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A client who is at 6 weeks of gestation with her first pregnancy asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make?
- A. This will occur during the last trimester of pregnancy.
- B. This will happen by the end of the first trimester of pregnancy.
- C. This will occur between the fourth and fifth months of pregnancy.
- D. This will happen once the uterus begins to rise out of the pelvis.
Correct Answer: C
Rationale: The correct answer is C: This will occur between the fourth and fifth months of pregnancy. Quickening typically happens around 18-20 weeks, which falls between the fourth and fifth months of pregnancy. During this time, the fetus's movements become more pronounced and can be felt by the pregnant person. Choices A, B, and D are incorrect because quickening does not occur in the last trimester, end of the first trimester, or when the uterus rises out of the pelvis. These options do not align with the typical timing of quickening in pregnancy.
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A client at 36 weeks of gestation is suspected of having placenta previa. Which of the following findings support this diagnosis?
- A. Painless red vaginal bleeding
- B. Increasing abdominal pain with a non-relaxed uterus
- C. Abdominal pain with scant red vaginal bleeding
- D. Intermittent abdominal pain following the passage of bloody mucus
Correct Answer: A
Rationale: The correct answer is A: Painless red vaginal bleeding. This finding supports the diagnosis of placenta previa due to the characteristic symptom of painless bleeding in the third trimester. Placenta previa occurs when the placenta partially or completely covers the cervix, leading to bleeding as the cervix begins to dilate. The other choices are incorrect because increasing abdominal pain with a non-relaxed uterus (B) may indicate placental abruption, abdominal pain with scant red vaginal bleeding (C) is not typical of placenta previa, and intermittent abdominal pain following the passage of bloody mucus (D) is more suggestive of preterm labor or bloody show.
A client with a BMI of 26.5 is seeking advice on weight gain during pregnancy at the first prenatal visit. Which of the following responses should the nurse provide?
- A. It would be best if you gained about 11 to 20 pounds.
- B. The recommendation for you is about 15 to 25 pounds.
- C. A gain of about 25 to 35 pounds is recommended for you.
- D. A gain of about 1 pound per week is the best pattern for you.
Correct Answer: B
Rationale: The correct answer is B (15 to 25 pounds) because this recommendation aligns with the guidelines for weight gain during pregnancy for a client with a BMI of 26.5. The Institute of Medicine recommends this weight gain range for individuals in the overweight category. It is important to strike a balance between gaining enough weight to support the health of the fetus and not gaining excess weight that may lead to complications.
Choice A (11 to 20 pounds) may not provide enough weight gain for optimal pregnancy outcomes, while choice C (25 to 35 pounds) may lead to excessive weight gain. Choice D (1 pound per week) is too specific and does not account for individual variations in weight gain patterns during pregnancy. It is crucial to tailor weight gain recommendations based on the client's BMI to ensure a healthy pregnancy.
When advising a woman considering pregnancy on nutritional needs to reduce the risk of giving birth to a newborn with a neural tube defect, what information should the nurse include?
- A. Limit alcohol consumption.
- B. Increase intake of iron-rich foods.
- C. Consume foods fortified with folic acid.
- D. Avoid foods containing aspartame.
Correct Answer: C
Rationale: The correct answer is C: Consume foods fortified with folic acid. Folic acid plays a crucial role in preventing neural tube defects in newborns. It is recommended that women of childbearing age consume 400 mcg of folic acid daily to reduce the risk. Foods fortified with folic acid include cereals, bread, and pasta.
A: Limit alcohol consumption - While important for overall health, alcohol consumption is not directly related to preventing neural tube defects.
B: Increase intake of iron-rich foods - Iron is essential during pregnancy, but it is not specifically linked to reducing the risk of neural tube defects.
D: Avoid foods containing aspartame - Aspartame is a sweetener and does not have a direct impact on neural tube defects prevention.
A healthcare provider is preparing to administer vitamin K by IM injection to a newborn. The medication should be administered into which of the following muscles?
- A. Vastus lateralis
- B. Ventrogluteal
- C. Dorsogluteal
- D. Deltoid
Correct Answer: A
Rationale: The correct answer is A: Vastus lateralis. This muscle is the preferred site for IM injections in newborns due to its large muscle mass and minimal risk of damage to nerves and blood vessels. Administering vitamin K in the vastus lateralis ensures proper absorption and distribution of the medication. Ventrogluteal and dorsogluteal sites are not recommended for newborns due to the risk of sciatic nerve damage and limited muscle mass. The deltoid muscle is typically used for older children and adults, not newborns.
During an assessment of a client in labor who received epidural anesthesia, which finding should the nurse identify as a complication of the epidural block?
- A. Vomiting
- B. Tachycardia
- C. Respiratory depression
- D. Hypotension
Correct Answer: D
Rationale: The correct answer is D: Hypotension. Epidural anesthesia can lead to hypotension due to vasodilation and sympathetic blockade, resulting in decreased blood pressure. This is a common complication that nurses should monitor for and manage promptly. Vomiting (A) is not a direct complication of epidural anesthesia. Tachycardia (B) is not typically associated with epidural anesthesia but may indicate other issues. Respiratory depression (C) is more commonly seen with opioids and not a typical complication of epidural anesthesia.