Nokea
The nurse is providing prenatal education to a patient who is at 20 weeks gestation. Which of the following topics should the nurse prioritize during this visit?
- A. Managing gestational diabetes
- B. Reviewing newborn care practices
- C. Educating about normal pregnancy changes
- D. Discussing postpartum care
Correct Answer: C
Rationale: The correct answer is C: Educating about normal pregnancy changes. At 20 weeks gestation, the priority is to educate the patient about normal physiological changes she may experience during pregnancy. This knowledge helps the patient understand what is considered normal and when to seek medical attention. Managing gestational diabetes (A) is important but typically addressed later in pregnancy. Reviewing newborn care practices (B) and discussing postpartum care (D) are important topics but not a priority at 20 weeks gestation. It is essential to focus on educating the patient about the current stage of pregnancy to promote optimal prenatal care.
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A nurse is providing discharge instructions to a postpartum person who had a cesarean birth. What is the most important instruction to include?
- A. avoid heavy lifting
- B. encourage deep breathing exercises
- C. encourage early ambulation
- D. avoid sexual activity
Correct Answer: B
Rationale: The correct answer is B: encourage deep breathing exercises. Deep breathing helps prevent complications like pneumonia after surgery, aids in lung expansion, and promotes overall respiratory health. Choice A is important but not the most crucial post-cesarean. Choice C promotes mobility but doesn't address immediate respiratory needs. Choice D is important but not the most vital in the early postpartum period.
A nurse is caring for a patient in labor who is experiencing intense pain. Which of the following would be the most appropriate intervention to manage pain during labor?
- A. Encourage the patient to practice deep breathing and relaxation techniques.
- B. Administer intravenous fluids to reduce pain sensation.
- C. Provide a sedative to help the patient rest between contractions.
- D. Suggest an epidural to block pain completely.
Correct Answer: A
Rationale: The correct answer is A: Encourage the patient to practice deep breathing and relaxation techniques. This is the most appropriate intervention to manage pain during labor because deep breathing and relaxation techniques can help the patient to cope with the pain, reduce stress, and promote a sense of control. These techniques are safe, non-invasive, and can be effective in managing labor pain without the need for medication or invasive procedures.
Summary:
- Choice B (Administer intravenous fluids): Intravenous fluids do not directly reduce pain sensation and are not a primary intervention for managing labor pain.
- Choice C (Provide a sedative): Sedatives may affect the baby and can interfere with the progress of labor. They do not address the root cause of pain during labor.
- Choice D (Suggest an epidural): While epidurals can provide effective pain relief, they are not always necessary or desired by all patients. Encouraging non-pharmacological methods first is often preferred.
A patient in labor is diagnosed with an occiput posterior (OP) fetal position. What is the most appropriate intervention to facilitate delivery?
- A. Encourage the patient to push vigorously with each contraction
- B. Position the patient on her hands and knees
- C. Perform a cesarean section
- D. Perform a cesarean section
Correct Answer: B
Rationale: The correct answer is B: Position the patient on her hands and knees. This position, known as the all-fours position, can help rotate the baby from an occiput posterior position to a more favorable position for delivery. Gravity assists in the rotation of the baby, making delivery easier. Encouraging the patient to push vigorously (option A) may not be effective in this situation as the baby may be facing the wrong way. Performing a cesarean section (option C and D) should be considered only if other interventions fail or if there are complications that necessitate surgical delivery.
When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of?
- A. Ambivalence.
- B. Depression.
- C. Anxiety.
- D. Ecstasy.
Correct Answer: A
Rationale: Ambivalence is a common psychological response in early pregnancy as the client adjusts to the idea of being pregnant. Depression, anxiety, and ecstasy are less common at this stage.
Which clinical conditions are associated with increased levels of alpha-fetoprotein (AFP)? (Select all that apply.)
- A. Down syndrome
- B. Molar pregnancy
- C. Twin gestation
- D. Incorrect gestational age assessment of a normal fetus—estimation is earlier in the pregnancy
Correct Answer: C
Rationale: Elevated AFP levels are seen in multiple gestations, miscalculated gestational age, and threatened abortion.