Nokea
A patient in labor is experiencing back labor and complains of severe back pain. Which position is likely to provide the most comfort?
- A. Supine with knees bent
- B. Hands and knees position
- C. Lying flat on the left side
- D. Sitting upright in a chair
Correct Answer: B
Rationale: The correct answer is B: Hands and knees position. This position helps relieve pressure on the lower back by allowing the baby to shift away from the mother's spine, reducing back pain. It also promotes optimal fetal positioning for labor progress.
A: Supine with knees bent may worsen back labor by putting pressure on the spine.
C: Lying flat on the left side does not actively alleviate back pain or assist with fetal positioning.
D: Sitting upright in a chair may not provide the same relief as the hands and knees position since it doesn't encourage the baby to shift position away from the back.
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A pregnant patient at 28 weeks gestation reports lower back pain. What should the nurse do first?
- A. Administer pain medication and encourage rest.
- B. Assess the patient's posture and recommend appropriate exercises.
- C. Instruct the patient to lie flat on her back to relieve pain.
- D. Perform a pelvic exam to check for any underlying complications.
Correct Answer: B
Rationale: The correct answer is B because assessing the patient's posture and recommending appropriate exercises can help alleviate lower back pain during pregnancy. Poor posture and lack of exercise are common causes of back pain in pregnancy. Administering pain medication as in choice A may not address the root cause. Instructing the patient to lie flat on her back (choice C) can actually worsen back pain and pose risks during pregnancy. Performing a pelvic exam (choice D) is not necessary unless there are specific indications for it related to the patient's complaint. Therefore, choice B is the most appropriate initial action to address the lower back pain in this pregnant patient.
The nurse is caring for a pregnant patient who is 30 weeks gestation and has a BMI of 32. Which of the following complications should the nurse monitor for more closely?
- A. Gestational diabetes and preeclampsia
- B. Hyperemesis gravidarum and miscarriage
- C. Iron-deficiency anemia and urinary tract infections
- D. Gestational hypertension and placenta previa
Correct Answer: A
Rationale: The correct answer is A: Gestational diabetes and preeclampsia. A pregnant patient with a BMI of 32 is considered obese, which increases the risk of developing gestational diabetes and preeclampsia. Gestational diabetes is more likely in overweight women and can lead to complications for both the mother and baby. Preeclampsia is also more common in obese women and can result in high blood pressure and organ damage. Monitoring for these complications is crucial to ensure the well-being of both the mother and baby.
Incorrect choices:
B: Hyperemesis gravidarum and miscarriage - These complications are not directly related to the patient's weight or BMI.
C: Iron-deficiency anemia and urinary tract infections - While these complications can occur in pregnancy, they are not specifically associated with the patient's BMI.
D: Gestational hypertension and placenta previa - While gestational hypertension can be a concern in obese patients, placenta previa is not directly linked to
Why is pregnancy planning important for women of childbearing age?
- A. Much organogenesis occurs before the missed period
- B. Insurance preapproval is required
- C. No more than 3 pregnancies are recommended
- D. Pregnancies less than 2 years apart stress the cardiovascular system
Correct Answer: A
Rationale: Organogenesis occurs early in pregnancy, often before a missed period, making early intervention critical for fetal health.
A gravid woman and her husband inform the nurse that they have just moved into a three-story home that was built in the 1930s. Which of the following is critical for the nurse to advise the woman to protect the unborn child?
- A. Stay out of any rooms that are being renovated.
- B. Drink water only from the hot water tap.
- C. Refrain from entering the basement.
- D. Climb the stairs only once per day.
Correct Answer: A
Rationale: Renovations in older homes may release lead dust or asbestos, which are harmful to the developing fetus. Drinking water from the hot tap, limiting stair climbing, or avoiding basements are less critical concerns compared to exposure to renovation hazards.
A 26-year-old pregnant woman who is 12 weeks gestation asks the nurse about the importance of folic acid. Which of the following is the best response by the nurse?
- A. Folic acid helps prevent birth defects of the spine and brain.
- B. Folic acid increases the chances of having a boy.
- C. Folic acid prevents nausea during pregnancy.
- D. Folic acid helps the placenta attach to the uterus.
Correct Answer: A
Rationale: The correct answer is A: Folic acid helps prevent birth defects of the spine and brain. Folic acid is crucial during pregnancy as it plays a key role in neural tube development, reducing the risk of neural tube defects like spina bifida. This is supported by research and guidelines.
B: Folic acid does not influence the gender of the baby, as it is determined by the father's sperm.
C: Folic acid does not directly prevent nausea during pregnancy; it is mainly for neural tube development.
D: Folic acid does not specifically help the placenta attach to the uterus; that process is regulated by other factors.
In summary, choice A is correct as it directly relates to the essential role of folic acid in preventing birth defects, while the other choices are unrelated or inaccurate in the context of folic acid's benefits during pregnancy.