Nokea
A pregnant patient with significant iron-deficiency anemia is prescribed iron supplements. The patient explains to the nurse that she cannot take iron because it makes her nauseous. What is the best response by the nurse?
- A. Iron will be absorbed more readily if taken with orange juice.'
- B. It is important to take this drug regardless of this side effect.'
- C. Taking the drug with milk may decrease your symptoms.'
- D. Try taking the iron at bedtime on an empty stomach.'
Correct Answer: D
Rationale: The correct answer is D: "Try taking the iron at bedtime on an empty stomach." Taking iron on an empty stomach at bedtime can help reduce nausea because there are fewer digestive interactions. Iron supplements are best absorbed on an empty stomach. Taking them with food or other beverages can worsen gastrointestinal side effects. Option A is incorrect as orange juice may increase the likelihood of nausea due to its acidity. Option B is incorrect as patient comfort and adherence are important considerations. Option C is incorrect as milk can decrease iron absorption.
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A patient postdelivery is concerned about getting back to her prepregnancy weight as soon as possible. She had only gained 15 lb during her pregnancy. Which assessment factor would be of concern at her 6-week postpartum checkup?
- A. Patient has lost 30 lb during the 6-week period prior to her scheduled checkup.
- B. Patient states that she is eating healthy and limiting intake of processed foods.
- C. Patient relates increased consumption of fruits and vegetables in her diet postbirth.
- D. Patient has resumed her usual exercise pattern of walking around the neighborhood for 10 minutes each night.
Correct Answer: A
Rationale: The correct answer is (A) because losing 30 lb in the 6-week postpartum period is concerning as it is excessive and may indicate underlying health issues like hyperthyroidism or inadequate nutrition. This rapid weight loss can also affect the mother's energy levels, milk production, and overall health.
Choice (B) is incorrect as eating healthy and limiting processed foods is a positive behavior that supports weight management. Choice (C) is also incorrect as increased consumption of fruits and vegetables is beneficial for overall health. Choice (D) is incorrect because resuming a light exercise routine like walking is generally encouraged postpartum, as long as it is done safely and does not lead to excessive strain.
A term multigravida, who is receiving oxytocin for labor augmentation is requesting pain medication. Review of the clients record indication that she was medicated 30 minutes ago with butorphanol (Stadol) 2 mg and promethazine (Phenergan) 25 mg IV push. Vaginal examination reveals that the client cervical dilation is 3 cm, 70% effaced, and at a 0 station. What action should the nurse implement?
- A. Discontinue the Pitocin infusion
- B. Medicate the client with an additional 1 mg of Stadol IV push
- C. Notify the healthcare provider
- D. Instruct the client to use deep breathing during contraction
Correct Answer: D
Rationale: Deep breathing techniques (D) can help manage pain without additional medication.
Changes in the diet of the pregnant patient who has phenylketonuria would include
- A. adding foods high in vitamin C.
- B. eliminating drinks containing aspartame.
- C. restricting protein intake to <20 g a day.
- D. increasing caloric intake to at least 1800 cal/day.
Correct Answer: B
Rationale: The correct answer is B: eliminating drinks containing aspartame. Patients with phenylketonuria lack the enzyme to metabolize phenylalanine, found in aspartame. Avoiding aspartame-containing products is crucial to prevent phenylalanine buildup. Choice A is incorrect as vitamin C is not directly related to phenylketonuria. Choice C is incorrect as protein restriction is necessary, but the recommended intake is individualized and not a fixed amount. Choice D is incorrect as caloric intake is important, but the focus should be on managing phenylalanine levels.
Which is the most important reason for evaluating the pattern of weight gain in pregnancy?
- A. Prevents excessive adipose tissue deposits
- B. Determines cultural influences on the woman's diet
- C. Assesses the need to limit caloric intake in obese women
- D. Identifies potential nutritional problems or complications of pregnancy
Correct Answer: D
Rationale: The correct answer is D because evaluating the pattern of weight gain in pregnancy helps identify potential nutritional problems or complications. Monitoring weight gain can indicate if the woman is receiving adequate nutrition for fetal development, detect issues like gestational diabetes or pre-eclampsia, and ensure overall maternal and fetal health.
Incorrect choice analysis:
A: Preventing excessive adipose tissue deposits is important, but the primary reason for evaluating weight gain in pregnancy is to identify nutritional problems and complications.
B: Cultural influences on diet are relevant but not the most important reason for evaluating weight gain.
C: Limiting caloric intake in obese women is important, but evaluating weight gain is more about ensuring proper nutrition and detecting complications rather than focusing solely on caloric restriction.
A patient at 8 weeks' gestation complains to the nurse, 'I feel sick almost every morning. And I throw up at least two or three times a week.' What is the nurse's best guidance for this patient?
- A. Do you like cheese?'
- B. Try eating four meals a day instead of three meals a day.'
- C. Try eating peanut butter on whole wheat bread right before going to bed.'
- D. If you can eat enough throughout the day, you don't have to worry about being sick.'
Correct Answer: C
Rationale: The correct answer is C: 'Try eating peanut butter on whole wheat bread right before going to bed.' This recommendation is based on the fact that consuming a small snack high in protein and complex carbohydrates before going to bed can help stabilize blood sugar levels and reduce morning sickness symptoms in pregnant women. Peanut butter provides protein and whole wheat bread provides complex carbohydrates, which can help alleviate nausea and vomiting.
Choice A is incorrect because asking about cheese does not address the patient's symptoms or provide any practical guidance for managing morning sickness.
Choice B is incorrect because increasing the number of meals may not necessarily alleviate morning sickness and could potentially exacerbate symptoms.
Choice D is incorrect because suggesting that eating enough throughout the day will prevent sickness oversimplifies the issue and does not offer targeted advice for managing morning sickness.