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The nurse is caring for a pregnant patient who is 22 weeks gestation and is concerned about her weight gain. Which of the following statements by the patient indicates the need for further teaching?
- A. I should aim to gain 1 to 2 pounds per week during my pregnancy.
- B. I will avoid eating extra food to prevent excessive weight gain.
- C. I can eat for two during my pregnancy to ensure the baby's growth.
- D. I will maintain a healthy diet and exercise regularly to support my pregnancy.
Correct Answer: C
Rationale: Correct Answer: C - "I can eat for two during my pregnancy to ensure the baby's growth."
Rationale:
1. Eating for two is a common misconception; the pregnant woman only needs an additional 300-500 calories per day.
2. Overeating can lead to excessive weight gain which may pose risks to both the mother and the baby.
3. The statement does not reflect an accurate understanding of healthy nutrition during pregnancy.
Summary of Incorrect Choices:
A: Choosing to gain 1 to 2 pounds per week aligns with healthy weight gain during pregnancy.
B: Avoiding excessive food intake is an appropriate strategy to prevent excessive weight gain.
D: Maintaining a healthy diet and regular exercise are essential for supporting a healthy pregnancy.
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A nurse is caring for a postpartum person who is at risk for uterine atony. What is the most important intervention to prevent uterine atony?
- A. administer uterotonic medications
- B. perform fundal massage
- C. perform a vaginal exam
- D. monitor vital signs
Correct Answer: B
Rationale: The correct answer is B: perform fundal massage. Fundal massage helps stimulate uterine contractions and prevents uterine atony by promoting uterine firmness and reducing the risk of excessive bleeding. It is a non-invasive intervention that can be done immediately after delivery to prevent postpartum hemorrhage. Administering uterotonic medications (Choice A) may be necessary in severe cases but fundal massage is the initial intervention. Performing a vaginal exam (Choice C) is not indicated unless there are specific concerns or indications. Monitoring vital signs (Choice D) is important but addressing uterine atony requires more direct intervention like fundal massage.
What is the purpose of initiating contractions in a contraction stress test (CST)?
- A. Increase placental blood flow.
- B. Identify fetal acceleration patterns.
- C. Determine the degree of fetal activity.
- D. Apply a stressful stimulus to the fetus.
Correct Answer: D
Rationale: The CST assesses fetal response to the stress of uterine contractions to determine if the fetus can tolerate labor.
A pregnant patient is concerned about the use of caffeine during pregnancy. Which of the following statements by the nurse would be most appropriate?
- A. Caffeine is completely safe during pregnancy and has no impact on the baby.
- B. Moderate caffeine consumption is safe, but it is recommended to limit it to 200 mg per day.
- C. You should avoid caffeine completely to prevent any complications.
- D. Caffeine can cause premature labor, so it should be avoided entirely.
Correct Answer: B
Rationale: The correct answer is B. Moderate caffeine consumption is safe, but it is recommended to limit it to 200 mg per day during pregnancy. This answer is appropriate because it balances the potential risks of caffeine with the benefits of moderate consumption. Excessive caffeine intake has been associated with adverse pregnancy outcomes, so setting a limit is a prudent approach.
Explanation for Incorrect Choices:
A: This statement is incorrect as excessive caffeine intake during pregnancy can have negative effects on the baby.
C: Complete avoidance of caffeine is not necessary unless the individual has specific health concerns that warrant it.
D: While high levels of caffeine can be linked to complications, the statement that caffeine always causes premature labor is an oversimplification.
A pregnant patient at 36 weeks gestation reports difficulty breathing when lying flat. What should the nurse do first?
- A. Encourage the patient to rest in a semi-reclined position or on her left side.
- B. Administer oxygen as prescribed to improve oxygenation.
- C. Monitor the fetal heart rate and assess for signs of distress.
- D. Instruct the patient to take shallow breaths and stay in bed.
Correct Answer: A
Rationale: The correct answer is A because positioning the patient in a semi-reclined or left side position can alleviate pressure on the diaphragm and improve breathing. This position helps optimize blood flow to the uterus and placenta. Encouraging rest in this position can improve oxygenation for both the mother and fetus. Administering oxygen (Choice B) may help with oxygenation but does not address the underlying issue of positional discomfort. Monitoring fetal heart rate (Choice C) is important but not the first action to address the mother's breathing difficulty. Instructing the patient to take shallow breaths and stay in bed (Choice D) does not address the positional component of the issue.
A nurse is caring for a postpartum person who is experiencing excessive bleeding. What is the first step in managing postpartum hemorrhage?
- A. administer uterotonics
- B. administer IV fluids
- C. perform a manual removal of the placenta
- D. monitor vital signs every 15 minutes
Correct Answer: A
Rationale: The correct answer is A: administer uterotonics. Uterotonics help to contract the uterus, which can help stop the bleeding in postpartum hemorrhage. This is the initial step in managing postpartum hemorrhage to address the primary cause of excessive bleeding. Administering IV fluids (B) can support circulation but does not address the underlying issue. Performing manual removal of the placenta (C) is invasive and not the first-line treatment for postpartum hemorrhage. Monitoring vital signs (D) is important but should not delay the immediate intervention of administering uterotonics.