Nokea
When the client asks why folic acid is important, which response by the nurse is most accurate?
- A. Folic acid helps prevent neural tube defects such as spina bifida.
- B. Folic acid helps build strong bones for your baby.
- C. Folic acid helps your baby become resistant to infections.
- D. Folic acid prevents your baby from becoming anemic.
Correct Answer: A
Rationale: Folic acid is critical for preventing neural tube defects like spina bifida by supporting early fetal development.
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The nurse is assessing the Hispanic client who is in the active stage of labor. Which is the most crucial information that the nurse should assess related to the client’s ethnicity and stage of labor?
- A. Choice of pain control measures
- B. Desire for hot or cold fluids
- C. Persons to be in the room during labor and birth
- D. Desire for circumcision if a male infant is born
Correct Answer: A
Rationale: Because cultural variations exist in pain control measures used and pain tolerance, the most crucial assessment in the active stage of labor is the client’s choice of pain control measures. A desire for hot or cold fluids is an important aspect that should be determined during the early stage of labor. Determination of support persons is an important aspect that should be made during the early stage of labor. The desire for circumcision is an important consideration, but it is not the primary need during the active stage of labor.
Which statement by the client indicates understanding of prenatal education?
- A. I should avoid all exercise during pregnancy.
- B. I need to attend prenatal visits only in the third trimester.
- C. I should report any decrease in fetal movement.
- D. I can consume alcohol in moderation after the first trimester.
Correct Answer: C
Rationale: Reporting decreased fetal movement is critical, as it may indicate fetal distress, showing the client understands key prenatal education.
The client tells the nurse that she is using cocoa butter on her abdomen to prevent stretch marks. Which is the most accurate response from the nurse?
- A. “That is wonderful. If you continue to use cocoa butter daily, you should have no stretch marks after delivery.”
- B. “The cocoa butter will not prevent stretch marks completely, but it will help to reduce their number.”
- C. “The cocoa butter will not prevent stretch marks but will decrease the appearance of the linea nigra.”
- D. “Cocoa butter does not prevent stretch marks, but it soothes itching that occurs as your abdomen enlarges.”
Correct Answer: D
Rationale: Cocoa butter is an emollient and provides moisture to the skin, thereby decreasing the itching associated with stretching of the skin as the abdomen enlarges. Cocoa butter does not prevent striae gravidarum. Cocoa butter does not decrease the incidence of striae gravidarum. Cocoa butter does not prevent the appearance of linea nigra.
The nurse asks the 12-hour postpartum client, who is breastfeeding her baby now, why she has not yet received a dinner tray. The client states that her mother is bringing curry and that she won’t be eating the hospital food tonight. Which response by the nurse is best?
- A. “Please let me know if you change your mind. I can order food for you later.”
- B. “Since you are breastfeeding, you should avoid eating highly spiced food.”
- C. “I will ask the dietitian to meet with you so you can discuss your nutritional needs.”
- D. “You should not be eating highly spiced food 12 hours after delivery.”
Correct Answer: A
Rationale: Offering to order food later if the client changes her mind is the best response. Many clients have culturally based beliefs about food and beverages that should be consumed in the postpartum period. Unless contraindicated, nurses should support and encourage women to incorporate food preferences with cultural significance into their postpartum diet. Some breastfeeding infants are sensitive to certain flavors, seasonings, or foods, but, there is no evidence to support maternal food restrictions unless the infant shows a sensitivity. If there is a strong family history of a food allergy that causes anaphylaxis, such as a peanut allergy, these foods may be avoided. Many women would benefit from speaking to a dietician, but this client is not at any increased risk that would make a dietary consultation necessary. There are no food restrictions 12 hours after delivery unless there have been complications.
The laboring client’s amniotic membranes have just ruptured. Which nursing action should be priority?
- A. Monitor maternal temperature.
- B. Inspect characteristics of the fluid.
- C. Perform a sterile vaginal examination.
- D. Assess the fetal heart rate pattern.
Correct Answer: D
Rationale: The priority nursing action is to assess the FHR pattern for several minutes immediately after membrane rupture to determine fetal well being. The umbilical cord may prolapse as a result of the rupture, causing life-threatening changes in the FHR. The maternal temperature should be monitored during labor and at least every two hours after the membranes rupture to assess for possible infection. However, this is not the priority nursing action. Characteristics of the fluid (color, odor, and estimated amount) should be assessed and documented after rupture, but this is not the priority at this time. A vaginal exam that assesses the progress of labor does need to be performed right after membrane rupture, but it is not the priority.