Nokea
A 36-week gestation gravid lies flat on her back.
- A. Hypertension.
- B. Dizziness.
- C. Rales.
- D. Chloasma.
Correct Answer: B
Rationale: Lying flat on the back can compress the inferior vena cava, leading to reduced blood flow and dizziness. Chloasma, rales, and hypertension are unrelated to this position.
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A pregnant patient at 36 weeks gestation reports sudden swelling of the face and hands. What is the nurse's priority action?
- A. Monitor the patient's blood pressure and check for signs of preeclampsia.
- B. Instruct the patient to rest and elevate her feet.
- C. Recommend the patient drink more water to reduce swelling.
- D. Administer diuretics as prescribed to manage fluid retention.
Correct Answer: A
Rationale: The correct answer is A: Monitor the patient's blood pressure and check for signs of preeclampsia. At 36 weeks gestation, sudden swelling of the face and hands can indicate preeclampsia, a serious condition characterized by high blood pressure and proteinuria in pregnancy. Monitoring blood pressure and assessing for other signs of preeclampsia, such as headache or vision changes, is crucial for timely diagnosis and intervention to prevent complications for both the mother and baby.
Summary:
B: Instructing the patient to rest and elevate her feet may provide some relief for swelling but does not address the underlying potential issue of preeclampsia.
C: Recommending increased water intake may not be appropriate if the swelling is due to preeclampsia and can worsen the condition.
D: Administering diuretics without proper assessment and diagnosis of preeclampsia can be harmful and is not the initial priority action.
A couple is preparing to interview obstetric primary care providers to determine who they will go to for care during their pregnancy and delivery.
- A. Take a tour of hospital delivery areas.
- B. Develop a preliminary birth plan.
- C. Make appointments with three or four obstetric care providers.
- D. Search the Internet for the malpractice histories of the providers.
Correct Answer: B
Rationale: Developing a preliminary birth plan helps couples clarify their preferences and priorities, facilitating better communication with potential providers.
Which is an expected characteristic of amniotic fluid?
- A. Deep yellow color
- B. Clear, with small white particles
- C. Nitrazine test: acidic result
- D. Absence of ferning
Correct Answer: B
Rationale: The correct answer is B: Clear, with small white particles. Amniotic fluid is typically clear with small white particles, representing vernix caseosa. Vernix caseosa is a white, cheese-like substance that covers the skin of the fetus. It helps protect the skin and regulate body temperature. The presence of vernix particles in amniotic fluid is a normal and expected characteristic.
Incorrect choices:
A: Deep yellow color - Amniotic fluid is usually clear or slightly straw-colored. A deep yellow color may indicate the presence of meconium, which suggests fetal distress.
C: Nitrazine test: acidic result - Amniotic fluid is normally alkaline, not acidic. An acidic result may indicate infection.
D: Absence of ferning - Ferning is a characteristic pattern seen under a microscope in dried cervical mucus, not amniotic fluid. Absence of ferning in amniotic fluid is not a relevant characteristic.
The nurse is caring for a pregnant patient who has been diagnosed with gestational diabetes. Which of the following interventions should be implemented first?
- A. Administer insulin to control blood glucose levels.
- B. Instruct the patient to follow a diabetic diet and monitor blood glucose levels.
- C. Schedule a cesarean delivery due to the risk of macrosomia.
- D. Start the patient on antihypertensive medications to control blood pressure.
Correct Answer: B
Rationale: The correct answer is B because instructing the patient to follow a diabetic diet and monitor blood glucose levels is the initial intervention for managing gestational diabetes. This step is crucial in controlling blood glucose levels and preventing complications for both the mother and the baby. Administering insulin (option A) may be necessary but is not the first step. Scheduling a cesarean delivery (option C) is not indicated unless there are specific obstetric indications. Starting the patient on antihypertensive medications (option D) is not relevant for managing gestational diabetes unless the patient also has hypertension.
A nurse is assessing a pregnant patient at 34 weeks gestation who reports feeling itchy and has noticed jaundice. Which of the following conditions should the nurse suspect?
- A. Gestational diabetes
- B. Preeclampsia
- C. Cholestasis of pregnancy
- D. Hyperthyroidism
Correct Answer: C
Rationale: The correct answer is C: Cholestasis of pregnancy. This condition presents with itching, especially on the palms and soles, and jaundice. It is more common in the third trimester. Cholestasis of pregnancy is a liver condition that can lead to complications for both the mother and the baby if not managed promptly. Gestational diabetes (Choice A) presents with high blood sugar levels. Preeclampsia (Choice B) is characterized by high blood pressure and protein in the urine. Hyperthyroidism (Choice D) involves an overactive thyroid gland, which can present with symptoms such as weight loss and palpitations.