When developing an educational program for adolescents about nutrition during the third trimester of pregnancy, which of the following statements should be included?
- A. Consume three to four servings of dairy each day.
- B. Increase daily caloric intake by 600 to 700 calories.
- C. Limit daily sodium intake to less than 1 gram.
- D. Increase protein intake to 40 to 50 grams per day.
Correct Answer: A
Rationale: The correct answer is A: Consume three to four servings of dairy each day. During the third trimester of pregnancy, calcium needs increase to support the baby's bone development. Dairy products are a rich source of calcium. Adolescents are still growing themselves, so adequate calcium intake is crucial for both the mother and baby.
B: Increasing caloric intake by 600 to 700 calories is not specific to the third trimester and may lead to excessive weight gain, which can be harmful.
C: Limiting sodium intake to less than 1 gram is not necessary during pregnancy, and some sodium is required for maintaining fluid balance.
D: Increasing protein intake to 40 to 50 grams per day is important, but it is not specific to the third trimester and may vary based on individual needs.
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A client who is pregnant states that her last menstrual period was April 1st. What is the client's estimated date of delivery?
- A. January 8
- B. January 15
- C. February 8
- D. February 15
Correct Answer: A
Rationale: The estimated date of delivery (EDD) is calculated by adding 280 days to the first day of the last menstrual period (LMP). In this case, April 1st + 280 days = January 8, which is the correct EDD. Choice A is correct. Choices B, C, and D are incorrect because they do not account for the 280-day gestation period from the LMP.
A healthcare provider in a clinic is reinforcing teaching with a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency?
- A. Iron deficiency anemia
- B. Poor bone formation
- C. Macrosomic fetus
- D. Neural tube defects
Correct Answer: D
Rationale: The correct answer is D: Neural tube defects. Folic acid is crucial for neural tube development in the fetus. Without sufficient folic acid, neural tube defects like spina bifida can occur. Iron deficiency anemia (A) is not directly related to folic acid deficiency. Poor bone formation (B) is more associated with calcium and vitamin D deficiencies. Macrosomic fetus (C) refers to excessive fetal growth, not a direct consequence of folic acid deficiency. In summary, folic acid deficiency primarily increases the risk of neural tube defects in the fetus or neonate.
A client who is postpartum is receiving discharge teaching from a nurse. For which of the following clinical manifestations should the client be instructed to monitor and report to the provider?
- A. Persistent abdominal striae
- B. Temperature 37.8° C (100.2° F)
- C. Unilateral breast pain
- D. Brownish-red discharge on day 5
Correct Answer: C
Rationale: Rationale: Unilateral breast pain in a postpartum client can indicate mastitis, a bacterial infection of the breast tissue. This requires prompt medical attention to prevent complications like abscess formation.
Other Choices:
A: Abdominal striae are normal after pregnancy and don't require immediate intervention.
B: Mild temperature elevation is common postpartum and doesn't necessarily indicate infection.
D: Brownish-red discharge on day 5 is typically normal lochia and not concerning unless foul-smelling or accompanied by fever.
A healthcare professional is assisting with the care for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this condition?
- A. No alteration in menses
- B. Transvaginal ultrasound indicating a fetus in the uterus
- C. Blood progesterone greater than the expected reference range
- D. Report of severe shoulder pain
Correct Answer: D
Rationale: The correct answer is D: Report of severe shoulder pain. In a ruptured ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tube. As the tube ruptures, there is internal bleeding which can irritate the diaphragm, causing referred pain to the shoulder. This phenomenon is known as Kehr's sign. The other choices are incorrect because with a ruptured ectopic pregnancy, there would typically be altered menses due to the pregnancy disruption, a transvaginal ultrasound would not show a fetus in the uterus, and blood progesterone levels would not be elevated.
During a vaginal exam on a client in labor who reports severe pressure and pain in the lower back, a nurse notes that the fetal head is in a posterior position. Which of the following is the best nonpharmacological intervention for the nurse to perform to relieve the client's discomfort?
- A. Back rub
- B. Counter-pressure
- C. Playing music
- D. Foot massage
Correct Answer: B
Rationale: The correct answer, B: Counter-pressure, is the best nonpharmacological intervention for a client with a posterior fetal head position causing lower back pain. Counter-pressure applied to the sacrum can help alleviate discomfort by reducing pressure on the lower back and providing support during contractions. This technique can aid in rotating the baby's head to a more optimal position for delivery.
Choice A: Back rub, may offer some comfort but may not specifically address the issue of lower back pain caused by the fetal position. Choice C: Playing music, and Choice D: Foot massage, are unlikely to provide direct relief for the client's specific discomfort related to the baby's posterior position.