Advanced Maternal Age Monitoring

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The nurse is assessing a pregnant patient who is at 14 weeks gestation and reports light vaginal bleeding. What is the nurse's priority action?

  • A. Monitor the patient's blood pressure and check for protein in the urine.
  • B. Call the healthcare provider immediately to assess for miscarriage.
  • C. Encourage the patient to rest and wait for symptoms to resolve.
  • D. Perform a pelvic exam to check for cervical dilation.
Correct Answer: B

Rationale: The correct answer is B: Call the healthcare provider immediately to assess for miscarriage. The priority action in this scenario is to promptly notify the healthcare provider to assess for potential complications like miscarriage, which could be life-threatening to the patient or fetus. This step ensures timely intervention and appropriate management. Monitoring blood pressure and urine for protein (Choice A) is important but not the immediate priority. Encouraging rest and waiting for symptoms to resolve (Choice C) may delay necessary medical intervention. Performing a pelvic exam (Choice D) could potentially worsen the situation if miscarriage is occurring. Thus, calling the healthcare provider for assessment is the most appropriate and urgent action to take in this situation.

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A nurse is assisting with a vaginal delivery. What is the most important action to take when the fetal head crowns?

  • A. apply gentle downward pressure
  • B. assist with shoulder delivery
  • C. assist with perineal massage
  • D. administer pain relief
Correct Answer: A

Rationale: The correct answer is A: apply gentle downward pressure. This action helps prevent rapid delivery, reducing the risk of perineal tearing and ensuring a controlled birth. Applying too much pressure can cause trauma to the mother and baby. Incorrect choices: B is premature, as shoulder delivery should only be done after the head and shoulders are delivered. C is not the most important action at crowning. D is not necessary at this specific stage of delivery.

A pregnant patient reports nausea and vomiting and asks the nurse about ways to manage these symptoms. Which of the following suggestions should the nurse make?

  • A. Eat large meals to avoid hunger and nausea.
  • B. Take anti-nausea medication without consulting a provider.
  • C. Avoid foods with strong smells and eat small, frequent meals.
  • D. Lie down immediately after meals to prevent nausea.
Correct Answer: C

Rationale: The correct answer is C: Avoid foods with strong smells and eat small, frequent meals. This suggestion is appropriate as it helps manage nausea and vomiting in pregnancy. Avoiding strong smells can reduce triggers for nausea, and eating small, frequent meals helps maintain stable blood sugar levels. This approach prevents the stomach from becoming too full or too empty, which can trigger nausea.

A: Eating large meals can exacerbate nausea and vomiting due to increased stomach distention.
B: Taking anti-nausea medication without consulting a healthcare provider is not safe during pregnancy as it may harm the fetus.
D: Lying down immediately after meals can worsen symptoms by promoting reflux and indigestion.

In summary, Option C is the best choice as it addresses the symptoms of nausea and vomiting in pregnancy effectively.

The normal volume of amniotic fluid is approximately _______________ mL at 37 weeks’ gestation.

  • A. 1000
  • B. 0.1
  • C. 100
  • D. 10000
Correct Answer: A

Rationale: The volume of amniotic fluid steadily increases throughout pregnancy, reaching approximately 1000 mL at 37 weeks. This fluid is crucial for maintaining a stable environment for fetal development.

A 37-week gravid client states that she noticed a 'white liquid' leaking from her breasts during a recent shower.

  • A. Advise the woman that she may have a galactocele.
  • B. Encourage the woman to pump her breasts to stimulate an adequate milk supply.
  • C. Assess the liquid because a breast discharge is diagnostic of a mammary infection.
  • D. Reassure the mother that this is normal in the third trimester.
Correct Answer: D

Rationale: In the third trimester, colostrum production can cause a white liquid to leak from the breasts. This is a normal physiological response as the body prepares for breastfeeding.

A nurse is monitoring a laboring person who is receiving oxytocin for labor induction. What is the priority assessment during oxytocin infusion?

  • A. monitor fetal heart rate
  • B. assess maternal vital signs
  • C. assess uterine tone
  • D. monitor for signs of uterine hyperstimulation
Correct Answer: C

Rationale: The correct answer is C: assess uterine tone. This is the priority assessment during oxytocin infusion because oxytocin can cause uterine hyperstimulation, leading to fetal distress. By assessing uterine tone regularly, the nurse can detect any signs of hyperstimulation early and take appropriate action to prevent complications. Monitoring fetal heart rate (A) is important but assessing uterine tone takes precedence as it directly impacts fetal well-being. Maternal vital signs (B) are important but are not as directly related to the safety of the fetus during oxytocin infusion. Monitoring for signs of uterine hyperstimulation (D) is essential, but assessing uterine tone is the proactive approach to detect hyperstimulation before it escalates.

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