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A patient who is 40 weeks pregnant presents to the labor and delivery unit with decreased fetal movement. What is the first step in management?
- A. Perform a nonstress test (NST)
- B. Administer a corticosteroid injection
- C. Monitor fetal heart rate
- D. Monitor the fetal heart rate
Correct Answer: A
Rationale: The correct answer is A: Perform a nonstress test (NST). This is the first step in assessing fetal well-being when a patient presents with decreased fetal movement at 40 weeks gestation. The NST evaluates fetal heart rate in response to fetal movement, providing immediate information on fetal well-being. Administering a corticosteroid injection (B) would not be indicated at this point as it is not the first-line management for decreased fetal movement. Monitoring fetal heart rate (C and D) is important, but the NST provides more comprehensive information on fetal well-being.
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The nurse is caring for a pregnant patient who is at 25 weeks gestation and is concerned about gestational diabetes. Which of the following symptoms should the nurse educate the patient to watch for?
- A. Increased thirst and frequent urination
- B. Severe leg cramps and dizziness
- C. Constant fatigue and swollen feet
- D. Shortness of breath and dizziness upon standing
Correct Answer: A
Rationale: The correct answer is A: Increased thirst and frequent urination. These symptoms are indicative of gestational diabetes due to elevated blood sugar levels. Increased thirst is a result of the body trying to dilute the excess glucose through increased fluid intake, leading to frequent urination. This occurs because the kidneys work to eliminate the excess glucose from the blood by excreting it in the urine. Therefore, educating the patient to watch for these symptoms is crucial for early detection and management of gestational diabetes.
Choices B, C, and D are incorrect as they do not directly correlate with the symptoms of gestational diabetes. Severe leg cramps and dizziness (Choice B) may be related to other factors such as dehydration or electrolyte imbalance. Constant fatigue and swollen feet (Choice C) could be common symptoms during pregnancy but are not specific to gestational diabetes. Shortness of breath and dizziness upon standing (Choice D) are more likely to be related to issues such as anemia or changes
The nurse is caring for a pregnant patient who is at 28 weeks gestation and has been diagnosed with a urinary tract infection (UTI). Which of the following interventions should the nurse prioritize?
- A. Administer antibiotics to treat the UTI.
- B. Encourage the patient to drink cranberry juice.
- C. Teach the patient to practice good hand hygiene.
- D. Perform a bladder scan to check for residual urine.
Correct Answer: A
Rationale: The correct answer is A because administering antibiotics is crucial in treating a urinary tract infection (UTI) during pregnancy to prevent complications such as preterm labor or kidney infection. Antibiotics are necessary to eradicate the infection and ensure the health of both the mother and the baby.
Encouraging the patient to drink cranberry juice (B) may help prevent UTIs but is not sufficient treatment for an existing infection. Teaching the patient to practice good hand hygiene (C) is important for general infection prevention but does not directly address the UTI. Performing a bladder scan (D) to check for residual urine is not a priority in this case as the focus should be on treating the infection first.
The nurse is caring for a 15-year-old female who is pregnant with her first child. In her previous prenatal visit, the patient tested negative for chlamydia, syphilis, gonorrhea, and HIV. Based on the information provided, which condition is the patient's baby at higher risk for?
- A. Intestinal problems
- B. Neonatal conjunctivitis
- C. Blindness
- D. Pneumonia
Correct Answer: B
Rationale: Step 1: The patient tested negative for chlamydia, syphilis, gonorrhea, and HIV, reducing the risk of transmission of these infections to the baby.
Step 2: Neonatal conjunctivitis is commonly caused by exposure to maternal genital tract bacteria during birth.
Step 3: Since the patient tested negative for the common infections, neonatal conjunctivitis becomes the higher risk for the baby.
Summary: A, C, and D are not directly related to the information provided, making them incorrect choices. Neonatal conjunctivitis is the most likely risk due to maternal genital tract bacteria exposure during birth.
What is the priority nursing action when a nurse suspects a cord prolapse during labor?
- A. place the person in the knee-chest position
- B. administer oxygen via mask
- C. apply pressure to the cord
- D. administer an epidural
Correct Answer: A
Rationale: The correct answer is A: place the person in the knee-chest position. This is the priority nursing action because it helps relieve pressure on the cord and prevents further prolapse. Placing the person in the knee-chest position also promotes optimal fetal oxygenation. Administering oxygen via mask (choice B) is important but not the priority. Applying pressure to the cord (choice C) should never be done as it can further compromise blood flow to the fetus. Administering an epidural (choice D) is not the priority in this emergency situation.
The results of a contraction stress test (CST) are positive. Which intervention is necessary based on this test result?
- A. Repeat the test in 1 week so that results can be trended based on this baseline result.
- B. Contact the health care provider to discuss birth options for the patient.
- C. Send the patient out for a meal and repeat the test to confirm that the results are valid.
- D. Ask the patient to perform a fetal kick count assessment for the next 30 minutes and then reassess the patient.
Correct Answer: B
Rationale: A positive CST is an abnormal finding that may indicate fetal compromise, requiring immediate discussion of birth options.