Nokea
The nurse is educating the postpartum client. Which prevention strategies for postpartum depression should the nurse include? Select all that apply.
- A. Attend a support group that has other postpartum women.
- B. Use the baby’s nap time to complete household chores.
- C. Keep a journal of feelings during the postpartum period.
- D. Call the HCP if feelings of sadness do not subside quickly.
- E. Develop a daily schedule of activities, and follow the plan.
Correct Answer: A,C,D,E
Rationale: A postpartum support group can be a place where realistic information about postpartum depression can be discussed and symptoms recognized. Fatigue is a major concern for all postpartum women. Clients should be encouraged to nap when their infant is napping rather than using that time for other activities. Keeping a journal can be emotionally cathartic and can help prevent postpartum depression. Postpartum mothers should be encouraged to call their HCPs if symptoms of postpartum depression, such as feelings of sadness, do not subside quickly or if the symptoms become severe. Structuring activity with a schedule helps counteract inertia that comes with feeling sad or unsettled.
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The nurse is providing nutrition counseling to a primigravida who is 10 weeks pregnant. Which meal choice stated by the client indicates she needs additional information?
- A. Black beans, wild rice, collard greens
- B. Dry cereal, milk, dried cranberries
- C. Tuna, broccoli, baked potato
- D. Beef strips, lentils, red peppers
Correct Answer: C
Rationale: Tuna contains mercury and should be limited in pregnancy due to risk of mercury poisoning. The nurse should provide this additional information. Black beans provide a good source of calcium, iron, and protein. Black beans, wild rice, and collard greens provide fiber. Collard greens provide a good source of calcium and folic acid. Dry cereal provides a good source of vitamin D, milk provides a good source of calcium, and dried cranberries provide a good source of calcium and iron. Beef provides a good source of protein and iron, lentils provide a good source of iron, and red peppers provide a good source of vitamin C.
When the nurse discusses the tasks to be accomplished during the client's visit at 24 weeks' gestation, which routine test will be performed?
- A. Coombs' test
- B. Glucose tolerance test
- C. Urinalysis
- D. Rubella titer
Correct Answer: B
Rationale: The glucose tolerance test is routinely performed around 24-28 weeks to screen for gestational diabetes.
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.
At one minute after birth, a neonate is pink, except for blue extremities. The neonate is crying, gagging, and grimacing when the bulb syringe is used and has some flexion of extremities and an HR of 97. Based on the Apgar score, what should the nurse do next?
- A. Notify the health care provider
- B. Recheck the Apgar at 5 minutes after birth
- C. Initiate resuscitation measures immediately
- D. Swaddle and hand to mother for breastfeeding
Correct Answer: B
Rationale: Rechecking the Apgar score at 5 minutes after birth will determine if the newborn is continuing to make a good transition to the extrauterine environment. Notifying the HCP is not necessary at this time. The one-minute Apgar score is 6, very close to the 7 to 10 normal limits. This newborn has a good cry, indicating good transition to the extrauterine environment thus far. Initiating resuscitation measures immediately is not necessary. This would be done if the newborn were not crying and demonstrated a blue or pale body. Swaddling and giving the newborn to the mother for breastfeeding are important but should occur after the 5-minute Apgar, if the score is WNL. Keeping this newborn in the radiant warmer, rather than giving him or her to the mother, will help prevent hypothermia and promote better transition to extrauterine life.
The nurse correctly sends a requisition and specimen for which laboratory test?
- A. Alpha-fetoprotein (AFP)
- B. Corticotropin-releasing hormone (CRH)
- C. Human chorionic gonadotropin (hCG)
- D. Follicle-stimulating hormone (FSH)
Correct Answer: C
Rationale: Human chorionic gonadotropin (hCG) is the hormone tested to confirm pregnancy, as it is produced by the placenta shortly after implantation.