The nurse identifies which factor as increasing the risk of gestational hypertension?
- A. Low body mass index
- B. Family history of hypertension
- C. First pregnancy at age 20
- D. Vegetarian diet
Correct Answer: B
Rationale: A family history of hypertension increases the risk of gestational hypertension, as genetics play a significant role.
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The nurse caring for the postpartum client who is 15 years old is concerned about this client’s ability to parent a newborn. Which behavior is characteristic of the developmental level of the 15-year-old that justifies the nurse’s concern?
- A. Developing autonomy
- B. Follows rules established by others
- C. Career oriented
- D. Egocentric
Correct Answer: D
Rationale: The development of autonomy is a developmental task of toddlerhood. School-age children are motivated to follow rules established by others. Adult women are concerned about the effect of childbearing on careers. Although it is biologically possible for the adolescent female to become a parent, her egocentricity and concrete thinking interfere with her ability to parent effectively. Because of this normal development, the adolescent may inadvertently neglect her child.
The 39-year-old client with type 1 DM presents at 36 weeks’ gestation with Drag and Drop contractions. An HCP decides to do an amniocentesis. Which statement best supports why the nurse and NA should prepare the client for an amniocentesis now?
- A. Diabetic women have a higher incidence of birth defects, and the HCP wants to determine if a birth defect is present.
- B. The client is over 35, at 36 weeks’ gestation with Drag and Drop contractions, and is at risk for chromosomal disorders.
- C. An amniocentesis performed at 36 weeks’ gestation is being completed to determine if the fetal lungs have matured.
- D. The amniocentesis is more accurate than the fetal fibronectin test in determining if delivery is imminent.
Correct Answer: C
Rationale: Infants of diabetic mothers are less likely to have mature lung capacity at 36 weeks; knowing lung maturity can influence whether delivery should proceed. In mid pregnancy, the cells in amniotic fluid can be studied for genetic abnormalities such as Down’s syndrome and birth defects, but amniocentesis would not be performed for this purpose when the client is in preterm labor. Many women over the age of 35 have amniocentesis completed to test for chromosomal disorders, but not this late in the pregnancy. Fetal fibronectin testing is used to determine if a preterm birth is likely, but it cannot be used to determine lung maturity.
The nurse advises the client to perform which exercise to strengthen pelvic floor muscles?
- A. Kegel exercises
- B. High-impact aerobics
- C. Sit-ups
- D. Weightlifting
Correct Answer: A
Rationale: Kegel exercises strengthen pelvic floor muscles, aiding postpartum recovery and preventing incontinence.
Which activity should the nurse recommend to prepare for labor?
- A. Practicing relaxation and breathing techniques
- B. Increasing caffeine intake
- C. Avoiding all physical activity
- D. Taking daily hot baths
Correct Answer: A
Rationale: Practicing relaxation and breathing techniques helps manage labor pain and prepares the client for childbirth.
Which action by the nurse best ensures that an accurate fetal heart rate is obtained?
- A. Assess the fetal heart rate when the client is lying on her right side.
- B. Assess the fetal heart rate when the client reports fetal movement.
- C. Assess the fetal heart rate between Braxton Hicks contractions.
- D. Assess the maternal pulse and fetal heart rate, and compare the two.
Correct Answer: D
Rationale: Comparing maternal pulse with fetal heart rate ensures the nurse is not mistaking the maternal pulse for the fetal heartbeat.