Nokea
The nurse recognizes which symptom as a warning sign of preterm labor?
- A. Mild lower back pain
- B. Regular contractions before 37 weeks
- C. Increased appetite
- D. Frequent urination
Correct Answer: B
Rationale: Regular contractions before 37 weeks are a key sign of preterm labor, requiring immediate medical attention.
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Which statement by the client indicates understanding of prenatal education?
- A. I should avoid all exercise during pregnancy.
- B. I need to attend prenatal visits only in the third trimester.
- C. I should report any decrease in fetal movement.
- D. I can consume alcohol in moderation after the first trimester.
Correct Answer: C
Rationale: Reporting decreased fetal movement is critical, as it may indicate fetal distress, showing the client understands key prenatal education.
The client expresses concerns related to nausea in the first trimester of pregnancy. Which recommendation should the nurse make?
- A. Eat crackers while still in bed in the morning.
- B. Lie down and rest whenever nausea occurs.
- C. Eat more frequently throughout the day.
- D. Avoid food items containing ginger.
Correct Answer: A
Rationale: The nurse should instruct the client to eat dry crackers before rising from bed. This typically relieves some of the nausea. Lying down when the nausea occurs may increase heartburn and reflux, thereby increasing nausea. Eating frequently may increase heartburn and reflux, thereby increasing nausea. Food items with ginger may help to alleviate nausea and are recommended (rather than avoided), including ginger tea.
The RN and the student nurse are caring for the postpartum client who is 16 hours postdelivery. The RN evaluates that the student needs more education about uterine assessment when the student is observed doing which activity?
- A. Elevating the client’s head 30 degrees before doing the assessment
- B. Supporting the lower uterine segment during the assessment
- C. Gently palpating the uterine fundus for firmness and location
- D. Observing the abdomen before beginning palpation
Correct Answer: A
Rationale: For uterine assessment, the client should be positioned in a supine position so the height of the uterus is not influenced by an elevated position. When beginning the assessment, one hand should be placed at the base of the uterus just above the symphysis pubis to support the lower uterine segment. This prevents the inadvertent inversion of the uterus during palpation. Once the lower hand is in place, the fundus of the uterus can be gently palpated. The abdomen should be observed prior to palpation for contour to detect distention and for the appearance of striae or a diastasis.
The nurse advises a client with a history of miscarriage to monitor which symptom?
- A. Mild fatigue
- B. Vaginal spotting
- C. Increased appetite
- D. Normal fetal movement
Correct Answer: B
Rationale: Vaginal spotting may indicate a threatened miscarriage, requiring close monitoring and medical evaluation.
The experienced nurse is observing the new nurse determine the fetal position of the pregnant client using Leopold maneuver. The experienced nurse determines that the new nurse correctly identifies the first Leopold maneuver when placing the hands in which position illustrated first?
- A. Image A
- B. Image B
- C. Image C
- D. Image D
Correct Answer: B
Rationale: This illustration shows the first step of Leopold’s maneuver. The nurse palpates the fundus to determine which fetal body part (e.g., head or buttocks) occupies the uterine fundus. Image A shows the fourth Leopold maneuver. The nurse’s fingertips are used to determine the location of the cephalic prominence. Image C shows the third Leopold maneuver (“Pawlik maneuver”). During this maneuver the fetal part in the fundal region is compared with the part in the lower uterine segment. It is completed primarily to confirm that the fetus is in a cephalic (head) presentation. Image D shows the second Leopold maneuver. The second maneuver determines the location of the fetal back or spine.