Nokea
Which dietary adjustment is most appropriate for a pregnant teenager?
- A. Increase caloric intake to 2,500 calories per day.
- B. Drink decaffeinated beverages instead of carbonated ones.
- C. Eat foods that are low in carbohydrates and fats.
- D. Choose nonspicy, easy to digest foods.
Correct Answer: A
Rationale: Pregnant teenagers require about 2,500 calories daily to support their growth and the fetus's development.
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The nurse observes a sinusoidal FHR pattern on the monitor tracing. How should the nurse interpret this pattern?
- A. The fetus may be in a sleep state.
- B. Congenital anomalies are possible.
- C. This may indicate severe fetal anemia.
- D. This predicts normal fetal well-being.
Correct Answer: C
Rationale: A sinusoidal pattern, which is Drag and Drop, smooth, undulating, and uncommon, classically occurs with severe fetal anemia as a result of abnormal perinatal conditions. An FHR pattern having minimal variability (not a sinusoidal pattern) might indicate that the fetus is in a sleep state. Absent or minimal variability, not a sinusoidal FHR pattern, could indicate possible congenital anomalies. Moderate variability of the FHR (not a sinusoidal pattern) reflects normal fetal well-being.
The nurse is caring for the client who has been in the second stage of labor for the last 12 hours. The nurse should monitor for which cardiovascular change that occurs during this stage of labor?
- A. An increase in maternal heart rate
- B. A decrease in the cardiac output
- C. An increase in the white blood cell (WBC) count
- D. A decreased intravascular volume during contractions
Correct Answer: A
Rationale: Maternal HR is normally increased due to pain resulting from increased catecholamine secretion, fear, anxiety, and increased blood volume. When the laboring client holds her breath and pushes against a closed glottis, intrathoracic pressure rises. Blood in the lungs is forced into the left atrium, leading to a transient increase (not decrease) in cardiac output. Although the WBCS increase to 25,000/mm3 to 30,000/mm3 during labor and early postpartum as a physiological response to stress, this is not a cardiovascular change. During the second stage of labor, the maternal intravascular volume is increased (not decreased) by 300 to 500 mL of blood from the contracting uterus.
The client in labor received an epidural anesthesia 20 minutes ago. The nurse assesses that the client’s BP is 98/62 mm Hg and that the client is lying supine. What should the nurse do next?
- A. Increase the lactated Ringer’s infusion rate.
- B. Elevate the client’s legs for 2 to 3 minutes.
- C. Place the bed in 10- to 20-degree Trendelenburg.
- D. Position the client in a left side-lying position.
Correct Answer: D
Rationale: The first action is to place the client in a left side-lying position. This displaces the uterus and alleviates aortocaval compression. Increasing the infusion rate may be implemented if repositioning the client does not correct the hypotension. Elevating the client’s legs for 2 to 3 minutes is done with severe or prolonged hypertension to increase blood return from the extremities. It may be implemented after repositioning to left side, increasing the IV rate, and placing in Trendelenburg position. Placing in 10- to 20-degree Trendelenburg position is usually implemented if the BP does not increase within 1 to 2 minutes after repositioning to left side and increasing the IV flow rate.
The nurse correctly instructs the client to drink how many glasses of milk per day to meet calcium requirements?
- A. 1 to 2
- B. 3 to 4
- C. 5 to 6
- D. 7 to 8
Correct Answer: B
Rationale: Three to four glasses of milk daily provide approximately 1200 mg of calcium, meeting pregnancy requirements.
How early in a pregnancy can the nurse expect to hear the fetal heartbeat using a Doppler device?
- A. 4 to 6 weeks
- B. 8 to 10 weeks
- C. 12 to 14 weeks
- D. 16 to 18 weeks
Correct Answer: C
Rationale: A fetal heartbeat can typically be detected by Doppler around 12-14 weeks, when the fetus is sufficiently developed.