Nokea
The nurse recommends which supplement for a vegetarian pregnant client?
- A. Vitamin B12
- B. Vitamin C
- C. Calcium
- D. Magnesium
Correct Answer: A
Rationale: Vitamin B12 supplementation is crucial for vegetarian pregnant clients, as it is primarily found in animal products and supports fetal neurological development.
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The nurse correctly instructs the client to drink how many glasses of milk per day to meet calcium requirements?
- A. 1 to 2
- B. 3 to 4
- C. 5 to 6
- D. 7 to 8
Correct Answer: B
Rationale: Three to four glasses of milk daily provide approximately 1200 mg of calcium, meeting pregnancy requirements.
The client in labor received an epidural anesthesia 20 minutes ago. The nurse assesses that the client’s BP is 98/62 mm Hg and that the client is lying supine. What should the nurse do next?
- A. Increase the lactated Ringer’s infusion rate.
- B. Elevate the client’s legs for 2 to 3 minutes.
- C. Place the bed in 10- to 20-degree Trendelenburg.
- D. Position the client in a left side-lying position.
Correct Answer: D
Rationale: The first action is to place the client in a left side-lying position. This displaces the uterus and alleviates aortocaval compression. Increasing the infusion rate may be implemented if repositioning the client does not correct the hypotension. Elevating the client’s legs for 2 to 3 minutes is done with severe or prolonged hypertension to increase blood return from the extremities. It may be implemented after repositioning to left side, increasing the IV rate, and placing in Trendelenburg position. Placing in 10- to 20-degree Trendelenburg position is usually implemented if the BP does not increase within 1 to 2 minutes after repositioning to left side and increasing the IV flow rate.
The postpartum client, who is 24 hours post—cesarean section, tells the nurse that she has much less lochial discharge after this birth than with her vaginal birth 2 years ago. The client asks if this is normal after a cesarean birth. Which statement should be the basis for the nurse’s response?
- A. A decrease in her lochia is not expected; further assessment is needed.
- B. Women usually have increased lochial discharge after cesarean births.
- C. Women normally have less lochial discharge after a cesarean birth.
- D. The lochia amount depends on whether surgery was emergent or planned.
Correct Answer: C
Rationale: A decrease in lochia is expected after a cesarean birth; no further assessment is needed regarding the lochial amount unless it is totally absent. A decrease in lochia is expected after a cesarean birth, not an increase. The client’s lochial discharge is usually decreased after cesarean birth because the uterus is cleaned during surgery. The amount of lochia is not dependent on whether the surgery was emergent or planned because the uterus is cleaned during surgery in both situations.
The postpartum client suffered a fourth-degree perineal laceration during her vaginal birth. Which interventions should the nurse add to the client’s plan of care? Select all that apply.
- A. Limit ambulation to bathroom privileges only.
- B. Decrease fluid intake to 1000 mL every 24 hours.
- C. Instruct the client on a high-fiber diet.
- D. Monitor the uterus for firmness every 2 hours.
- E. Give pm prescribed stool softeners in the am. and at h.s.
Correct Answer: C,E
Rationale: Activity should be increased, not decreased, to reduce the potential for constipation. Fluids should be increased, not decreased, to reduce the potential for dehydration and constipation. The client with a fourth-degree perineal laceration should be instructed to increase dietary fiber to help maintain bowel continence and decrease perineal trauma from constipation. A perineal laceration will not affect the condition of the uterus; there is no need to increase uterine monitoring. The client with a fourth-degree perineal laceration should be given a stool softener bid to help maintain bowel continence and decrease perineal trauma from constipation.
Two days after hospital discharge, the nurse is assessing the mother and her newborn twins in their home. Which statement or question made by the nurse best demonstrates empathy?
- A. “You may be feeling overwhelmed. This is normal.”
- B. “I can’t imagine how tired you must be with twins.”
- C. “How are you feeling about being the mother of twins?”
- D. “I saw that laundry is piling up. Do you want a home aide?”
Correct Answer: C
Rationale: Projecting feelings onto the client does not demonstrate empathy. This statement imposes a personal assumption and does not demonstrate empathy. This question demonstrates empathy. The nurse is asking a question to allow the client to explain her situation and feelings while the nurse listens. The nurse is attempting to understand the experience as lived by the client. Acknowledging that laundry is piling up and offering home aide services do not demonstrate empathy. Commenting on the laundry on the first visit may suggest to the client that she lacks support, and she may be defensive or hurt by the acknowledgement.