Nokea
A client at 10 weeks gestation is being seen by the nurse. The client reports that she has nausea and vomiting each morning. Which is the nurse's best response?
- A. Drink a large glass of milk before you get out of bed.
- B. Eat crackers before you get out of bed.
- C. Eat dinner before 6:00 p.m. every night.
- D. Eat small meals during the day.
Correct Answer: B
Rationale: The correct answer is B: Eat crackers before you get out of bed. This is the best response because eating crackers before getting out of bed can help alleviate nausea and vomiting associated with morning sickness in early pregnancy. The crackers can help stabilize blood sugar levels and settle the stomach. Drinking a large glass of milk (choice A) may exacerbate nausea for some individuals. Eating dinner before 6:00 p.m. (choice C) is not directly related to morning sickness. Eating small meals during the day (choice D) is generally a good strategy, but specifically eating crackers before getting out of bed is more effective for morning sickness.
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To reassure and educate pregnant patients about changes in their breasts, nurses should be aware that:
- A. the visibility of blood vessels that form an intertwining blue network indicates full function of Montgomery's tubercles and possibly infection of the tubercles.
- B. the mammary glands do not develop until 2 weeks before labor.
- C. lactation is inhibited until the estrogen level declines after birth.
- D. colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.
Correct Answer: A
Rationale: Rationale for Correct Answer A:
1. Montgomery's tubercles are sebaceous glands on the areola.
2. Blood vessels becoming visible indicates increased blood supply due to hormonal changes during pregnancy.
3. The intertwining blue network reflects full function of Montgomery's tubercles.
4. Infection may cause inflammation and increased visibility of blood vessels.
Summary of Incorrect Choices:
B: Incorrect, mammary glands develop during puberty, not right before labor.
C: Incorrect, lactation is primarily influenced by prolactin, not estrogen.
D: Incorrect, colostrum is a thick, yellowish fluid containing antibodies, not an oily substance for lubrication.
Which finding in the urine analysis of a pregnant woman is considered a variation of normal?
- A. Proteinuria
- B. Glycosuria
- C. Bacteria in the urine
- D. Ketones in the urine
Correct Answer: B
Rationale: Small amounts of glucose (glycosuria) can occur normally during pregnancy. Proteinuria, bacteria, and ketones indicate potential complications.
A first-time mother at 18 weeks of gestation comes for her regularly scheduled prenatal visit. The patient tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the patient that this type of contraction:
- A. is painless.
- B. increases with walking.
- C. causes cervical dilation.
- D. impedes oxygen flow to the fetus.
Correct Answer: A
Rationale: Uterine contractions can be felt through the abdominal wall soon after the fourth month of gestation. Braxton Hicks contractions are regular and painless and continue throughout the pregnancy.
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
- A. primipar
- B. primigravida
- C. multipara
- D. nulligravida.
Correct Answer: A
Rationale: The correct answer is A: primipar. A primipar refers to a woman who has completed one pregnancy with a fetus reaching the stage of fetal viability. This term specifically indicates that the woman has given birth to at least one viable fetus.
Explanation:
1. Primipar specifically refers to the number of completed pregnancies, indicating one pregnancy with a viable fetus.
2. Primigravida (B) refers to a woman who is pregnant for the first time and has not yet given birth.
3. Multipara (C) refers to a woman who has completed two or more pregnancies resulting in viable offspring.
4. Nulligravida (D) refers to a woman who has never been pregnant.
In summary, the correct answer, primipar, is the most accurate term to describe a woman who has completed one pregnancy with a fetus reaching the stage of fetal viability, distinguishing her from the other choices.
A client is complaining of heartburn. The nurse understands this is caused by which change of pregnancy?
- A. An increase in water reabsorption by the colon
- B. The relaxation of the lower esophageal ('cardiac') sphincter
- C. A decrease in the capacity of the stomach
- D. An increase in stomach acid production
Correct Answer: B
Rationale: The correct answer is B: The relaxation of the lower esophageal ('cardiac') sphincter. During pregnancy, hormonal changes can cause the lower esophageal sphincter to relax, allowing stomach acid to flow back up into the esophagus, leading to heartburn. This is known as gastroesophageal reflux. The other choices are incorrect because heartburn in pregnancy is not caused by an increase in water reabsorption by the colon (A), a decrease in the capacity of the stomach (C), or an increase in stomach acid production (D). The key factor in pregnancy-related heartburn is the relaxation of the lower esophageal sphincter, which allows acid reflux into the esophagus.