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A client, in her third trimester, is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy.
- A. Don't worry. You'll know the difference when the contractions start.
- B. The contractions may feel just like a backache
- C. but they will come and go.
- D. Contractions are a lot worse than your pregnancy aches and pains.
Correct Answer: B
Rationale: Labor contractions typically have a pattern, coming and going at regular intervals, whereas normal aches and pains do not follow such a predictable pattern.
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A client makes the following statement after finding out that her pregnancy test is positive, 'This is not a good time. I am in college and the baby will be due during final exams!' Which of the following responses by the nurse would be most appropriate at this time?
- A. I’m absolutely positive that everything will turn out all right.
- B. I suggest that you e-mail your professors to set up an alternate plan.
- C. It sounds like you’re feeling a little overwhelmed right now.
- D. You and the baby’s father will find a way to get through the pregnancy.
Correct Answer: C
Rationale: Acknowledging the client's feelings of being overwhelmed is the most supportive response. Offering solutions or reassurance without first addressing the client's emotions may not be as effective.
Which factors should be considered a contraindication for transcervical chorionic villus sampling?
- A. Rh-negative mother
- B. Gestation less than 15 weeks
- C. Maternal age younger than 35 years
- D. Positive for group B Streptococcus
Correct Answer: D
Rationale: Maternal infection, such as group B Streptococcus, is a contraindication for the procedure due to the risk of infection.
A patient in labor is having difficulty pushing during the second stage of labor. Which of the following interventions would be most helpful?
- A. Increase the epidural dose
- B. Encourage the patient to bear down with each contraction
- C. Perform a cesarean section
- D. Place the patient in a lithotomy position
Correct Answer: B
Rationale: The correct answer is B: Encourage the patient to bear down with each contraction. This is the most helpful intervention as it helps the patient effectively push during the second stage of labor, facilitating the descent of the baby through the birth canal. Increasing the epidural dose (choice A) can further impair the patient's ability to push. Performing a cesarean section (choice C) is not necessary unless there are other complications. Placing the patient in a lithotomy position (choice D) is a common position for delivery but does not address the issue of difficulty pushing.
The nurse is caring for a pregnant patient at 32 weeks gestation who reports feeling lightheaded and faint when standing. What should the nurse recommend?
- A. Increase fluid intake and avoid standing for long periods.
- B. Take deep breaths and rise quickly from a seated position.
- C. Rest and avoid any physical activity during the day.
- D. Sit upright and avoid bending forward at the waist.
Correct Answer: A
Rationale: The correct answer is A: Increase fluid intake and avoid standing for long periods. This recommendation is appropriate for the patient's symptoms of lightheadedness and fainting, which could be due to dehydration or low blood pressure common in pregnancy. Increasing fluid intake can help maintain adequate blood volume and pressure. Avoiding prolonged standing can prevent pooling of blood in the lower extremities, reducing the risk of dizziness.
Choices B, C, and D are incorrect:
B: Taking deep breaths and rising quickly may worsen symptoms by causing a sudden drop in blood pressure.
C: Complete rest and avoiding physical activity may not address the underlying issue of hydration or blood pressure.
D: Sitting upright and avoiding bending forward may not directly address the need for increased fluid intake and reduced standing time.
A pregnant patient at 32 weeks gestation reports severe heartburn. What should the nurse recommend to relieve symptoms?
- A. Take over-the-counter antacids after every meal.
- B. Eat smaller, more frequent meals and avoid lying down after eating.
- C. Drink a large glass of water immediately after meals to dilute stomach acid.
- D. Increase caffeine intake to speed up digestion.
Correct Answer: B
Rationale: The correct answer is B: Eat smaller, more frequent meals and avoid lying down after eating. This recommendation helps prevent acid reflux by reducing the pressure on the stomach and ensuring that the stomach is not overly full. Eating smaller meals more frequently prevents the stomach from becoming too full, which can trigger heartburn. Avoiding lying down after eating helps prevent stomach acid from flowing back into the esophagus. Options A, C, and D are incorrect. Taking antacids after every meal can lead to excessive intake and potential side effects. Drinking water immediately after meals may exacerbate heartburn by diluting stomach acid further. Increasing caffeine intake can worsen heartburn symptoms due to its ability to relax the lower esophageal sphincter.