Nokea
A woman who is 25 weeks pregnant asks the nurse what her fetus looks like. What does the nurse explain is one physical characteristic present in a 25-week-old fetus?
- A. Lanugo covering the body
- B. Constant motion
- C. Skin that is pink and smooth
- D. Eyes that are closed
Correct Answer: A
Rationale: By 25 weeks, the body of the fetus is covered with lanugo, the eyes are open, the skin is wrinkled, and the fetus has definite periods of movement and sleeping.
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A nurse is caring for a pregnant patient who is at 36 weeks gestation and reports that her baby has not moved as much as usual. What should the nurse instruct the patient to do first?
- A. Lie on her left side and drink a cold beverage to stimulate movement.
- B. Rest for a few hours and count fetal movements.
- C. Call the healthcare provider immediately to report the lack of movement.
- D. Monitor fetal movement over the next 24 hours and report if the pattern continues.
Correct Answer: A
Rationale: The correct answer is A: Lie on her left side and drink a cold beverage to stimulate movement. This is because changing positions can encourage fetal movement due to the change in gravity and blood flow. Additionally, the cold beverage may stimulate the baby to move. Option B suggests resting without actively trying to stimulate movement, which may delay necessary action. Option C advises immediate contact with the healthcare provider, which could be an overreaction at this stage. Option D delays action and may not address the immediate concern of decreased fetal movement.
The nurse is caring for a pregnant patient who is experiencing leg swelling. Which of the following actions should the nurse encourage to reduce the swelling?
- A. Limit physical activity and avoid standing for long periods.
- B. Increase sodium intake to help retain water and reduce swelling.
- C. Wear tight compression stockings to improve circulation.
- D. Elevate the legs and avoid crossing them while sitting.
Correct Answer: D
Rationale: The correct answer is D. Elevating the legs and avoiding crossing them while sitting helps reduce swelling by promoting venous return and improving circulation. Elevating the legs above the heart level assists in reducing edema. Choices A and C are incorrect as limiting physical activity and wearing tight compression stockings may not effectively address the underlying issue of poor circulation. Choice B is also incorrect as increasing sodium intake can lead to fluid retention and worsen swelling.
A patient in active labor starts to complain of circumoral numbness and tingling in her fingertips. What should the nurse do?
- A. Increase intravenous fluids.
- B. Give the woman pain medication.
- C. Obtain an arterial blood gas.
- D. Encourage the woman to slow down her breathing.
Correct Answer: D
Rationale: The correct answer is D: Encourage the woman to slow down her breathing. Circumoral numbness and tingling in the fingertips are symptoms of hyperventilation, which can occur during labor due to increased anxiety. Slowing down breathing helps to correct the imbalance of oxygen and carbon dioxide levels, alleviating the symptoms. Increasing IV fluids (A) is not indicated for hyperventilation. Pain medication (B) does not address the root cause. Obtaining an arterial blood gas (C) is not necessary unless the symptoms persist after addressing hyperventilation.
Which of the following is true about the use of a birthing ball during labor?
- A. It is contraindicated for patients with high blood pressure
- B. It promotes pelvic mobility and can help reduce pain
- C. It should only be used during the second stage of labor
- D. It is only effective in early labor
Correct Answer: B
Rationale: The correct answer is B because a birthing ball promotes pelvic mobility, which can help reduce pain during labor by encouraging movement and optimal positioning of the baby. It is not contraindicated for patients with high blood pressure unless specifically advised by a healthcare provider. It can be used throughout labor, not just during the second stage, and is effective at various stages, not just in early labor.
A pregnant patient who is 28 weeks gestation reports a sudden increase in vaginal discharge. What is the nurse's priority action?
- A. Instruct the patient to use a sanitary pad and monitor for any changes.
- B. Assess the discharge for characteristics such as color, odor, and consistency.
- C. Encourage the patient to rest and avoid physical activity for 24 hours.
- D. Call the healthcare provider immediately to report the increase in discharge.
Correct Answer: B
Rationale: The correct answer is B: Assess the discharge for characteristics such as color, odor, and consistency. This is the priority action because sudden changes in vaginal discharge during pregnancy could indicate a potential infection or other complications that need to be promptly addressed. By assessing the characteristics of the discharge, the nurse can gather important information to determine the appropriate next steps, whether it requires immediate medical attention or can be managed with monitoring.
Choice A is incorrect because simply using a sanitary pad and monitoring for changes does not address the underlying cause of the increased discharge. Choice C is incorrect as rest alone may not address the potential issue with the discharge. Choice D is also incorrect because while contacting the healthcare provider is important, assessing the discharge first provides crucial information for a more informed discussion with the provider.