Nokea
A client with hyperemesis gravidarum is receiving dietary teaching. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will eat foods that appeal to my taste instead of trying to balance my meals.
- B. I will avoid having a snack at bedtime.
- C. I will have 8 ounces of hot tea with each meal.
- D. I will pair my sweets with a starch instead of eating them alone.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Hyperemesis gravidarum causes severe nausea and vomiting during pregnancy, leading to poor appetite and weight loss.
2. Eating foods that appeal to taste can help the client consume more calories and nutrients.
3. Balancing meals may not be a priority during hyperemesis gravidarum as the focus is on maintaining adequate nutrition.
4. Choices B, C, and D do not directly address the client's nutritional needs or coping with hyperemesis gravidarum.
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A client who is 12 hours postpartum has a fundus located two fingerbreadths above the umbilicus, deviated to the right of the midline, and less firm than previously noted. Which of the following actions should the nurse take?
- A. Place the client in a side-lying position.
- B. Assist the client to the bathroom to void.
- C. Obtain a prescription for IV oxytocin.
- D. Administer methylergonovine.
Correct Answer: B
Rationale: The correct answer is B: Assist the client to the bathroom to void. This action can help promote uterine contractions by relieving bladder distention, which can cause the fundus to be displaced. Voiding can help the uterus return to its normal position and firmness. Placing the client in a side-lying position (A) may be helpful for fundal massage but addressing bladder distention is the priority. Obtaining a prescription for IV oxytocin (C) or administering methylergonovine (D) are not indicated as first-line interventions for a fundus located above the umbilicus postpartum.
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 provider is discussing the differences between true labor and false labor with a group of expectant parents. Which of the following characteristics should the healthcare provider include when discussing true labor?
- A. Contractions become stronger with walking.
- B. Discomfort can be relieved with a back massage.
- C. Contractions become irregular with a change in activity.
- D. Discomfort is felt above the umbilicus.
Correct Answer: A
Rationale: The correct answer is A: Contractions become stronger with walking. This is because true labor is characterized by contractions that consistently increase in intensity and frequency, which is often enhanced by physical activity like walking. Contractions in false labor do not typically intensify with movement. Discomfort in true labor is usually not easily relieved by a back massage (B) and contractions in true labor remain regular even with changes in activity (C). Discomfort in true labor is typically felt in the lower abdomen and back, not above the umbilicus (D).
When caring for clients in a prenatal clinic, a nurse should report which client's weight gain to the provider?
- A. 1.8 kg (4 lb) weight gain in the first trimester
- B. 3.6 kg (8 lb) weight gain in the first trimester
- C. 6.8 kg (15 lb) weight gain in the second trimester
- D. 11.3 kg (25 lb) weight gain in the third trimester
Correct Answer: B
Rationale: The correct answer is B: 3.6 kg (8 lb) weight gain in the first trimester. This amount of weight gain in the first trimester is higher than the recommended range of 1.1-4.5 lbs. It could indicate potential issues such as gestational diabetes or preeclampsia. Choices A, C, and D fall within or closer to the expected weight gain ranges for each trimester, making them less concerning. Reporting excessive weight gain early allows for timely intervention and monitoring.
A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea, vomiting, and scant, prune-colored discharge. The client has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect?
- A. Hyperemesis gravidarum
- B. Threatened abortion
- C. Hydatidiform mole
- D. Preterm labor
Correct Answer: C
Rationale: The correct answer is C: Hydatidiform mole. At 4 months of gestation, prune-colored discharge indicates possible passage of vesicular tissue characteristic of a molar pregnancy. This, along with continued nausea, vomiting, and larger fundal height, are signs of a hydatidiform mole. Hyperemesis gravidarum (A) typically involves severe nausea and vomiting leading to weight loss, which the client did not experience. Threatened abortion (B) presents with vaginal bleeding and cramping, not prune-colored discharge. Preterm labor (D) is characterized by regular contractions leading to cervical changes, not the symptoms described.