Advanced Maternal Age Monitoring

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A 38-week pregnant patient in active labor is experiencing frequent and painful contractions. What is the most appropriate action for the nurse?

  • A. Administer narcotic analgesics for pain relief
  • B. Provide emotional support and reassurance
  • C. Assess the fetal heart rate and contraction patterns
  • D. Prepare for delivery
Correct Answer: D

Rationale: The correct answer is D: Prepare for delivery. At 38 weeks of gestation and in active labor, the most appropriate action is to prepare for delivery as the patient is likely to be close to giving birth. This involves ensuring that all necessary equipment and supplies are ready, notifying the healthcare team, and positioning the patient for delivery. Administering narcotic analgesics (choice A) may not be ideal at this stage as the priority is the imminent delivery. While emotional support and reassurance (choice B) are important, they should be provided alongside preparing for delivery. Assessing the fetal heart rate and contraction patterns (choice C) is crucial but should be done concurrently with preparing for delivery to ensure the safety of both the mother and baby.

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The nurse is providing prenatal education to a pregnant patient about the signs of labor. Which of the following symptoms should the nurse instruct the patient to report immediately?

  • A. Feeling pressure in the lower abdomen
  • B. A bloody show or the loss of the mucous plug
  • C. Regular contractions every 5 minutes for 1 hour
  • D. A sudden increase in fetal movements
Correct Answer: C

Rationale: The correct answer is C: Regular contractions every 5 minutes for 1 hour. This is a sign of active labor and indicates that the patient should seek immediate medical attention. Contractions at this frequency and duration suggest that labor is progressing and the patient should go to the hospital. Choices A, B, and D are not indicative of active labor and do not require immediate medical attention. Feeling pressure in the lower abdomen may be a normal part of pregnancy. A bloody show or loss of the mucous plug can be early signs of labor but do not require immediate attention unless accompanied by other symptoms. A sudden increase in fetal movements is generally considered a positive sign of fetal well-being.

A nurse is caring for a postpartum person who is experiencing a boggy uterus. What is the priority intervention?

  • A. perform uterine massage
  • B. encourage early ambulation
  • C. assist with positioning
  • D. perform a pelvic exam
Correct Answer: A

Rationale: The correct answer is A: perform uterine massage. This is the priority intervention for a boggy uterus to prevent postpartum hemorrhage by promoting uterine contraction and reducing bleeding. Uterine massage helps the uterus to firm up and expel clots. Early ambulation (B) and positioning (C) can support recovery but do not directly address the boggy uterus. Performing a pelvic exam (D) is not necessary for managing a boggy uterus and may even exacerbate bleeding.

A nurse is caring for a patient in labor who is receiving oxytocin for induction. Which of the following is a priority assessment for the nurse?

  • A. Fetal heart rate monitoring
  • B. Fluid intake and output
  • C. Uterine tone assessment
  • D. Maternal blood pressure monitoring
Correct Answer: A

Rationale: The correct answer is A: Fetal heart rate monitoring. This is a priority assessment because oxytocin can cause uterine hyperstimulation, leading to fetal distress. Monitoring the fetal heart rate allows early detection of any signs of fetal compromise. Choices B, C, and D are important assessments but not the priority in this situation. Monitoring fluid intake and output, uterine tone, and maternal blood pressure are also crucial but do not directly assess fetal well-being, which is the primary concern during labor induction with oxytocin.

A 37-week gravid client states that she noticed a 'white liquid' leaking from her breasts during a recent shower.

  • A. Advise the woman that she may have a galactocele.
  • B. Encourage the woman to pump her breasts to stimulate an adequate milk supply.
  • C. Assess the liquid because a breast discharge is diagnostic of a mammary infection.
  • D. Reassure the mother that this is normal in the third trimester.
Correct Answer: D

Rationale: In the third trimester, colostrum production can cause a white liquid to leak from the breasts. This is a normal physiological response as the body prepares for breastfeeding.

What alternative could the nurse suggest to someone practicing pica?

  • A. Replace laundry starch with salt
  • B. Replace ice with frozen fruit juice
  • C. Replace soap with cream cheese
  • D. Replace soil with uncooked pie crust
Correct Answer: B

Rationale: Replacing ice with frozen fruit juice provides a safer alternative while satisfying the craving for cold substances.

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