What is the primary purpose of a non-stress test (NST) during pregnancy?
- A. to assess fetal heart rate variability
- B. to evaluate fetal well-being
- C. to assess fetal heart rate accelerations
- D. to assess maternal well-being
Correct Answer: C
Rationale: The correct answer is C: to assess fetal heart rate accelerations. An NST is used to monitor the baby's heart rate and movement to ensure adequate oxygen supply. Fetal heart rate accelerations indicate a healthy, responsive baby. Assessing heart rate variability (A) is important but not the primary purpose. Evaluating fetal well-being (B) is broad and doesn't capture the specific focus on heart rate accelerations. Assessing maternal well-being (D) is not the purpose of an NST.
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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.
A nurse is caring for a postpartum person during the fourth stage of labor. The nurse is assessing uterine involution to ensure that the uterus is returning to its prepregnancy size and position. Which finding is indicative of normal uterine involution during this stage?
- A. Uterus is palpable at the level of the umbilicus.
- B. Uterine fundus is firm, at the level of the umbilicus.
- C. Uterus is displaced to the right side of the abdomen.
- D. Uterus is above the level of the umbilicus.
Correct Answer: B
Rationale: The correct answer is B because during the fourth stage of labor, the uterine fundus should be firm and at the level of the umbilicus. This indicates proper involution as the uterus is contracting and reducing in size. Choice A is incorrect as the uterus should not be palpable at the level of the umbilicus during normal involution. Choice C is incorrect as the uterus should not be displaced to the right side of the abdomen. Choice D is incorrect as the uterus should not be above the level of the umbilicus, as this would suggest inadequate involution.
Which factors should be considered a contraindication for transcervical chorionic villus sampling?
- A. Rh-negative mother
- B. Gestation less than 15 weeks
- C. Maternal age younger than 35 years
- D. Positive for group B Streptococcus
Correct Answer: D
Rationale: Maternal infection, such as group B Streptococcus, is a contraindication for the procedure due to the risk of infection.
A pregnant patient at 32 weeks gestation reports severe heartburn. What should the nurse recommend to relieve symptoms?
- A. Take over-the-counter antacids after every meal.
- B. Eat smaller, more frequent meals and avoid lying down after eating.
- C. Drink a large glass of water immediately after meals to dilute stomach acid.
- D. Increase caffeine intake to speed up digestion.
Correct Answer: B
Rationale: The correct answer is B: Eat smaller, more frequent meals and avoid lying down after eating. This recommendation helps prevent acid reflux by reducing the pressure on the stomach and ensuring that the stomach is not overly full. Eating smaller meals more frequently prevents the stomach from becoming too full, which can trigger heartburn. Avoiding lying down after eating helps prevent stomach acid from flowing back into the esophagus. Options A, C, and D are incorrect. Taking antacids after every meal can lead to excessive intake and potential side effects. Drinking water immediately after meals may exacerbate heartburn by diluting stomach acid further. Increasing caffeine intake can worsen heartburn symptoms due to its ability to relax the lower esophageal sphincter.
A client makes the following statement after finding out that her pregnancy test is positive, 'This is not a good time. I am in college and the baby will be due during final exams!' Which of the following responses by the nurse would be most appropriate at this time?
- A. I’m absolutely positive that everything will turn out all right.
- B. I suggest that you e-mail your professors to set up an alternate plan.
- C. It sounds like you’re feeling a little overwhelmed right now.
- D. You and the baby’s father will find a way to get through the pregnancy.
Correct Answer: C
Rationale: Acknowledging the client's feelings of being overwhelmed is the most supportive response. Offering solutions or reassurance without first addressing the client's emotions may not be as effective.