Nokea
During an assessment, a client at 26 weeks of gestation presents with which of the following clinical manifestations that should be reported to the provider?
- A. Leukorrhea
- B. Supine hypotension
- C. Periodic numbness of the fingers
- D. Decreased urine output
Correct Answer: D
Rationale: The correct answer is D: Decreased urine output. At 26 weeks of gestation, decreased urine output can be a sign of potential complications like preeclampsia or dehydration, which require immediate medical attention to prevent harm to the mother and baby. Leukorrhea (choice A) is a common pregnancy symptom and not typically concerning. Supine hypotension (choice B) is a known issue in pregnancy but usually occurs later in the third trimester due to pressure on the vena cava when lying on the back. Periodic numbness of the fingers (choice C) can be related to carpal tunnel syndrome, which is common in pregnancy but not typically urgent at 26 weeks unless severe and persistent.
You may also like to solve these questions
During a vaginal exam on a client in labor who reports severe pressure and pain in the lower back, a nurse notes that the fetal head is in a posterior position. Which of the following is the best nonpharmacological intervention for the nurse to perform to relieve the client's discomfort?
- A. Back rub
- B. Counter-pressure
- C. Playing music
- D. Foot massage
Correct Answer: B
Rationale: The correct answer, B: Counter-pressure, is the best nonpharmacological intervention for a client with a posterior fetal head position causing lower back pain. Counter-pressure applied to the sacrum can help alleviate discomfort by reducing pressure on the lower back and providing support during contractions. This technique can aid in rotating the baby's head to a more optimal position for delivery.
Choice A: Back rub, may offer some comfort but may not specifically address the issue of lower back pain caused by the fetal position. Choice C: Playing music, and Choice D: Foot massage, are unlikely to provide direct relief for the client's specific discomfort related to the baby's posterior position.
A client with pregestational type 1 diabetes mellitus is being taught by a nurse about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should aim to maintain my fasting blood glucose between 100 and 120.
- B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or higher.
- C. I will continue taking my insulin if I experience nausea and vomiting.
- D. I will avoid exercise if my blood glucose exceeds 250.
Correct Answer: C
Rationale: The correct answer is C because continuing to take insulin during nausea and vomiting is crucial for maintaining blood glucose control in clients with diabetes. Nausea and vomiting can lead to decreased food intake, risking hypoglycemia if insulin is not adjusted.
Choice A is incorrect because fasting blood glucose levels should ideally be maintained between 60-90 mg/dL in pregnant clients with diabetes for optimal outcomes, not 100-120 mg/dL.
Choice B is incorrect because engaging in moderate exercise when blood glucose is high (250 or higher) can exacerbate hyperglycemia rather than help in lowering blood glucose levels.
Choice D is incorrect because avoiding exercise when blood glucose exceeds 250 is not recommended. Exercise can help lower blood glucose levels and improve insulin sensitivity.
A client in a prenatal clinic is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following responses should the nurse make?
- A. This is due to an increase in blood volume.
- B. This is due to pressure from the uterus on the diaphragm.
- C. This is due to the weight of the uterus on the vena cava.
- D. This is due to increased cardiac output.
Correct Answer: C
Rationale: The correct answer is C: This is due to the weight of the uterus on the vena cava. Maternal hypotension during pregnancy can occur when the growing uterus compresses the vena cava, reducing blood flow back to the heart and causing a drop in blood pressure. This compression can lead to decreased blood flow to the brain and other vital organs, resulting in symptoms of hypotension. The other choices are incorrect because:
A: An increase in blood volume during pregnancy typically leads to an increase in blood pressure, not hypotension.
B: Pressure from the uterus on the diaphragm may cause discomfort or shortness of breath but is not the primary cause of maternal hypotension.
D: Increased cardiac output is a normal adaptation in pregnancy to meet the demands of the growing fetus and placenta, but it does not directly cause maternal hypotension.
A healthcare provider is assisting with the care for a client who reports manifestations of preterm labor. Which of the following findings are risk factors for this condition? (Select all that apply)
- A. Urinary tract infection
- B. Multifetal pregnancy
- C. Oligohydramnios
- D. All of the Above
Correct Answer: D
Rationale: The correct answer is D because all of the choices are risk factors for preterm labor.
A: Urinary tract infection can lead to inflammation and contractions.
B: Multifetal pregnancy puts more stress on the uterus, increasing the risk.
C: Oligohydramnios is associated with a higher risk of preterm labor due to decreased amniotic fluid levels.
In summary, all the choices contribute to the increased likelihood of preterm labor.
When discussing intermittent fetal heart monitoring with a newly licensed nurse, which statement should a nurse include?
- A. Count the fetal heart rate for 15 seconds to determine the baseline.
- B. Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor.
- C. Count the fetal heart rate after a contraction to determine baseline changes.
- D. Auscultate the fetal heart rate every 30 minutes during the second stage of labor.
Correct Answer: C
Rationale: The correct answer is C because counting the fetal heart rate after a contraction helps determine baseline changes, which is essential for identifying fetal distress. This method allows for accurate assessment of fetal well-being in response to contractions. Choice A is incorrect as 15 seconds is not enough time to establish a baseline. Choice B is incorrect as auscultating every 5 minutes may not provide timely information during the active phase. Choice D is incorrect because auscultating every 30 minutes in the second stage may miss important changes in fetal status. Therefore, option C is the most appropriate choice for intermittent fetal heart monitoring.