Nokea
The nurse is teaching a client with gestational diabetes about nutrition and insulin need for pregnancy. Which content should the nurse include in this client teaching plan?
- A. Insulin production is decreased during pregnancy
- B. Increase daily caloric intake is needed
- C. Injection requirements remain the same
- D. Blood sugars need less monitoring in the first trimester
Correct Answer: B
Rationale: An increase in caloric intake is often necessary to meet the increased metabolic demands of pregnancy, especially in clients with gestational diabetes.
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The nurse should encourage the laboring client to begin pushing when
- A. There is only an anterior or posterior lip of cervix left
- B. The client describes the need to have a bowel movement
- C. The cervix is completely dilated
- D. The cervix is completely effaced
Correct Answer: C
Rationale: Pushing begins with the second stage of labor, i.e., when the cervix is completely dilated (C), the cervix can become edematous and may never completely dilate, necessitating an operative delivery. Many primigravidas begin active labor 100% effaced and then proceed to dilate.
Which nursing intervention is written correctly?
- A. Force fluids as necessary.
- B. Observe interaction with the infant.
- C. Encourage turning, coughing, and deep breathing.
- D. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
Correct Answer: D
Rationale: Interventions must be detailed and specific; assisting to ambulate within specified timeframes is clear and actionable.
The nurse is caring for a woman with a previously diagnosed heart disease who is in the second stage of labor. Which assessment findings are of greatest concern?
- A. Edema, basilar rales, and an irregular pulse.
- B. Increased urinary output, and tachycardia.
- C. Dyspnea, bradycardia, and hypertension.
- D. Regular heart rate, and hypertension.
Correct Answer: A
Rationale: Edema, basilar rales, and an irregular pulse indicate potential cardiac decompensation, which is of greatest concern in a woman with heart disease during labor.
Which patient has correctly increased her caloric intake from her recommended pregnancy intake to the amount necessary to sustain breastfeeding in the first 6 postpartum months?
- A. From 1800 to 2200 calories per day
- B. From 2000 to 2500 calories per day
- C. From 2200 to 2530 calories per day
- D. From 2500 to 2730 calories per day
Correct Answer: C
Rationale: Rationale: The correct answer is C because for breastfeeding, an additional 500 calories/day are needed compared to pregnancy. The recommended caloric intake during pregnancy is around 2200 calories/day. Therefore, increasing from 2200 to 2530 calories/day aligns with the additional 500 calories necessary for sustaining breastfeeding.
Summary:
A: Going from 1800 to 2200 calories/day does not provide the extra 500 calories needed for breastfeeding.
B: Increasing from 2000 to 2500 calories/day does not account for the original pregnancy intake or the additional calories required for breastfeeding.
D: Jumping from 2500 to 2730 calories/day exceeds the additional 500 calories needed for breastfeeding, potentially leading to excessive weight gain.
The nurse's assessment of a preterm infant reveals decreased muscle tone, signs of respiratory difficulty, irritability, and mottled, cool skin. Which intervention should the nurse implement first?
- A. Position radiant warmer over the crib
- B. Assess the infants blood glucose level
- C. Nipple feed 1 ounce 1% glucose in water
- D. Place the infant in side-lying position
Correct Answer: A
Rationale: A radiant warmer (A) helps stabilize the infant's temperature and provides immediate warmth.