Nokea
A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time?
- A. We expect you to gain about 1 lb per week, so your weight is a little low at this time.
- B. Most women gain no weight during the first trimester, so I would suggest you eat fewer desserts for the next few weeks.
- C. You entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need.
- D. Your weight gain is exactly what we would expect it to be at this time.
Correct Answer: D
Rationale: A weight gain of 3 to 5 lb is expected during the first trimester. The client's weight gain is within the normal range.
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The patient who has received a dose of preservative-free morphine (Duramorph) is beginning to experience pruritus. Which medication is used to treat this?
- A. Low-dose naloxone infusion
- B. Diphenhydramine
- C. Dilaudid
- D. Sublimaze
Correct Answer: B
Rationale: The correct answer is B: Diphenhydramine. Pruritus is a common side effect of opioids like morphine. Diphenhydramine, an antihistamine, can help alleviate itching by blocking histamine receptors. Low-dose naloxone infusion (A) is used to reverse opioid overdose, not treat pruritus. Dilaudid (C) and Sublimaze (D) are also opioids and would not be effective in treating pruritus caused by morphine. Diphenhydramine is the most appropriate choice for addressing this specific symptom.
A 20-year-old client states that the at-home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time?
- A. Congratulations, you and your family must be so happy.
- B. Have you told the baby’s father yet?
- C. How do you feel about the results?
- D. Please tell me when your last menstrual period was.
Correct Answer: C
Rationale: It is important to assess the client's emotional response to the pregnancy test result before providing further guidance or congratulations.
A pregnant patient is concerned about the safety of using over-the-counter medications for her cold symptoms. Which of the following responses is most appropriate for the nurse?
- A. It is always safe to use OTC medications during pregnancy.
- B. You should avoid using any medications during pregnancy unless prescribed by your healthcare provider.
- C. OTC medications for cold symptoms are safe during any trimester of pregnancy.
- D. Use herbal remedies instead of OTC medications to avoid harm to the baby.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. During pregnancy, it is crucial to minimize medication use to prevent potential harm to the fetus.
2. Many OTC medications have not been extensively studied for safety in pregnancy.
3. Healthcare providers can recommend safe and effective treatment options tailored to the individual.
4. Avoiding unnecessary medication reduces the risk of adverse effects on the developing baby.
Summary:
A: Incorrect. Not all OTC medications are safe during pregnancy, and blanket statements can be harmful.
C: Incorrect. Safety of OTC medications can vary by trimester, so blanket statements are not appropriate.
D: Incorrect. Herbal remedies can also pose risks during pregnancy, and individualized guidance is necessary.
The nurse is caring for a pregnant patient who is 22 weeks gestation and is concerned about her weight gain. Which of the following statements by the patient indicates the need for further teaching?
- A. I should aim to gain 1 to 2 pounds per week during my pregnancy.
- B. I will avoid eating extra food to prevent excessive weight gain.
- C. I can eat for two during my pregnancy to ensure the baby's growth.
- D. I will maintain a healthy diet and exercise regularly to support my pregnancy.
Correct Answer: C
Rationale: Correct Answer: C - "I can eat for two during my pregnancy to ensure the baby's growth."
Rationale:
1. Eating for two is a common misconception; the pregnant woman only needs an additional 300-500 calories per day.
2. Overeating can lead to excessive weight gain which may pose risks to both the mother and the baby.
3. The statement does not reflect an accurate understanding of healthy nutrition during pregnancy.
Summary of Incorrect Choices:
A: Choosing to gain 1 to 2 pounds per week aligns with healthy weight gain during pregnancy.
B: Avoiding excessive food intake is an appropriate strategy to prevent excessive weight gain.
D: Maintaining a healthy diet and regular exercise are essential for supporting a healthy pregnancy.
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.