the plan that if the client progresses from Preeclampsia to eclampsia, the
nurse’s first action is to:

A. Administer magnesium sulfate intravenously

B. Assess the blood pressure and fetal heart rate

C. Clean and maintain an open airway (answer)

D. Administer oxygen by face mask

Explanation: The immediate care during a seizure (eclampsia) is to ensure a patent airway. The other
options are actions that follow or will be implemented after the seizure has ceased.

Q: In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the:

Answer: Blood level of LH is too high

Explanation: It is the surge of LH secretion in mid cycle that is responsible for ovulation.

Q: The chief function of progesterone is the:

Answer: Preparation of the uterus to receive a fertilized egg

Q: Which of the following conditions is common in pregnant women in the 2nd trimester of pregnancy?

A. Mastitis
B. Metabolic alkalosis

C. Physiologic Anemia (answer)

D. Respiratory acidosis

Explanation: Hemoglobin and hematocrit levels decrease during pregnancy as the increase in plasma
volume exceeds the increase in red blood cell production.

�Maternal and fetal blood are never exchanged. Only nutrients and waste products are transferred
across the placenta. Blood exchange only occurs in complications and some medical procedures
accidentally.

�Increase in vaginal secretions during pregnancy is called leukorrhea and is caused by increased in
estrogen.

Explanation: The increase of estrogen during pregnancy causes hyperplasia of the vaginal mucosa, which
leads to increased production of mucus by the endocervical glands. The mucus contains exfoliated
epithelial cells.

�Tiny, blanched, slightly raised end arterioles found on the face, neck, arms, and chest during pregnancy
is Telangiectasias, also known as spider veins, are small dilated blood vessels near the surface of the skin
or mucous membranes, measuring between 0.5 and 1 millimeter in diameter.

Q: The developing cells are called a fetus from the:

A. Time the fetal heart is heard

B. Eighth week to the time of birth

C. Implantation of the fertilized ovum

D. End of the send week to the onset of labor

Explanation: In the first 7-14 days the ovum is known as a blastocyst; it is called an embryo until the
eighth week; the developing cells are then called a fetus until birth.

Q: Test for the presence of ballottement

Answer: Initiating a gentle upward tap on the cervix

Explanation: Ballottement is a technique of palpating a floating structure by bouncing it gently and

feeling it rebound. In the technique used to palpate the fetus, the examiner places a finger in the vagina
and taps gently upward, causing the fetus to rise. The fetus then sinks, and the examiner feels a gentle
tap on the finger.

Q: An expected cardiopulmonary adaptation experienced by most pregnant women is:

Answer: Shortness of breath on exertion

Explanation: This is an expected cardiopulmonary adaptation during pregnancy; it is caused by an

increased ventricular rate and elevated diaphragm.