The nurse states to the newly pregnant patient, 'Tell me how you feel about being pregnant.' Which communication technique is the nurse using with this patient?
- A. Clarifying
- B. Paraphrasing
- C. Reflection
- D. Structuring
Correct Answer: A
Rationale: The nurse is attempting to follow up and check the accuracy of the patient's message, which is clarifying.
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The nurse is teaching a woman how to use her basal body temperature (BBT) pattern as a tool to assist her in conceiving a child. Which temperature pattern indicates the occurrence of ovulation, and therefore, the best time for intercourse to ensure conception?
- A. Between the time the temperature falls and rises
- B. Between 36 and 48 hours after the temperature rises
- C. When the temperature falls and remains low for 36 hours
- D. Within 72 hours before the temperature falls
Correct Answer: A
Rationale: In most women, the BBT drops slightly 24 to 36 hours before ovulation and rises 24 to 72 hours after ovulation, when the corpus luteum of the ruptured ovary produces progesterone. Therefore, intercourse between the time of the temperature fall and rise (A) is the best time for conception.
A 26-week gestational primigravida who is carrying twins is seen in the clinic today. Her fundal height is measured at 29 cm. Based on these findings what actions the nurse implement.
- A. Notify the healthcare provider of the finding
- B. Document the finding in the medical record
- C. Schedule the client for a biophysical profile
- D. Request another nurse measure the fundus
Correct Answer: A
Rationale: Fundal height greater than expected may indicate a complication, so notifying the healthcare provider (A) is necessary.
A pregnant patient would like to know which foods, other than dairy products, contain the most calcium. Which food group would the nurse recommend?
- A. Legumes
- B. Lean meat
- C. Whole grains
- D. Yellow vegetables
Correct Answer: A
Rationale: The correct answer is A: Legumes. Legumes such as chickpeas, lentils, and beans are rich sources of calcium. They provide a plant-based alternative for calcium intake. Legumes are also high in fiber, protein, and other essential nutrients beneficial for pregnancy. Lean meat (B) and yellow vegetables (D) are not significant sources of calcium. While whole grains (C) offer some calcium, they are not as high in calcium content as legumes. Therefore, for a pregnant patient looking to increase calcium intake without relying on dairy products, legumes are the most recommended food group.
A client at 30-weeks gestation, complaining of pressure over the pubic area, is admitted for observation. She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high. Based on these data, which intervention should the nurse implement first?
- A. Provide oral hydration
- B. Have a complete blood count (CBC) drawn
- C. Obtain a specimen for urine analysis
- D. Place the client on strict bedrest
Correct Answer: C
Rationale: Obtaining a urine analysis (C) should be done first because preterm clients with uterine irritability and contractions are often suffering from a urinary tract infection, and this should be ruled out first.
The nurse is caring for a multigravida client in active labor with continuous epidural anesthesia. When the client is 7 cm dilated, her blood pressure drops to 90/50 mm Hg, and the fetal heart rate shows signs of decelerations. What action should the nurse take first?
- A. Place the client in a lateral position.
- B. Administer oxygen via face mask.
- C. Increase the rate of IV fluid infusion.
- D. Notify the healthcare provider.
Correct Answer: A
Rationale: Placing the client in a lateral position can improve venous return and blood pressure, addressing both maternal hypotension and fetal distress.