Nokea
During a prenatal visit, a gravid client is complaining of ptyalism. Which of the following nursing interventions is appropriate?
- A. Encourage the woman to brush her teeth carefully.
- B. Advise the woman to have her blood pressure checked regularly.
- C. Encourage the woman to wear supportive hosiery.
- D. Advise the woman to avoid eating rare meat.
Correct Answer: A
Rationale: Ptyalism (excessive salivation) can lead to oral hygiene issues, so encouraging careful tooth brushing is appropriate. Blood pressure checks, wearing supportive hosiery, and avoiding rare meat address other concerns but are unrelated to ptyalism.
You may also like to solve these questions
A pregnant woman who is 28 weeks gestation reports that she feels dizzy and faint when she stands up. What should the nurse instruct the patient to do?
- A. Lie down flat on your back immediately.
- B. Stand up quickly to prevent dizziness from worsening.
- C. Drink a large amount of water to alleviate the dizziness.
- D. Get up slowly and avoid standing for long periods.
Correct Answer: D
Rationale: The correct answer is D, instructing the pregnant woman to get up slowly and avoid standing for long periods. This is because during pregnancy, blood pressure can drop when standing up quickly, leading to dizziness and fainting. Getting up slowly allows the body to adjust gradually, preventing a sudden drop in blood pressure. Standing for long periods can worsen these symptoms, so it is important to avoid prolonged standing.
A: Lying down flat on the back immediately can worsen symptoms in this case by reducing blood flow to the brain.
B: Standing up quickly can exacerbate dizziness and fainting by causing a sudden drop in blood pressure.
C: Drinking a large amount of water may not address the underlying issue of postural hypotension and could potentially worsen symptoms by increasing blood volume without addressing the drop in blood pressure.
A patient in labor is having difficulty pushing during the second stage of labor. Which of the following interventions would be most helpful?
- A. Increase the epidural dose
- B. Encourage the patient to bear down with each contraction
- C. Perform a cesarean section
- D. Place the patient in a lithotomy position
Correct Answer: B
Rationale: The correct answer is B: Encourage the patient to bear down with each contraction. This is the most helpful intervention as it helps the patient effectively push during the second stage of labor, facilitating the descent of the baby through the birth canal. Increasing the epidural dose (choice A) can further impair the patient's ability to push. Performing a cesarean section (choice C) is not necessary unless there are other complications. Placing the patient in a lithotomy position (choice D) is a common position for delivery but does not address the issue of difficulty pushing.
What organ does the ductus venosus shunt blood away from in fetal circulation?
- A. Liver
- B. Heart
- C. Lungs
- D. Kidneys
Correct Answer: A
Rationale: Fetal blood bypasses the liver through the ductus venosus by carrying blood directly to the inferior vena cava.
A pregnant patient has received the results of her triple-screen testing and it is positive. What would the nurse anticipate as the next step in the patient’s plan of care?
- A. No further testing is indicated at this time because results are normal.
- B. Refer to the physician for additional testing.
- C. Validate the results with the lab facility.
- D. Repeat the test in 2 weeks and have the patient return for her regularly scheduled prenatal visit.
Correct Answer: B
Rationale: A positive triple-screen test suggests an increased risk of genetic abnormalities, requiring additional diagnostic testing.
A nurse is caring for a pregnant patient at 36 weeks gestation who has been diagnosed with preeclampsia. Which of the following interventions should the nurse prioritize?
- A. Encourage the patient to increase fluid intake to prevent dehydration.
- B. Monitor the patient's blood pressure and assess for signs of worsening preeclampsia.
- C. Provide education about managing gestational diabetes.
- D. Administer pain relief to reduce discomfort from swelling.
Correct Answer: B
Rationale: The correct answer is B because monitoring the patient's blood pressure and assessing for signs of worsening preeclampsia is crucial in managing the condition and preventing potential complications. At 36 weeks gestation, close monitoring is essential to detect any changes in the patient's condition promptly. Increasing fluid intake (choice A) may not be recommended for patients with preeclampsia due to the risk of fluid overload. Providing education about managing gestational diabetes (choice C) is irrelevant in this scenario. Administering pain relief (choice D) may provide temporary relief but does not address the underlying issue of worsening preeclampsia. Prioritizing blood pressure monitoring ensures timely intervention and management of preeclampsia to promote the well-being of both the patient and the baby.