Nokea
A patient in her third trimester of pregnancy is asking about safe travel. Which statement should the nurse provide regarding safe travel during pregnancy?
- A. Only travel by car during pregnancy.'
- B. Avoid use of the seat belt during the third trimester.'
- C. You can travel by plane until your 38th week of gestation.'
- D. If you are traveling by car stop to walk every 1 to 2 hours.'
Correct Answer: D
Rationale: The correct answer is D: "If you are traveling by car, stop to walk every 1 to 2 hours." This is the best advice because it promotes circulation and reduces the risk of blood clots during long car rides. Walking helps prevent stiffness and discomfort.
A: "Only travel by car during pregnancy" is incorrect because other modes of transportation can be safe as well.
B: "Avoid use of the seat belt during the third trimester" is incorrect as wearing a seat belt is crucial for the safety of both the mother and the baby in case of an accident.
C: "You can travel by plane until your 38th week of gestation" is incorrect as most airlines have restrictions on flying after 36 weeks due to the risk of preterm labor.
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A nurse is providing home care to a home-bound patient treated with intravenous (IV) therapy and enteral nutrition. What is the home health nurse’s primary objective?
- A. Screening
- B. Education
- C. Dependence
- D. Counseling
Correct Answer: B
Rationale: Health promotion and education are traditionally the primary objectives of home care, yet at present most patients receive home care because they need nursing care. Screening is preventive care. The home health nurse focuses on patient and family independence. Counseling is through psychiatric care.
A client who is 18 weeks’ gestation has been diagnosed with a hydatiform mole (gestational trophoblastic disease). In addition to vaginal loss, which of the following signs/symptoms would the nurse expect to see?
- A. Hyperemesis and hypertension.
- B. Diarrhea and hyperthermia.
- C. Polycythemia.
- D. Polydipsia.
Correct Answer: A
Rationale: Hyperemesis and hypertension are common symptoms of a hydatiform mole due to the excessive production of hCG.
At the first prenatal visit, the patient informs the nurse that the first day of her last menstrual period (LMP) was February 18, 2024. Using Naegle's Rule, calculate the patient's EDD.
- A. 11-Nov-24
- B. 11-Nov-25
- C. 25-Nov-24
- D. 25-Nov-25
Correct Answer: C
Rationale: The correct answer is C: 25-Nov-24. Naegle's Rule is to add 7 days to the first day of the last menstrual period (LMP), then subtract 3 months, and finally add 1 year. In this case, LMP was February 18, 2024. Adding 7 days gives February 25, 2024. Subtracting 3 months gives November 25, 2024. Adding 1 year gives the estimated due date (EDD) of November 25, 2024. Choices A, B, and D are incorrect because they do not follow the correct calculation steps of Naegle's Rule.
The nurse is providing patient teaching to a client who plans to bottle feed her newborn infant. Which of the following information should be included in the education session?
- A. The baby should be burped after every 3 ounces of formula.
- B. If the bottle nipple is not filled throughout the feeding, the baby may take in a large amount of air.
- C. The best way to heat formula for the baby is in the microwave.
- D. If the mother is busy with her other children, she can prop the baby bottle up on a blanket or towel.
Correct Answer: B
Rationale: The bottle nipple should be filled with formula throughout the feeding to prevent the baby from taking in air, which can cause discomfort and gas.
A biophysical profile is performed on a pregnant patient. The following assessments are noted: nonreactive stress test (NST), three episodes of fetal breathing movements (FBMs), limited gross movements, opening and closing of hang indicating the presence of fetal tone, and adequate amniotic fluid index (AFI) meeting criteria. Which answer would be the correct interpretation of this test result?
- A. A score of 10 would indicate that the results are equivocal.
- B. A score of 8 would indicate normal results.
- C. A score of 6 would indicate that birth should be considered as a possible treatment option.
- D. A score of 9 would indicate reassurance.
Correct Answer: B
Rationale: The correct answer is B: A score of 8 would indicate normal results. In a biophysical profile, each component is scored as either 0 or 2, totaling a maximum of 10. In this case, the patient has: 0 for NST, 2 for FBMs, 1 for gross movements, 2 for fetal tone, and 2 for AFI, totaling 7. However, if there are at least 2 episodes of FBMs, this component is given a score of 2. Therefore, the correct total score is 8. This score indicates normal results, as it meets the criteria for a reassuring biophysical profile.
Incorrect Choices:
A: A score of 10 would indicate that the results are equivocal - This is incorrect as a score of 10 would indicate normal results, not equivocal.
C: A score of 6 would indicate that birth should be considered as a possible treatment option - This is incorrect, as a score