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A nurse is caring for a client who is at 9 weeks of gestation and reports nausea in the morning that continues until midafternoon.
Which of the following actions should the nurse encourage the client to take?
- A. Take an over-the-counter antacid
- B. Eat dry, bland foods in the morning
- C. Restrict fluids to 1,000mL/day
- D. Increase intake of fresh fruits
Correct Answer: B
Rationale: Eating dry, bland foods like crackers in the morning stabilizes blood sugar and reduces nausea.
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A nurse in an antepartum unit is assisting with the care of a client who has preeclampsia and is receiving IV magnesium sulfate therapy.
For which of the following adverse effects should the nurse monitor and report to the provider?
- A. Polyuria
- B. Hyporeflexia
- C. Agitation
- D. Tachypnea
Correct Answer: B
Rationale: Hyporeflexia is an early sign of magnesium toxicity, indicating excessive neuromuscular blockade, requiring immediate reporting.
A nurse is assisting with the admission of a client who has hyperemesis gravidarum.
Which of the following laboratory tests is the priority to complete?
- A. CBC
- B. Serum bilirubin
- C. Urinalysis of ketones
- D. Liver enzymes
Correct Answer: C
Rationale: Urinalysis for ketones is the priority as it indicates ketosis from prolonged vomiting, guiding the need for IV fluids and nutritional support in hyperemesis gravidarum.
A nurse in an obstetric clinic is caring for four clients.
The nurse should identify that an intrauterine device is contraindicated for which of the following clients?
- A. A client who has a positive pregnancy test
- B. A client who smokes one pack of cigarettes per day
- C. A client who has a history of gallbladder disease
- D. A client who is nulliparous
Correct Answer: A
Rationale: An IUD is contraindicated in pregnancy due to risks of miscarriage, infection, and preterm labor.
A nurse is reinforcing teaching about breastfeeding with a client who is postpartum.
Which of the following statements by the client indicates an understanding of the teaching?
- A. I will nurse my baby for 5 to 10 minutes on each breast.
- B. I will make sure that just the nipple is in my baby's mouth.
- C. I will lay my baby on a pillow at the level of my breast.
- D. I will apply vitamin E oil to my nipples after each feeding.
Correct Answer: C
Rationale: Positioning the baby at breast level with a pillow promotes a comfortable latch and effective feeding.
Medical History: Gravida 1 Para 1, 41 weeks of gestation, Cesarean birth following prolonged rupture of membranes and cephalopelvic disproportion. Vital Signs: Temperature 38.4° C (101.1° F), Blood pressure 118/72 mm Hg, Heart rate 108/min, Respiratory rate 20/min. Breasts: Client reports their breasts are starting to feel firmer and heavier. Denies nipple discomfort. Client is bottle-feeding their newborn. Uterus: Boggy and tender to palpation. Fundus at the umbilicus. Lochia: Moderate amount of dark brown, foul-smelling discharge. Bladder: Client reports frequent voiding without difficulty. Lower extremities: Bilateral edema of lower extremities noted without pain, warmth, or tenderness. Nurses' Notes: Client reports general malaise, chills, and a decreased appetite.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to evaluate the client's progress. Condition Most Likely: ___ Actions to Take: ___ Parameters to Monitor: ___
- A. Plan to administer broad-spectrum antibiotic medication, Administer an oxytocic medication, Apply ice packs to the breasts, Encourage the client to increase fluid intake, Initiate anticoagulant therapy
- B. Engorgement, Endometritis, Deep vein thrombosis, Urinary tract infection
- C. Temperature, Lochia amount and odor, Bladder distension, Integrity of the nipples, Circumference of lower extremities
Correct Answer:
Rationale: The client has fever (38.4°C/101.1°F), tachycardia (HR 108/min), uterine tenderness, and foul-smelling lochia, all of which indicate postpartum uterine infection (endometritis). Administering broad-spectrum antibiotics treats the infection, and oxytocic medication promotes uterine contraction to reduce bacterial growth. Monitoring temperature and lochia amount/odor evaluates treatment progress.