Nokea
A primigravida at 39-weeks gestation is admitted to the labor and delivery unit in active labor. She is given an epidural anesthetic. Her blood pressure drops to 90/50 mm Hg, and the fetal heart rate shows late decelerations. What is the most likely cause of these findings?
- A. Maternal hypotension.
- B. Uteroplacental insufficiency.
- C. Fetal distress.
- D. Amniotic fluid embolism.
Correct Answer: A
Rationale: Maternal hypotension following epidural anesthesia can lead to decreased placental perfusion, causing late decelerations in the fetal heart rate.
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The nurse is conducting a prenatal nutrition education class for a group of nursing students. Which statement best describes the condition known as pica?
- A. Iron-deficiency anemia
- B. Intolerance to milk products
- C. Ingestion of nonfood substances
- D. Episodes of anorexia and vomiting
Correct Answer: C
Rationale: The correct answer is C: Ingestion of nonfood substances. Pica is a condition where individuals have a persistent craving to eat items that are not considered food, such as dirt, clay, or ice. This behavior can be seen in pregnant women due to nutritional deficiencies or psychological factors. Choices A, B, and D are incorrect because they do not accurately describe pica. Iron-deficiency anemia (A) is a condition related to low iron levels in the blood, intolerance to milk products (B) is a lactose intolerance issue, and episodes of anorexia and vomiting (D) are symptoms of eating disorders, not pica.
A pregnant patient's diet may not meet her need for folate. Which food choice is an excellent source of this nutrient?
- A. Chicken
- B. Cheese
- C. Potatoes
- D. Green leafy vegetables
Correct Answer: D
Rationale: The correct answer is D: Green leafy vegetables. Green leafy vegetables such as spinach, kale, and broccoli are excellent sources of folate, a crucial nutrient for pregnant women to prevent neural tube defects in the fetus. These vegetables are rich in natural folate, making them an ideal choice for meeting the increased folate requirements during pregnancy. Chicken (A), cheese (B), and potatoes (C) do not contain as high levels of folate as green leafy vegetables, making them less optimal choices for ensuring adequate intake of this essential nutrient during pregnancy.
A medical-surgical nurse is asked to float to a women's health unit to care for patients who are scheduled for therapeutic abortions. The nurse refuses to accept this assignment and expresses her personal beliefs as being incongruent with this medical practice. The nursing supervisor states that the unit is short-staffed and the nurse is familiar with caring for postoperative patients. In consideration of legal and ethical practices, can the nursing supervisor enforce this assignment?
- A. The staff nurse has the responsibility of accepting any assignment that is made while working for a healthcare facility.
- B. Because the unit is short-staffed, the staff nurse should accept the assignment to provide care.
- C. The staff nurse has expressed a legitimate concern based on his or her feelings; the nursing supervisor does not have the authority to enforce this assignment.
- D. The nursing supervisor should emphasize that this assignment requires care of a surgical patient for which the staff nurse is adequately trained.
Correct Answer: C
Rationale: The Nurse Practice Act allows nurses to refuse assignments involving practices opposed to their religious, cultural, ethical, or moral values.
When planning care for a laboring client, the nurse identifies the need to withhold solids food while the client is in labored. What is the most important reasons for this nursing intervention?
- A. Nausea occurs from analgesics used during labor
- B. Autonomic nervous system stimulation during labor decrease peristalsis
- C. An increased risk of aspiration can occur if general anesthesia is needed
- D. Gastric emptying time decreases during labor.
Correct Answer: C
Rationale: Aspiration risk (C) is a primary reason for withholding solid foods during labor.
The nurse states to the newly pregnant patient, 'Tell me how you feel about being pregnant.' Which communication technique is the nurse using with this patient?
- A. Clarifying
- B. Paraphrasing
- C. Reflection
- D. Structuring
Correct Answer: A
Rationale: The nurse is attempting to follow up and check the accuracy of the patient's message, which is clarifying.