Nokea
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.
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The embryo is termed a fetus at which stage of prenatal development?
- A. 2 weeks
- B. 4 weeks
- C. 9 weeks
- D. 16 weeks
Correct Answer: C
Rationale: The fetus (third stage of prenatal development) begins at the ninth week and continues until the 40th week of gestation or until birth.
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.
The blood of a pregnant client was initially assessed at 10 weeks’ gestation and reassessed at 38 weeks’ gestation.
- A. Rise in hematocrit from 34% to 38%.
- B. Rise in white blood cells from 5 000 cells/mm3 to 15 000 cells/mm3.
- C. Rise in potassium from 3.9 mEq/L to 5.2 mEq/L.
- D. Rise in sodium from 137 mEq/L to 150 mEq/L.
Correct Answer: B
Rationale: White blood cell count increases during pregnancy due to physiological stress and immune system changes. Hematocrit levels typically decrease due to plasma expansion, while potassium and sodium levels remain stable.
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks’ gestation; delivered a daughter, now 5 years old, at 39 weeks’ gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman’s gravidity and parity?
- A. G4 P2121.
- B. G4 P1212.
- C. G5 P1122.
- D. G5 P2211.
Correct Answer: D
Rationale: Gravidity includes all pregnancies (live births, miscarriages, abortions, and current pregnancy). Parity reflects live births. This woman has had 5 pregnancies (2 live births, 1 miscarriage, 1 abortion, and 1 current pregnancy), making her G5 P2211.
A patient is in active labor and is experiencing back labor. Which position would be most helpful to relieve the back pain?
- A. Supine position
- B. Hands and knees position
- C. Lithotomy position
- D. Squatting position
Correct Answer: B
Rationale: The correct answer is B: Hands and knees position. This position helps relieve back pain during labor by promoting optimal fetal positioning, reducing pressure on the back, and allowing gravity to assist in the descent of the baby. It also opens up the pelvic outlet, making it easier for the baby to navigate through the birth canal.
Incorrect choices:
A: Supine position can worsen back pain as it puts pressure on the lower back and restricts blood flow to the uterus.
C: Lithotomy position can exacerbate back pain as it involves lying on the back with legs in stirrups, which can increase pressure on the back.
D: Squatting position may not be ideal for relieving back pain in this scenario as it can put additional strain on the back muscles and may not provide optimal support for the laboring individual.