Nokea
At 32 weeks' gestation, a 15-year-old primigravid client who is 5 feet, 2 inches tall has gained a total of 20 lb, with a 1-lb gain in the last 2 weeks. Urinalysis reveals negative glucose and a trace of protein. The nurse should advise the client that which of the following factors increases her risk for preeclampsia?
- A. Total weight gain.
- B. Short stature.
- C. Adolescent age group.
- D. Proteinuria.
Correct Answer: C
Rationale: Adolescents are at higher risk for preeclampsia due to incomplete physical maturity.
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A multigravid client in active labor has been diagnosed with class II heart disease and has had a prosthetic valve replacement. When developing the plan of care for this client, the nurse should anticipate that the physician most likely will order which of the following medications?
- A. Anticoagulants.
- B. Antibiotics.
- C. Diuretics.
- D. Folic acid supplements.
Correct Answer: B
Rationale: Prosthetic heart valves increase the risk of endocarditis during labor due to bacteremia. Prophylactic antibiotics are typically ordered. Anticoagulants may be adjusted, but antibiotics are prioritized during labor.
A primiparous client is on a regular diet 24 hours postpartum. She is from Guatemala and speaks little English. The client's mother asks the nurse if she can bring her daughter some "special foods from home." The nurse responds, based on the understanding about which of the following?
- A. Foods from home are generally discouraged on the postpartum unit.
- B. The mother can bring the daughter any foods that she desires.
- C. This is permissible as long as the foods are nutritious and high in iron.
- D. The client's physician needs to give permission for the foods.
Correct Answer: C
Rationale: Nutritious, iron-rich foods support postpartum recovery and respect cultural preferences.
A nurse is teaching a client about the lactational amenorrhea method. Which of the following instructions should the nurse include?
- A. Exclusively breastfeed and remain amenorrheic for up to 6 months postpartum.
- B. Breastfeed at least once daily for up to 12 months.
- C. Use this method if your periods have returned.
- D. Supplement with formula for flexibility.
Correct Answer: A
Rationale: The lactational amenorrhea method requires exclusive breastfeeding, amenorrhea, and being less than 6 months postpartum to suppress ovulation effectively. The other options reduce its reliability.
A primiparous client 3 days postpartum is to be discharged on heparin therapy. After teaching her about possible adverse effects of heparin therapy, the nurse determines that the client needs further instruction when she states the adverse effects include which of the following?
- A. Epistaxis.
- B. Bleeding gums.
- C. Slow pulse.
- D. Petechiae.
Correct Answer: C
Rationale: Slow pulse is not a typical adverse effect of heparin; bleeding symptoms like epistaxis, bleeding gums, and petechiae are expected.
During a home visit to a breast-feeding primiparous client at 1 week postpartum, the client tells the nurse that her nipples have become sore and cracked from the feedings. Which of the following should the nurse instruct the client to do?
- A. Wipe off any lanolin creams from the nipple before each feeding.
- B. Position the baby with the entire areola in the baby's mouth.
- C. Feed the baby less often for the next several days.
- D. Use a mild soap while in the shower to prevent an infection.
Correct Answer: B
Rationale: Proper positioning with the areola in the baby's mouth prevents and heals sore nipples.