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The nurse responds that, for clients with uncomplicated pregnancies, it is usually best to plan monthly visits for the first 28 weeks and then more frequent visits following which schedule?
- A. Weekly for the remainder of the pregnancy
- B. Every 2 weeks for the remainder of the pregnancy
- C. Every 2 weeks up to 36 weeks, then weekly for the last month
- D. Weekly up to 36 weeks, then twice weekly for the last month
Correct Answer: C
Rationale: Standard prenatal care involves monthly visits until 28 weeks, biweekly until 36 weeks, and weekly thereafter for uncomplicated pregnancies.
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The nurse includes which topic in the prenatal education plan for a first-time mother?
- A. Breastfeeding techniques
- B. Advanced labor pain management
- C. Neonatal surgical procedures
- D. Postpartum weight loss strategies
Correct Answer: A
Rationale: Breastfeeding techniques are essential for a first-time mother to ensure successful feeding and bonding with the newborn.
The client, who is Chinese American and pregnant, is receiving nutritional counseling about the need for increased amounts of calcium in her diet. Which response by the nurse is most helpful when the client states she does not consume any dairy products?
- A. “Tell me how you perceive dairy products in your culture.”
- B. “Try having a glass of soy milk at each meal and at bedtime.”
- C. “Tell me about your intake of fortified tofu and leafy green vegetables.”
- D. “Rice milk fortified with calcium and nettle tea are good calcium choices.”
Correct Answer: C
Rationale: Assessing the client’s intake of calcium-rich foods is the best response. Both fortified tofu and leafy green vegetables are high in calcium and are common foods consumed in the Chinese American diet. Although asking about the client’s perception of dairy products shows cultural sensitivity, the client has already stated she does not consume these. This statement is not the most helpful regarding helping the client to increase calcium intake in her diet. The nurse is making a recommendation without further assessing the client’s dietary preferences. Soy milk should be calcium fortified; yet, according to research the calcium content can be as much as 85 percent less than the amount indicated on the product label. Both rice milk fortified with calcium and nettle tea are sources of calcium; however, the nurse is making an assumption that the client consumes these beverages.
Which of the following beverages should be included in the list of unhealthy drinks to avoid? Select all that apply.
- A. Alcohol
- B. Coffee
- C. Tea
- D. Cola beverages
- E. Sports drinks
- F. Orange juice
Correct Answer: A,B,C,D
Rationale: Alcohol is harmful to the fetus, and caffeinated drinks (coffee, tea, cola) should be limited due to potential effects on fetal development.
The laboring multigravida client’s last vaginal examination was 8/90/+1. The client now states feeling rectal pressure. Which action should the nurse perform first?
- A. Encourage the client to push.
- B. Notify the obstetrician or midwife.
- C. Help the client to the bathroom.
- D. Complete another vaginal exam.
Correct Answer: D
Rationale: The nurse should first evaluate labor progress by performing another vaginal exam. Previously the client was almost fully effaced (90%), and fetal station was 1 cm below the ischial spines (+1). Rectal pressure is often due to pressure exerted during descent of the fetal presenting part. The client needs to be fully dilated (10 cm, not 8 cm) and fully effaced (100%, not 90%) before being encouraged to push. Pushing too early may cause cervical edema and lacerations and may slow the labor process. Rectal pressure may indicate that the client has progressed since the last vaginal exam. Another vaginal exam should be performed before contacting the obstetrician or midwife. During labor, rectal pressure is usually not due to the need for a bowel movement because intestinal motility decreases.
Which instruction should the nurse provide about postpartum recovery?
- A. Resume heavy exercise immediately
- B. Monitor vaginal bleeding for heavy flow
- C. Avoid bathing for two weeks
- D. Ignore perineal discomfort
Correct Answer: B
Rationale: Monitoring vaginal bleeding for heavy flow is crucial to detect postpartum hemorrhage, a key recovery instruction.