Nokea
A pregnant client asks why she needs to avoid lying on her back during the third trimester. What is the best response?
- A. Lying on your back increases the risk of preterm labor.
- B. Lying on your back can reduce blood flow to your baby.
- C. Lying on your back causes increased fetal movements.
- D. Lying on your back is uncomfortable for most women.
Correct Answer: B
Rationale: Supine positioning can compress the vena cava, reducing blood flow to the fetus.
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Which intervention is most critical for a mother with a uterine atony postpartum?
- A. Perform uterine massage
- B. Administer oxytocin infusion
- C. Monitor blood pressure and pulse frequently
- D. Encourage breastfeeding to stimulate uterine contractions
Correct Answer: A
Rationale: Performing uterine massage helps contract the uterus and reduce bleeding in uterine atony.
Magnesium sulfate is given to a pregnant client for which of the following reasons? (Select all that apply) Provide fetal neuroprotection Improve patellar reflexes and increase respiratory efficiency Induction of labor Prevent seizures Stop/decrease uterine contractions The clinical nurse talks with a client about her possible pregnancy. The client has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. What are these symptoms best described as? Possible signs of pregnancy Positive signs pregnancy Presumptive signs of pregnancy Probable signs of pregnancy The clinic nurse talks with a patient about her possible pregnancy. The patient has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. She is convinced she is pregnant and is reluctant to pay for a pregnancy test. Which action by the nurse is best?
- A. Agree that these signs usually signal pregnancy so no test is needed.
- B. Delete the order for the pregnancy test and inform the provider.
- C. Explain that these symptoms can be caused by other conditions.
- D. Inform the woman that this is standard procedure and must be done.
Correct Answer: C
Rationale: The best action for the nurse to take in this situation is to explain to the patient that these symptoms can be caused by other conditions besides pregnancy. It is important for the nurse to educate the patient that while these symptoms are commonly associated with pregnancy, they are not definitive signs and can also be attributed to other factors or medical conditions. Encouraging the patient to undergo a pregnancy test can help confirm or rule out pregnancy and provide appropriate care and guidance moving forward.
The nurse is caring for a client whose labor is being augmented with Pitocin. He or she recognizes that Pitocin should be stopped immediately if there is evidence of what?
- A. Fetal HR 180 without sense of variability
- B. Rupture of amniotic membrane
- C. Client needs to void
- D. Uterine contractions q8-10 minutes
Correct Answer: A
Rationale: Pitocin is a medication commonly used to induce or augment labor by stimulating uterine contractions. It is critical for the nurse to monitor the client closely for potential adverse effects. Fetal distress is a serious concern when Pitocin is being administered. A fetal heart rate of 180 beats per minute without variability may indicate fetal distress due to uteroplacental insufficiency. This is a sign of fetal hypoxia and warrants immediate intervention, including stopping the infusion of Pitocin, repositioning the mother, administering oxygen, and notifying the healthcare provider. It is crucial for the nurse to act promptly to ensure the safety and well-being of both the fetus and the mother.
What does the nurse know about the definition of a family?
- A. Families are made up of couples with biological children.
- B. Families are created through marriage or birth.
- C. Families can be blended but are not called families.
- D. Families are made of kinships defined by the family.
Correct Answer: D
Rationale: Families are diverse and defined by the individuals involved, not limited to traditional structures.
A client at 12 weeks' gestation asks why folic acid is important during pregnancy. What is the nurse's best response?
- A. It helps prevent gestational diabetes.
- B. It promotes fetal brain development.
- C. It reduces the risk of neural tube defects.
- D. It increases maternal energy levels.
Correct Answer: C
Rationale: Folic acid is essential during early pregnancy to reduce the risk of neural tube defects like spina bifida.