You are performing assessments for an obstetric patient who is 5 months pregnant with her third child. Which finding would cause you to suspect that the patient was at risk?

Correct Answer: B

Rationale: The correct answer is B: Fundal height is below the umbilicus. At 5 months pregnant with her third child, fundal height should be at or above the level of the umbilicus. A fundal height below the umbilicus may indicate intrauterine growth restriction or other fetal growth issues. This finding suggests a potential risk to the pregnancy's progress. Incorrect Choices: A: Patient not feeling Braxton Hicks contractions is common and not necessarily indicative of risk. C: Presence of cervical changes like Goodell's and Chadwick's signs are expected physiological changes in pregnancy and do not necessarily indicate risk. D: Increased vaginal secretions can be normal during pregnancy and do not necessarily signify a risk.

Correct Answer: B

Rationale: The correct answer is B: Death before or after birth. Smoking during pregnancy increases the risk of fetal death, both before and after birth, due to the harmful effects of nicotine and other toxins on the developing fetus. Smoking can lead to complications such as placental abruption, preterm birth, low birth weight, and stillbirth. A: Congenital anomalies - While smoking during pregnancy can increase the risk of certain birth defects, the primary concern related to smoking is not congenital anomalies. C: Neonatal hypoglycemia - Smoking during pregnancy is not directly linked to neonatal hypoglycemia, which is usually related to maternal diabetes or other factors. D: Neonatal withdrawal syndrome - Although smoking during pregnancy can lead to nicotine exposure in the fetus, resulting in withdrawal symptoms after birth, the immediate risk of death is a more critical concern associated with smoking during pregnancy.

Correct Answer: C

Rationale: The correct answer is C: "Have you felt a fluttering sensation in your lower pelvic area yet?" This is the correct question to ask because feeling a fluttering sensation in the lower pelvic area is indicative of quickening, which typically occurs around 18-20 weeks of pregnancy. Quickening is an important milestone in pregnancy that signifies fetal movement. Palpating the fundus at the umbilicus suggests the pregnancy is around 20 weeks, so asking about quickening confirms fetal viability and normal development. Choice A is incorrect because fundal height does not correlate with ease of breathing. Choice B is incorrect as hearing the baby's heartbeat for the first time is not directly related to fundal height. Choice D is incorrect as unusual cravings are not typically associated with fundal height assessment.

Correct Answer: C

Rationale: The correct answer is C: Coping with common discomforts of pregnancy. Early pregnancy classes in the first and second trimesters focus on providing expecting mothers with strategies to manage common physical and emotional challenges during pregnancy. This includes information on dealing with nausea, fatigue, backaches, and emotional changes. Understanding and coping with these discomforts can help pregnant women have a more comfortable and healthy pregnancy. A: Methods of pain relief are typically covered in childbirth preparation classes closer to the due date, not in early pregnancy classes. B: The phases and stages of labor are usually discussed in depth in childbirth education classes taken later in pregnancy, not in early pregnancy classes. D: Prebirth and postbirth care of a patient having a cesarean birth is a specific topic that may be covered in a separate class for women who are planning or have been recommended to have a cesarean birth, not typically in early pregnancy classes.

Correct Answer: B

Rationale: The correct answer is B: Effleurage. Effleurage is a type of massage technique involving long, gentle strokes on the skin. Massaging the abdomen with effleurage can help improve circulation, relax muscles, and promote digestion. Imagery (A) is a technique involving mental visualization, not physical touch. Mental stimulation (C) refers to cognitive activities, not physical touch. Thermal stimulation (D) involves the application of temperature changes, not massage. Therefore, effleurage is the most suitable choice for massage of the abdomen.