Prenatal Care (20 Questions)

1. Mme Archambault, a 26-year-old G3P0 (two previous miscarriages at 16 and 18 weeks), presents to the clinic at 19 weeks gestation. She reports a sensation of "pelvic pressure" and an increase in vaginal discharge that is pink-tinged. She denies any painful contractions. Her vital signs are stable.

Question:
Based on her obstetric history and current symptoms, which medical intervention should the nurse anticipate the physician will consider? *

Prescription for strict bed rest and oral hydration.

Administration of Betamethasone (Celestone) to mature fetal lungs.

A non-stress test (NST) to monitor for uterine contractions.

An immediate transvaginal ultrasound to measure cervical length and possible cerclage placement.

2. Mme Bélanger, 34 weeks gestation, arrives for her routine checkup. Her pre-pregnancy BP was 110/70. Today, her BP is 142/92 mmHg. She mentions, "I’ve been feeling fine, just a little swollen." Upon assessment, you note 2+ pitting edema in her feet and mild edema in her hands and face.

Question:
Which additional assessment finding would transition the diagnosis from Gestational Hypertension to Preeclampsia? *

A weight gain of 1 kg in the last month.

The presence of protein in the urine (Proteinuria ≥ 1+ on dipstick).

Occasional lower back pain.

A fetal heart rate of 150 bpm.

3. Mme Charbonneau, 30 weeks gestation, rushes into the triage unit. She is pale and anxious. She reports, "I was watching TV and suddenly felt wet. When I stood up, blood ran down my legs. There was no pain, just blood."

Question:
What is the priority nursing precaution in this situation? *

Perform a sterile vaginal examination to assess cervical dilation.

Administer an enema to clear the bowel before potential surgery.

Strictly avoid any digital vaginal examinations until placental position is confirmed by ultrasound.

Encourage the patient to walk around to see if the bleeding increases.

4. Mme Desjardins, 10 weeks gestation, is admitted with a diagnosis of Hyperemesis Gravidarum. She has lost 5% of her pre-pregnancy weight and cannot keep fluids down. The physician orders: "IV Lactated Ringer’s at 125 mL/hr, NPO for 24 hours, Dimenhydrinate (Gravol) 50mg IV q4h PRN."

Question:
Which laboratory result is most critical to monitor to assess the severity of her condition? *

Urine Ketones and Serum Electrolytes.

White Blood Cell (WBC) count.

Hemoglobin and Hematocrit.

Blood type and Rh factor.

5. Mme Éthier is at her 36-week prenatal visit. You are preparing to perform a vaginal/rectal swab. Mme Éthier asks, "Why are you doing this test? I don't have any infections or STDs."

Question:
What is the best explanation of the purpose of GBS screening? *

"This tests for a common bacteria that lives naturally in some women but can cause serious illnes"

"This is a test to see if your cervix is ready for labor."

"This checks for a sexually transmitted infection that could blind the baby."

"This determines if you will need a Cesarean section."

6. Mme Fortin, 38 weeks gestation, lies flat on her back on the examination table for an abdominal ultrasound. After 5 minutes, she states, "I feel really dizzy and nauseous," and her skin becomes pale and clammy. You note the fetal heart rate on the monitor has dropped from 145 to 110 bpm.

Question:
What is the immediate nursing action? *

Run to get a glass of orange juice for hypoglycemia.

Elevate her legs to improve circulation.

Turn Mme Fortin onto her left side immediately.

Administer oxygen via face mask.

7. Mme Gagnon is 28 weeks pregnant. Her blood type is A Negative. The antibody screen (indirect Coombs) is negative. The physician has ordered "WinRho (Rho(D) Immune Globulin) 300 mcg IM". Mme Gagnon asks, "Why do I need this shot now? I thought I got it after the baby is born."

Question:
What is the correct nursing response regarding the timing? *

"We give it now to start protecting the baby from your antibodies immediately."

"You are actually receiving a vaccine against rubella."

"This shot will ensure your baby has a negative blood type like you."

"It is given routinely at 28 weeks because there is a risk of your blood mixing with the baby's blood during the third trimester, which could sensitize you."

8. Mme Hébert, 32 weeks gestation, calls the clinic complaining of a "dull, low backache" that comes and goes, and she feels like "the baby is pushing down." She denies sharp pain or fluid leakage.

Question:
How should the nurse interpret these symptoms? *

Advise her to take a warm bath and Tylenol, as this is normal pregnancy back pain.

Instruct her to come to the hospital immediately for assessment.

Tell her to wait until she has contractions every 5 minutes for 1 hour.

Schedule her for a massage therapy appointment.

9. Mme Isabel, 12 weeks pregnant, is asking about diet. She says, "I have a craving for soft cheeses like Brie and Camembert, and I love cold deli meat sandwiches."

Question:
What specific teaching must the nurse provide regarding these food choices? *

"These foods are high in salt, so limit them to prevent swelling."

"You should avoid unpasteurized soft cheeses and cold deli meats."

"Those foods are perfectly safe as long as you wash your hands before eating."

"You can eat them, but take an extra iron supplement because they block iron absorption."

10. Mme Joly, 39 weeks gestation, arrives at the birthing center. She tells the nurse, "I usually feel the baby kick all morning, but today I haven't felt him move at all since I woke up 4 hours ago."

Question:
What is the priority nursing action? *

Instruct the patient to go home, drink orange juice, and count kicks for 2 hours.

Palpate the abdomen to check the fetal position.

Apply the electronic fetal monitor immediately for a Non-Stress Test (NST).

Use a Doppler to check the heart rate for one minute, then send her home if it is normal.

11. Mme Lavoie, 8 weeks gestation, presents to the emergency department reporting sharp, stabbing pain in her lower left abdominal quadrant. She also complains of shoulder pain. Her blood pressure is 96/60 mmHg and her pulse is 110 bpm. She has spotting of dark red vaginal blood.

Question:
What complication should the nurse suspect primarily, considering the referred shoulder pain? *

Spontaneous abortion (Miscarriage).

Round Ligament Pain due to uterine stretching.

Appendicitis.

Ruptured Ectopic Pregnancy with intra-abdominal bleeding.

12. Mme Parent, 28 weeks gestation, complains of extreme fatigue and shortness of breath during mild activity. Her lab results show a Hemoglobin (Hgb) of 98 g/L. The physician prescribes: "Ferrous Sulfate 300 mg PO daily."

Question:
What teaching should the nurse provide to maximize the absorption of this medication? *

"Take the pill with a glass of milk to prevent stomach upset."

"Take the medication with orange juice or a Vitamin C supplement."

"Take the medication right before bed with an antacid for heartburn."

"Take the pill with a high-fiber breakfast to prevent diarrhea."

13. Mme Rousseau, 35 weeks gestation, is brought by ambulance after a minor car accident. She is crying and clutching her abdomen. She describes the pain as "constant, knife-like, and unremitting." Upon palpation, the uterus feels board-like and rigid. The fetal monitor shows late decelerations.

Question:
How does this presentation differ from Placenta Previa? *

Abruptio Placentae presents with painless bright red bleeding, whereas Previa is painful.

There is no difference; they are the same condition.

Abruptio Placentae is only diagnosed during labor contractions.

Abruptio Placentae involves premature separation of the placenta causing severe pain and a rigid abdomen, whereas Previa is typically painless

14. Mme St-Pierre is at the clinic for her 26-week visit. The physician has ordered a "50g Glucose Challenge Test (GCT)." Mme St-Pierre asks, "Do I need to come back tomorrow morning fasting for this?"

Question:
What is the correct nursing instruction for this specific screening test? *

"Yes, you must not eat or drink anything for 12 hours before the test."

"You need to eat a high-carbohydrate breakfast before coming in."

"No, you do not need to fast. You will drink the sugary solution, and we will draw your blood exactly one hour later."

"We will just prick your finger to check your sugar right now."

15. Mme Tanguay, 38 weeks gestation, calls the triage nurse. She says, "I've been having contractions every 10 minutes for the last 2 hours, but they hurt more in my lower front abdomen. I tried walking around, and the pain actually got better and stopped."

Question:
How should the nurse classify this labor status? *

True Labor: She should come to the hospital immediately.

Precipitous Labor: She is likely to deliver at home.

Back Labor: The baby is in the posterior position.

False Labor (Braxton Hicks): The contractions are irregular, focused in the front, and relieved by activity.

16. Mme Giroux, 10 weeks pregnant, mentions to the nurse, "I'm so tired, I barely have the energy to clean my cat's litter box, but I'm forcing myself to do it."

Question:
What is the priority health teaching regarding this statement? *

"You should get rid of the cat until the baby is born."

"You must not change the litter box yourself."

"Make sure you wear gloves and a mask, and it will be safe."

"Cats are fine, but you should avoid contact with dogs."

17. Mme Mercier visits the clinic to confirm her pregnancy. She states that the first day of her Last Menstrual Period (LMP) was August 10th. She has a regular 28-day cycle.

Question:
Using Naegele’s Rule, what is her Estimated Date of Confinement (EDC/Due Date)? *

May 17th.

May 10th.

June 17th.

April 17th.

18. Mme Daoust, 39 weeks gestation, arrives stating, "My water broke about an hour ago." Upon inspection, you note the fluid on her pad is green-tinged and has a moderate consistency.

Question:
What is the clinical significance of this finding? *

This is normal amniotic fluid; continue with routine admission.

The fluid is purulent, indicating an intrauterine infection (Chorioamnionitis).

The fetus has passed Meconium, which indicates potential fetal stress.

The mother has a yeast infection causing discoloration.

19. Mme Bedard, 16 weeks gestation, receives a call from the clinic. Her blood work for the Maternal Serum Alpha-Fetoprotein (MSAFP) has returned with elevated levels. She is terrified and asks what this means.

Question:
What condition is associated with high levels of AFP? *

Down Syndrome (Trisomy 21).

Gestational Diabetes.

Placenta Previa.

Neural Tube Defects (such as Spina Bifida).

20. Mme Cloutier, 28 weeks pregnant, complains of heart palpitations and feeling like her heart is racing sometimes. Her resting pulse is 88 bpm. An ECG rules out arrhythmia.

Question:
How should the nurse explain this physiological change to the patient? *

"This indicates you are developing heart failure and need strict bed rest."

"This is caused by anxiety; you should see a therapist."

"During pregnancy, your blood volume increases by 40-50%, and your heart rate naturally increases by 10-15 beats per minute to handle the extra work."

"You are likely drinking too much caffeine."