Nokea
Which food provides the best alternative source of calcium?
- A. Organ meats
- B. White bread
- C. Leafy green vegetables
- D. Dark turkey meat
Correct Answer: C
Rationale: Leafy green vegetables, such as kale and spinach, are rich in calcium and a good alternative for those who dislike milk.
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The nurse monitors which vital sign closely in a client with gestational diabetes?
- A. Blood pressure
- B. Respiratory rate
- C. Pulse rate
- D. Temperature
Correct Answer: A
Rationale: Blood pressure monitoring is crucial in gestational diabetes, as it increases the risk of preeclampsia.
The postpartum client, who had a forceps-assisted vaginal birth 4 hours ago, tells the nurse that she is having continuing perineal pain rated at 7 out of 10 and rectal pressure. An oral analgesic was given and ice applied to the perineum earlier. What should the nurse do now?
- A. Call the HCP to report the pain
- B. Closely reinspect the perineum
- C. Help her out of bed to ambulate
- D. Administer a stool softener
Correct Answer: B
Rationale: Reexamination of the perineum should be completed before calling the HCP to report the pain level. A forceps-assisted delivery can increase the risk of hematoma development. Rectal pressure and perineal pain can indicate a hematoma in the posterior vaginal wall. The nurse should closely examine the perineum and the vaginal introitus for ecchymosis and a bulging mass. Ambulation would not help the perineal pain. A stool softener would be appropriate to avoid constipation but would not help the immediate problem.
The nurse is caring for the antepartum client with a velamentous cord insertion. The client asks what symptom she would most likely experience first if one of the vessels should tear. The nurse should respond that she would most likely experience which symptom first?
- A. Vaginal bleeding
- B. Abdominal cramping
- C. Uterine contractions
- D. Placental abruption
Correct Answer: A
Rationale: In a velamentous cord insertion, vessels of the cord divide some distance from the placenta in the placental membrane. Thus, the most likely first symptom would be vaginal bleeding. Abdominal cramping is unlikely to occur; velamentous cord insertion is not related to uterine activity. Contractions are unlikely to occur; velamentous cord insertion is not related to uterine activity. An abruption, when the placenta comes off the uterine wall, results in severe abdominal pain.
The nurse explained the process of cervical effacement to the client in early labor. Which statement by the client indicates that she understands the information?
- A. “The cervix will widen from less than 1 cm to about 10 cm.”
- B. “The cervix will pull or draw up and become paper-thin.”
- C. “The cervical changes will cause my membranes to rupture.”
- D. “The cervical changes will help my baby to change position.”
Correct Answer: B
Rationale: In cervical effacement, the cervix progressively changes from a thick and long structure, to paper thin. This statement indicates that the client understands the information. Widening of the cervix describes cervical dilation, not effacement. Cervical changes will not cause membranes to rupture. The power of contractions causes cervical changes (effacement and dilation) and, possibly, membrane rupture. Cervical changes will not help the fetus to change position. Fetal descent is thought to occur from the pressure of contractions, especially from the fundus, and from the pressure of the amniotic fluid. Fetal position changes also occur from the fetal head and body adjusting to the maternal pelvis as they descend.
Which snack is most appropriate for a pregnant client with nausea?
- A. Dry crackers
- B. Ice cream
- C. Spicy chips
- D. Carbonated soda
Correct Answer: A
Rationale: Dry crackers are bland and easy to digest, helping to alleviate nausea without exacerbating symptoms.