Nokea
The nurse is teaching a prenatal class about breast changes during pregnancy. Which change is expected?
- A. Decrease in nipple pigmentation.
- B. Reduction in breast size.
- C. Darkening of the areola.
- D. Development of inverted nipples.
Correct Answer: C
Rationale: Darkening of the areola is a common change due to hormonal influences during pregnancy.
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A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, PaCO2 68 mm Hg, Base excess -2, PaO2 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Metabolic alkalosis
- D. Respiratory alkalosis
Correct Answer: A
Rationale: The ABG values provided indicate respiratory acidosis. In respiratory acidosis, there is an increase in PaCO2 above the normal range (35-45 mm Hg) leading to a decrease in pH (<7.35). In this case, the pH is 7.22 (below normal) with an elevated PaCO2 of 68 mm Hg. The other values do not suggest metabolic acidosis (which would typically show low bicarbonate levels) or metabolic alkalosis. Therefore, the correct interpretation of the ABGs is respiratory acidosis.
The nurse is teaching a client about signs of preterm labor. Which symptom should be reported immediately?
- A. Increased fetal movements.
- B. Lower back pain and cramping.
- C. Mild swelling of the feet.
- D. Occasional Braxton Hicks contractions.
Correct Answer: B
Rationale: Lower back pain and cramping may indicate preterm labor and should be reported promptly.
A woman's temperature has just risen 0.4°F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the change?
- A. Progesterone
- B. Follicle stimulating hormone
- C. Luteinizing hormone
- D. Estrogen
Correct Answer: D
Rationale: The hormone responsible for the increase in body temperature prior to menstruation is estrogen. Estrogen is the primary female sex hormone that plays a key role in regulating the menstrual cycle. Around the time of ovulation, estrogen levels peak, which can lead to a slight rise in body temperature. This increase in temperature is known as the "estrogenic temperature shift" and is a normal part of the menstrual cycle. The rise in body temperature indicates that ovulation has occurred and that a woman is approaching her fertile window. Estrogen also helps prepare the uterine lining for pregnancy and plays a role in many other reproductive functions.
A client at 35 weeks' gestation reports mild vaginal bleeding and no pain. What condition should the nurse suspect?
- A. Abruptio placentae.
- B. Placenta previa.
- C. Preterm labor.
- D. Urinary tract infection.
Correct Answer: B
Rationale: Painless vaginal bleeding in late pregnancy is a classic sign of placenta previa.
How should a nurse educate a mother about kangaroo care for her preterm infant?
- A. Encourage frequent visits to the NICU
- B. Educate about skin-to-skin contact benefits
- C. Explain the importance of bonding
- D. Teach the mother about safe handling of the newborn
Correct Answer: B
Rationale: Kangaroo care promotes bonding and regulates temperature for preterm infants.