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When advising a woman considering pregnancy on nutritional needs to reduce the risk of giving birth to a newborn with a neural tube defect, what information should the nurse include?
- A. Limit alcohol consumption.
- B. Increase intake of iron-rich foods.
- C. Consume foods fortified with folic acid.
- D. Avoid foods containing aspartame.
Correct Answer: C
Rationale: The correct answer is C: Consume foods fortified with folic acid. Folic acid plays a crucial role in preventing neural tube defects in newborns. It is recommended that women of childbearing age consume 400 mcg of folic acid daily to reduce the risk. Foods fortified with folic acid include cereals, bread, and pasta.
A: Limit alcohol consumption - While important for overall health, alcohol consumption is not directly related to preventing neural tube defects.
B: Increase intake of iron-rich foods - Iron is essential during pregnancy, but it is not specifically linked to reducing the risk of neural tube defects.
D: Avoid foods containing aspartame - Aspartame is a sweetener and does not have a direct impact on neural tube defects prevention.
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A client is 1 hour postpartum and the nurse observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take?
- A. Notify the healthcare provider.
- B. Increase the frequency of fundal massage.
- C. Encourage the client to empty their bladder.
- D. Document the findings and continue to monitor the client.
Correct Answer: D
Rationale: Rationale:
1. Lochia rubra and small clots are expected postpartum.
2. The firm, midline fundus indicates normal involution.
3. No signs of excessive bleeding or fundus displacement.
4. Documenting and monitoring is appropriate for normal postpartum assessment.
Summary:
A: Not necessary as no complications present.
B: Unnecessary and could cause discomfort.
C: Bladder emptying may help fundal position but not urgent.
D: Correct option for normal postpartum assessment and monitoring.
While observing the electronic fetal heart rate monitor tracing for a client at 40 weeks of gestation in labor, a nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?
- A. Early decelerations
- B. Accelerations
- C. Late decelerations
- D. Variable decelerations
Correct Answer: D
Rationale: The correct answer is D: Variable decelerations. Variable decelerations are abrupt decreases in the fetal heart rate that coincide with contractions, indicating umbilical cord compression. This pattern can lead to fetal hypoxia and distress. Early decelerations (A) are gradual decreases in heart rate that mirror contractions and are considered benign. Accelerations (B) are increases in heart rate and are a reassuring sign of fetal well-being. Late decelerations (C) are gradual decreases in heart rate that occur after the peak of a contraction, indicating uteroplacental insufficiency.
After an amniotomy, what is the priority nursing action?
- A. Observe color and consistency of fluid
- B. Assess the fetal heart rate pattern
- C. Assess the client's temperature
- D. Evaluate the client for the presence of chills and increased uterine tenderness using palpation
Correct Answer: B
Rationale: The correct answer is B: Assess the fetal heart rate pattern. After an amniotomy (breaking of the water), the priority is to monitor the fetal well-being to ensure the baby is tolerating the procedure well. Assessing the fetal heart rate pattern helps the nurse determine if the baby is experiencing any distress or changes in oxygenation. This immediate assessment is crucial in identifying any potential complications and taking prompt action.
Observing the color and consistency of fluid (A) is important but not as immediate as assessing the fetal heart rate. Assessing the client's temperature (C) and evaluating for chills and increased uterine tenderness (D) are important but do not address the immediate concern of fetal well-being post-amniotomy.
During an assessment of a newborn following a vacuum-assisted delivery, which of the following findings should the healthcare provider be informed about?
- A. Poor sucking
- B. Blue discoloration of the hands and feet
- C. Soft, edematous area on the scalp
- D. Facial edema
Correct Answer: A
Rationale: The correct answer is A: Poor sucking. This finding is concerning as it may indicate potential issues with feeding and nutrition in the newborn, which can lead to complications. Poor sucking can be a sign of various underlying problems that require prompt intervention. Blue discoloration of the hands and feet (choice B) is likely due to peripheral cyanosis, which is common in newborns and often resolves on its own. Soft, edematous area on the scalp (choice C) is a common finding in newborns after vacuum-assisted delivery and typically resolves without intervention. Facial edema (choice D) is also a common finding in newborns after delivery and typically resolves on its own.
A client is learning how to check basal temperature to determine ovulation. When should the client check her temperature?
- A. On days 13 to 17 of her menstrual cycle
- B. Every morning before arising
- C. 1 hour following intercourse
- D. Before going to bed every night
Correct Answer: B
Rationale: The correct answer is B: Every morning before arising. This is because basal body temperature is the lowest body temperature attained during rest, typically just before waking up. Checking the temperature at this time provides the most accurate measurement of basal temperature. Options A, C, and D are incorrect because ovulation typically occurs around 14 days before the start of the next menstrual period, not on days 13 to 17 specifically (A), 1 hour following intercourse is not a reliable indicator of ovulation (C), and basal temperature should be checked in the morning, not before going to bed at night (D).