Nokea
A couple is preparing to interview obstetric primary care providers to determine who they will go to for care during their pregnancy and delivery.
- A. Take a tour of hospital delivery areas.
- B. Develop a preliminary birth plan.
- C. Make appointments with three or four obstetric care providers.
- D. Search the Internet for the malpractice histories of the providers.
Correct Answer: B
Rationale: Developing a preliminary birth plan helps couples clarify their preferences and priorities, facilitating better communication with potential providers.
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A nurse is preparing a laboring person for an epidural block. What is the nurse's priority action before the procedure?
- A. ensure the birthing person is positioned correctly
- B. check for allergies to anesthesia
- C. administer a test dose of anesthesia
- D. administer IV fluids
Correct Answer: A
Rationale: The correct answer is A: ensure the birthing person is positioned correctly. This is the priority action because proper positioning is crucial for the safe and effective administration of an epidural block. Incorrect positioning can lead to complications such as inadequate pain relief, nerve damage, or difficulty in performing the procedure. Checking for allergies to anesthesia (B) is important but not the priority before positioning. Administering a test dose of anesthesia (C) should only be done after ensuring correct positioning. Administering IV fluids (D) is important but not the priority action before positioning.
A 37-week gravid client states that she noticed a 'white liquid' leaking from her breasts during a recent shower.
- A. Advise the woman that she may have a galactocele.
- B. Encourage the woman to pump her breasts to stimulate an adequate milk supply.
- C. Assess the liquid because a breast discharge is diagnostic of a mammary infection.
- D. Reassure the mother that this is normal in the third trimester.
Correct Answer: D
Rationale: In the third trimester, colostrum production can cause a white liquid to leak from the breasts. This is a normal physiological response as the body prepares for breastfeeding.
A pregnant patient at 36 weeks gestation reports sudden swelling of the face and hands. What is the nurse's priority action?
- A. Monitor the patient's blood pressure and check for signs of preeclampsia.
- B. Instruct the patient to rest and elevate her feet.
- C. Recommend the patient drink more water to reduce swelling.
- D. Administer diuretics as prescribed to manage fluid retention.
Correct Answer: A
Rationale: The correct answer is A: Monitor the patient's blood pressure and check for signs of preeclampsia. At 36 weeks gestation, sudden swelling of the face and hands can indicate preeclampsia, a serious condition characterized by high blood pressure and proteinuria in pregnancy. Monitoring blood pressure and assessing for other signs of preeclampsia, such as headache or vision changes, is crucial for timely diagnosis and intervention to prevent complications for both the mother and baby.
Summary:
B: Instructing the patient to rest and elevate her feet may provide some relief for swelling but does not address the underlying potential issue of preeclampsia.
C: Recommending increased water intake may not be appropriate if the swelling is due to preeclampsia and can worsen the condition.
D: Administering diuretics without proper assessment and diagnosis of preeclampsia can be harmful and is not the initial priority action.
A patient in labor is undergoing an epidural block and is given intravenous fluid. What is the purpose of this?
- A. To treat hypotension that results from hemorrhage
- B. To increase urine output
- C. To treat insensible fluid losses
- D. To treat hypotension that results from sympathetic blockade
Correct Answer: D
Rationale: The correct answer is D: To treat hypotension that results from sympathetic blockade. When an epidural block is administered during labor, sympathetic blockade can lead to a drop in blood pressure. By providing intravenous fluid, the goal is to increase preload and maintain blood pressure to counteract the hypotension caused by sympathetic blockade.
A: Treating hypotension from hemorrhage is not the primary purpose in this scenario.
B: Increasing urine output is not the main goal of giving intravenous fluid during an epidural block.
C: Treating insensible fluid losses is not the immediate concern when a patient is experiencing hypotension from sympathetic blockade.
Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following?
- A. Avoid eating greasy foods.
- B. Drink orange juice before rising.
- C. Consume 1 teaspoon of nutmeg each morning.
- D. Eat 3 large meals plus a bedtime snack.
Correct Answer: A
Rationale: Greasy foods can exacerbate nausea and vomiting. Small, frequent meals are recommended, and saltine crackers before rising can help alleviate symptoms. Orange juice and nutmeg are not recommended.