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A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, which of the following is the client’s estimated date of delivery?
- A. May 13
- B. May 17
- C. May 3
- D. May 20
Correct Answer: B
Rationale: The correct answer is B: May 17. Nägele's Rule states to add 7 days to the first day of the last menstrual period, then subtract 3 months, and add 1 year. In this case, August 10 + 7 days = August 17. Subtracting 3 months gives us May 17. This date is the estimated date of delivery. Choice A (May 13) is incorrect as it does not follow Nägele's Rule. Choice C (May 3) is too early based on the calculation. Choice D (May 20) is too late as it exceeds the estimated date.
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A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Hematocrit 37% (37% to 47%)
- B. Creatinine 0.9 mg/dL (0.5 to 1 mg/dL)
- C. WBC count 11,000/mm3 (5,000 to 10,000/mm3)
- D. Fasting blood glucose 180 mg/dL (74 to 106 mg/dL)
Correct Answer: D
Rationale: The correct answer is D: Fasting blood glucose 180 mg/dL (74 to 106 mg/dL). A high fasting blood glucose level during pregnancy may indicate gestational diabetes, which can lead to complications for both the mother and the fetus. The nurse should report this finding to the provider for further evaluation and management to prevent adverse outcomes.
Choice A: Hematocrit of 37% falls within the normal range for a pregnant woman and does not require immediate reporting.
Choice B: Creatinine level of 0.9 mg/dL is within the normal range and does not indicate any immediate concerns.
Choice C: WBC count of 11,000/mm3 is slightly elevated but can be a normal response to pregnancy and does not typically require immediate action.
In summary, the correct answer is D because it indicates a potentially serious condition that requires further investigation, while choices A, B, and C are within normal limits for pregnancy and do not raise immediate concerns.
A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?
- A. Feed the newborn 5 to 10 min per breast.
- B. Offer the newborn 30 mL (1 oz) of water between feedings.
- C. Expect two to four wet diapers every 24 hr.
- D. Allow the baby to feed at least every 3 hr.
Correct Answer: D
Rationale: The correct answer is D: Allow the baby to feed at least every 3 hours. This is crucial for maintaining the baby's nutrition and ensuring an adequate milk supply. Breastfeeding on demand helps establish a healthy feeding pattern and promotes bonding between the mother and baby. Option A is incorrect because newborns should feed until they are satisfied, not based on time. Option B is incorrect as newborns should not be given water as it can interfere with breastfeeding and lead to water intoxication. Option C is incorrect as newborns should have at least 6-8 wet diapers a day.
A nurse is discussing fertility treatment options with a client and their partner. Which of the following nonpharmacological treatments should the nurse suggest?
- A. Use a lubricant during intercourse.
- B. Drink herbal tea two times daily.
- C. Maintain a healthy weight.
- D. Take daily hot baths.
Correct Answer: C
Rationale: The correct answer is C: Maintain a healthy weight. Maintaining a healthy weight is crucial for fertility as being underweight or overweight can negatively impact fertility. Excess body fat can disrupt hormone levels and ovulation, while being underweight can lead to irregular periods or anovulation. By suggesting this nonpharmacological treatment, the nurse is addressing a key factor in optimizing fertility. Drinking herbal tea (B) and taking hot baths (D) do not have a direct impact on fertility. Using a lubricant during intercourse (A) may actually hinder conception by affecting sperm motility.
A nurse is obtaining a 2-hr postprandial blood glucose from a client. Which of the following actions should the nurse take?
- A. Puncture the finger while still damp with antiseptic solution.
- B. Smear the blood onto the reagent strip.
- C. Hold the finger above the heart prior to puncture.
- D. Select the lateral side of the finger for puncture.
Correct Answer: D
Rationale: The correct answer is D: Select the lateral side of the finger for puncture. This is because the lateral side of the finger has fewer nerve endings, which can reduce pain for the client. Puncturing the finger while still damp with antiseptic solution (A) can dilute the blood sample and affect accuracy. Smearing the blood onto the reagent strip (B) can lead to inaccurate results. Holding the finger above the heart prior to puncture (C) can increase blood flow and dilute the sample. In summary, selecting the lateral side of the finger for puncture is the best option to minimize pain and ensure an accurate blood glucose reading.
Which of the following findings should the nurse report to the provider? (Select all that apply.)
- A. Coombs test result
- B. Mucous membrane assessment
- C. Intake and output
- D. Respiratory rate
- E. Head assessment finding
- F. Heart rate
- G. Sclera color
Correct Answer: A,B,C,G
Rationale: The correct answers are A, B, C, and G. A Coombs test result should be reported as it indicates the presence of antibodies that can cause hemolytic anemia. Mucous membrane assessment is crucial for detecting hydration status and oxygenation. Intake and output monitoring helps assess kidney function and fluid balance. Sclera color can indicate liver function or jaundice. Choices D, E, and F are not necessarily critical findings to report urgently to the provider in most cases. Monitoring respiratory rate, heart rate, and head assessment findings are important but may not require immediate provider notification unless there are significant abnormalities.