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The nurse is caring for a pregnant patient who is complaining of frequent heartburn. Which of the following suggestions would be most helpful for managing heartburn during pregnancy?
- A. Lie down immediately after meals to help with digestion.
- B. Eat smaller meals more frequently throughout the day.
- C. Drink large amounts of water after meals to dilute stomach acid.
- D. Increase intake of spicy foods to stimulate digestion.
Correct Answer: B
Rationale: The correct answer is B: Eat smaller meals more frequently throughout the day. This suggestion helps manage heartburn during pregnancy by preventing large meals that can put pressure on the stomach and lead to acid reflux. Eating smaller, more frequent meals helps maintain stable digestion and minimizes the likelihood of triggering heartburn episodes.
A: Lie down immediately after meals is incorrect because it can worsen heartburn by allowing stomach acid to flow back into the esophagus.
C: Drinking large amounts of water after meals can dilute stomach acid, but it may also distend the stomach and exacerbate heartburn symptoms.
D: Increasing intake of spicy foods can aggravate heartburn due to the potential for irritating the stomach lining and increasing acid production.
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A 34-week pregnant woman presents with a non-reactive nonstress test (NST). What should the nurse do next?
- A. Administer a tocolytic agent
- B. Perform a biophysical profile (BPP)
- C. Monitor the fetal heart rate for 30 minutes
- D. Monitor fetal heart rate
Correct Answer: B
Rationale: The correct answer is B: Perform a biophysical profile (BPP). A non-reactive NST indicates fetal distress, so a BPP is necessary to assess the overall well-being of the fetus. BPP evaluates fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and NST results. Administering a tocolytic agent (A) is not indicated as the issue is fetal distress, not preterm labor. Monitoring the fetal heart rate for 30 minutes (C) may delay necessary intervention if fetal distress is present. Monitoring fetal heart rate (D) alone does not provide a comprehensive assessment of fetal well-being.
A pregnant patient is at 30 weeks gestation and is experiencing difficulty breathing, especially when lying flat. What is the nurse's priority action?
- A. Encourage the patient to rest in an upright position.
- B. Administer oxygen and prepare the patient for delivery.
- C. Monitor the fetal heart rate for signs of distress.
- D. Instruct the patient to take deep breaths and stay in bed.
Correct Answer: A
Rationale: The correct answer is A - Encourage the patient to rest in an upright position. This is the priority action because the patient is likely experiencing supine hypotensive syndrome due to pressure on the vena cava when lying flat. This can compromise blood flow to the fetus. By having the patient rest in an upright position, the pressure on the vena cava is reduced, improving blood flow and oxygenation for both the patient and the fetus. Administering oxygen and preparing for delivery (option B) is not the immediate priority. Monitoring fetal heart rate (option C) is important but not the initial action. Instructing the patient to take deep breaths and stay in bed (option D) does not address the underlying issue of supine hypotensive syndrome.
Which of the following skin changes should the nurse highlight for a pregnant woman’s health care practitioner?
- A. Linea nigra.
- B. Melasma.
- C. Petechiae.
- D. Spider nevi.
Correct Answer: C
Rationale: Petechiae (small hemorrhages under the skin) could indicate underlying medical conditions such as thrombocytopenia or coagulopathy, warranting further investigation. Linea nigra and melasma are common benign changes, while spider nevi are usually harmless but less urgent.
The nurse is caring for a pregnant patient who is at 30 weeks gestation and has been diagnosed with gestational diabetes. Which of the following is the most important aspect of the patient's care plan?
- A. Maintaining a healthy weight gain during pregnancy.
- B. Monitoring blood glucose levels and maintaining a balanced diet.
- C. Increasing fluid intake to reduce the risk of dehydration.
- D. Administering insulin to control blood sugar levels.
Correct Answer: B
Rationale: The correct answer is B: Monitoring blood glucose levels and maintaining a balanced diet. This is the most important aspect of care for a pregnant patient with gestational diabetes because it helps control blood sugar levels, reducing the risk of complications for both the mother and the baby. Monitoring blood glucose levels ensures that the patient's blood sugar remains within the target range, while maintaining a balanced diet helps provide essential nutrients without causing spikes in blood sugar levels.
A: Maintaining a healthy weight gain during pregnancy is important but not as crucial as monitoring blood glucose levels for a patient with gestational diabetes.
C: Increasing fluid intake is important for overall health during pregnancy, but it is not the most critical aspect of care for a patient with gestational diabetes.
D: Administering insulin may be necessary in some cases, but it is not the most important aspect of care compared to monitoring blood glucose levels and maintaining a balanced diet.
An 18-week gestation client telephones the obstetrician’s office stating, 'I’m really scared. I think I have breast cancer. My breasts are filled with tumors.' The nurse should base the response on which of the following?
- A. Breast cancer is often triggered by pregnancy.
- B. Nodular breast tissue is normal during pregnancy.
- C. The woman is exhibiting signs of a psychotic break.
- D. Anxiety attacks are especially common in the second trimester.
Correct Answer: B
Rationale: Nodular breast tissue is a normal change during pregnancy due to hormonal fluctuations. Breast cancer is not typically triggered by pregnancy, and anxiety attacks are not specifically common in the second trimester.