Nokea
A 36-week pregnant woman is admitted with ruptured membranes and a positive test for Group B Streptococcus (GBS). What is the appropriate nursing action?
- A. Start prophylactic antibiotics for the patient
- B. Perform a cesarean section
- C. Administer IV fluids
- D. Provide patient education on labor progression
Correct Answer: A
Rationale: The correct answer is A: Start prophylactic antibiotics for the patient. In this scenario, the woman is at risk for ascending infection due to ruptured membranes and positive GBS test. Prophylactic antibiotics are necessary to prevent neonatal GBS sepsis. Performing a cesarean section is not indicated unless there are other obstetric indications. Administering IV fluids is important but not the priority in this case. Patient education on labor progression is not the immediate concern when the woman is at risk for infection.
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A newly pregnant patient tells the nurse that she has irregular periods and is unsure of when she got pregnant. When is the best time for the nurse to schedule the patient’s ultrasound?
- A. Immediately
- B. In 2 weeks
- C. In 4 weeks
- D. In 6 weeks
Correct Answer: A
Rationale: An ultrasound at around 5-6 weeks after the last menstrual period is the most accurate time to determine gestational age.
Which statement about fetal circulation is correct?
- A. The foramen ovale is between ventricles
- B. Umbilical vein contains oxygen-poor blood
- C. Right atrium contains mixed blood
- D. Ductus venosus lies between aorta and pulmonary artery
Correct Answer: C
Rationale: The right atrium contains both oxygen-rich and oxygen-poor blood due to the unique fetal circulatory system.
At what point in prenatal development do the lungs begin to produce surfactant?
- A. 17 weeks
- B. 20 weeks
- C. 25 weeks
- D. 30 weeks
Correct Answer: C
Rationale: During week 25, the alveoli begin to produce surfactant, which enables the alveoli to stay open for adequate lung oxygenation to occur.
The nurse is caring for a pregnant patient who is 22 weeks gestation and is concerned about her weight gain. Which of the following statements by the patient indicates the need for further teaching?
- A. I should aim to gain 1 to 2 pounds per week during my pregnancy.
- B. I will avoid eating extra food to prevent excessive weight gain.
- C. I can eat for two during my pregnancy to ensure the baby's growth.
- D. I will maintain a healthy diet and exercise regularly to support my pregnancy.
Correct Answer: C
Rationale: Correct Answer: C - "I can eat for two during my pregnancy to ensure the baby's growth."
Rationale:
1. Eating for two is a common misconception; the pregnant woman only needs an additional 300-500 calories per day.
2. Overeating can lead to excessive weight gain which may pose risks to both the mother and the baby.
3. The statement does not reflect an accurate understanding of healthy nutrition during pregnancy.
Summary of Incorrect Choices:
A: Choosing to gain 1 to 2 pounds per week aligns with healthy weight gain during pregnancy.
B: Avoiding excessive food intake is an appropriate strategy to prevent excessive weight gain.
D: Maintaining a healthy diet and regular exercise are essential for supporting a healthy pregnancy.
The nurse is providing education to a pregnant patient about diet during pregnancy. Which of the following statements indicates that the patient needs further teaching?
- A. I should increase my intake of fruits, vegetables, and whole grains.
- B. I need to limit my intake of high-fat and high-sugar foods.
- C. I can eat whatever I want as long as I am gaining weight steadily.
- D. I should drink plenty of water and stay hydrated throughout the day.
Correct Answer: C
Rationale: The correct answer is C because the statement "I can eat whatever I want as long as I am gaining weight steadily" indicates a misunderstanding of healthy eating during pregnancy. The rationale is that pregnancy is a crucial time for proper nutrition, and simply focusing on weight gain without considering the quality of food can lead to health risks for both the mother and the baby. Choices A, B, and D are all correct statements that promote a healthy diet during pregnancy by emphasizing the importance of nutrient-dense foods, limiting unhealthy choices, and staying hydrated.