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The nurse is providing education to a pregnant patient who is experiencing nausea and vomiting during pregnancy. Which of the following interventions should the nurse recommend?
- A. Increase fluid intake with large amounts of water at once.
- B. Eat small, frequent meals and avoid greasy foods.
- C. Take over-the-counter anti-nausea medications without consulting a doctor.
- D. Lie flat on your back immediately after eating to prevent reflux.
Correct Answer: B
Rationale: The correct answer is B because eating small, frequent meals and avoiding greasy foods can help manage nausea and vomiting during pregnancy by preventing the stomach from becoming too full or empty. Large amounts of water at once (choice A) can worsen nausea. Taking anti-nausea medications without consulting a doctor (choice C) can be unsafe during pregnancy. Lying flat on your back after eating (choice D) can increase the risk of acid reflux.
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A pregnant patient at 32 weeks gestation reports a sudden headache and blurred vision. What is the nurse's priority action?
- A. Assess the patient's blood pressure and check for signs of preeclampsia.
- B. Administer pain medication and advise the patient to rest.
- C. Encourage the patient to drink fluids and take deep breaths.
- D. Perform a visual acuity test and schedule a follow-up appointment.
Correct Answer: A
Rationale: The correct answer is A: Assess the patient's blood pressure and check for signs of preeclampsia. This is the priority action because sudden headache and blurred vision are symptoms of preeclampsia, a serious condition in pregnancy. Step 1: Assessing blood pressure is crucial to identify hypertension, a hallmark of preeclampsia. Step 2: Checking for other signs of preeclampsia, such as proteinuria and edema, helps confirm the diagnosis. Step 3: Prompt intervention is necessary to prevent complications for both the mother and the baby. Choices B, C, and D are incorrect because they do not address the potential life-threatening condition of preeclampsia and may delay appropriate treatment.
A patient is in active labor and is experiencing back labor. Which position would be most helpful to relieve the back pain?
- A. Supine position
- B. Hands and knees position
- C. Lithotomy position
- D. Squatting position
Correct Answer: B
Rationale: The correct answer is B: Hands and knees position. This position helps relieve back pain during labor by promoting optimal fetal positioning, reducing pressure on the back, and allowing gravity to assist in the descent of the baby. It also opens up the pelvic outlet, making it easier for the baby to navigate through the birth canal.
Incorrect choices:
A: Supine position can worsen back pain as it puts pressure on the lower back and restricts blood flow to the uterus.
C: Lithotomy position can exacerbate back pain as it involves lying on the back with legs in stirrups, which can increase pressure on the back.
D: Squatting position may not be ideal for relieving back pain in this scenario as it can put additional strain on the back muscles and may not provide optimal support for the laboring individual.
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks’ gestation; delivered a daughter, now 5 years old, at 39 weeks’ gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman’s gravidity and parity?
- A. G4 P2121.
- B. G4 P1212.
- C. G5 P1122.
- D. G5 P2211.
Correct Answer: D
Rationale: Gravidity includes all pregnancies (live births, miscarriages, abortions, and current pregnancy). Parity reflects live births. This woman has had 5 pregnancies (2 live births, 1 miscarriage, 1 abortion, and 1 current pregnancy), making her G5 P2211.
A nurse is assessing the fetal heart rate of a laboring person. What is the most significant finding that would indicate fetal distress?
- A. variable decelerations
- B. late decelerations
- C. bradycardia
- D. accelerations
Correct Answer: C
Rationale: The correct answer is C, bradycardia. Bradycardia in the fetal heart rate is a significant finding indicating fetal distress because it signifies a heart rate below normal range, which can lead to inadequate oxygen supply to the fetus. Bradycardia can be a sign of fetal hypoxia, acidosis, or other serious conditions. Variable decelerations (choice A) are often caused by umbilical cord compression, late decelerations (choice B) are associated with uteroplacental insufficiency, and accelerations (choice D) are considered a reassuring sign of fetal well-being. Therefore, in the context of fetal distress, bradycardia is the most concerning finding.
A nurse is assisting with a vaginal birth and is monitoring for signs of placental separation. What is the most reliable clinical indicator that the placenta has separated?
- A. a gush of clear amniotic fluid
- B. uterine contractions every 2 to 3 minutes
- C. lengthening of the umbilical cord
- D. maternal report of intense pain
Correct Answer: C
Rationale: The correct answer is C: lengthening of the umbilical cord. This is the most reliable indicator of placental separation because as the placenta detaches from the uterine wall, the cord lengthens as it moves downward. This signifies that the placenta has separated completely.
A: A gush of clear amniotic fluid is not a reliable indicator of placental separation as it can occur before or after placental separation.
B: Uterine contractions every 2 to 3 minutes are a sign of labor progression, not specifically placental separation.
D: Maternal report of intense pain can be subjective and may not always indicate placental separation.