Nokea
When should iron supplementation during a normal pregnancy begin?
- A. Before pregnancy
- B. In the first trimester
- C. In the third trimester
- D. In the second trimester
Correct Answer: D
Rationale: The correct answer is D: In the second trimester. During the second trimester, the demand for iron significantly increases due to the rapid growth of the fetus and expansion of maternal blood volume. This is the optimal time to begin iron supplementation to prevent iron deficiency anemia in both the mother and the developing baby. Starting iron supplementation in the first trimester may not be necessary as iron needs are not as high yet. Waiting until the third trimester may lead to insufficient time for iron stores to build up adequately. Beginning before pregnancy is not necessary unless the mother has pre-existing iron deficiency.
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An obviously pregnant woman walks into the hospital's emergency department entrance shouting. 'Help me! Help me! My baby is coming! I'm so afraid!' The nurse determines if delivery is indeed imminent, what action is most important for the nurse to take?
- A. Determine the gestational age of fetus
- B. Assess the amount and color of the amniotic fluid
- C. Obtain peripheral IV access and begin administration of IV fluids
- D. Provide clear concise instructions in a calm, deliberate manner
Correct Answer: D
Rationale: Providing clear instructions (D) helps manage the situation calmly and effectively.
The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14 ounces, has a head circumference of 13 inches, and a chest circumference of 10 inches. Based on these physical findings, assessment for which condition has the highest priority?
- A. Hyperthermia
- B. Hyperbilirubinemia
- C. Polycythemia
- D. Hypoglycemia
Correct Answer: D
Rationale: Small-for-gestational-age infants are at high risk for hypoglycemia (D).
A pregnant patient's diet may not meet her need for folate. Which food choice is an excellent source of this nutrient?
- A. Chicken
- B. Cheese
- C. Potatoes
- D. Green leafy vegetables
Correct Answer: D
Rationale: The correct answer is D: Green leafy vegetables. Green leafy vegetables such as spinach, kale, and broccoli are excellent sources of folate, a crucial nutrient for pregnant women to prevent neural tube defects in the fetus. These vegetables are rich in natural folate, making them an ideal choice for meeting the increased folate requirements during pregnancy. Chicken (A), cheese (B), and potatoes (C) do not contain as high levels of folate as green leafy vegetables, making them less optimal choices for ensuring adequate intake of this essential nutrient during pregnancy.
The nurse assesses a client admitted to the labor and delivery unit and obtains the following data: dark red vaginal bleeding, uterus slightly tense between contractions, BP 110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced. Based on these assessment findings, what intervention should the nurse implement?
- A. Insert an internal fetal monitor
- B. Assess for cervical changes q1h
- C. Monitor bleeding from IV sites
- D. Perform Leopold's maneuvers
Correct Answer: C
Rationale: Monitoring bleeding from peripheral sites (C) is the priority intervention. This client is presenting with signs of placental abruption. Disseminated intravascular coagulation (DIC) is a complication of placental abruption, characterized by abnormal bleeding.
A 26-week gestational primigravida who is carrying twins is seen in the clinic today. Her fundal height is measured at 29 cm. Based on these findings what actions the nurse implement.
- A. Notify the healthcare provider of the finding
- B. Document the finding in the medical record
- C. Schedule the client for a biophysical profile
- D. Request another nurse measure the fundus
Correct Answer: A
Rationale: Fundal height greater than expected may indicate a complication, so notifying the healthcare provider (A) is necessary.