Nokea
The nurse plans to provide anticipatory guidance to a 10-week gravid client who is being seen in the prenatal clinic. Which of the following information should be a priority for the nurse to provide?
- A. Pain management during labor.
- B. Methods to relieve backaches.
- C. Breastfeeding positions.
- D. Characteristics of the newborn.
Correct Answer: B
Rationale: Backaches are a common complaint during pregnancy, and providing guidance on how to relieve them is a priority at this stage. Pain management during labor, breastfeeding positions, and newborn characteristics are typically addressed later in pregnancy.
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A nurse is assisting with a vaginal delivery. What is the most important action when the fetal head begins to crown?
- A. apply gentle downward pressure
- B. perform perineal massage
- C. perform a vaginal exam
- D. assist with breathing exercises
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This action helps prevent rapid delivery, reducing the risk of tearing and allowing the perineum to stretch gradually. It also helps control the delivery, ensuring a safe and controlled birth process. Performing perineal massage (B) is beneficial during the pushing stage but is not the most important action when the head crowns. Performing a vaginal exam (C) is unnecessary and may increase the risk of infection. Assisting with breathing exercises (D) is important during labor but not specifically when the head crowns.
A pregnant patient’s biophysical profile score is 8. The patient asks the nurse to explain the results. What is the nurse’s most appropriate response?
- A. The test results are within normal limits.
- B. Immediate birth by cesarean birth is being considered.
- C. Further testing will be performed to determine the meaning of this score.
- D. An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth.
Correct Answer: A
Rationale: A score of 8-10 is within the normal range for a biophysical profile, indicating no immediate concerns for the fetus.
A nurse is assessing a pregnant patient at 18 weeks gestation who complains of feeling lightheaded when standing. What should the nurse advise the patient to do?
- A. Take deep breaths and lie flat on your back.
- B. Increase fluid intake and avoid standing for long periods.
- C. Take frequent rests while sitting upright.
- D. Change positions slowly and sit down immediately if feeling faint.
Correct Answer: D
Rationale: The correct answer is D because changing positions slowly helps prevent a sudden drop in blood pressure, which can cause lightheadedness. Sitting down immediately if feeling faint promotes safety and prevents falls. Taking deep breaths and lying flat on the back (choice A) can exacerbate lightheadedness by reducing blood flow to the brain. Increasing fluid intake and avoiding prolonged standing (choice B) may help with other issues but may not directly address the lightheadedness. Taking frequent rests while sitting upright (choice C) does not address the issue of changing positions slowly to prevent lightheadedness.
The nurse is caring for a pregnant patient at 32 weeks gestation who reports feeling lightheaded and faint when standing. What should the nurse recommend?
- A. Increase fluid intake and avoid standing for long periods.
- B. Take deep breaths and rise quickly from a seated position.
- C. Rest and avoid any physical activity during the day.
- D. Sit upright and avoid bending forward at the waist.
Correct Answer: A
Rationale: The correct answer is A: Increase fluid intake and avoid standing for long periods. This recommendation is appropriate for the patient's symptoms of lightheadedness and fainting, which could be due to dehydration or low blood pressure common in pregnancy. Increasing fluid intake can help maintain adequate blood volume and pressure. Avoiding prolonged standing can prevent pooling of blood in the lower extremities, reducing the risk of dizziness.
Choices B, C, and D are incorrect:
B: Taking deep breaths and rising quickly may worsen symptoms by causing a sudden drop in blood pressure.
C: Complete rest and avoiding physical activity may not address the underlying issue of hydration or blood pressure.
D: Sitting upright and avoiding bending forward may not directly address the need for increased fluid intake and reduced standing time.
What procedure might the nurse perform to determine the presentation of the fetus?
- A. vaginal exam
- B. ultrasound
- C. palpation of contractions
- D. laboring person interview
Correct Answer: B
Rationale: The correct answer is B: ultrasound. Ultrasound is the most accurate and non-invasive method to determine the presentation of the fetus by visualizing the position of the baby in the womb. It allows the nurse to see if the fetus is in a cephalic (head-down) or breech (feet or buttocks down) position. This information is crucial for assessing the progress of labor and planning appropriate interventions.
A: Vaginal exam is not typically used to determine fetal presentation as it does not provide a clear view of the baby's position.
C: Palpation of contractions helps assess the strength and frequency of contractions but does not directly determine fetal presentation.
D: Laboring person interview may provide valuable information about symptoms and history but does not offer direct insight into fetal presentation.