Prenatal And Antepartum Support - NCLEX Pn

Which maternal blood test screens for neural tube defects in the fetus?

Maternal serum alpha-fetoprotein (MSAFP). Elevated or low levels of this protein in maternal serum between 15-20 weeks can indicate fetal neural tube defects or other anomalies.
Which instruction improves absorption when taking oral iron in pregnancy?

Take with vitamin C or orange juice. Vitamin C enhances non-heme iron absorption in the gastrointestinal tract by reducing ferric iron to the more absorbable ferrous form.
Which symptom combination suggests preterm labor and requires prompt evaluation?

Regular contractions with low backache or pelvic pressure. This combination may signal uterine activity leading to cervical changes before 37 weeks, necessitating evaluation to prevent preterm birth.
Which finding is positive (diagnostic) evidence of pregnancy?

Fetal heart tones heard by Doppler. Positive signs provide definitive confirmation of pregnancy through direct evidence of fetal presence or activity detected by reliable methods.
Which action is priority if a pregnant patient has painless bright red vaginal bleeding in the third trimester?

Avoid vaginal exam and notify provider immediately. Painless bleeding may indicate placenta previa, where vaginal exams could provoke massive hemorrhage, requiring immediate provider notification for safe management.
Which symptom in pregnancy requires immediate evaluation for possible preeclampsia?

Severe headache with visual changes. These symptoms indicate possible severe preeclampsia, a hypertensive disorder requiring urgent assessment to prevent eclampsia or other complications.
Which vaccine is contraindicated during pregnancy because it is a live virus vaccine?

MMR (measles, mumps, rubella). Live virus vaccines pose a theoretical risk of fetal infection, making them contraindicated during pregnancy to ensure maternal and fetal safety.
Which finding indicates possible premature rupture of membranes and requires evaluation?

Gush or continuous leakage of fluid from vagina. Such leakage suggests amniotic fluid escape, which can increase infection risk and requires assessment to confirm rupture and plan management.
What is the recommended daily iron supplementation amount often prescribed in pregnancy?

$30\ \text{mg/day}$ elemental iron. Pregnancy increases iron demands for fetal growth and maternal blood volume expansion, making this supplementation essential to prevent anemia.
Which finding is probable evidence of pregnancy (not diagnostic)?

Goodell sign (softened cervix). Probable signs are objective findings detected by an examiner that strongly indicate pregnancy but are not definitive, as they may mimic other conditions.
What is the recommended timing for the first prenatal visit in an uncomplicated pregnancy?

As soon as pregnancy is suspected (first trimester). Early prenatal care initiation allows for timely risk assessment, health promotion, and intervention to optimize maternal and fetal outcomes.
What is the recommended daily folic acid amount to reduce neural tube defects (routine pregnancy)?

$0.4\ \text{mg/day}$ . This dosage supports neural tube development in the fetus, as adequate folic acid intake is crucial during early pregnancy to prevent birth defects.
Which lab is used to screen for gestational diabetes at about 24 to 28 weeks?

Oral glucose challenge test (screening). This non-fasting test measures blood glucose after a glucose load to identify women at risk for gestational diabetes requiring further diagnostic evaluation.
Which events in pregnancy require Rh immune globulin for an Rh-negative patient?

Any bleeding or fetomaternal mixing (e.g., amniocentesis, trauma). These events may cause fetal-maternal blood mixing, prompting prophylaxis in Rh-negative mothers to avoid sensitization and future complications.
When is Rh immune globulin commonly given to an Rh-negative pregnant patient?

At 28 weeks and within 72 hours after birth if infant is Rh-positive. Administration at these times prevents maternal antibody formation against Rh-positive fetal cells, reducing risk of hemolytic disease in the newborn.
Which position best relieves supine hypotensive syndrome in late pregnancy?

Left lateral side-lying position. This position reduces compression of the inferior vena cava by the gravid uterus, improving venous return and preventing hypotension.
Which finding is presumptive evidence of pregnancy (not diagnostic)?

Amenorrhea (missed menstrual period). Presumptive signs of pregnancy are subjective symptoms experienced by the woman that suggest but do not confirm pregnancy, as they can occur for other reasons.
What is the recommended weight gain for a patient with normal pre-pregnancy BMI?

$25$ to $35\ \text{lb}$ (about $11.5$ to $16\ \text{kg}$ ). This range supports optimal fetal growth and maternal health without excessive risks, based on pre-pregnancy BMI guidelines from health organizations.
What is the typical fetal heart rate (FHR) range in pregnancy?

110 to 160 beats/min. The normal fetal heart rate reflects adequate oxygenation and cardiac function, typically ranging between these values throughout pregnancy.
Which vaccine is recommended during each pregnancy to protect the newborn from pertussis?

Tdap during $27$ to $36$ weeks gestation. Administering Tdap in this window provides passive immunity to the newborn via maternal antibodies, protecting against pertussis until infant vaccination.
What is the purpose of Rh(D) typing during pregnancy?

Identify need for Rh immune globulin prophylaxis. Rh typing determines if the mother is Rh-negative, necessitating prophylaxis to prevent alloimmunization and hemolytic disease in future pregnancies.
Which food should be avoided in pregnancy to reduce listeriosis risk?

Unpasteurized dairy products (soft cheeses). Unpasteurized products may contain Listeria monocytogenes, which can cross the placenta and cause severe fetal infection or miscarriage.
Which instruction is appropriate for daily fetal movement counting (kick counts)?

Report decreased movements or no movement within expected time. Monitoring fetal movements helps assess well-being, with reduced activity potentially indicating distress and warranting immediate medical attention.
Which instruction should be given to decrease constipation related to iron in pregnancy?

Increase fluids and dietary fiber. Iron supplementation can cause constipation by altering gut motility, which is mitigated by increased hydration and fiber to promote bowel regularity.
Which teaching is correct for nausea and vomiting of pregnancy (morning sickness)?

Eat small frequent meals; dry crackers before rising. These strategies help manage symptoms by preventing an empty stomach, which exacerbates nausea due to hormonal changes in early pregnancy.

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