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 caring for the postpartum client who is 15 years old is concerned about this client’s ability to parent a newborn. Which behavior is characteristic of the developmental level of the 15-year-old that justifies the nurse’s concern?
- A. Developing autonomy
- B. Follows rules established by others
- C. Career oriented
- D. Egocentric
Correct Answer: D
Rationale: The development of autonomy is a developmental task of toddlerhood. School-age children are motivated to follow rules established by others. Adult women are concerned about the effect of childbearing on careers. Although it is biologically possible for the adolescent female to become a parent, her egocentricity and concrete thinking interfere with her ability to parent effectively. Because of this normal development, the adolescent may inadvertently neglect her child.
Which assessment finding best indicates the presence of this condition?
- A. Painful blisters on the labia
- B. Heavy, grayish white discharge
- C. Milky white discharge that smells like fish
- D. Thick, white, curdlike vaginal discharge
Correct Answer: B
Rationale: Chlamydia often presents with heavy, grayish-white discharge, unlike the other options, which suggest different infections.
The postpartum client’s blood type is A negative, and her newborn infant’s blood type is AB negative. The client received RhoGAM in her second trimester and another dose in her third trimester, after a minor car accident. The client is preparing for discharge and asks the nurse when she will receive her RhoGAM injection. The nurse correctly responds with which statement?
- A. “You already received two doses of RhoGAM and do not need an additional dose.”
- B. “I will give your last dose of RhoGAM today, before you are discharged to home.”
- C. “You and your baby have negative blood types; a dose of RhoGAM is not needed.”
- D. “RhoGAM would have been already given while you were in the delivery room.”
Correct Answer: C
Rationale: The number of RhoGAM doses given in pregnancy does not affect whether or not the client receives a dose postpartum. Both the client and newborn are Rh negative; no dose is required. Rh immune globulin (RhoGAM) is administered to women with Rh negative blood types at approximately 28 weeks of gestation and again after any trauma, such as a car accident or fall. After delivery, RhoGAM is only indicated if the newborn has a positive blood type; both the client and newborn are Rh negative. For postpartum clients who require RhoGAM, the dose is given within 72 hours of delivery. However, no dose is necessary because the client and newborn are both Rh negative.
The nurse recognizes which behavior as a sign of potential depression in a pregnant client?
- A. Occasional fatigue
- B. Persistent sadness and withdrawal
- C. Increased appetite
- D. Excitement about the pregnancy
Correct Answer: B
Rationale: Persistent sadness and withdrawal are hallmark signs of depression, requiring further assessment and intervention.
The nurse is reviewing the laboratory test results of the pregnant client. Which laboratory test findings would require further follow-up from the nurse?
- A. Hemoglobin
- B. 50-g, 1-hour glucose test
- C. Glucosuria
- D. Proteinuria
Correct Answer: A
Rationale: The normal Hgb level should be 12—16 g/dL in the pregnant client. The nurse should encourage iron-rich foods. The 50-g 1-hour glucose test should be less than 140. Values over 140 warrant a 3-hour glucose screen to determine if the client has gestational diabetes. The presence of glucose in the urine (glucosuria) is negative, which is a normal finding. Proteinuria in trace amounts is common in pregnant women, although higher protein concentrations should be evaluated.