Nokea
The nurse explains to the group that frequent urination during early pregnancy usually subsides at which time?
- A. When the placenta is fully developed
- B. When fetal kidneys begin to function
- C. When the uterus rises into the abdominal cavity
- D. When the hormonal balance is reestablished
Correct Answer: C
Rationale: Frequent urination subsides in the second trimester as the uterus rises into the abdominal cavity, reducing bladder pressure.
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Which intervention is most appropriate for a client with placenta previa?
- A. Prepare for cesarean delivery
- B. Encourage ambulation
- C. Administer oxytocin
- D. Perform vaginal exams
Correct Answer: A
Rationale: Placenta previa often requires cesarean delivery to prevent life-threatening bleeding, unlike the other options.
The laboring client is experiencing problems, and the nurse is concerned about possible side effects from the epidural anesthetic just administered. Which problems should the nurse attribute to the epidural anesthetic? Select all that apply.
- A. Has breakthrough sharp pain
- B. Blood pressure is increased
- C. Has a pounding headache
- D. Unable to feel a full bladder
- E. Has an elevated temperature
Correct Answer: A,C,D,E
Rationale: Breakthrough pain can occur when the continuous infusion rate of the anesthetic agent is below the recommended rate for a therapeutic dose. Breakthrough pain can also occur when the client has a full bladder or when the cervix is completely dilated. A spinal headache can be a complication of epidural anesthesia and occurs when the dura is accidently punctured during epidural placement. A sensory level of T10 is usually maintained during epidural anesthesia; most women are unable to feel a full bladder or to void after receiving an epidural anesthetic. Maternal temperature may be elevated to 100.1°F (37.8°C) or higher with an epidural. Sympathetic blockade may decrease sweat production and diminish heat loss. Hypertension is a contraindication for epidural anesthesia. A major side effect of epidural anesthesia is hypotension (not hypertension) caused by a spinal blockade, which lowers peripheral resistance, decreases venous return to the heart, and subsequently lessens cardiac output and lowers BP.
The nurse correctly instructs the client to drink how many glasses of milk per day to meet calcium requirements?
- A. 1 to 2
- B. 3 to 4
- C. 5 to 6
- D. 7 to 8
Correct Answer: B
Rationale: Three to four glasses of milk daily provide approximately 1200 mg of calcium, meeting pregnancy requirements.
The nurse is caring for the 24-year-old client whose pregnancy history is as follows: elective termination age 18 years, spontaneous abortion age 21 years, term vaginal delivery at 22 years old, and currently pregnant again. Which documentation by the nurse of the client’s gravidity and parity is correct?
- A. G4P1
- B. G4P2
- C. G3P1
- D. G2P1
Correct Answer: A
Rationale: The client has been pregnant four times in all (gravidity). This client has delivered once (parity) and is currently pregnant, so the parity is 1. Although the client has been pregnant four times in all (gravidity), she would have had to deliver two fetuses over 20 weeks old, regardless of whether either fetus survived. The client has been pregnant four times in all, not three (gravidity). Parity of 1 is correct. The client has been pregnant four times in all, not two times (gravidity). Parity of 1 is correct.
The nurse explains that, in addition to increased blood volume, which other condition causes varicose veins during pregnancy?
- A. Impaired venous return
- B. Decreased cardiac output
- C. Altered center of gravity
- D. Impaired kidney function
Correct Answer: A
Rationale: Impaired venous return, due to the uterus compressing veins, causes varicose veins, compounded by increased blood volume.