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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The nurse is caring for a postpartum client who is complaining of severe pain and a feeling of pressure in her perineum. Her fundus is firm, and she has a moderate lochia flow. On inspection the nurse finds that a perineal hematoma is beginning to form. Which assessment findings show the nurse obtain first?
- A. Abdominal contour and bowel sounds
- B. Hemoglobin and hematocrit
- C. Heart rate and blood pressure
- D. Urinary output and IV fluid intake
Correct Answer: C
Rationale: Hematomas can cause significant blood loss, so assessing heart rate and blood pressure (C) is critical.
A client at 40-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 8 cm, 100% effaced, and the fetus is at +1 station. The client begins to push forcefully with contractions. What action should the nurse take?
- A. Encourage the client to pant-blow during contractions.
- B. Assist the client to push with contractions.
- C. Prepare for an immediate delivery.
- D. Notify the healthcare provider.
Correct Answer: A
Rationale: Pant-blow breathing helps prevent premature pushing before full dilation, reducing the risk of cervical edema.
A client receiving epidural anesthesia begins to experience nausea and becomes pale and clammy. What intervention should the nurse implement first?
- A. Raise the foot of the bed
- B. Assess for vaginal bleeding
- C. Evaluate the fetal heart rate
- D. Take the client's blood pressure
Correct Answer: A
Rationale: These symptoms are suggestive of hypotension which is a side effect of epidural anesthesia. Raising the foot of the bed (A) will increase venous return and provide blood to the vital areas. Increasing the IV fluid rate using a balanced non-dextrose solution and ensuring that the silent is in a lateral position are also appropriate interventions.
A patient in her fifth month of pregnancy asks the nurse, 'How many more calories should I be eating daily?' What is the correct response by the nurse?
- A. 180 more calories a day
- B. 340 more calories a day
- C. 452 more calories a day
- D. 500 more calories a day
Correct Answer: B
Rationale: The correct response is B: 340 more calories a day. During the second trimester, an additional 340 calories per day is recommended for pregnant women. This ensures proper nutrition for both the mother and the developing fetus. Option A (180 more calories) may not provide enough energy for the needs of pregnancy. Options C (452 more calories) and D (500 more calories) are excessive and could lead to unnecessary weight gain, which may pose risks during pregnancy. Option B strikes a balanced approach to support the increased energy demands of pregnancy without being excessive.
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.