Nokea
A client at 10 weeks gestation is being seen by the nurse. The client reports that she has nausea and vomiting each morning. Which is the nurse's best response?
- A. Drink a large glass of milk before you get out of bed.
- B. Eat crackers before you get out of bed.
- C. Eat dinner before 6:00 p.m. every night.
- D. Eat small meals during the day.
Correct Answer: B
Rationale: The correct answer is B: Eat crackers before you get out of bed. This is the best response because eating crackers before getting out of bed can help alleviate nausea and vomiting associated with morning sickness in early pregnancy. The crackers can help stabilize blood sugar levels and settle the stomach. Drinking a large glass of milk (choice A) may exacerbate nausea for some individuals. Eating dinner before 6:00 p.m. (choice C) is not directly related to morning sickness. Eating small meals during the day (choice D) is generally a good strategy, but specifically eating crackers before getting out of bed is more effective for morning sickness.
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A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?
- A. Not palpable above the symphysis at this time
- B. Slightly above the symphysis pubis
- C. At the level of the umbilicus
- D. Slightly above the umbilicus
Correct Answer: B
Rationale: In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the symphysis pubis sometime between the 12th and 14th weeks of pregnancy.
Now in her second trimester of pregnancy, the client, who was a marathon runner before nausea and overwhelming tiredness kept her from exercising regularly, is wondering whether she can run now. What is the nurse's best response?
- A. Certainly, if you feel up to it.
- B. Your level of exercise will be somewhat modified by the changes occurring in your body.
- C. Your primary health care provider will need to give you permission.
- D. Because your body is meeting the needs of two people now, you should avoid too much exercise.
Correct Answer: B
Rationale: The correct answer is B: "Your level of exercise will be somewhat modified by the changes occurring in your body."
Rationale:
1. Pregnancy impacts a woman's body significantly, including changes in hormones, weight distribution, and center of gravity.
2. These changes can affect a woman's ability to engage in high-impact activities like running.
3. The nurse's response acknowledges the need for modification in exercise routine to accommodate these changes.
4. It promotes a balanced approach to exercise during pregnancy, considering both the benefits of physical activity and the safety of the mother and baby.
Summary of Other Choices:
A: "Certainly, if you feel up to it." - This response oversimplifies the situation and does not consider the specific physiological changes during pregnancy that may impact the woman's ability to run safely.
C: "Your primary health care provider will need to give you permission." - While consulting a healthcare provider is important, this response does not address the specific concerns related to exercise during pregnancy.
A patient in her first trimester complains of nausea and vomiting. She asks, 'Why does this happen?' The nurse's best response is:
- A. It is due to an increase in gastric motility.'
- B. It may be due to changes in hormones.'
- C. It is related to an increase in glucose levels.'
- D. It is caused by a decrease in gastric secretions.'
Correct Answer: B
Rationale: Nausea and vomiting are believed to be caused by increased levels of hormones, decreased gastric motility, and hypoglycemia.
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?
- A. Less audible heart sounds (S , S ) 1 2
- B. Increased pulse rate
- C. Increased blood pressure
- D. Decreased red blood cell (RBC) production
Correct Answer: B
Rationale: The correct answer is B: Increased pulse rate. During the second trimester of pregnancy, it is normal for a woman's heart rate to increase due to the increased blood volume and cardiac output needed to support the growing fetus. This physiological change helps meet the increased metabolic demands of both the mother and the baby.
A: Less audible heart sounds (S1, S2) is incorrect because heart sounds are typically more audible during pregnancy due to the increased blood flow and volume in the cardiovascular system.
C: Increased blood pressure is incorrect because blood pressure tends to decrease slightly during the second trimester before rising again in the third trimester.
D: Decreased red blood cell (RBC) production is incorrect because RBC production actually increases during pregnancy to support the increased oxygen-carrying capacity required for the mother and the fetus.
The nurse caring for the pregnant patient must understand that the hormone essential for maintaining pregnancy is:
- A. estrogen
- B. human chorionic gonadotropin (hCG)
- C. oxytocin
- D. progesterone
Correct Answer: D
Rationale: Progesterone is crucial for maintaining pregnancy as it relaxes smooth muscles, reducing uterine activity and preventing miscarriage.