Nokea
The nurse advises the client with constipation to increase intake of which food?
- A. High-fiber fruits and vegetables
- B. White rice
- C. Processed meats
- D. Sugary desserts
Correct Answer: A
Rationale: High-fiber fruits and vegetables promote bowel regularity, relieving constipation safely during pregnancy.
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Before hospitalization, an adolescent client had decided to give up her newborn for adoption. The client had an uncomplicated vaginal delivery and is still committed to her decision. Which intervention should the nurse exclude?
- A. Offer to the client a transfer to a different unit within the hospital.
- B. Talk to the client about having possible feelings of ambivalence.
- C. Initiate a case management or social work consult for the client.
- D. Notify her family to ensure that support is available upon her discharge.
Correct Answer: D
Rationale: Offering to transfer the client is appropriate and would not be excluded. The postpartum unit may be filled with sounds and sights that may distress the client. It would be appropriate for the nurse to discuss possible ambivalence with the client, as she may have increased feelings of attachment, love, and grief after delivery. Having those feelings does not necessarily mean that the client has made the wrong decision. Initiating a case management or social work consult is appropriate and would not be excluded. The client may not have support systems available because she may not have disclosed her pregnancy to others. The adolescent may not have disclosed the pregnancy to family. Although it would be appropriate for the nurse to explore the client’s support system with the client, the nurse should not contact the client’s family.
Which statement made by a participant indicates the need for additional teaching regarding management of urinary frequency?
- A. Limiting fluid intake will help control this problem.
- B. I should report a burning sensation during urination.
- C. Urinating before going to bed may help control this problem.
- D. Avoiding caffeinated beverages may help control the problem.
Correct Answer: A
Rationale: Limiting fluid intake is not recommended, as hydration is essential; the other statements reflect appropriate management strategies.
The nurse evaluates the pregnant client with sickle cell disease during her second trimester. The nurse should identify which manifestation as being related to sickle cell disease and not the pregnancy?
- A. Hand and lower extremities edema
- B. Elevated serum blood glucose level
- C. Decreased oxygen saturation level
- D. Elevated blood pressure
Correct Answer: C
Rationale: Decreased oxygen saturation level is a clinical manifestation of sickle cell disease. Dehydration and anemia during pregnancy can result in vaso-occlusive crisis, which causes damage to RBCs and decreased oxygenation. The decrease in oxygenation manifests in decreased oxygen saturation levels. Edema is a normal finding related to pregnancy. A decrease in osmotic pressure causes a shift of body fluids into interstitial spaces, leading to edema. Elevated serum blood glucose levels after a meal help ensure that there is a sustained supply of glucose available for the fetus. Sustained elevation may be associated with pregnancy-related diabetes, not sickle cell disease. Elevated BP is associated with essential hypertension or preeclampsia.
The client admitted in preterm labor is told that an amniocentesis needs to be performed. The client asks the nurse why this is necessary when the HCP has been performing ultrasounds throughout the pregnancy. Which is an appropriate response by the nurse?
- A. “Your baby is older now, and an amniocentesis provides us with more information on how your baby is doing.”
- B. “An amniocentesis could not be Performed before 32 weeks, so you will be having this test from now until delivery.”
- C. “Your doctor wants to make sure that there are no problems with the baby that an ultrasound might not be able to identify.”
- D. “With your preterm labor your doctor needs to know your baby’s lung maturity; this is best identified by amniocentesis.”
Correct Answer: D
Rationale: The amniocentesis is being performed to determine fetal lung maturity. Once fetal lung maturity is determined, appropriate care can be planned, including administration of betamethasone, administration of tocolytics, or delivery of the baby. While an amniocentesis can provide fetal information that an ultrasound cannot, the rationale for the amniocentesis is to determine lung maturity. Stating additional information is too broad. An amniocentesis can be performed as early as 12 weeks’ gestation, not after 32 weeks. The amniocentesis is not being performed to identify fetal anomalies.
Which item should the client include in her hospital bag?
- A. Comfortable loose clothing
- B. High-heeled shoes
- C. Heavy perfumes
- D. Large meals
Correct Answer: A
Rationale: Comfortable loose clothing is practical for labor and postpartum, ensuring ease and comfort.