Nokea
A nurse is teaching clients in a prenatal class about the importance of taking folic acid during pregnancy. The nurse should instruct the clients to consume an adequate amount of folic acid from various sources to prevent which of the following fetal abnormalities?
- A. Neural tube defect
- B. Trisomy 21
- C. Cleft lip
- D. Atrial septal defect
Correct Answer: A
Rationale: The correct answer is A: Neural tube defect. Folic acid is essential for proper neural tube development in the fetus, preventing abnormalities like spina bifida. Consuming an adequate amount of folic acid before and during pregnancy reduces the risk of neural tube defects. Trisomy 21 (choice B) is caused by an extra copy of chromosome 21, not influenced by folic acid intake. Cleft lip (choice C) and atrial septal defect (choice D) have multifactorial causes and are not directly prevented by folic acid consumption.
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A client who received carboprost for postpartum hemorrhage is being assessed by a nurse. Which of the following findings is an adverse effect of this medication?
- A. Hypertension
- B. Hypothermia
- C. Constipation
- D. Muscle weakness
Correct Answer: A
Rationale: The correct answer is A: Hypertension. Carboprost is a prostaglandin used to treat postpartum hemorrhage that can cause hypertension as an adverse effect due to its vasoconstrictive properties. This can lead to increased blood pressure, which should be monitored closely. Hypothermia (choice B) is not a common adverse effect of carboprost. Constipation (choice C) and muscle weakness (choice D) are also not typically associated with carboprost use. Monitoring blood pressure and signs of hypertension is crucial due to the potential adverse effects of carboprost.
A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states, 'I missed one menstrual cycle and cannot be pregnant because I have an intrauterine device.' The nurse should suspect which of the following?
- A. Missed abortion
- B. Ectopic pregnancy
- C. Severe preeclampsia
- D. Hydatidiform mole
Correct Answer: B
Rationale: The correct answer is B: Ectopic pregnancy. Given the client's symptoms of right-sided lower quadrant abdominal pain, vaginal bleeding, missed menstrual cycle, and presence of an intrauterine device, these are classic signs of an ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, commonly in the fallopian tube, leading to abdominal pain and vaginal bleeding. The other choices are incorrect because:
A: Missed abortion would typically present with cramping, bleeding, and passage of tissue.
C: Severe preeclampsia is characterized by high blood pressure and proteinuria, not the symptoms described.
D: Hydatidiform mole would typically present with vaginal bleeding and uterine enlargement, but not the sharp abdominal pain described.
A client who is at 22 weeks of gestation reports concern about the blotchy hyperpigmentation on her forehead. Which of the following actions should the nurse take?
- A. Tell the client to follow up with a dermatologist.
- B. Explain to the client this is an expected occurrence.
- C. Instruct the client to increase her intake of vitamin D.
- D. Inform the client she might have an allergy to her skin care products.
Correct Answer: B
Rationale: The correct answer is B. The blotchy hyperpigmentation on the client's forehead is likely melasma, a common occurrence during pregnancy. This is due to hormonal changes causing increased melanin production. The nurse should educate the client that this is an expected occurrence during pregnancy and reassure her that it is usually temporary and will fade postpartum.
Choice A (Tell the client to follow up with a dermatologist) is incorrect because dermatological consultation is not typically necessary for melasma during pregnancy.
Choice C (Instruct the client to increase her intake of vitamin D) is incorrect because vitamin D deficiency is not typically associated with blotchy hyperpigmentation on the forehead during pregnancy.
Choice D (Inform the client she might have an allergy to her skin care products) is incorrect because melasma is not caused by allergies to skincare products.
A client who is at 12 weeks of gestation is reviewing a new prescription of ferrous sulfate. Which of the following statements by the client indicates understanding of the teaching?
- A. I will take this pill with my breakfast.
- B. I will take this medication with a glass of milk.
- C. I plan to drink more orange juice while taking this pill.
- D. I plan to add more calcium-rich foods to my diet while taking this medication.
Correct Answer: C
Rationale: The correct answer is C: "I plan to drink more orange juice while taking this pill." Orange juice is rich in vitamin C, which enhances the absorption of iron from ferrous sulfate, helping to combat iron deficiency anemia during pregnancy. Taking the pill with a vitamin C source is important for optimal absorption.
A: Taking the pill with breakfast may not provide enough vitamin C for optimal absorption.
B: Milk may inhibit iron absorption due to its calcium content, so it is not ideal to take with ferrous sulfate.
D: While increasing calcium-rich foods is important during pregnancy, it is not directly related to enhancing iron absorption from ferrous sulfate.
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.