Nokea
A pregnant patient is at 30 weeks gestation and is concerned about gestational diabetes. Which of the following is a key sign that the nurse should monitor for?
- A. Frequent urination and excessive thirst
- B. Nausea and vomiting after meals
- C. Increased appetite and weight gain
- D. Fatigue and dizziness during physical activity
Correct Answer: A
Rationale: The correct answer is A: Frequent urination and excessive thirst. In gestational diabetes, the body may not be able to produce enough insulin, leading to high blood sugar levels. The excess sugar in the blood can cause increased thirst and frequent urination as the body tries to eliminate the sugar through urine. This is a key sign that the nurse should monitor for in a pregnant patient at 30 weeks gestation. Nausea and vomiting after meals (B) are more commonly associated with morning sickness in early pregnancy. Increased appetite and weight gain (C) can occur during pregnancy but are not specific signs of gestational diabetes. Fatigue and dizziness during physical activity (D) can be common in pregnancy due to hormonal changes and increased demands on the body but are not specific to gestational diabetes.
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A patient who is 40 weeks pregnant presents to the labor and delivery unit with decreased fetal movement. What is the first step in management?
- A. Perform a nonstress test (NST)
- B. Administer a corticosteroid injection
- C. Monitor fetal heart rate
- D. Monitor the fetal heart rate
Correct Answer: A
Rationale: The correct answer is A: Perform a nonstress test (NST). This is the first step in assessing fetal well-being when a patient presents with decreased fetal movement at 40 weeks gestation. The NST evaluates fetal heart rate in response to fetal movement, providing immediate information on fetal well-being. Administering a corticosteroid injection (B) would not be indicated at this point as it is not the first-line management for decreased fetal movement. Monitoring fetal heart rate (C and D) is important, but the NST provides more comprehensive information on fetal well-being.
What factor should the nurse consider when counseling a Chinese immigrant?
- A. Many Chinese eat little protein
- B. Many Chinese believe in eating cold foods
- C. Many Chinese are prone to anemia
- D. Many Chinese believe strawberries cause birth defects
Correct Answer: D
Rationale: Cultural beliefs, such as the idea that strawberries might cause birth defects, should be considered to provide culturally sensitive care.
A nurse is assisting a laboring person with a vacuum extraction. What is the most important nursing action to ensure a safe procedure?
- A. monitor fetal heart rate continuously
- B. prepare the person for a cesarean section
- C. monitor for signs of uterine rupture
- D. assist with positioning the person
Correct Answer: B
Rationale: The correct answer is B: prepare the person for a cesarean section. In the scenario of vacuum extraction, if there are complications or the procedure is unsuccessful, the person may need to undergo an emergency cesarean section. By preparing the person for this possibility, the nurse ensures timely intervention if needed, prioritizing the safety of both the person and the baby. Monitoring fetal heart rate continuously (A) is important but not the most crucial action in this case. Monitoring for signs of uterine rupture (C) is not directly related to vacuum extraction. Assisting with positioning (D) is important but not as critical as preparing for a potential cesarean section.
The nurse is caring for a pregnant patient who is at 25 weeks gestation and is concerned about gestational diabetes. Which of the following symptoms should the nurse educate the patient to watch for?
- A. Increased thirst and frequent urination
- B. Severe leg cramps and dizziness
- C. Constant fatigue and swollen feet
- D. Shortness of breath and dizziness upon standing
Correct Answer: A
Rationale: The correct answer is A: Increased thirst and frequent urination. These symptoms are indicative of gestational diabetes due to elevated blood sugar levels. Increased thirst is a result of the body trying to dilute the excess glucose through increased fluid intake, leading to frequent urination. This occurs because the kidneys work to eliminate the excess glucose from the blood by excreting it in the urine. Therefore, educating the patient to watch for these symptoms is crucial for early detection and management of gestational diabetes.
Choices B, C, and D are incorrect as they do not directly correlate with the symptoms of gestational diabetes. Severe leg cramps and dizziness (Choice B) may be related to other factors such as dehydration or electrolyte imbalance. Constant fatigue and swollen feet (Choice C) could be common symptoms during pregnancy but are not specific to gestational diabetes. Shortness of breath and dizziness upon standing (Choice D) are more likely to be related to issues such as anemia or changes
The patient who has received a dose of preservative- free morphine (Duramorph) is beginning to experience pruritus. Which medication is used to treat this?
- A. Low-dose naloxone infusion
- B. Diphenhydramine
- C. Dilaudid
- D. Sublimaze
Correct Answer: B
Rationale: The correct answer is B: Diphenhydramine. Pruritus is a common side effect of opioid medications like morphine. Diphenhydramine, an antihistamine, can help relieve itching. Low-dose naloxone infusion (A) is used for opioid overdose, not pruritus. Dilaudid (C) and Sublimaze (D) are other opioid medications similar to morphine, and using them would not address the pruritus. Diphenhydramine is the most appropriate choice to alleviate the itching without interfering with the pain relief provided by the morphine.