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Which effect is a common response to both smoking and cocaine use in the pregnant patient?
- A. Vasoconstriction
- B. Increased appetite
- C. Increased metabolism
- D. Changes in insulin metabolism
Correct Answer: A
Rationale: The correct answer is A: Vasoconstriction. Both smoking and cocaine use can lead to vasoconstriction, which is the narrowing of blood vessels. In pregnant patients, this can reduce blood flow to the fetus, leading to potential complications. Increased appetite (B) and increased metabolism (C) are not common responses to both smoking and cocaine use. Changes in insulin metabolism (D) are more commonly associated with conditions like gestational diabetes rather than as a common response to smoking and cocaine use during pregnancy.
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A newborn infant is receiving immunization prior discharge. Which action should the nurse implement?
- A. Give the first dose of the vaccine for rotavirus if any have diarrhea now.
- B. Obtain signed consent from the mother for administration of hepatitis B vaccine
- C. Prepare the first dose for DTaP
- D. Ask the mother if she wants the infant immunized for
Correct Answer: B
Rationale: Hepatitis B vaccine is routinely given at birth, and consent is required (B).
In order to increase the absorption of iron by a pregnant patient, which beverage should an iron preparation be given with?
- A. Tea
- B. Milk
- C. Coffee
- D. Orange juice
Correct Answer: D
Rationale: To increase iron absorption, it should be taken with Vitamin C. Orange juice is high in Vitamin C, which enhances non-heme iron absorption. Tea and coffee contain tannins that inhibit iron absorption. Milk contains calcium, which can interfere with iron absorption. Therefore, the correct choice is D as it provides the necessary Vitamin C to improve iron absorption.
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.
A client at 39-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 6 cm, 90% effaced, and the fetus is at 0 station. The client's membranes rupture spontaneously, and the fluid is clear. What action should the nurse take next?
- A. Monitor the fetal heart rate pattern.
- B. Perform a vaginal examination.
- C. Encourage the client to ambulate.
- D. Administer pain medication.
Correct Answer: A
Rationale: Monitoring the fetal heart rate pattern after membrane rupture is essential to detect any changes in fetal status.
The nurse assesses a client admitted to the labor and delivery unit and obtains the following data: dark red vaginal bleeding, uterus slightly tense between contractions, BP 110/68, FHR 110 beats/minute, cervix 1 cm dilated and uneffaced. Based on these assessment findings, what intervention should the nurse implement?
- A. Insert an internal fetal monitor
- B. Assess for cervical changes q1h
- C. Monitor bleeding from IV sites
- D. Perform Leopold's maneuvers
Correct Answer: C
Rationale: Monitoring bleeding from peripheral sites (C) is the priority intervention. This client is presenting with signs of placental abruption. Disseminated intravascular coagulation (DIC) is a complication of placental abruption, characterized by abnormal bleeding.