Nokea
When assessing a pregnant woman AT 39-weeks gestation who is admitted to labor and delivery which finding is most important to report to the health care provider?
- A. proteinuria
- B. 130/70 blood pressure
- C. pedal edema
- D. 101.2 oral temperature
Correct Answer: D
Rationale: Fever (D) can indicate infection, which requires prompt evaluation.
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A client at 41-weeks gestation is admitted to the labor and delivery unit for induction of labor. The client's cervix is dilated 2 cm, 50% effaced, and the fetus is at -2 station. The Bishop score is 4. What action should the nurse anticipate?
- A. Administration of prostaglandin gel.
- B. Rupture of membranes.
- C. Administration of oxytocin.
- D. Preparation for a cesarean section.
Correct Answer: A
Rationale: A Bishop score of 4 indicates an unfavorable cervix, and prostaglandin gel is typically used to ripen the cervix before induction.
A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicated that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record?
- A. 3-1-2-0-3
- B. 4-1-2-0-3
- C. 2-1-2-1-2
- D. 3-1-1-0-3
Correct Answer: D
Rationale: (D) describes the correct GTPAL. The client has been pregnant 3 times including the current pregnancy (G-3). She had one full-term infant (T-1). She also had a preterm (P-1) twin pregnancy (a multifetal gestation is considered one birth when calculating parity). There were no abortions (A-0), so this client has a total of 3 living children.
A patient with a BMI of 32 has a positive pregnancy test. What is the maximum number of pounds that the nurse will advise the patient gain during the pregnancy?
- A. 20 lb
- B. 25 lb
- C. 28 lb
- D. 40 lb
Correct Answer: A
Rationale: The correct answer is A (20 lb). During pregnancy, the recommended weight gain for a woman with a BMI of 30-39.9 is 11-20 pounds. This range helps reduce the risk of complications associated with excessive weight gain. Option B (25 lb) exceeds this recommended range, while options C (28 lb) and D (40 lb) are even further beyond the healthy weight gain guidelines for a BMI of 32. Thus, advising the patient to gain a maximum of 20 pounds is the most appropriate recommendation to ensure a healthy pregnancy outcome.
A pregnant woman of normal weight enters her 13th week of pregnancy. If the patient eats and exercises as directed, what will the nurse anticipate as the ongoing weight gain for the remaining trimesters?
- A. 0.3 lb every week
- B. 1 lb every week
- C. 1.8 lb every week
- D. 2 lb every week
Correct Answer: B
Rationale: The correct answer is B: 1 lb every week. During the second and third trimesters, a pregnant woman is expected to gain about 1 lb per week on average. This weight gain is important for the healthy development of the baby and to support the mother's changing body. Gaining weight too slowly can lead to complications, while gaining too quickly can also have negative effects. Choices A, C, and D are incorrect because they suggest weight gain rates that are either too low or too high for a healthy pregnancy. It is crucial for the nurse to educate the patient on the importance of appropriate weight gain throughout the remaining trimesters to ensure the well-being of both the mother and the baby.
Which patient has correctly increased her caloric intake from her recommended pregnancy intake to the amount necessary to sustain breastfeeding in the first 6 postpartum months?
- A. From 1800 to 2200 calories per day
- B. From 2000 to 2500 calories per day
- C. From 2200 to 2530 calories per day
- D. From 2500 to 2730 calories per day
Correct Answer: C
Rationale: Rationale: The correct answer is C because for breastfeeding, an additional 500 calories/day are needed compared to pregnancy. The recommended caloric intake during pregnancy is around 2200 calories/day. Therefore, increasing from 2200 to 2530 calories/day aligns with the additional 500 calories necessary for sustaining breastfeeding.
Summary:
A: Going from 1800 to 2200 calories/day does not provide the extra 500 calories needed for breastfeeding.
B: Increasing from 2000 to 2500 calories/day does not account for the original pregnancy intake or the additional calories required for breastfeeding.
D: Jumping from 2500 to 2730 calories/day exceeds the additional 500 calories needed for breastfeeding, potentially leading to excessive weight gain.