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 nurse correctly explains that the bleeding is the result of sloughing of which structure?
- A. Endometrium
- B. Myometrium
- C. Epimetrium
- D. None of the above
Correct Answer: A
Rationale: Menstrual bleeding occurs due to the sloughing of the endometrium, the inner lining of the uterus, when pregnancy does not occur.
The 42-year-old client who had a partial hydatidiform molar pregnancy 3 months ago asks the nurse whether she and her husband can try conceiving again. Which response by the nurse is incorrect and warrants follow-up action by the observing nurse manager?
- A. “You will need serial levels of beta human chorionic gonadotropin (BHCG) drawn.”
- B. “You cannot conceive ever again because of your risk of choriocarcinoma.”
- C. “You should not become pregnant yet for 6 to 12 months.”
- D. “Your risk of another hydatidiform molar pregnancy is low.”
Correct Answer: B
Rationale: Women who have had a molar pregnancy can conceive again once their BHCG levels are normal and remain normal for a certain time period, usually 6 to 12 months. This response by the nurse is incorrect and should be followed up by the observing nurse manager. Because of the risk of choriocarcinoma, serial serum BHCG testing is completed after a hydatidiform molar pregnancy. Because the client will undergo serial serum BHCG testing after a hydatidiform molar pregnancy, she should not get pregnant for 6 to 12 months until testing is completed and it is confirmed that she does not have a malignancy. Couples with a past history of molar pregnancy have the same statistical chance of conceiving again and having a normal pregnancy as those without.
The nurse correctly assists the client into which position?
- A. Lithotomy
- B. Prone
- C. Sims'
- D. Trendelenburg's
Correct Answer: A
Rationale: The lithotomy position, with legs elevated and apart, is standard for pelvic examinations to provide access to the pelvic area.
The 28-year-old pregnant client (G3P2) has just been diagnosed with gestational diabetes at 30 weeks. The client asks what types of complications may occur with this diagnosis. Which complications should the nurse identify as being associated with gestational diabetes? Select all that apply.
- A. Seizures
- B. Large-for-gestational-age infant
- C. Low-birth-weight infant
- D. Congenital anomalies
- E. Preterm labor
Correct Answer: B,D
Rationale: Infants of diabetic mothers can be large as a result of excess glucose to the fetus. Congenital anomalies are more common in diabetic pregnancies. Seizures do not occur as a result of diabetes but can be associated with preeclampsia, another pregnancy complication. Infants of diabetic mothers are usually large for gestational age and do not have a low birth weight. Preterm labor is not typically associated with maternal diabetes.
The nurse is caring for the client with mild preeclampsia. The nurse should monitor for which complications associated with mild preeclampsia? Select all that apply.
- A. Placental abruption
- B. Hyperbilirubinemia
- C. Nonreassuring fetal status
- D. Severe preeclampsia
- E. Gestational diabetes
Correct Answer: A,B,C,D
Rationale: Placental abruption can occur as a complication of preeclampsia due to hypoperfusion of the placenta and endothelial injury. Hyperbilirubinemia can occur as a complication of preeclampsia due to hypoperfusion to the liver. Nonreassuring fetal status can occur as a complication of preeclampsia due to hypoperfusion to the placenta. Severe preeclampsia can occur as a complication of preeclampsia if the BP remains uncontrolled. Gestational diabetes is not associated with preeclampsia.