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A nurse is caring for a pregnant patient who is at 36 weeks gestation and reports that her baby has not moved as much as usual. What should the nurse instruct the patient to do first?
- A. Lie on her left side and drink a cold beverage to stimulate movement.
- B. Rest for a few hours and count fetal movements.
- C. Call the healthcare provider immediately to report the lack of movement.
- D. Monitor fetal movement over the next 24 hours and report if the pattern continues.
Correct Answer: A
Rationale: The correct answer is A: Lie on her left side and drink a cold beverage to stimulate movement. This is because changing positions can encourage fetal movement due to the change in gravity and blood flow. Additionally, the cold beverage may stimulate the baby to move. Option B suggests resting without actively trying to stimulate movement, which may delay necessary action. Option C advises immediate contact with the healthcare provider, which could be an overreaction at this stage. Option D delays action and may not address the immediate concern of decreased fetal movement.
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A nurse is caring for a laboring person who is receiving an epidural. What is the most important nursing intervention when administering an epidural?
- A. Ensure the person is positioned correctly
- B. Monitor the person's blood pressure
- C. Monitor the person's oxygen saturation
- D. Administer a pain medication
Correct Answer: A
Rationale: The correct answer is A: Ensure the person is positioned correctly. This is crucial because proper positioning ensures the medication is distributed correctly and helps prevent complications like uneven distribution or nerve injury. Monitoring blood pressure (B) and oxygen saturation (C) are important but secondary to ensuring correct positioning. Administering pain medication (D) is not a nursing intervention specific to epidural administration.
The nurse is reviewing fetal circulation with a pregnant patient and explains that blood circulates through the placenta to the fetus. What vessel(s) carry blood to the fetus?
- A. One umbilical vein
- B. Two umbilical veins
- C. One umbilical artery
- D. Two umbilical arteries
Correct Answer: A
Rationale: The umbilical vein transports richly oxygenated blood from the placenta to the fetus.
A pregnant patient with a history of anemia is asking the nurse about managing iron deficiency. Which of the following statements by the nurse would be most appropriate?
- A. Iron supplements should be taken with milk for better absorption.
- B. Iron supplements should be taken with a source of vitamin C to enhance absorption.
- C. Iron supplements should be avoided during the second trimester.
- D. Iron supplements should be taken at night before bed.
Correct Answer: B
Rationale: The correct answer is B: Iron supplements should be taken with a source of vitamin C to enhance absorption. Iron absorption is increased in the presence of vitamin C. Vitamin C helps convert iron into a more absorbable form. This is crucial for managing iron deficiency anemia in pregnant patients.
Incorrect choices:
A: Iron supplements should not be taken with milk as calcium in milk can hinder iron absorption.
C: Iron supplements are safe to take throughout pregnancy, and avoiding them during the second trimester is not recommended.
D: There is no specific recommendation to take iron supplements at night before bed; it can be taken at any time of the day.
The nurse is assessing a pregnant patient who is at 32 weeks gestation and is concerned about leg cramps. Which intervention should the nurse recommend?
- A. Apply a heating pad to the legs to relieve cramps.
- B. Perform gentle stretching exercises to reduce muscle tension.
- C. Increase calcium intake to prevent muscle cramps.
- D. Lie down and elevate the legs to prevent cramps.
Correct Answer: B
Rationale: The correct answer is B: Perform gentle stretching exercises to reduce muscle tension. Leg cramps during pregnancy are common due to increased weight and pressure on muscles. Gentle stretching exercises can help relieve tension and improve circulation, reducing the likelihood of cramps. Applying heat (choice A) can worsen swelling in pregnancy. Increasing calcium intake (choice C) can help prevent cramps but is not an immediate intervention. Lying down and elevating legs (choice D) can provide temporary relief but may not address the underlying muscle tension.
A 32-year-old patient who is pregnant with her first child is inquiring about labor and delivery. Which of the following statements by the nurse is most appropriate?
- A. Labor usually lasts 12 to 24 hours for first-time mothers.
- B. Labor typically lasts 6 to 8 hours for first-time mothers.
- C. Labor for first-time mothers is usually much shorter than for those having their second child.
- D. Labor can be unpredictable, but it usually takes less than 12 hours for first-time mothers.
Correct Answer: A
Rationale: The correct answer is A: Labor usually lasts 12 to 24 hours for first-time mothers. This is the most appropriate response as it provides a realistic timeframe for labor in first-time mothers, which can vary but generally falls within this range. This information prepares the patient for a potentially lengthy labor and helps manage expectations.
Choice B is incorrect because stating that labor typically lasts 6 to 8 hours for first-time mothers is too short of a timeframe, which may lead to unrealistic expectations.
Choice C is incorrect because it inaccurately suggests that labor for first-time mothers is usually much shorter than for those having their second child, which is not necessarily true.
Choice D is incorrect because while labor can be unpredictable, stating that it usually takes less than 12 hours for first-time mothers is not accurate, as labor duration can vary greatly among individuals.