Nokea
A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomforts as common during the first trimester? Select all that apply.
- A. Breast tenderness
- B. Urinary frequency
- C. Backache
- D. Cravings
- E. Leg cramps
Correct Answer: A,B,D
Rationale: First trimester discomforts include breast tenderness (hormonal growth), urinary frequency (bladder pressure), and cravings (taste changes). Backache and leg cramps typically occur later due to weight and nerve pressure.
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A nurse suspects that a pregnant client may be experiencing placenta abruption based on which finding? Select all that apply.
- A. Absence of pain
- B. Insidious onset
- C. Dark red vaginal bleeding
- D. Rigid uterus
- E. Absent fetal heart tones
Correct Answer: C,D,E
Rationale: Placental abruption involves sudden separation of the placenta, causing severe pain, a rigid uterus from bleeding, dark red vaginal bleeding due to clotted blood, and absent fetal heart tones if the fetus is compromised. Absence of pain and insidious onset are not typical, as abruption is acute and painful.
A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which findings would the nurse most likely assess? Select all that apply.
- A. Ultrasound visualization of the fetus
- B. Softening of the cervix
- C. Positive pregnancy test
- D. Absence of menstruation
- E. Ballottement
- F. Auscultation of a fetal heart beat
Correct Answer: B,C,D,E
Rationale: Probable signs include softening of the cervix (Goodell's), positive pregnancy test (hCG), amenorrhea, and ballottement (fetal rebound). Ultrasound and fetal heartbeat are positive signs, confirming pregnancy definitively.
A 22-year-old homeless woman arrives at a walk-in clinic seeking pregnancy confirmation. The nurse notes on assessment a 12-week gestational uterus, a BP of 110/70, a BMI of 17.5. The client admits to using cocaine a few times. She has been pregnant before and indicates she 'loses them early.' What characteristics place the client in the high-risk pregnancy category? Select all that apply.
- A. Homelessness
- B. Age
- C. BP 110/70
- D. BMI 17.5
- E. Prenatal care
- F. Prenatal history
Correct Answer: A,D,E,F
Rationale: Homelessness increases risks via poor nutrition and stress; BMI 17.5 indicates malnutrition; lack of prenatal care raises complication risks; prior losses suggest underlying issues. Age (22) is optimal, and BP 110/70 is normal, not risks.
A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure. Which finding would lead the nurse to suspect that the client is having an adverse effect associated with this drug?
- A. Gastrointestinal bleeding
- B. Sweating
- C. Tachycardia
- D. Blurred vision
Correct Answer: C
Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia as blood pressure drops, increasing cardiac strain. Gastrointestinal bleeding, sweating, and blurred vision (a preeclampsia symptom) are not typical adverse effects.
A provider prescribes quetiapine 50 mg PO divided equally every 12 hours for 3 days. Available is quetiapine 25 mg tablets. How many tablets should the nurse administer per dose on day 3?
- A. 2 tablets
- B. 1 tablet
- C. 3 tablets
- D. 4 tablets
Correct Answer: B
Rationale: Daily dose (50 mg) ÷ 2 (every 12 hours) = 25 mg per dose. At 25 mg/tablet, 25 mg ÷ 25 mg = 1 tablet per dose, consistent on day 3 as dosing doesn't change.