Nokea
A client at 36 weeks' gestation reports severe itching without a rash. What condition should the nurse suspect?
- A. Cholestasis of pregnancy.
- B. Preeclampsia.
- C. Gestational diabetes.
- D. Intrauterine growth restriction.
Correct Answer: A
Rationale: The correct answer is A: Cholestasis of pregnancy. Severe itching without a rash in a pregnant client at 36 weeks' gestation is often indicative of cholestasis of pregnancy, a liver condition that can occur during pregnancy. This condition is characterized by reduced bile flow, leading to the accumulation of bile acids in the blood, resulting in itching, especially on the palms and soles of the feet. Other choices (B) Preeclampsia, (C) Gestational diabetes, and (D) Intrauterine growth restriction are not typically associated with severe itching without a rash in the absence of other specific symptoms. Preeclampsia presents with hypertension and proteinuria, gestational diabetes with high blood sugar levels, and intrauterine growth restriction with poor fetal growth.
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The nurse is reviewing a prenatal chart and notes a client with placenta previa. What is the priority nursing consideration?
- A. Encourage vaginal delivery.
- B. Avoid vaginal examinations.
- C. Encourage bed rest at home.
- D. Prepare for immediate induction of labor.
Correct Answer: B
Rationale: The correct answer is B: Avoid vaginal examinations. Placenta previa is a condition where the placenta partially or completely covers the cervix, increasing the risk of bleeding. Vaginal examinations can trigger bleeding by disrupting the placenta. The priority is to minimize the risk of bleeding and prevent complications. Encouraging vaginal delivery (A) is contraindicated due to the risk of hemorrhage. Bed rest at home (C) may be recommended but is not the priority. Immediate induction of labor (D) can be dangerous and is not indicated unless there is an emergency situation.
The nurse is preparing a postpartum client for discharge. Which instruction is most important?
- A. Avoid breastfeeding if you feel tired.
- B. Report foul-smelling lochia to your doctor.
- C. Resume all physical activity immediately.
- D. Stop taking your prenatal vitamins after discharge.
Correct Answer: B
Rationale: The correct answer is B: Report foul-smelling lochia to your doctor. This instruction is crucial because foul-smelling lochia can indicate an infection, which requires immediate medical attention to prevent complications. Reporting this to the doctor promptly ensures timely treatment.
A: Avoid breastfeeding if you feel tired - Incorrect. Breastfeeding is important for the baby's nutrition and bonding, regardless of the mother's fatigue.
C: Resume all physical activity immediately - Incorrect. Gradual resumption of physical activity is recommended to allow the body to heal properly.
D: Stop taking your prenatal vitamins after discharge - Incorrect. Prenatal vitamins are beneficial for postpartum recovery and breastfeeding, so stopping them abruptly is not advisable.
A nurse is caring for newborn who is 1 hr. old and has a respiratory rate of 50/min, a heart rate of 130/min, and an auxiliary temperature of 36.1*C (97F). Which of the following actions should the nurse take?
- A. Give the newborn a warm bath.
- B. Apply a cap to the newborn head.
- C. Reposition the newborn.
- D. Obtain an oxygen saturation level
Correct Answer: C
Rationale: The correct action is to reposition the newborn. The vital signs provided indicate that the newborn may be experiencing cold stress, which can lead to hypothermia. Repositioning the newborn can help conserve heat and maintain a stable temperature. Giving a warm bath (choice A) may further decrease body temperature. Applying a cap (choice B) may help retain heat but does not address the underlying issue. Obtaining an oxygen saturation level (choice D) is not necessary based on the information provided.
In what stage does the corpus luteum form?
- A. Luteal phase
- B. Follicular phase
- C. Proliferative phase
- D. Shedding of endometrium phase
Correct Answer: A
Rationale: The corpus luteum forms during the luteal phase of the menstrual cycle. After ovulation, the ruptured follicle transforms into the corpus luteum, which secretes progesterone to prepare the uterus for potential pregnancy. If fertilization doesn't occur, the corpus luteum degenerates, leading to a drop in progesterone levels and the start of menstruation. The other choices, such as the follicular phase (B) where the follicles develop, proliferative phase (C) where the endometrium thickens, and shedding of endometrium phase (D) where menstruation occurs, do not involve the formation of the corpus luteum.
A client at 10 weeks' gestation reports frequent nausea. What dietary advice should the nurse provide?
- A. Consume small, frequent meals throughout the day.
- B. Avoid eating before going to bed.
- C. Drink large amounts of fluids with meals.
- D. Eat only three large meals daily.
Correct Answer: A
Rationale: The correct answer is A. Consuming small, frequent meals helps manage nausea by preventing an empty stomach, which can worsen symptoms. Eating smaller meals throughout the day can help stabilize blood sugar levels and provide a constant source of nutrients. This approach is recommended for managing nausea during early pregnancy.
Choice B is incorrect because avoiding eating before bed does not address the underlying issue of nausea during the day.
Choice C is incorrect because drinking large amounts of fluids with meals may worsen nausea by causing bloating and discomfort.
Choice D is incorrect because eating only three large meals daily can lead to periods of fasting in between meals, which may exacerbate nausea.