Nokea
Which information about shortness of breath during pregnancy is correct?
- A. It is not common during pregnancy and may indicate a blood clot in the lungs.
- B. It is probably the result of anxiety about the baby's impending delivery.
- C. It is probably caused by the enlarged uterus pressing against the diaphragm.
- D. It is probably caused by decreased oxygen secondary to slow venous circulation.
Correct Answer: C
Rationale: Shortness of breath is common in late pregnancy due to the enlarged uterus pressing against the diaphragm, limiting lung expansion.
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The nurse is about to auscultate an FHR on the client in triage. What information should the nurse determine first in order to find the correct placement for auscultation?
- A. Position of the fetus
- B. Position of the placenta
- C. Presence of contractions
- D. Where to apply the ultrasonic gel
Correct Answer: A
Rationale: The nurse should first perform Leopold’s maneuvers to determine the fetal position. This will enable proper placement of the Doppler device over the location of the FHR. The position of the placenta can provide important information. However, if the Doppler device is placed over the placenta, the nurse will hear a swishing sound and not the FHR. The FHR is still assessed regardless of the presence of contractions. The nurse who has difficulty obtaining an FHR because of a contraction can listen again once the contraction has concluded. Ultrasonic gel is used with any ultrasound device and allows for the conduction of sound and continuous contact of the device with the maternal abdomen. In order to apply the gel to the correct location, the position of the fetus must be known.
The nurse is caring for the client who is Rh negative at 13 weeks’ gestation. The client is having cramping and has moderate vaginal bleeding. Which HCP order should the nurse question?
- A. Administer Rho(D) immune globulin (RhoGAM).
- B. Obtain a beta human chorionic gonadotropin level (BHCG).
- C. Schedule for an immediate ultrasound.
- D. Place on continuous external fetal monitoring.
Correct Answer: B
Rationale: Obtaining the BHCG level is not indicated at 13 weeks’ gestation. BHCG levels are followed in early pregnancy before a fetal heartbeat can be confirmed. RhoGAM is indicated for any pregnant client with bleeding who is Rh negative. An ultrasound can identify the cause of bleeding and confirm fetal viability. Continuous external fetal monitoring can be used to confirm a fetal heartbeat, fetal viability, and fetal risk.
The postpartum client is being discharged to home with a streptococcal puerperal infection. The client is taking antibiotics but asks the nurse what precautions she should take at home to prevent spreading the infection to her husband, newborn, and toddler. Which is the best response by the nurse?
- A. “No precautions are necessary since you are taking antibiotics.”
- B. “You should always wear a mask when caring for your newborn and toddler.”
- C. “Wash your hands before caring for your children and after toileting and perineal care.”
- D. “Your husband should provide all cares for both children until your infection is gone.”
Correct Answer: C
Rationale: The course of an endometrial infection is approximately 7 to 10 days, and thus standard precautions should be in place for that period of time even if the client has started antibiotics. Puerperal infections are not spread by droplets, and thus a mask is not necessary. Other than hand hygiene, no additional precautions need to be taken by the client in her home. The client is able to provide cares for her children, but hand washing is required before cares.
Which of the following beverages should be included in the list of unhealthy drinks to avoid? Select all that apply.
- A. Alcohol
- B. Coffee
- C. Tea
- D. Cola beverages
- E. Sports drinks
- F. Orange juice
Correct Answer: A,B,C,D
Rationale: Alcohol is harmful to the fetus, and caffeinated drinks (coffee, tea, cola) should be limited due to potential effects on fetal development.
The nurse includes which topic in the prenatal education plan for a first-time mother?
- A. Breastfeeding techniques
- B. Advanced labor pain management
- C. Neonatal surgical procedures
- D. Postpartum weight loss strategies
Correct Answer: A
Rationale: Breastfeeding techniques are essential for a first-time mother to ensure successful feeding and bonding with the newborn.