ATI RN
Atrium Health Womens Care Maternal Fetal Monitoring Questions
Question 1 of 5
A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? Select all that apply.
Correct Answer: A
Rationale: In this scenario, the correct assessment for the gravida having her first prenatal physical examination is A) Pap smear. The Pap smear is a crucial screening test to detect any abnormal cervical cells that could indicate cervical cancer or other issues. During the initial prenatal visit, it is important to assess the client's cervical health to ensure early detection and appropriate management if any abnormalities are found. B) Mammogram is not typically performed during the first prenatal visit. Mammograms are primarily recommended for women over 40 years of age as a screening tool for breast cancer. C) The glucose challenge test is usually performed later in pregnancy to screen for gestational diabetes, not during the initial prenatal visit for a gravida. D) The biophysical profile is a test performed later in pregnancy to assess the baby's well-being, usually starting around the third trimester. It includes ultrasound evaluation of fetal movements, muscle tone, breathing, amniotic fluid levels, and heart rate patterns. This assessment is not typically done during the first prenatal visit. Educationally, understanding the timing and purpose of specific assessments during prenatal care is vital for nurses and other healthcare providers to provide comprehensive and evidence-based care to pregnant clients. It ensures appropriate interventions, monitoring, and support throughout the pregnancy journey, promoting positive maternal and fetal outcomes.
Question 2 of 5
The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the physician? Select all that apply.
Correct Answer: A
Rationale: In this scenario, the correct answer is option A, which is "17 weeks’ gestation; denies feeling fetal movement." This finding should be highlighted to the physician because at 17 weeks of gestation, fetal movements should typically be felt by the mother. The absence of fetal movement at this stage could indicate a potential issue with fetal well-being, such as fetal distress or abnormal development, warranting further evaluation and monitoring. Option B, "24 weeks’ gestation; fundal height at the umbilicus," is not a concerning finding as fundal height corresponds to the gestational age and can vary among individuals. At 24 weeks, the fundal height at the umbilicus is within the expected range. Option C, "27 weeks’ gestation; salivates excessively," is not a typical indicator of a significant issue in pregnancy. While excessive salivation can be uncomfortable for the mother, it is not typically a cause for immediate concern unless it is accompanied by other symptoms. Option D, "34 weeks’ gestation; experiences uterine cramping," could indicate preterm labor, which is a serious concern in pregnancy. However, in this scenario, the absence of fetal movement at 17 weeks is a more urgent finding that requires immediate attention compared to uterine cramping at 34 weeks, which can be managed with appropriate interventions. Educationally, this question highlights the importance of assessing fetal movements as a crucial aspect of antenatal care. It underscores the significance of recognizing abnormal findings during pregnancy and the need for prompt communication with healthcare providers to ensure timely interventions and monitoring for maternal and fetal well-being.
Question 3 of 5
A woman states that she frequently awakens with 'painful leg cramps' during the night. Which of the following assessments should the nurse make?
Correct Answer: A
Rationale: In this scenario, the correct assessment the nurse should make is option A) Dietary evaluation. Leg cramps can be caused by various factors, including nutritional deficiencies such as low levels of potassium, calcium, or magnesium. By conducting a dietary evaluation, the nurse can assess the woman's intake of these essential nutrients and identify any deficiencies that may be contributing to the leg cramps. Option B) Goodell’s sign and option C) Hegar’s sign are not relevant in this context as they are specific to obstetric and gynecological assessments related to pregnancy. Goodell’s sign refers to the softening of the cervix, while Hegar’s sign is the softening of the lower segment of the uterus. These signs are not indicative of leg cramps. Option D) Posture evaluation is also not directly related to the woman's complaint of painful leg cramps. While posture can play a role in musculoskeletal issues, it is not the primary assessment needed in this situation. Educationally, this question highlights the importance of considering a holistic approach to assessment in nursing practice. It emphasizes the need to explore potential causes of symptoms beyond the obvious and to consider how factors such as nutrition can impact a patient's health. This type of critical thinking and assessment skills are essential for nurses to provide comprehensive care to their patients.
Question 4 of 5
The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that are within normal limits during the latter half of the pregnancy.
Correct Answer: A
Rationale: The correct answer is option A: "During the third trimester I may experience frequent urination." This is an accurate anticipatory guidance because during the latter half of pregnancy, the growing uterus puts pressure on the bladder, leading to increased urinary frequency. This is a common and normal symptom in the third trimester due to the physical changes in the body. Option B, heartburn, is a common discomfort during pregnancy, particularly in the third trimester, but it is more related to the relaxation of the muscle that separates the esophagus from the stomach, allowing stomach acid to leak into the esophagus. While common, it is not specifically associated with the latter half of pregnancy as much as frequent urination. Option C, nagging backaches, are also common during pregnancy due to the increased strain on the back and pelvic area as the baby grows. However, this symptom can occur throughout pregnancy and is not necessarily more prevalent in the third trimester. Option D, persistent headache, while headaches can occur during pregnancy, persistent headaches may indicate a more serious issue like preeclampsia, which is not a normal symptom and requires immediate medical attention. In an educational context, providing anticipatory guidance to pregnant women is crucial for their understanding of the changes their bodies will go through and to help them differentiate between normal discomforts and potential warning signs that require medical attention. Understanding these normal physiological changes can help alleviate anxiety and promote better self-care during pregnancy.
Question 5 of 5
A woman is 36 weeks’ gestation. Which of the following tests will be done during her prenatal visit?
Correct Answer: C
Rationale: In prenatal care, conducting vaginal and rectal cultures (Option C) is crucial during a woman's prenatal visit at 36 weeks' gestation. These cultures help assess for any potential infections that could be passed to the baby during labor and delivery, allowing for timely treatment and prevention of complications. The other options are not typically done at 36 weeks' gestation: A) Glucose challenge test is usually performed around 24-28 weeks to screen for gestational diabetes. B) Amniotic fluid volume assessment is typically done in the third trimester if there are concerns about fetal well-being. D) Karyotype analysis is not a routine test during prenatal visits but may be done in cases where there are specific indications for genetic testing. Educationally, understanding the timing and rationale behind each prenatal test is essential for healthcare providers to provide optimal care for pregnant women and their babies. It ensures appropriate monitoring, timely interventions, and overall positive outcomes for both mother and child.