Needs of Maternal and Reproductive Health Clients

Needs of Maternal and Reproductive Health Clients Related

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Which patient would require additional calories and nutrients?

  • A. A 36-year-old female gravida 2, para 1, in her first trimester of pregnancy
  • B. An 18-year-old female who delivered a 7-lb baby and is bottle feeding
  • C. A 23-year-old female who had a cesarean birth and is bottle feeding
  • D. A 20-year-old female who had a vaginal birth 5 months ago and is breastfeeding
Correct Answer: D

Rationale: The correct answer is D because breastfeeding requires additional calories and nutrients to support the mother's milk production and maintain her own health. Breastfeeding burns extra calories, so the mother needs to consume more to meet her body's needs. Additionally, breastfeeding mothers need to ensure they are getting enough nutrients like calcium, iron, and protein to support their own health and the production of nutritious breast milk for their baby.

Choice A is incorrect because the patient is in her first trimester of pregnancy, not breastfeeding. Choice B is incorrect because bottle feeding does not require as many additional calories and nutrients as breastfeeding. Choice C is incorrect because although the patient had a cesarean birth, the method of feeding (bottle feeding) does not require as much additional nutrition as breastfeeding.

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Which clinical finding is associated with inadequate maternal weight gain during pregnancy?

  • A. Prolonged labor
  • B. Preeclampsia
  • C. Gestational diabetes
  • D. Low-birth-weight infant
Correct Answer: D

Rationale: The correct answer is D: Low-birth-weight infant. Inadequate maternal weight gain during pregnancy is associated with an increased risk of delivering a low-birth-weight infant due to insufficient fetal growth and development. When a mother does not gain enough weight during pregnancy, it can result in the baby being born smaller than expected, which can lead to various health issues. Prolonged labor (choice A) is not directly linked to inadequate weight gain. Preeclampsia (choice B) and gestational diabetes (choice C) are more commonly associated with excessive weight gain or other factors. Therefore, the correct choice is D as it directly correlates with inadequate maternal weight gain.

A client at 39-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 6 cm, 90% effaced, and the fetus is at 0 station. The client's membranes rupture spontaneously, and the fluid is clear. What action should the nurse take next?

  • A. Monitor the fetal heart rate pattern.
  • B. Perform a vaginal examination.
  • C. Encourage the client to ambulate.
  • D. Administer pain medication.
Correct Answer: A

Rationale: Monitoring the fetal heart rate pattern after membrane rupture is essential to detect any changes in fetal status.

The nurse should encourage the laboring client to begin pushing when

  • A. There is only an anterior or posterior lip of cervix left
  • B. The client describes the need to have a bowel movement
  • C. The cervix is completely dilated
  • D. The cervix is completely effaced
Correct Answer: C

Rationale: Pushing begins with the second stage of labor, i.e., when the cervix is completely dilated (C), the cervix can become edematous and may never completely dilate, necessitating an operative delivery. Many primigravidas begin active labor 100% effaced and then proceed to dilate.

A multigravida client arrives at the labor and delivery unit and tells the nurse that her bag of water has broken. The nurse identifies the presence of meconium fluid on the perineum and determines the fetal heart rate is between 140 to 150 beats/minute. What action should the nurse implement next?

  • A. Complete a sterile vaginal exam
  • B. Take maternal temperature every 2 hours
  • C. Prepare for an immediate cesarean birth
  • D. Obtain sterile suction equipment
Correct Answer: A

Rationale: A vaginal exam (A) should be performed after the rupture of membranes to determine the presence of a prolapsed cord.

The father of a 3-day old infant who is breastfeeding calls the postpartum help line to report that his wife is acting strangely. She is irritable, cannot cope with the baby, and frequently cries for no appeared reason. What information is most important for the nurse to provide the father?

  • A. Contact the clinic if the behaviors continue for more than two weeks or becomes worse
  • B. Tell the father count the newborns number of soiled diapers over the next few days.
  • C. A fluctuation in hormones in the early postpartum period can cause mood changes.
  • D. Recommend giving supplemental bottle feedings to the baby between breast feeding.
Correct Answer: C

Rationale: Hormonal fluctuations (C) are common causes of mood changes in the early postpartum period.

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