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A patient at 40 weeks gestation is admitted with spontaneous rupture of membranes. What is the first priority action?
- A. Perform a vaginal examination to assess for cord prolapse
- B. Start an IV and administer antibiotics
- C. Monitor fetal heart rate for decelerations
- D. Check the amniotic fluid for meconium staining
Correct Answer: A
Rationale: The correct answer is A: Perform a vaginal examination to assess for cord prolapse. This is the first priority action because cord prolapse is a life-threatening emergency that requires immediate intervention to prevent fetal compromise. By performing a vaginal examination, the healthcare provider can quickly determine if the umbilical cord is presenting before the fetus, allowing for prompt management.
Choice B is incorrect because starting an IV and administering antibiotics is important but not the first priority in this situation. Choice C is incorrect as monitoring fetal heart rate for decelerations is essential but not as urgent as assessing for cord prolapse. Choice D is also incorrect as checking for meconium staining is important but does not take precedence over assessing for cord prolapse.
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A nurse is providing prenatal education to a patient who is 22 weeks gestation. Which of the following topics should be emphasized at this stage of pregnancy?
- A. Signs and symptoms of preterm labor
- B. Signs of gestational diabetes
- C. Breastfeeding education
- D. Postpartum care
Correct Answer: A
Rationale: The correct answer is A: Signs and symptoms of preterm labor. At 22 weeks gestation, it is crucial to educate the patient about potential signs of preterm labor to help prevent premature birth and ensure the well-being of the baby. Symptoms such as regular contractions, abdominal cramping, backache, and vaginal bleeding should be discussed. This topic is time-sensitive and requires immediate action if observed.
Summary of other choices:
B: Signs of gestational diabetes - While important, monitoring for gestational diabetes typically occurs later in pregnancy, usually around 24-28 weeks.
C: Breastfeeding education - Important, but not as time-sensitive as preterm labor education.
D: Postpartum care - Relevant but more appropriate for later stages of pregnancy or after birth, not specifically at 22 weeks gestation.
The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, 'I do not need to stop smoking my electronic cigarette because it will not harm my baby.' Which is the best response by the nurse?
- A. You are correct. Electronic cigarettes are not harmful during pregnancy.
- B. Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.
- C. According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy.
- D. Electronic cigarettes are considered harmful only in the first trimester.
Correct Answer: B
Rationale: The correct answer is B: Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.
Rationale:
1. Nicotine from electronic cigarettes can cross the placenta, affecting fetal development.
2. Nicotine exposure during pregnancy is associated with adverse outcomes like low birth weight and preterm birth.
3. The best practice during pregnancy is to avoid all tobacco products, including electronic cigarettes.
Summary:
A: Incorrect. Electronic cigarettes can harm the fetus due to nicotine exposure.
C: Incorrect. FDA does not consider electronic cigarettes safe during pregnancy.
D: Incorrect. Harm from electronic cigarettes is not limited to the first trimester.
A nurse is caring for a pregnant patient at 36 weeks gestation who has been diagnosed with preeclampsia. Which of the following interventions should the nurse prioritize?
- A. Encourage the patient to increase fluid intake to prevent dehydration.
- B. Monitor the patient's blood pressure and assess for signs of worsening preeclampsia.
- C. Provide education about managing gestational diabetes.
- D. Administer pain relief to reduce discomfort from swelling.
Correct Answer: B
Rationale: The correct answer is B because monitoring the patient's blood pressure and assessing for signs of worsening preeclampsia is crucial in managing the condition and preventing potential complications. At 36 weeks gestation, close monitoring is essential to detect any changes in the patient's condition promptly. Increasing fluid intake (choice A) may not be recommended for patients with preeclampsia due to the risk of fluid overload. Providing education about managing gestational diabetes (choice C) is irrelevant in this scenario. Administering pain relief (choice D) may provide temporary relief but does not address the underlying issue of worsening preeclampsia. Prioritizing blood pressure monitoring ensures timely intervention and management of preeclampsia to promote the well-being of both the patient and the baby.
A patient with a history of asthma is about to receive an epidural block for pain management during labor. What should the nurse monitor for after the procedure?
- A. Respiratory depression
- B. Tachycardia
- C. Elevated blood pressure
- D. Hyperthermia
Correct Answer: A
Rationale: The correct answer is A: Respiratory depression. After receiving an epidural block, the nurse should monitor for respiratory depression in a patient with a history of asthma due to the potential for decreased lung function. This is crucial as the medication from the block can affect respiratory drive, leading to compromised breathing. Tachycardia (choice B), elevated blood pressure (choice C), and hyperthermia (choice D) are not typically associated with epidural blocks and are not the primary concerns for a patient with asthma undergoing this procedure.
Which dairy product should the client avoid during pregnancy?
- A. Vanilla yogurt
- B. Parmesan cheese
- C. Gorgonzola cheese
- D. Chocolate milk
Correct Answer: C
Rationale: Gorgonzola cheese is a soft, mold-ripened cheese that may contain Listeria, posing a risk during pregnancy.