A client is being educated by a healthcare provider about the physiological changes that occur during pregnancy. The client is at 10 weeks of gestation and has a BMI within the expected reference range. Which of the following client statements indicates an understanding of the teaching?
- A. I should gain more than 15 to 20 pounds during my pregnancy.
- B. I will likely need to use alternative positions for sexual intercourse.
- C. I'm glad I had a breast reduction years ago so they will not enlarge with my pregnancy.
- D. I'm glad I have a light complexion and will not get any stretch marks.
Correct Answer: B
Rationale: The correct answer is B: "I will likely need to use alternative positions for sexual intercourse." At 10 weeks of gestation, the uterus begins to enlarge, potentially causing discomfort in the missionary position. This statement shows an understanding of the physical changes in pregnancy.
A is incorrect because the recommended weight gain for a client with normal BMI is 25-35 pounds during pregnancy, not less than 15-20 pounds. C is incorrect as breast size typically increases during pregnancy due to hormonal changes, regardless of prior breast reduction surgery. D is incorrect because stretch marks are common during pregnancy, regardless of skin complexion.
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A client in active labor at 39 weeks of gestation is receiving continuous IV oxytocin and has early decelerations in the FHR on the monitor tracing. What action should the nurse take?
- A. Discontinue the oxytocin infusion.
- B. Continue monitoring the client.
- C. Request that the provider assess the client.
- D. Increase the infusion rate of the maintenance IV fluid.
Correct Answer: B
Rationale: The correct action for the nurse to take when a client in active labor at 39 weeks of gestation has early decelerations in the FHR on the monitor tracing is to continue monitoring the client. Early decelerations are typically benign and are associated with head compression during contractions, which is a normal response to labor. There is no need to discontinue the oxytocin infusion as early decelerations do not indicate fetal distress. Requesting the provider to assess the client may not be necessary at this point unless other concerning signs are present. Increasing the infusion rate of the maintenance IV fluid is not indicated as it would not address the early decelerations. Therefore, the best course of action is to continue monitoring the client for any changes in the FHR pattern.
A parent is receiving discharge teaching from a nurse regarding caring for their newborn after a circumcision. Which instruction should the nurse include?
- A. Apply slight pressure with a sterile gauze pad for mild bleeding.
- B. Inspect the circumcision site every 6 to 8 hours.
- C. Avoid using baby wipes containing alcohol to cleanse the penis with each diaper change.
- D. Clean the circumcision site daily using a warm, wet washcloth.
Correct Answer: A
Rationale: The correct answer is A: Apply slight pressure with a sterile gauze pad for mild bleeding. This instruction is crucial because it addresses the immediate post-circumcision care to control bleeding. Applying slight pressure with a sterile gauze pad helps to promote clotting and prevent excessive bleeding. This step is essential to ensure the newborn's safety and prevent complications.
Summary of other choices:
B: Inspecting the circumcision site every 6 to 8 hours is important, but not as critical as addressing bleeding promptly.
C: Avoiding baby wipes containing alcohol is a good practice to prevent irritation, but it is not the most urgent instruction for immediate care.
D: Cleaning the circumcision site daily using a warm, wet washcloth is generally recommended for routine care, but in the immediate post-circumcision period, controlling bleeding takes precedence.
A caregiver is learning about newborn safety. Which of the following statements by a parent indicates an understanding of the teaching?
- A. I will dress my baby in flame-retardant clothing.
- B. I will ensure a bib on my baby at night to keep her clothing dry.
- C. I will warm my baby's formula using the lowest setting in the microwave.
- D. I will cover the crib mattress with plastic to prevent staining.
Correct Answer: A
Rationale: The correct answer is A because dressing the baby in flame-retardant clothing is a safety measure to reduce the risk of burns. Flame-retardant clothing can help protect the baby in case of accidental exposure to fire or heat sources.
Choice B is incorrect because putting a bib on the baby at night can pose a suffocation hazard. Choice C is incorrect because warming formula in the microwave can create hot spots that may burn the baby's mouth. Choice D is incorrect because covering the crib mattress with plastic can increase the risk of suffocation and overheating for the baby.
A healthcare professional is preparing to administer magnesium sulfate 2 g/hr IV to a client who is in preterm labor. Available is 20 g of magnesium sulfate in 500 mL of dextrose 5% in water (D5W). How many mL/hr should the IV infusion pump be set to administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 60
- B. 30
- C. 50
- D. 80
Correct Answer: C
Rationale: To calculate the mL/hr for the IV infusion pump, we need to use the formula: (Desired dose in mg/hr * Volume of solution in mL) / Concentration of solution in mg/mL.
Given:
Desired dose = 2 g/hr = 2000 mg/hr
Volume of solution = 500 mL
Concentration of solution = 20 g in 500 mL = 20,000 mg in 500 mL = 40 mg/mL
Now, plug these values into the formula:
(2000 mg/hr * 500 mL) / 40 mg/mL = 25,000 mL/hr
Round this to the nearest whole number, which is 25,000 mL/hr ≈ 50 mL/hr. Therefore, the IV infusion pump should be set to administer 50 mL/hr, making choice C the correct answer.
Option A (60 mL/hr) and Option D (80 mL/hr) are incorrect as they do not match the calculated value. Option
A healthcare provider in a clinic is reinforcing teaching with a client of childbearing age about recommended folic acid supplements. Which of the following defects can occur in the fetus or neonate as a result of folic acid deficiency?
- A. Iron deficiency anemia
- B. Poor bone formation
- C. Macrosomic fetus
- D. Neural tube defects
Correct Answer: D
Rationale: The correct answer is D: Neural tube defects. Folic acid is crucial for neural tube development in the fetus. Without sufficient folic acid, neural tube defects like spina bifida can occur. Iron deficiency anemia (A) is not directly related to folic acid deficiency. Poor bone formation (B) is more associated with calcium and vitamin D deficiencies. Macrosomic fetus (C) refers to excessive fetal growth, not a direct consequence of folic acid deficiency. In summary, folic acid deficiency primarily increases the risk of neural tube defects in the fetus or neonate.