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The nurse is educating a pregnant patient about the symptoms of preterm labor. Which of the following symptoms should the nurse advise the patient to report immediately?
- A. Occasional low back pain and cramping
- B. Increased vaginal discharge
- C. Painful, regular contractions every 10 minutes or less
- D. Feeling of pelvic pressure after physical activity
Correct Answer: C
Rationale: Step-by-step rationale:
1. Painful, regular contractions every 10 minutes or less can indicate preterm labor.
2. Regular contractions are a sign of the uterus preparing for birth.
3. Painful contractions at regular intervals can progress quickly to preterm delivery.
4. Reporting this symptom immediately allows for timely intervention to prevent premature birth.
Summary:
A: Low back pain and cramping are common in pregnancy but not necessarily indicative of preterm labor.
B: Increased vaginal discharge may be normal in pregnancy and not a direct sign of preterm labor.
C: Painful, regular contractions every 10 minutes or less are a critical sign of preterm labor.
D: Feeling pelvic pressure after physical activity is common in late pregnancy and not specific to preterm labor.
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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.
A nurse is caring for a pregnant patient who is at 26 weeks gestation and reports a sudden decrease in fetal movement. Which action should the nurse take first?
- A. Encourage the patient to drink a sugary beverage and count fetal movements.
- B. Monitor the patient's blood pressure and assess for any signs of hypertension.
- C. Perform a nonstress test to assess fetal well-being.
- D. Call the healthcare provider immediately to report the decrease in fetal movement.
Correct Answer: A
Rationale: The correct answer is A: Encourage the patient to drink a sugary beverage and count fetal movements. This action is appropriate as decreased fetal movement can indicate fetal distress, and the sugary beverage can stimulate the baby to move. If the baby responds with increased movements, it indicates a reassuring fetal status. If there is no improvement, further evaluation can be pursued.
Incorrect choices:
B: Monitoring blood pressure is not the priority in this situation as the main concern is fetal movement.
C: Performing a nonstress test is not the first action to take as it requires time and resources, which may delay immediate intervention.
D: While eventually contacting the healthcare provider is important, the immediate action should be to assess fetal well-being by encouraging fetal movements.
A pregnant patient is at 28 weeks gestation and reports leg cramps. What is the most appropriate action for the nurse to take?
- A. Instruct the patient to stretch the legs and elevate them to alleviate the cramps.
- B. Recommend that the patient increase calcium intake through dietary changes.
- C. Administer prescribed pain medication to relieve discomfort.
- D. Encourage the patient to walk for 30 minutes each day to prevent cramps.
Correct Answer: A
Rationale: The correct answer is A. Leg cramps during pregnancy are common due to increased weight and pressure on leg muscles. Stretching and elevating legs can help alleviate cramps by improving circulation and reducing muscle tension. Increasing calcium intake (B) may help prevent cramps but is not the immediate action needed. Administering pain medication (C) should be avoided unless absolutely necessary. Walking (D) is beneficial for overall health during pregnancy but may not directly address the immediate leg cramps.
A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the preprocedure teaching?
- A. Fast for 12 hours before the test.
- B. Bring a urine specimen to the laboratory on the day of the test.
- C. Be prepared to have 4 blood specimens taken on the day of the test.
- D. The test should take one hour to complete.
Correct Answer: D
Rationale: The glucose challenge test typically takes one hour to complete and does not require fasting or multiple blood specimens. A urine specimen is not required for this test.
A patient who is about to undergo a cesarean section for breech presentation without fetal distress asks her nurse what kind of anesthesia would be best for her. The nurse explains that which of the following is the preferred method of anesthesia in this nonemergent case?
- A. Spinal block
- B. Epidural block
- C. General anesthesia
- D. Intravenous sedation
Correct Answer: A
Rationale: The correct answer is A: Spinal block. In a non-emergent cesarean section for breech presentation without fetal distress, a spinal block is preferred due to its rapid onset, reliable anesthesia for surgical procedures, and minimal risk to the fetus. Spinal block provides adequate pain relief and muscle relaxation without affecting the mother's ability to breathe and interact with the newborn immediately after delivery.
Summary of other choices:
B: Epidural block - Epidural block may not provide a dense enough block for a cesarean section and might require more time to administer.
C: General anesthesia - General anesthesia poses more risks to both the mother and the fetus compared to regional anesthesia methods.
D: Intravenous sedation - Intravenous sedation may not provide sufficient anesthesia for a cesarean section and is not the preferred method for this type of surgery.