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In preparing a pregnant patient for a nonstress test (NST), which of the following should be included in the plan of care?
- A. Have the patient void prior to being placed on the fetal monitor because a full bladder will interfere with results.
- B. Maintain NPO status prior to testing.
- C. Position the patient for comfort, adjusting the tocotransducer belt to locate fetal heart rate.
- D. Have an infusion pump prepared with oxytocin per protocol for evaluation.
Correct Answer: C
Rationale: The patient should be positioned comfortably, and the tocotransducer should be adjusted to obtain an accurate fetal heart rate reading.
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When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent?
- A. Congenital heart defects
- B. Neural tube defects
- C. Mental retardation
- D. Premature birth
Correct Answer: B
Rationale: It is now known that folic acid supplements can prevent neural tube defects such as spina bifida.
The nurse is assessing a pregnant patient who is 30 weeks gestation and is concerned about the possibility of gestational diabetes. Which of the following symptoms should the nurse educate the patient to report?
- A. Increased thirst and frequent urination
- B. Sudden weight loss and increased energy
- C. Extreme fatigue and headaches
- D. Decreased fetal movement and nausea
Correct Answer: A
Rationale: The correct answer is A: Increased thirst and frequent urination. This is because these symptoms are indicative of hyperglycemia, which is common in gestational diabetes. Increased thirst occurs due to the body trying to flush out excess sugar through urine, leading to frequent urination. This should be reported to the healthcare provider for further evaluation and management.
Other choices are incorrect:
B: Sudden weight loss and increased energy are not typical symptoms of gestational diabetes. Weight loss can occur in uncontrolled diabetes, but it is not a common symptom in gestational diabetes.
C: Extreme fatigue and headaches can be non-specific symptoms and are not necessarily related to gestational diabetes.
D: Decreased fetal movement and nausea are more commonly associated with other complications in pregnancy, such as placental insufficiency or preeclampsia, rather than gestational diabetes.
A nurse is caring for a postpartum person who is experiencing difficulty with breastfeeding. What is the most appropriate intervention?
- A. assist with latching
- B. provide skin-to-skin contact
- C. educate the person on breast care
- D. educate the person on postpartum care
Correct Answer: B
Rationale: The correct answer is B: provide skin-to-skin contact. This is the most appropriate intervention because it promotes bonding, regulates the baby's temperature, and enhances breastfeeding success by stimulating the baby's natural instincts. Assisting with latching (choice A) may be necessary but providing skin-to-skin contact should be prioritized. Educating on breast care (choice C) and postpartum care (choice D) are important, but the immediate need is to establish successful breastfeeding through skin-to-skin contact.
A 36-week gestation gravid client is complaining of dyspnea when lying flat.
- A. Maternal hypertension.
- B. Fundal height.
- C. Hydramnios.
- D. Congestive heart failure.
Correct Answer: B
Rationale: As the uterus grows, the fundal height increases, which can press on the diaphragm and lead to shortness of breath when lying flat.
The nurse is caring for a pregnant patient who is 24 weeks gestation and reports nausea, vomiting, and weight loss. What is the most appropriate action for the nurse to take?
- A. Instruct the patient to eat a high-protein diet and avoid fluids during meals.
- B. Encourage the patient to rest and avoid any exercise.
- C. Assess the patient's hydration status and notify the healthcare provider if necessary.
- D. Recommend over-the-counter anti-nausea medications to control symptoms.
Correct Answer: C
Rationale: The correct answer is C: Assess the patient's hydration status and notify the healthcare provider if necessary.
Rationale:
1. Nausea, vomiting, and weight loss in pregnancy may indicate hyperemesis gravidarum, a severe form of morning sickness that can lead to dehydration and electrolyte imbalances.
2. Assessing hydration status is crucial to determine the severity of the condition and guide appropriate interventions.
3. Notifying the healthcare provider allows for further evaluation, possible treatment adjustments, and monitoring to prevent complications.
Summary:
A: Instructing the patient to eat a high-protein diet and avoid fluids during meals does not address the immediate concern of dehydration and may worsen symptoms.
B: Encouraging the patient to rest and avoid exercise is important but does not address the primary issue of dehydration.
D: Recommending over-the-counter anti-nausea medications may provide symptomatic relief but does not address the underlying cause or hydration status.