External Maternal Monitoring

External Maternal Monitoring Related

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A pregnant patient is at 34 weeks gestation and reports frequent headaches and visual changes. What should the nurse do first?

  • A. Monitor the patient's blood pressure and assess for signs of preeclampsia.
  • B. Encourage the patient to rest and drink plenty of fluids.
  • C. Administer pain medication as prescribed to relieve the headache.
  • D. Schedule an appointment with an eye specialist to check for vision changes.
Correct Answer: A

Rationale: The correct answer is A. At 34 weeks gestation, headaches and visual changes can be signs of preeclampsia, a serious pregnancy complication. The nurse should first monitor the patient's blood pressure as elevated BP is a key indicator of preeclampsia. Assessing for other signs like proteinuria and edema is crucial for early detection and timely intervention. Encouraging rest and fluids (choice B) may not address the underlying issue. Administering pain medication (choice C) only masks symptoms without addressing the potential serious condition. Scheduling an eye specialist appointment (choice D) is not the priority as the symptoms are more indicative of a systemic issue like preeclampsia.

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Which feature would be absent in a 41-week gestation fetus?

  • A. Fingernails
  • B. Eyelashes
  • C. Lanugo
  • D. Milia
Correct Answer: C

Rationale: Lanugo, the fine hair covering the fetus, typically sheds before term, making it absent in a 41-week gestation fetus.

The woman's partner is lightly stroking her abdomen as an alternative to medication for pain relief in labor. What is this known as?

  • A. Counterpressure
  • B. Effieurage
  • C. Guided imagery
  • D. Biofeedback
Correct Answer: A

Rationale: The correct answer is A: Counterpressure. This technique involves applying pressure to specific areas to alleviate pain during labor. In this scenario, the partner is using light strokes on the woman's abdomen to provide pain relief. Counterpressure helps release endorphins, which are natural painkillers, and distracts the brain from focusing on the pain sensations. Effleurage (B) is a gentle stroking technique used for relaxation, not specifically for pain relief. Guided imagery (C) involves visualizing calming scenes to reduce stress, not directly addressing pain. Biofeedback (D) is a method of monitoring and controlling physiological responses, not a hands-on pain relief technique like counterpressure.

Where is the usual location for implantation of the zygote?

  • A. Upper section of the posterior uterine wall
  • B. Lower portion of the uterus near the cervical os
  • C. Inner third of the fallopian tube near the uterus
  • D. Lateral aspect of the uterine wall
Correct Answer: A

Rationale: The zygote usually implants in the upper section of the posterior uterine wall.

The nurse is providing prenatal education to a pregnant patient at 24 weeks gestation. Which of the following topics should the nurse prioritize during this visit?

  • A. Signs and symptoms of preterm labor and when to call the healthcare provider
  • B. Breastfeeding techniques and infant care
  • C. Postpartum care and family planning options
  • D. Managing pregnancy-related fatigue and morning sickness
Correct Answer: A

Rationale: The correct answer is A: Signs and symptoms of preterm labor and when to call the healthcare provider. This is the most crucial topic to prioritize at 24 weeks gestation because preterm labor can have serious consequences for both the mother and the baby. By educating the patient on the signs and symptoms of preterm labor, such as abdominal cramping, backache, or vaginal bleeding, the nurse can empower the patient to recognize these warning signs early and seek prompt medical attention, potentially preventing preterm birth.

Choice B: Breastfeeding techniques and infant care, and Choice C: Postpartum care and family planning options are important topics but are more relevant for later stages of pregnancy or after delivery. Choice D: Managing pregnancy-related fatigue and morning sickness is also important but is generally not as urgent as being aware of signs of preterm labor.

Which of the following findings in an 8-week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? Select all that apply.

  • A. Body mass index of 17 kg/m².
  • B. Rubella titer of 1:8.
  • C. Blood pressure of 100/60 mm Hg.
  • D. Hematocrit of 30%.
Correct Answer: A

Rationale: A low BMI, low rubella titer, and low hematocrit are all concerning findings that should be highlighted for further evaluation. A blood pressure of 100/60 mm Hg is within normal limits.

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