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The nurse is assessing a pregnant patient who is 30 weeks gestation and reports severe lower back pain. What is the most appropriate intervention for the nurse to recommend?
- A. Instruct the patient to lie flat on her back to relieve pain.
- B. Encourage the patient to perform gentle stretching exercises and maintain good posture.
- C. Encourage the patient to rest in bed and avoid any physical activity.
- D. Recommend taking over-the-counter pain medication to alleviate discomfort.
Correct Answer: B
Rationale: The correct answer is B: Encourage the patient to perform gentle stretching exercises and maintain good posture. This option promotes active management of lower back pain in pregnancy by improving muscle strength and flexibility, reducing strain on the back. Stretching exercises can help alleviate discomfort and improve posture, which are important for managing back pain during pregnancy. Option A is incorrect as lying flat on the back is contraindicated in pregnancy due to the risk of supine hypotensive syndrome. Option C is incorrect as complete bed rest is not recommended for back pain management. Option D is incorrect as over-the-counter pain medication should be used judiciously during pregnancy and is not the first-line intervention for managing back pain.
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A nurse is assisting with a vaginal delivery. What is the most important intervention when the fetal head begins to crown?
- A. apply gentle downward pressure
- B. perform perineal massage
- C. assist with perineal care
- D. apply a warm compress
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This intervention helps to control the speed of delivery, prevent rapid tearing of the perineum, and reduce the risk of maternal and fetal complications. Applying pressure can also help guide the baby's head to prevent sudden expulsion, allowing for a controlled delivery. Performing perineal massage (B) and assisting with perineal care (C) are important but not the most critical interventions at this stage. Applying a warm compress (D) may provide comfort but does not address the immediate need for controlled delivery.
A pregnant patient at 30 weeks gestation reports feeling dizzy when standing. What should the nurse instruct the patient to do?
- A. Lie down flat on your back to restore blood flow.
- B. Rise slowly from a sitting or lying position to avoid dizziness.
- C. Increase fluid intake to prevent dehydration.
- D. Avoid physical activity to prevent further dizziness.
Correct Answer: B
Rationale: The correct answer is B: Rise slowly from a sitting or lying position to avoid dizziness. This recommendation is appropriate because pregnant patients often experience dizziness due to changes in blood pressure and circulation. Rising slowly helps prevent sudden drops in blood pressure, which can lead to dizziness. Lying flat on the back can worsen dizziness by reducing blood flow to the brain. Increasing fluid intake is generally recommended during pregnancy but may not directly address the issue of dizziness. Avoiding physical activity entirely is not necessary and may not address the underlying cause of the dizziness.
A pregnant patient at 30 weeks gestation reports lower back pain and difficulty sleeping. Which of the following is the most appropriate recommendation for the nurse to make?
- A. Rest in bed with your legs elevated to reduce back pain.
- B. Use a firm mattress and avoid sleeping on your back.
- C. Take over-the-counter pain medications as prescribed to alleviate pain.
- D. Perform light stretching exercises before bed to relieve discomfort.
Correct Answer: B
Rationale: The correct answer is B. Using a firm mattress and avoiding sleeping on the back is the most appropriate recommendation for a pregnant patient at 30 weeks gestation experiencing lower back pain. Here's why:
1. Firm mattress provides better support for the back and helps maintain proper spinal alignment during sleep.
2. Avoiding sleeping on the back reduces pressure on the major blood vessels, preventing potential complications like supine hypotensive syndrome.
3. Resting in bed with legs elevated (choice A) may not address the root cause of back pain and may not be recommended for extended periods during pregnancy.
4. Taking over-the-counter pain medications (choice C) should be avoided unless prescribed by a healthcare provider due to potential risks to the fetus.
5. Performing light stretching exercises (choice D) can be beneficial, but avoiding certain positions like lying on the back is more crucial for back pain relief during pregnancy.
A 29-week pregnant woman presents with preterm labor symptoms. What is the most appropriate intervention?
- A. Administer magnesium sulfate
- B. Perform a cesarean section
- C. Administer tocolytics to delay labor
- D. Induce labor immediately
Correct Answer: C
Rationale: The correct answer is C: Administer tocolytics to delay labor. This intervention helps to delay preterm labor, giving time for corticosteroids to enhance fetal lung maturity and reduce neonatal morbidity. Administering magnesium sulfate (Choice A) is used for neuroprotection in preterm labor but is not the initial intervention. Performing a cesarean section (Choice B) is not recommended unless there are complications. Inducing labor immediately (Choice D) is not appropriate as the goal is to delay labor to improve neonatal outcomes.
A nurse is caring for a postpartum person who is at risk for infection. What is the most important intervention to reduce the risk of infection?
- A. administer antibiotics
- B. apply a sterile dressing
- C. perform a vaginal exam
- D. administer pain relief
Correct Answer: A
Rationale: Correct Answer: A (administer antibiotics)
Rationale:
1. Administering antibiotics targets potential infection-causing pathogens directly.
2. Antibiotics help prevent the spread of infection within the body.
3. Prophylactic antibiotics are commonly used postpartum for high-risk individuals.
4. This intervention directly addresses the root cause of infection risk.
Summary:
B: Applying a sterile dressing is important for wound care but doesn't target systemic infection risk.
C: Performing a vaginal exam can introduce pathogens and increase infection risk.
D: Administering pain relief is important for comfort but doesn't directly reduce infection risk.