A nurse is teaching routine prenatal care to a group of clients who are pregnant.
Which of the following statements by a client indicates an understanding of the teaching?

I will be able to hear my baby's heartbeat when I am 6 weeks pregnant.

I will have monthly prenatal visits for the first 28 weeks of pregnancy.

I will have a complete blood count performed at each prenatal visit.

I will have a blood test to check for neural tube defects when I am 32 weeks pregnant.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Fetal cardiac activity is typically detectable via transvaginal ultrasound as early as 5.5 to 6 weeks gestational age, when the embryo is approximately 2-4 mm in crown-rump length. However, hearing the heartbeat with a Doppler stethoscope usually occurs later, around 10 to 12 weeks, as the fetal heart is still very small and sound transmission is limited.

Choice B rationale

The standard schedule for prenatal visits involves monthly appointments from the first prenatal visit until 28 weeks of gestation. This frequency allows for consistent monitoring of maternal and fetal well-being, early detection of potential complications, and timely interventions. After 28 weeks, visits typically become more frequent.

Choice C rationale

While a complete blood count (CBC) is a crucial laboratory test performed during pregnancy, it is not typically done at every prenatal visit. Initial CBCs are obtained at the first prenatal visit to establish baseline values, and then repeated later in pregnancy, often around 28 weeks, to screen for anemia and other hematologic changes.

Choice D rationale

Screening for neural tube defects, often through maternal serum alpha-fetoprotein (MSAFP) testing, is typically performed between 15 and 20 weeks of gestation. This timing is crucial for accurate interpretation of results and allows for further diagnostic evaluation if abnormalities are detected, well before 32 weeks.

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Correct Answer is A

Explanation

Choice A rationale

Epigastric pain in a pregnant client, especially at 33 weeks gestation, can be a symptom of preeclampsia, a serious hypertensive disorder of pregnancy. This pain may indicate hepatic involvement and impending eclampsia, requiring immediate medical evaluation to prevent severe maternal and fetal complications.

Choice B rationale

Leukorrhea, an increase in vaginal discharge, is a common physiological finding during pregnancy due to increased estrogen levels and blood flow to the vaginal area. It is typically thin, white, and odorless, and does not generally require reporting unless accompanied by itching, odor, or color changes.

Choice C rationale

Excessive salivation, or ptyalism, is a common and benign complaint during pregnancy, often attributed to hormonal changes. While bothersome, it does not indicate a pathological condition and is not a finding that requires reporting to the provider.

Choice D rationale

Darkening of the skin on the face, known as chloasma or melasma gravidarum, is a normal physiological change in pregnancy caused by increased melanin production due to hormonal fluctuations. It is a cosmetic issue and not indicative of a medical concern requiring provider notification.

A. “You might have to have cultures for sexually transmitted infections prior to placement of the device.” B. “The device will have to be replaced every 2 years.” C. “You might experience irregular spotting the first few months after placement of the device.” D. “You will need to avoid using tampons during menstrual cycles.” E. “You will need to sign informed consent prior to the procedure.”

Correct Answer is ["A","C","E"]

Explanation

Choice A rationale: Screening for sexually transmitted infections (STIs) prior to IUD placement is essential to reduce the risk of pelvic inflammatory disease (PID). The insertion process can introduce bacteria from the cervix or vagina into the uterine cavity, increasing infection risk if an STI is present. Guidelines recommend screening high-risk patients or those with recent STI history. Identifying infections before insertion allows treatment, preventing serious reproductive complications, including infertility.

Choice B rationale: Most intrauterine devices (IUDs) have a lifespan longer than 2 years; copper IUDs last up to 10 years, and hormonal IUDs typically last between 3 and 7 years depending on the type. Replacing the device every 2 years is unnecessary and not evidence-based. Premature removal or replacement increases risk of procedure-related complications without added contraceptive benefit.

Choice C rationale: Irregular spotting or breakthrough bleeding during the first few months after IUD insertion is common due to endometrial adjustment to the foreign body and hormonal changes (for hormonal IUDs). This occurs as the endometrial lining remodels, and bleeding usually decreases with time. Patient education about this transient effect improves adherence and reduces anxiety related to unexpected bleeding.

Choice D rationale: There is no contraindication to tampon use while an IUD is in place. Tampons do not interfere with IUD function or position. Although some clinicians advise caution initially post-insertion to prevent infection, scientific evidence does not support a permanent restriction on tampon use during menstruation after proper healing.

Choice E rationale: Signing informed consent before IUD insertion is legally and ethically required. It ensures the client understands benefits, risks, potential complications (such as expulsion or perforation), and alternative contraceptive methods. This process protects patient autonomy and supports shared decision-making, critical components of safe clinical practice.

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A nurse is teaching routine prenatal care to a group of clients who are pregnant. Which of the following statements by a client indicates an understanding of the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is at 33 weeks of gestation. Which of the following findings should the nurse report to the provider?

Correct Answer is A

Explanation

A nurse is providing teaching to a female client regarding an intrauterine device (IUD) in the outpatient clinic. Which of the following statements should the nurse include in the teaching?

Correct Answer is ["A","C","E"]

Explanation

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A nurse is teaching routine prenatal care to a group of clients who are pregnant. Which of the following statements by a client indicates an understanding of the teaching?

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A nurse is teaching routine prenatal care to a group of clients who are pregnant.
Which of the following statements by a client indicates an understanding of the teaching?