A 20-week pregnant client is being seen in the prenatal clinic.

Her fundus is palpated 3 cm below the umbilicus.

This finding is:

Higher than normal for gestational age.

A sign of impending complications.

Appropriate for gestational age.

Lower than normal for gestational age.

Answer and Explanation

The Correct Answer is D

Choice A rationale

A fundal height 3 cm below the umbilicus at 20 weeks of gestation is not considered higher than normal. At approximately 20 weeks, the fundus should be reliably palpable right at the level of the umbilicus, which serves as a clinical landmark. A fundus that is higher than the umbilicus at this point might suggest an error in dating, multiple gestation, or polyhydramnios, but the described finding is the opposite.

Choice B rationale

A fundal height 3 cm below the umbilicus at 20 weeks is not typically a sign of impending complications, but it does suggest the uterus is measuring smaller than expected for the gestational age. Clinical assessment of fundal height is often used to screen for intrauterine growth restriction (IUGR) or oligohydramnios, which would require further diagnostic investigation like an ultrasound, but this specific finding is low, not high.

Choice C rationale

The fundus is generally expected to be palpable at the umbilicus (approximately 20 cm from the symphysis pubis) when the client is at 20 weeks of gestation. A finding of 3 cm below the umbilicus is significantly lower than this established norm. Fundal height measurement is a simple, quick method to estimate gestational age and assess fetal growth.

Choice D rationale

At 20 weeks of gestation, the uterine fundus should be at the level of the umbilicus. If the fundus is palpated 3 cm below the umbilicus, it is considered lower than expected for gestational age, suggesting that the uterus is smaller than anticipated. This finding warrants further investigation, such as ultrasound, to confirm the gestational age and rule out conditions like intrauterine growth restriction or oligohydramnios.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A rationale

Tub bathing is generally considered safe throughout pregnancy, including late gestation, as long as the woman is comfortable getting in and out of the tub and the water is not excessively hot. However, tub bathing should be avoided after the rupture of membranes (amniotic sac) to minimize the risk of ascending bacterial infection into the uterus.

Choice B rationale

Proper perineal hygiene involves wiping from front to back (urethra to anus). This technique prevents the transfer of fecal bacteria, such as Escherichia coli, from the anal area to the vaginal or urethral openings, significantly reducing the risk of developing a urinary tract or vaginal infection.

Choice C rationale

Cleansing the nipples during pregnancy is typically done with plain water and is part of the regular daily shower or bath routine. The use of specially treated soaps or harsh chemicals on the nipples should be avoided as they can remove protective oils and increase the dryness or irritation of the skin.

Choice D rationale

While bath time can be relaxing, expectant mothers should be advised to avoid using bubble baths, bath oils, or heavily scented soaps. These substances can sometimes irritate the sensitive vulvar and vaginal tissues, potentially leading to inflammation, itching, or even predisposing to a vaginal infection.

A. She is septic. B. She has thrombocytopenia. C. She is too far dilated. D. She is anemic.

Correct Answer is B

Explanation

Choice A rationale

Sepsis is a generalized infection, and while any systemic infection is a relative contraindication to an epidural due to the risk of spreading the infection to the central nervous system, local site infection is the primary concern, and sepsis is not the most common or specific hematological contraindication.

Choice B rationale

Thrombocytopenia, characterized by a platelet count below the normal range of 150,000 to 450,000/microL, significantly increases the risk of epidural hematoma formation at the puncture site, which can lead to spinal cord compression and permanent neurological damage, making it a critical contraindication for epidural placement.

Choice C rationale

The extent of cervical dilation is not an absolute contraindication for an epidural, as it can be placed even in active labor (4-7 cm) or occasionally later, although the effectiveness may be reduced if placed very close to delivery; a 5 cm dilation is generally an acceptable time for placement.

Choice D rationale

Anemia, defined as a low red blood cell count or hemoglobin level (normal Hgb for pregnant women is >11 g/dL in the first and third trimesters, >10.5 g/dL in the second), does not affect the risk of hemorrhage or neurological complications associated with epidural insertion and is therefore not a specific contraindication.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A 20-week pregnant client is being seen in the prenatal clinic. Her fundus is palpated 3 cm below the umbilicus. This finding is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

With regard to their role in the personal hygiene of the expectant mother, maternity nurses should be aware that:

Correct Answer is A

Explanation

Correct Answer is B

Explanation

A primigravida is pushing with contractions. The nurse notes that the woman's perineum is beginning to bulge and that there is an increase in bloody show. Which of the following actions by the nurse is appropriate at this time?

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. What is the most important thing the woman should take in when she exercises?

After an emergency birth, the nurse encourages the woman to breastfeed her newborn. The primary purpose of this activity is to:

The diagnosis of pregnancy is based on which positive signs of pregnancy? Choose all that apply.

When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include when possible:

With regard to primary and secondary powers, the maternity nurse should know that:

The nurse caring for the pregnant client must understand that the hormone essential for maintaining pregnancy is:

A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She asks the nurse: "One of my friends told me I need to take folic acid. Why do I have to do that?" The nurse's best response is:

A 20-week pregnant client is being seen in the prenatal clinic.

Her fundus is palpated 3 cm below the umbilicus.

This finding is: