Nokea
A 27-year-old primigravid client with insulin-dependent diabetes at 34 weeks' gestation undergoes a nonstress test, the results of which are documented as reactive. The nurse should tell the client that the test results indicate which of the following?
- A. A contraction stress test is necessary.
- B. The nonstress test should be repeated.
- C. Chorionic villus sampling is necessary.
- D. There is evidence of fetal well-being.
Correct Answer: D
Rationale: Reactive nonstress test indicates fetal well-being.
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After instruction of a primigravid client at 8 weeks' gestation about measures to overcome early morning nausea and vomiting, which of the following client statements indicates the need for additional teaching?
- A. "I'll eat dry crackers or toast before arising in the morning."
- B. "I'll drink adequate fluids separate from my meals or snacks."
- C. "I'll eat two large meals daily with frequent protein snacks."
- D. "I'll snack on a small amount of carbohydrates throughout the day."
Correct Answer: C
Rationale: Two large meals may worsen nausea; smaller, more frequent meals are recommended.
After the nurse instructs a 20-year-old nulligravid client on how to perform a breast self-examination, which of the following client statements indicates that the teaching has been successful?
- A. I should perform breast self-examination on the day my menstrual flow begins.
- B. It's important that I perform breast self-examination on the same day each month.
- C. If I notice that one of my breasts is much smaller than the other, I shouldn't worry.
- D. If there is discharge from my nipples, I should call my health care provider.
Correct Answer: D
Rationale: Breast self-examination should be performed about a week after the menstrual period begins, when breasts are least tender. Noticing nipple discharge is a concerning symptom that warrants contacting a healthcare provider, indicating successful teaching.
A multigravid client at 39 weeks' gestation diagnosed with insulin-dependent diabetes is admitted for induction of labor with oxytocin (Pitocin). Which of the following should the nurse include in the teaching plan as a possible disadvantage of this procedure?
- A. Urinary frequency.
- B. Maternal hypoglycemia.
- C. Preterm birth.
- D. Neonatal jaundice.
Correct Answer: B
Rationale: Oxytocin induction in diabetic clients increases metabolic demand, risking maternal hypoglycemia due to insulin use. Urinary frequency is unrelated, preterm birth is not a concern at 39 weeks, and neonatal jaundice is not directly linked.
Twenty-four hours after cesarean delivery, a neonate at 30 weeks' gestation is diagnosed with respiratory distress syndrome (RDS). When explaining to the parents about the cause of this syndrome, the nurse should include a discussion about an alteration in the body's secretion of which of the following?
- A. Somatotropin.
- B. Surfactant.
- C. Testosterone.
- D. Progesterone.
Correct Answer: B
Rationale: RDS is caused by insufficient surfactant production, which is critical for lung expansion and preventing alveolar collapse.
A nurse is teaching a client about the lactational amenorrhea method. Which of the following client statements indicates a need for further teaching?
- A. I need to exclusively breastfeed for this method to work.
- B. This method is effective for up to 6 months postpartum.
- C. I can use this method even if my periods have returned.
- D. I must breastfeed on demand, including at night.
Correct Answer: C
Rationale: The lactational amenorrhea method is not effective if periods have returned, as this indicates ovulation may have resumed, requiring further teaching. The other statements are correct.