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The nurse is teaching a client about foods rich in folic acid during pregnancy. Which food should the nurse recommend?
- A. Citrus fruits.
- B. Lean meats.
- C. Dairy products.
- D. Whole grains.
Correct Answer: A
Rationale: The correct answer is A, citrus fruits. Folic acid is important for fetal development and helps prevent birth defects. Citrus fruits like oranges, grapefruits, and lemons are rich sources of folic acid. They provide the necessary nutrients for a healthy pregnancy. Lean meats (B) are good sources of protein but not specifically high in folic acid. Dairy products (C) are important for calcium but do not contain significant amounts of folic acid. Whole grains (D) are beneficial for fiber and nutrients, but they are not the best source of folic acid compared to citrus fruits.
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A nurse is preparing to administer magnesium sulfate IV to a client who is experiencing preterm labor. Which of the following is the priority nursing assessment for this client?
- A. Temperature
- B. Fetal heart rate (FHR)
- C. Bowel sounds
- D. Respiratory rate
Correct Answer: B
Rationale: The correct answer is B: Fetal heart rate (FHR). When administering magnesium sulfate for preterm labor, monitoring the fetal heart rate is crucial as magnesium sulfate can affect the fetal heart rate. It is important to assess for any signs of fetal distress promptly.
A: Temperature is important to monitor for signs of magnesium toxicity, but not the priority assessment in this situation.
C: Bowel sounds are not directly related to the administration of magnesium sulfate for preterm labor.
D: Respiratory rate is important to monitor for respiratory depression from magnesium sulfate, but assessing the fetal heart rate takes precedence in this scenario.
What is the term for nonmedical factors that influence health outcomes, including conditions in which people are born, grow, work, live, and age, and the wider sets of forces and systems shaping the conditions of daily life?
- A. environmental influences
- B. life circumstances
- C. situational occurrences
- D. social determinants of health
Correct Answer: D
Rationale: The correct answer is D: social determinants of health. Social determinants of health refer to the external factors that impact health outcomes. These factors include socioeconomic status, education, employment, social support networks, access to healthcare, and the physical environment. The term encompasses a broad range of influences beyond individual behaviors or genetics.
A: Environmental influences focus more on physical factors like pollution or climate, rather than the broader societal factors.
B: Life circumstances may include individual factors like personal choices or experiences, but do not encompass the societal influences.
C: Situational occurrences imply random events or temporary situations, rather than the persistent societal factors that shape health outcomes.
The nurse practicing in a labor setting knows the woman most at risk for a uterine rupture is:
- A. G4 who had all 4 c/s birth
- B. G5 who had 2 vaginal birth and 2 c/s births
- C. G2 low segment vertical incision for delivery of 10lb infant
- D. G3 who had 2 lower segment transverse c/s birth
Correct Answer: C
Rationale: The correct answer is C because a low segment vertical incision for delivery of a large infant (10lb) puts the woman at the highest risk for uterine rupture. This type of incision weakens the uterine wall, increasing the likelihood of rupture during subsequent pregnancies or labor. Choices A, B, and D involve lower segment transverse c-section births, which are less likely to result in uterine rupture compared to a vertical incision. Additionally, the number of previous births or the mode of delivery does not increase the risk of uterine rupture as much as the type of uterine incision.
One goal of Healthy People 2030 is to improve pregnancy planning and prevent unintended pregnancy. What is a negative outcome related to unintended pregnancy that is related to this HP goal?
- A. lost jobs related to inabilities to continue to work
- B. depression and anxiety
- C. increased BMI and unintentional weight gain
- D. increased health-care costs in the United States
Correct Answer: B
Rationale: The correct answer is B: depression and anxiety. Unintended pregnancies can lead to mental health issues like depression and anxiety due to the emotional, financial, and social stress associated with unplanned parenthood. This aligns with the goal of Healthy People 2030 to improve pregnancy planning. Choice A is incorrect because while lost jobs can be a consequence of unintended pregnancy, it is not directly related to the mental health aspect targeted by this HP goal. Choice C is incorrect as increased BMI and weight gain are not typically cited as negative outcomes directly related to unintended pregnancy prevention. Choice D is incorrect as while unintended pregnancies can lead to increased healthcare costs, it does not specifically address the mental health aspect targeted by the HP goal.
The nurse is monitoring a client in labor with an epidural. What finding requires immediate intervention?
- A. Blood pressure of 100/60 mmHg.
- B. Fetal heart rate of 90 beats/minute.
- C. Client reports warmth in the lower extremities.
- D. Contractions every 5 minutes.
Correct Answer: B
Rationale: The correct answer is B: Fetal heart rate of 90 beats/minute. A fetal heart rate of 90 bpm indicates fetal distress and requires immediate intervention to prevent potential complications. Decreased fetal heart rate can be a sign of fetal hypoxia or distress. The other choices are not as concerning in this context. A blood pressure of 100/60 mmHg is within normal range. The client reporting warmth in the lower extremities is a common side effect of epidural anesthesia. Contractions every 5 minutes may indicate progress in labor but do not require immediate intervention unless associated with fetal distress.