Nokea
Client pregnant, BMI of 26.5
Which of the following statements is an appropriate response by the nurse?
- A. A gain of about 25 to 35 pounds is best for you and for your baby.
- B. The recommendation for you is about 15 to 25 pounds.
- C. You should gain 11 to 20 pounds.
- D. It really doesn't matter exactly how much weight you gain, as long as your diet is healthy.
Correct Answer: B
Rationale: The correct answer is B because the recommended weight gain during pregnancy varies based on pre-pregnancy weight. For a normal weight woman, gaining 25 to 35 pounds is ideal. However, for an underweight woman, it's recommended to gain 28 to 40 pounds, and for an overweight woman, 15 to 25 pounds is advised. Choice A is incorrect as it does not consider individual differences. Choice C is too narrow and may not be applicable to all women. Choice D is incorrect because weight gain does matter for both the mother and baby's health outcomes.
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Client at 34 weeks of gestation, suspected placenta previa
Which of the following actions should the nurse take?
- A. Perform a rectal exam.
- B. Apply an external fetal monitor.
- C. Complete a vaginal exam.
- D. Apply ice to the perineal area.
Correct Answer: B
Rationale: The correct answer is B: Apply an external fetal monitor. This action is crucial in monitoring the fetal heart rate and uterine contractions during labor, ensuring the well-being of both the mother and the baby. Performing a rectal exam (choice A) is not indicated in this context. Completing a vaginal exam (choice C) may be necessary but is not the immediate priority. Applying ice to the perineal area (choice D) is not relevant for fetal monitoring. Other choices are not provided.
Client regarding how to reduce the risk of giving birth to a newborn who has a neural tube defect
Which of the following instructions by the nurse is appropriate?
- A. Increase intake of iron.
- B. Eat foods fortified with folic acid.
- C. Avoid the use of aspirin.
- D. Limit consumption of alcohol.
Correct Answer: B
Rationale: The correct answer is B: Eat foods fortified with folic acid. This instruction is appropriate because folic acid is crucial during pregnancy for preventing birth defects. Iron intake (A) is important too, but not the most appropriate here. Aspirin avoidance (C) is relevant due to its potential risks. Limiting alcohol (D) is important, but not as critical as folic acid. The other choices are not applicable or less crucial in this context.
Client 4 hours postpartum, vaginal birth, saturated perineal pad within 10 minutes
Which of the following is the nurse's first action?
- A. Observe for pooling of blood under the buttocks.
- B. Assess client's blood pressure.
- C. Prepare to administer a prescribed oxytocic preparation.
- D. Massage the client's fundus.
Correct Answer: D
Rationale: The correct answer is D: Massage the client's fundus. This is the nurse's first action after childbirth to prevent postpartum hemorrhage by promoting uterine contractions and expelling any clots. Assessing blood pressure (B) is important but not the first action. Observing for pooling of blood under the buttocks (A) is a sign of excessive bleeding but not the first action. Administering oxytocic preparation (C) can help prevent postpartum hemorrhage, but it is not the first action.
Client in second trimester, new diagnosis of gestational diabetes
Which of the following statements by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of my daily caloric intake.
- B. I know I am at increased risk to develop type 2 diabetes.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I will take my glyburide daily with breakfast.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week goes against the goal of managing diabetes, which typically requires consistent physical activity. Regular exercise helps control blood sugar levels, improves insulin sensitivity, and promotes overall health. Choices A, B, and D demonstrate an understanding of diabetes management and medication adherence, indicating no need for further teaching in those areas.
Client in second trimester, new diagnosis of gestational diabetes
Which statement by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will take my glyburide daily with breakfast.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I know I am at increased risk to develop type 2 diabetes.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week contradicts the importance of regular physical activity in managing diabetes. Regular exercise helps improve insulin sensitivity and control blood sugar levels. Limiting carbohydrates to 50% of caloric intake (choice A) is a recommended dietary guideline for diabetes management. Taking glyburide daily with breakfast (choice B) indicates adherence to medication therapy. Knowing about the increased risk of developing type 2 diabetes (choice D) shows awareness of the condition.