Nokea
In the primigravid client, when is fetal movement typically felt for the first time?
- A. Between 10 and 14 weeks' gestation
- B. Between 16 and 20 weeks' gestation
- C. Between 22 and 26 weeks' gestation
- D. Between 28 and 32 weeks' gestation
Correct Answer: B
Rationale: Primigravid women typically feel fetal movement (quickening) between 16 and 20 weeks, later than multigravida women.
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Which nursing instruction given to the client complaining about shortness of breath is most appropriate?
- A. Contact your health care provider immediately.
- B. Decrease your activity level to conserve oxygen.
- C. Ask your physician for a mild sedative.
- D. Sleep with your upper body elevated on pillows.
Correct Answer: D
Rationale: Sleeping with the upper body elevated reduces pressure on the diaphragm, easing shortness of breath.
Which explanation by the nurse accurately identifies the recommended weight gain for a pregnant client who has a normal prepregnancy weight?
- A. Less than 15 pounds (<6.8 kg)
- B. 15 to 20 pounds (6.8 to 9 kg)
- C. 25 to 35 pounds (11.3 to 15.9 kg)
- D. No more than 40 pounds (≤18.1 kg)
Correct Answer: C
Rationale: For a woman with normal prepregnancy weight, the recommended weight gain is 25-35 pounds to support fetal development.
The nurse is caring for the postpartum primiparous client who is 13 hours post—vaginal delivery. The nurse observes that the client is passive and hesitant about making decisions about her own and her newborn’s care. In response to this observation, which interventions should be implemented by the nurse? Select all that apply.
- A. Question her closely about the presence of pain.
- B. Ask if she would like to talk about her birth experience.
- C. Encourage her to nap when her infant is napping.
- D. Encourage attendance in teaching sessions about infant care.
- E. Suggest that she begin to write her birth announcements.
Correct Answer: A,B,C
Rationale: Many women hesitate to ask for medication, as they believe their pain is expected. Thus, the nurse should ask the client about pain and assure her that there are methods to decrease her pain. During the initial postpartum “taking-in” phase, the client may have a great need to talk about her birthing experience and to ask questions for clarification as necessary. By encouraging this verbalization, the nurse helps the client to accept the experience and enables her to move to the next maternal phase. Physical discomfort can be intense initially postpartum and can interfere with rest. Sleep is a major need and should be encouraged. Anxiety and preoccupation with her new role often narrow the client’s perceptions, and information is not as easily assimilated at this time. Therefore, attending education sessions should be delayed if possible until the mother has completed this “taking in” phase. The client needs to suspend her involvement in everyday responsibilities during the “taking—in” phase, so writing birth announcements should be delayed until the mother has completed this phase.
The nurse correctly informs the participants that women who smoke during pregnancy have a greater risk of which problem?
- A. Having a premature delivery
- B. Having a cesarean birth
- C. Having a large, overweight baby
- D. Developing a prenatal infection
Correct Answer: A
Rationale: Smoking during pregnancy increases the risk of premature delivery due to reduced oxygen and nutrient delivery to the fetus.
Which method best promotes client comfort during the pelvic examination?
- A. Have the client lift her head off the table.
- B. Have the client press her back into the examination table.
- C. Have the client tighten her buttocks.
- D. Tell the client to let her knees fall outward.
Correct Answer: D
Rationale: Letting the knees fall outward relaxes the pelvic muscles, reducing discomfort during the pelvic examination.