Nokea
A patient in her first trimester complains of nausea and vomiting. She asks, 'Why does this happen?' The nurse's best response is:
- A. It is due to an increase in gastric motility
- B. It may be due to changes in hormones
- C. It is related to an increase in glucose levels
- D. It is caused by a decrease in gastric secretions
Correct Answer: B
Rationale: Nausea and vomiting are primarily caused by hormonal changes, particularly elevated human chorionic gonadotropin (hCG) and progesterone levels.
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The experienced nurse is instructing the new nurse about communications concerning the patient. The nurse suggests using an SBAR method and lists the four elements included in the technique. Which four elements should be included in the instruction?
- A. Shift-end report, background, assessment, and reassessment
- B. Situation, background, assessment, and recommendation
- C. Shift-end report, background, assessment, and recommendation
- D. Situation, background, actual nursing diagnoses, and remedy
Correct Answer: B
Rationale: SBAR stands for Situation, Background, Assessment, and Recommendation. This method is widely used in healthcare settings to ensure clear and concise communication.
The nurse is educating a pregnant client about common discomforts during the third trimester. Which statement by the nurse is appropriate?
- A. Perform pelvic-tilt exercises.
- B. Eat crackers prior to getting out of bed in the morning.
- C. Use humidifiers or saline nose drops.
- D. Wear a supportive bra.
Correct Answer: A
Rationale: The correct answer is A: Perform pelvic-tilt exercises. Pelvic-tilt exercises help alleviate back pain common in the third trimester by strengthening abdominal muscles and reducing strain on the lower back. This is appropriate for addressing discomforts during pregnancy.
B: Eating crackers before getting out of bed helps with morning sickness, not third-trimester discomforts.
C: Using humidifiers or saline nose drops is more related to nasal congestion, not common discomforts in the third trimester.
D: Wearing a supportive bra is important during pregnancy but does not directly address common discomforts in the third trimester.
Appendicitis may be difficult to diagnose in pregnancy because the appendix is:
- A. displaced upward and laterally, high and to the right.
- B. displaced upward and laterally, high and to the left.
- C. deep at McBurney point.
- D. displaced downward and laterally, low and to the right.
Correct Answer: D
Rationale: The correct answer is D because during pregnancy, the enlarging uterus pushes the appendix downward and laterally, making it low and to the right. This displacement can lead to atypical presentation of appendicitis symptoms. Choices A and B are incorrect as the appendix is not displaced high and to either side. Choice C is incorrect as the McBurney point is a specific location for appendicitis pain but does not describe the actual position of the appendix during pregnancy.
Physiologic anemia often occurs during pregnancy as a result of:
- A. inadequate intake of iron.
- B. dilution of hemoglobin concentration.
- C. the fetus establishing iron stores.
- D. decreased production of erythrocytes.
Correct Answer: B
Rationale: When blood volume expansion is more pronounced and occurs earlier than the increase in red blood cells, the woman has physiologic anemia, which is the result of dilution of hemoglobin concentration rather than inadequate hemoglobin.
To reassure and educate pregnant patients about changes in the uterus, nurses should be aware that:
- A. lightening occurs near the end of the second trimester as the uterus rises into a different position.
- B. the woman's increased urinary frequency in the first trimester is the result of exaggerated uterine anteflexion caused by softening.
- C. Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise.
- D. the uterine souffle is the movement of the fetus.
Correct Answer: B
Rationale: The softening of the lower uterine segment is called Hegar's sign. Lightening occurs in the last 2 weeks of pregnancy, when the fetus descends.