Nokea
A pregnant client with mitral stenosis Class III is prescribed complete bedrest. The client asks the nurse, 'Why must I stay in bed all the time?' Which response is best for the nurse to provide this client?
- A. Complete bedrest decreases oxygen needs and demands on the heart muscle tissue.
- B. You have a small opening in your heart and complete bedrest will help it get bigger.
- C. We want your baby to be healthy, and this is the only way we can make sure that will happen.
- D. Labor is difficult, and you need to save your energy so you will be strong enough then.
Correct Answer: A
Rationale: Complete bedrest decreases oxygen needs and demands on the heart muscle tissue, which is crucial for clients with mitral stenosis.
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When assessing a pregnant woman AT 39-weeks gestation who is admitted to labor and delivery which finding is most important to report to the health care provider?
- A. proteinuria
- B. 130/70 blood pressure
- C. pedal edema
- D. 101.2 oral temperature
Correct Answer: D
Rationale: Fever (D) can indicate infection, which requires prompt evaluation.
A pregnant patient arrives for her first prenatal visit at the clinic. She informs the nurse that she has been taking an additional 400 mcg of folic acid prior to becoming pregnant. Based on the patient's history, she has reached 8 weeks' gestation. Which recommendation would the nurse provide regarding folic acid supplementation?
- A. Have the patient continue to take 400 mcg folic acid throughout her pregnancy.
- B. Tell the patient that she no longer has to take additional folic acid because it will be included in her prenatal vitamins.
- C. Have the patient increase her folic acid intake to 1000 mcg throughout the rest of her pregnancy.
- D. Schedule the patient to go for an AFP (alpha-fetoprotein) test.
Correct Answer: B
Rationale: Step 1: The patient has been taking an additional 400 mcg of folic acid prior to pregnancy.
Step 2: Folic acid is crucial in the early stages of pregnancy for neural tube development.
Step 3: By 8 weeks' gestation, the neural tube has already formed.
Step 4: Prenatal vitamins typically contain the recommended amount of folic acid.
Step 5: Therefore, the nurse would recommend the patient to stop taking additional folic acid as it's included in prenatal vitamins.
The healthcare provides prescribes 10 units/L of oxytocin (Pitocin) via IV drips to augment a client labor because she is experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin?
- A. Uterus soft
- B. Contraction duration of 100 seconds
- C. Four contractions in 10 minutes
- D. Early deceleration of fetal heart rate
Correct Answer: B
Rationale: Contractions lasting longer than 90 seconds (B) can compromise fetal oxygenation and require discontinuing oxytocin.
The nurses assessing a 38-week gestation newborn infant immediately following a vaginal birth. Which assessment finding best indication that the infant is transitioning well to extrauterine life?
- A. Heart rate 220 beats/minute
- B. Cries vigorously when stimulated
- C. A positive Babinski reflex
- D. Flexion of all four extremities
Correct Answer: B
Rationale: Vigorous crying (B) indicates effective transition to extrauterine life.
The nurse is teaching a woman how to use her basal body temperature (BBT) pattern as a tool to assist her in conceiving a child. Which temperature pattern indicates the occurrence of ovulation, and therefore, the best time for intercourse to ensure conception?
- A. Between the time the temperature falls and rises
- B. Between 36 and 48 hours after the temperature rises
- C. When the temperature falls and remains low for 36 hours
- D. Within 72 hours before the temperature falls
Correct Answer: A
Rationale: In most women, the BBT drops slightly 24 to 36 hours before ovulation and rises 24 to 72 hours after ovulation, when the corpus luteum of the ruptured ovary produces progesterone. Therefore, intercourse between the time of the temperature fall and rise (A) is the best time for conception.