Nokea
The nurse is providing nutrition counseling to a primigravida who is 10 weeks pregnant. Which meal choice stated by the client indicates she needs additional information?
- A. Black beans, wild rice, collard greens
- B. Dry cereal, milk, dried cranberries
- C. Tuna, broccoli, baked potato
- D. Beef strips, lentils, red peppers
Correct Answer: C
Rationale: Tuna contains mercury and should be limited in pregnancy due to risk of mercury poisoning. The nurse should provide this additional information. Black beans provide a good source of calcium, iron, and protein. Black beans, wild rice, and collard greens provide fiber. Collard greens provide a good source of calcium and folic acid. Dry cereal provides a good source of vitamin D, milk provides a good source of calcium, and dried cranberries provide a good source of calcium and iron. Beef provides a good source of protein and iron, lentils provide a good source of iron, and red peppers provide a good source of vitamin C.
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The nurse is educating the postpartum client. Which prevention strategies for postpartum depression should the nurse include? Select all that apply.
- A. Attend a support group that has other postpartum women.
- B. Use the baby’s nap time to complete household chores.
- C. Keep a journal of feelings during the postpartum period.
- D. Call the HCP if feelings of sadness do not subside quickly.
- E. Develop a daily schedule of activities, and follow the plan.
Correct Answer: A,C,D,E
Rationale: A postpartum support group can be a place where realistic information about postpartum depression can be discussed and symptoms recognized. Fatigue is a major concern for all postpartum women. Clients should be encouraged to nap when their infant is napping rather than using that time for other activities. Keeping a journal can be emotionally cathartic and can help prevent postpartum depression. Postpartum mothers should be encouraged to call their HCPs if symptoms of postpartum depression, such as feelings of sadness, do not subside quickly or if the symptoms become severe. Structuring activity with a schedule helps counteract inertia that comes with feeling sad or unsettled.
The oncoming shift nurse assesses the fundus of the postpartum client 6 hours after a vaginal birth and finds that it is firm. When the nurse then assists the client out of bed for the first time, blood begins to run down the client’s leg. Which action by the nurse in response to the client’s bleeding is correct?
- A. Explain that extra bleeding can occur with initial standing
- B. Immediately assist the client back into bed
- C. Push the emergency call light in the room
- D. Call the HCP to report this increased bleeding
Correct Answer: A
Rationale: Lochia normally pools in the vagina when the postpartum client remains in a recumbent position for any length of time. When the client then stands, gravity causes the blood to flow out. As long as the nurse knows the fundus is firm and not bleeding, a simple explanation to the client is all that is required. There is no reason to return the client to bed; the fundus is firm. There is no reason to push the emergency call light. Increased bleeding is an expected response when standing for the first time. There is no reason to call the HCP.
The nurse correctly sends a requisition and specimen for which laboratory test?
- A. Alpha-fetoprotein (AFP)
- B. Corticotropin-releasing hormone (CRH)
- C. Human chorionic gonadotropin (hCG)
- D. Follicle-stimulating hormone (FSH)
Correct Answer: C
Rationale: Human chorionic gonadotropin (hCG) is the hormone tested to confirm pregnancy, as it is produced by the placenta shortly after implantation.
The nurse monitors which vital sign closely in a client with gestational diabetes?
- A. Blood pressure
- B. Respiratory rate
- C. Pulse rate
- D. Temperature
Correct Answer: A
Rationale: Blood pressure monitoring is crucial in gestational diabetes, as it increases the risk of preeclampsia.
Which snack is most appropriate for a pregnant client with nausea?
- A. Dry crackers
- B. Ice cream
- C. Spicy chips
- D. Carbonated soda
Correct Answer: A
Rationale: Dry crackers are bland and easy to digest, helping to alleviate nausea without exacerbating symptoms.