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Regarding advanced roles of nursing, which statement related to clinical practice is the most accurate?
- A. Family nurse practitioners (FNPs) can assist with childbirth care in the hospital setting.
- B. Clinical nurse specialists (CNSs) provide primary care to obstetric patients.
- C. Neonatal nurse practitioners provide emergency care in the postbirth setting to high-risk infants.
- D. A certified nurse midwife (CNM) is not considered to be an advanced practice nurse.
Correct Answer: C
Rationale: Neonatal NPs provide specialized care for high-risk neonates in the birth room and NICU as needed.
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A primigravida at 39-weeks gestation is admitted to the labor and delivery unit in active labor. She is given an epidural anesthetic. Her blood pressure drops to 90/50 mm Hg, and the fetal heart rate shows late decelerations. What is the most likely cause of these findings?
- A. Maternal hypotension.
- B. Uteroplacental insufficiency.
- C. Fetal distress.
- D. Amniotic fluid embolism.
Correct Answer: A
Rationale: Maternal hypotension following epidural anesthesia can lead to decreased placental perfusion, causing late decelerations in the fetal heart rate.
A 26-week gestational primigravida who is carrying twins is seen in the clinic today. Her fundal height is measured at 29 cm. Based on these findings what actions the nurse implement.
- A. Notify the healthcare provider of the finding
- B. Document the finding in the medical record
- C. Schedule the client for a biophysical profile
- D. Request another nurse measure the fundus
Correct Answer: A
Rationale: Fundal height greater than expected may indicate a complication, so notifying the healthcare provider (A) is necessary.
The nurse is caring for a multigravida client in active labor with continuous epidural anesthesia. When the client is 7 cm dilated, her blood pressure drops to 90/50 mm Hg, and the fetal heart rate shows signs of decelerations. What action should the nurse take first?
- A. Place the client in a lateral position.
- B. Administer oxygen via face mask.
- C. Increase the rate of IV fluid infusion.
- D. Notify the healthcare provider.
Correct Answer: A
Rationale: Placing the client in a lateral position can improve venous return and blood pressure, addressing both maternal hypotension and fetal distress.
A pregnant patient arrives for her first prenatal visit at the clinic. She informs the nurse that she has been taking an additional 400 mcg of folic acid prior to becoming pregnant. Based on the patient's history, she has reached 8 weeks' gestation. Which recommendation would the nurse provide regarding folic acid supplementation?
- A. Have the patient continue to take 400 mcg folic acid throughout her pregnancy.
- B. Tell the patient that she no longer has to take additional folic acid because it will be included in her prenatal vitamins.
- C. Have the patient increase her folic acid intake to 1000 mcg throughout the rest of her pregnancy.
- D. Schedule the patient to go for an AFP (alpha-fetoprotein) test.
Correct Answer: B
Rationale: Step 1: The patient has been taking an additional 400 mcg of folic acid prior to pregnancy.
Step 2: Folic acid is crucial in the early stages of pregnancy for neural tube development.
Step 3: By 8 weeks' gestation, the neural tube has already formed.
Step 4: Prenatal vitamins typically contain the recommended amount of folic acid.
Step 5: Therefore, the nurse would recommend the patient to stop taking additional folic acid as it's included in prenatal vitamins.
Which guidance related to a healthy diet during pregnancy will the nurse provide to a patient in her 1st trimester?
- A. Every day you need to have at least 6 ounces of protein from sources such as meat, fish, eggs, beans, nuts, soybean products, and tofu.'
- B. High-dose vitamin A supplements will promote optimal vision while preventing a common cause of blindness in neonates.'
- C. Meals such as sushi with a cold deli salad made with raw sprouts combine high-fiber foods with protein sources to meet multiple nutritional needs.'
- D. Vitamin and mineral supplements can meet your nutrient needs if you have inadequate intake because of nausea or a sensation of fullness.'
Correct Answer: A
Rationale: Step 1: During pregnancy, protein is essential for the growth and development of the fetus, making option A correct.
Step 2: The other options are incorrect due to potential risks. High-dose vitamin A (Option B) can be harmful to the fetus.
Step 3: Consuming raw sprouts (Option C) poses a risk of foodborne illness, which can be dangerous during pregnancy.
Step 4: Relying solely on supplements (Option D) is not recommended as they may not provide all the necessary nutrients found in whole foods.
In summary, option A is correct as it emphasizes the importance of protein intake during pregnancy, while the other options pose potential risks or limitations in meeting nutritional needs.