Nokea
Which nursing instruction is most appropriate regarding the relief of itchy skin during pregnancy?
- A. Take a hot bath daily.
- B. Increase fluid intake.
- C. Add a daily vitamin C tablet to the diet.
- D. Take diphenhydramine (Benadryl) twice per day.
Correct Answer: B
Rationale: Increasing fluid intake hydrates the skin, reducing itchiness, while hot baths or antihistamines may worsen symptoms or require medical approval.
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The pregnant client and her significant other are attending childbirth classes. The client asks for guidance on preparing her school-aged child for the new baby’s birth. Which strategies might the nurse suggest that the client use with her child? Select all that apply.
- A. Read books about bringing home a new baby.
- B. Think of unique names for the new baby.
- C. Help pack a bag for bringing the new baby home.
- D. Explain how pregnancy occurred, if asked.
- E. Help the child buy presents for the new baby.
Correct Answer: A,B,C,E
Rationale: Engaging the child in activities such as reading books about bringing the new baby home helps the child to feel a part of the experience. Engaging the child in activities such as naming the new baby helps the child to feel a part of the experience. Engaging the child in activities such as packing a bag for the new baby’s coming home helps the child to feel a part of the experience. Engaging the child in activities such as buying presents for the new baby helps the child to feel a part of the experience. Children younger than adolescents do not fully understand conception and pregnancy due to preoperational and concrete operational thinking. They are not usually asking for an explanation of sex during this time.
The nurse instructs the client to report which newborn symptom immediately?
- A. Mild jaundice on day 3
- B. Inability to suck or feed
- C. Occasional sneezing
- D. Soft spot on head
Correct Answer: B
Rationale: Inability to suck or feed is a serious symptom that may indicate neurological or health issues, requiring immediate reporting.
The nurse is taking the health history of the 40-year-old pregnant client. Which identified medical conditions increase the client’s risk for complications during her pregnancy? Select all that apply.
- A. Diabetes mellitus type 2
- B. Previous full-term pregnancy
- C. Controlled chronic hypertension
- D. New onset of iron-deficiency anemia
- E. Hemorrhage with a previous pregnancy
Correct Answer: A,C,D,E
Rationale: DM is a risk factor for complications such as preeclampsia, eclampsia, dystocia, fetal macrosomia, recurrent monilial vaginitis and UTIs, ketoacidosis, congenital abnormalities, and others. Controlled chronic hypertension may become uncontrolled during pregnancy due to water retention and other factors related to pregnancy. It is a risk factor for complications such as preeclampsia, placental abruption, and fetal hypoxia. Iron-deficiency anemia is associated with an increased incidence of preterm birth, low-birth-weight infants, and maternal and infant mortality. Previous pregnancy complications are a risk factor for complications. Having a previous full-term pregnancy is not a risk factor for a current pregnancy.
The nurse identifies which sign as indicative of postpartum depression?
- A. Occasional mood swings
- B. Persistent feelings of hopelessness
- C. Excitement about motherhood
- D. Increased energy levels
Correct Answer: B
Rationale: Persistent feelings of hopelessness are a key indicator of postpartum depression, requiring intervention.
The nurse notifies the HCP after feeling a pulsating mass during the vaginal examination of a newly admitted full-term pregnant client. Which HCP order should the nurse question?
- A. Prepare for possible cesarean section.
- B. Place the client in a knee-chest position.
- C. Initiate a low-dose oxytocin IV infusion.
- D. Give terbutaline 0.25 mg subcutaneously.
Correct Answer: C
Rationale: The nurse should question the administration of oxytocin (Pitocin). Oxytocin is used for stimulating contraction of the uterus. Uterine contractions can cause further umbilical cord compression. The pulsating mass indicates umbilical cord prolapse, which is a medical emergency. If vaginal birth is not imminent, a cesarean section is preferred in order to prevent hypoxic acidosis. Placing the client in a knee-chest position relieves pressure on the umbilical cord. Terbutaline (Brethine) is a tocolytic agent used to reduce contractions.