Nokea
Which activity should the nurse recommend to prepare for labor?
- A. Practicing relaxation and breathing techniques
- B. Increasing caffeine intake
- C. Avoiding all physical activity
- D. Taking daily hot baths
Correct Answer: A
Rationale: Practicing relaxation and breathing techniques helps manage labor pain and prepares the client for childbirth.
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The nurse prepares the client for which pain management option during labor?
- A. Epidural anesthesia
- B. Hot baths during active labor
- C. Over-the-counter pain relievers
- D. No pain relief options
Correct Answer: A
Rationale: Epidural anesthesia is a common and effective pain management option during labor, tailored to the client's needs.
The pregnant client is experiencing low back pain. After determining that the client is not in labor, the nurse instructs the client to perform which exercises to increase comfort and decrease the incidence of the low back pain? Select all that apply.
- A. Kegel exercises
- B. Pelvic tilt exercises
- C. Leg raises
- D. Back stretch
- E. Stepping
Correct Answer: B,C,D
Rationale: Pelvic tilt exercises strengthen and stretch the abdominal and back muscles to relieve pain. Leg raises strengthen and stretch leg and abdominal muscles to relieve pain. Back stretch relieves pain from the back muscles caused by lordosis. Kegel exercises strengthen the pubococcygeal muscle, decreasing urinary leakage, but do not relieve back pain. Stepping provides aerobic exercise, which is good for circulation but is not recommended to decrease low back pain.
While assessing the prenatal client, the nurse found a number of concerning problems. Place the concerning problems in the sequence that they should be addressed by the nurse.
- A. Currently bleeding and cramping
- B. Previous varicella infection
- C. Currently using tobacco
- D. Has intense pelvic pain
Correct Answer: D,A,C,B
Rationale: Has intense pelvic pain is most concerning and should be addressed first by the nurse. It could be a symptom of a serious medical condition, such as a miscarriage, ectopic pregnancy, or appendicitis. This symptom represents a possible pathology that could warrant immediate surgical intervention. Currently bleeding and cramping should be addressed next. It could be associated with the pelvic pain and could be a symptom of a serious medical condition, such as a miscarriage or ectopic pregnancy. Currently using tobacco can put the client at risk for multiple adverse outcomes and should be addressed, although it is not an immediately concerning factor. Previous varicella infection is important to document but poses no risk to the client or the fetus, so it is the least important to address.
The 39-year-old client with type 1 DM presents at 36 weeks’ gestation with Drag and Drop contractions. An HCP decides to do an amniocentesis. Which statement best supports why the nurse and NA should prepare the client for an amniocentesis now?
- A. Diabetic women have a higher incidence of birth defects, and the HCP wants to determine if a birth defect is present.
- B. The client is over 35, at 36 weeks’ gestation with Drag and Drop contractions, and is at risk for chromosomal disorders.
- C. An amniocentesis performed at 36 weeks’ gestation is being completed to determine if the fetal lungs have matured.
- D. The amniocentesis is more accurate than the fetal fibronectin test in determining if delivery is imminent.
Correct Answer: C
Rationale: Infants of diabetic mothers are less likely to have mature lung capacity at 36 weeks; knowing lung maturity can influence whether delivery should proceed. In mid pregnancy, the cells in amniotic fluid can be studied for genetic abnormalities such as Down’s syndrome and birth defects, but amniocentesis would not be performed for this purpose when the client is in preterm labor. Many women over the age of 35 have amniocentesis completed to test for chromosomal disorders, but not this late in the pregnancy. Fetal fibronectin testing is used to determine if a preterm birth is likely, but it cannot be used to determine lung maturity.
The nurse is screening prenatal clients who may be carriers for potential genetic abnormalities. Which ethnic group should the nurse identify as having the lowest risk for hemoglobinopathies, such as sickle cell disease and thalassemia?
- A. African descent
- B. Southeast Asian descent
- C. Scandinavian descent
- D. Mediterranean descent
Correct Answer: C
Rationale: Individuals of Scandinavian descent are not an identified risk group for hemoglobinopathies. Individuals of African descent are at risk for hemoglobinopathies and should be offered carrier screening. Individuals of Southeast Asian descent are at risk for hemoglobinopathies and should be offered carrier screening. Individuals of Mediterranean descent are at risk for hemoglobinopathies and should be offered carrier screening.