Nokea
A nurse is reviewing laboratory results for client who is pregnant. The Nurse should expect which of the following laboratory values to increase?
- A. RBC count
- B. Bilirubin
- C. Fasting blood glucose
- D. Bun
Correct Answer: A
Rationale: The correct answer is A: RBC count. During pregnancy, an increase in RBC count is expected due to physiological changes in the body to support the increased oxygen demand for the developing fetus. This is known as physiologic anemia of pregnancy. Bilirubin levels may remain stable or decrease during pregnancy. Fasting blood glucose levels may increase due to gestational diabetes, but this is not a universal finding. BUN levels can remain stable or slightly decrease during pregnancy due to increased renal blood flow and glomerular filtration rate.
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The nurse is educating a prenatal client about weight dysphoric disorder. Which statement by the client gain during pregnancy. Which statement by the would require immediate follow-up? client indicates effective understanding?
- A. I have been crying the week of my period.
- B. I should gain 2 to 4 pounds in the first trimester
- C. I am experiencing suicidal thoughts. and half a pound per week in the last two
- D. My menstrual cycle is 1 week late. trimesters.
Correct Answer: C
Rationale: Correct Answer: C. "I am experiencing suicidal thoughts."
Rationale: This statement indicates a serious mental health concern that requires immediate follow-up. Suicidal thoughts during pregnancy can be a sign of depression or other mental health issues that need to be addressed promptly to ensure the safety and well-being of the client and the baby.
Summary of Other Choices:
A: "I have been crying the week of my period." - This statement suggests premenstrual symptoms which are common and not necessarily alarming during pregnancy.
B: "I should gain 2 to 4 pounds in the first trimester and half a pound per week in the last two trimesters." - This statement reflects a correct understanding of weight gain recommendations during pregnancy and does not raise immediate concerns.
D: "My menstrual cycle is 1 week late." - This statement is not concerning during pregnancy as menstrual cycles typically stop during pregnancy.
A client at 37 weeks' gestation reports swollen feet and hands. What assessment finding requires immediate intervention?
- A. Blood pressure of 150/95 mmHg.
- B. Weight gain of 1 pound in a week.
- C. Mild nausea after eating.
- D. Fetal movements are regular.
Correct Answer: A
Rationale: The correct answer is A: Blood pressure of 150/95 mmHg. This finding indicates gestational hypertension, which can progress to preeclampsia, a serious condition that requires immediate intervention to prevent complications for both the mother and baby. High blood pressure can lead to organ damage and placental insufficiency.
B: Weight gain of 1 pound in a week is within the normal range for late pregnancy and may not require immediate intervention.
C: Mild nausea after eating is a common pregnancy symptom and does not indicate an urgent issue.
D: Regular fetal movements are a positive sign of fetal well-being and do not require immediate intervention.
A 45-year-old woman presents to the clinic for advice about contraception. What is the most appropriate contraception method for a woman who is nearing menopause?
- A. Oral contraceptives with estrogen
- B. Contraceptive injections
- C. IUD with progestin
- D. Barrier methods like condoms
Correct Answer: C
Rationale: The most appropriate contraception method for a woman nearing menopause is an IUD with progestin (Choice C). Progestin-containing IUDs are effective, long-lasting, and suitable for women of various ages. As women approach menopause, the hormonal changes make progestin-containing IUD a favorable option as it offers reliable contraception without the need for daily administration. Additionally, progestin can also help alleviate symptoms like heavy periods that women may experience during perimenopause.
Choices A and B are not ideal as oral contraceptives with estrogen can increase the risk of blood clots in older women, and contraceptive injections may not be as convenient for someone nearing menopause. Barrier methods like condoms (Choice D) are less effective and may not provide the level of protection needed during this stage of life.
The nurse is educating a client about folic acid during pregnancy. What food should the nurse recommend?
- A. Citrus fruits.
- B. Leafy green vegetables.
- C. Dairy products.
- D. Lean meats.
Correct Answer: B
Rationale: The correct answer is B: Leafy green vegetables. Folic acid is essential during pregnancy for proper fetal development. Leafy green vegetables like spinach, kale, and broccoli are rich sources of folic acid. Citrus fruits (Choice A) contain vitamin C but not as much folic acid as leafy greens. Dairy products (Choice C) provide calcium but are not significant sources of folic acid. Lean meats (Choice D) are good sources of protein but do not contain as much folic acid as leafy green vegetables. Therefore, recommending leafy green vegetables ensures the client gets an adequate intake of folic acid during pregnancy.
A preterm neonate develops physiologic jaundice and phototherapy is ordered. The nurse understands that this therapy:
- A. Activates the liver to dispose the bilirubin
- B. Breaks down the unconjugated bilirubin in the skin to conjugated form permitting excretion
- C. Activates Vit. K to facilitate excretion of the bilirubin
- D. Dissolves the bilirubin and allows it to be excreted from the skin
Correct Answer: B
Rationale: The correct answer is B because phototherapy works by breaking down unconjugated bilirubin in the skin to a water-soluble form, allowing it to be excreted from the body. This process does not activate the liver (choice A), nor does it activate Vitamin K (choice C) or dissolve the bilirubin for excretion from the skin (choice D). Phototherapy specifically targets the unconjugated bilirubin in the skin, converting it to a form that can be eliminated through the urine and stool.