Nokea
Which response by the nurse is most relevant when another participant talks about having recurrent mood swings?
- A. Try to avoid fatigue and decrease your stress.
- B. You need to be assessed for a possible mood disorder.
- C. Mood swings are caused by increased blood volume.
- D. Are you ambivalent about the pregnancy?
Correct Answer: A
Rationale: Avoiding fatigue and stress helps manage mood swings, which are common due to hormonal changes in pregnancy.
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The postpartum client delivered a healthy newborn 36 hours previously. The nurse finds the client crying and asks what is wrong. The client replies, “Nothing, really. I’m not in pain or anything, but I just seem to cry a lot for no reason.” What should be the nurse’s first intervention?
- A. Call the client’s support person to come and sit with her.
- B. Remind her that she has a healthy baby and that she shouldn’t be crying.
- C. Contact the HCP to have the counselor come see the client.
- D. Ask the client to discuss her birth experience.
Correct Answer: D
Rationale: The client’s support person should be given information about postpartum blues before the client is discharged from the hospital. However, contacting that individual should not be the first intervention. Reminding the client that she has a healthy baby is a nontherapeutic communication technique that implies disapproval of the client’s actions. There is no need to notify the HCP, as postpartum blues is a common self-limiting postpartum occurrence. A key feature of postpartum blues is episodic tearfulness without an identifiable reason. Interventions for postpartum blues include allowing the client to relive her birth experience.
The postpartum client suffered a fourth-degree perineal laceration during her vaginal birth. Which interventions should the nurse add to the client’s plan of care? Select all that apply.
- A. Limit ambulation to bathroom privileges only.
- B. Decrease fluid intake to 1000 mL every 24 hours.
- C. Instruct the client on a high-fiber diet.
- D. Monitor the uterus for firmness every 2 hours.
- E. Give pm prescribed stool softeners in the am. and at h.s.
Correct Answer: C,E
Rationale: Activity should be increased, not decreased, to reduce the potential for constipation. Fluids should be increased, not decreased, to reduce the potential for dehydration and constipation. The client with a fourth-degree perineal laceration should be instructed to increase dietary fiber to help maintain bowel continence and decrease perineal trauma from constipation. A perineal laceration will not affect the condition of the uterus; there is no need to increase uterine monitoring. The client with a fourth-degree perineal laceration should be given a stool softener bid to help maintain bowel continence and decrease perineal trauma from constipation.
Where can the nurse expect to palpate the fundus at this time?
- A. Just above the symphysis pubis
- B. Just below the xiphoid process
- C. Near the level of the umbilicus
- D. Just below the symphysis pubis
Correct Answer: C
Rationale: At 20 weeks' gestation, the fundus is typically palpated near the level of the umbilicus, reflecting uterine growth.
At this point in the client's pregnancy, which test is typically used to detect genetic disorders?
- A. Amniocentesis
- B. Chorionic villi sampling
- C. Rapid plasma reagin
- D. Ultrasound
Correct Answer: B
Rationale: Chorionic villi sampling is performed at 10-13 weeks to detect genetic disorders, suitable for a 10-week pregnancy.
The nurse correctly instructs the client to drink how many glasses of milk per day to meet calcium requirements?
- A. 1 to 2
- B. 3 to 4
- C. 5 to 6
- D. 7 to 8
Correct Answer: B
Rationale: Three to four glasses of milk daily provide approximately 1200 mg of calcium, meeting pregnancy requirements.