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Which suggestion is most helpful for the pregnant patient who is experiencing heartburn?
- A. Drink plenty of fluids at bedtime.
- B. Eat only three meals a day so the stomach is empty between meals.
- C. Drink coffee or orange juice immediately on arising in the morning.
- D. Use Tums or Rolaids to obtain relief, as directed by the health care provider.
Correct Answer: D
Rationale: The correct answer is D because Tums or Rolaids are safe antacids commonly recommended for heartburn during pregnancy. They help neutralize stomach acid and provide relief. Choice A is incorrect as drinking fluids before bedtime can aggravate heartburn. Choice B is incorrect because it's important to eat small, frequent meals to prevent heartburn. Choice C is incorrect as coffee and orange juice can trigger heartburn due to their acidity. Overall, using antacids under healthcare provider guidance is the best option for managing heartburn during pregnancy.
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The nurse is determining the G/TPAL of a patient at her first prenatal visit. The patient informs the nurse she delivered a set of twins at 32 weeks of gestation who are now 5 years old, delivered her first child 8 years ago 1 week early, and miscarried at 2 months' gestation 3 years ago. What is this patient's Gravida [G] and Parity [P] using the G/TPAL nomenclature?
- A. G3 P1113
- B. G3 P2113
- C. G4 P1113
- D. G4 P2113
Correct Answer: D
Rationale: The correct answer is D: G4 P2113. To determine the Gravida (G) and Parity (P) of the patient:
- Gravida (G): The patient has been pregnant a total of 4 times (twins at 32 weeks, first child 1 week early, miscarriage at 2 months, and current pregnancy). Therefore, G is 4.
- Parity (P): P is divided into four categories: term births (T), preterm births (P), abortions (A), and living children (L). The patient delivered twins at 32 weeks (P2), her first child 1 week early (T1), and had a miscarriage at 2 months (A1). Therefore, the Parity is P2A1L3, represented as 2113. Other choices are incorrect because they do not accurately reflect the patient's obstetric history.
A client presents to Labor & Delivery for an ultrasound at 16 weeks gestation for vaginal bleeding. She asks the nurse if the procedure will harm her baby. Which is appropriate for the nurse to tell the client?
- A. Since you are already bleeding, we cannot guarantee that the ultrasound will not have any negative effects on your pregnancy.'
- B. Ultrasounds use sound waves to view your baby, not radiation, so the procedure will not harm your baby.'
- C. There are no guarantees when you have a procedure performed.'
- D. The doctor wouldn't try to order a test that would hurt your baby.'
Correct Answer: B
Rationale: The correct answer is B: "Ultrasounds use sound waves to view your baby, not radiation, so the procedure will not harm your baby."
Rationale:
1. Ultrasound uses sound waves, not radiation, to create images of the baby in the womb.
2. The sound waves are considered safe for both the mother and the developing baby.
3. There is no evidence to suggest that ultrasound procedures pose any harm to the pregnancy.
4. It is important to reassure the client that the ultrasound is a routine procedure and will not harm the baby.
Summary:
Choice A is incorrect because it wrongly implies that the ultrasound could potentially harm the baby due to the existing bleeding, which is not true.
Choice C is incorrect as it does not provide specific information regarding the safety of ultrasound during pregnancy.
Choice D is incorrect as it lacks the specific information about the safety of ultrasound and relies on a general statement about the doctor's intentions.
The nurse is caring for a pregnant client who was sent to the hospital for a biophysical profile. She is 37 weeks gestation with her second child, has gestational diabetes, and complains of decreased fetal movement for the last 24 hours. Which action should the nurse take first?
- A. Perform vital signs
- B. Call physician
- C. Perform glucose
- D. Place on fetal monitor
Correct Answer: D
Rationale: The correct answer is D: Place on fetal monitor. This action is crucial to assess the fetal well-being and monitor the baby's heart rate and movements. It helps in determining if the baby is in distress and requires immediate intervention. Performing vital signs (A) is important but not the priority in this situation. Calling the physician (B) can be done after the initial assessment on the fetal monitor. Performing glucose (C) is not the priority when the main concern is the well-being of the baby.
A patient with an IUD in place has a positive pregnancy test. When planning care, the nurse will base decisions on which anticipated action?
- A. A therapeutic abortion will need to be scheduled since fetal damage is inevitable.
- B. Hormonal analyses will be done to determine the underlying cause of the false-positive test result.
- C. The IUD will need to be removed to avoid complications such as miscarriage or infection.
- D. The IUD will need to remain in place to avoid injuring the fetus.
Correct Answer: C
Rationale: Rationale:
C is correct because when a patient with an IUD in place has a positive pregnancy test, the IUD should be removed to avoid complications such as ectopic pregnancy, miscarriage, or infection. Leaving the IUD in place can increase the risk of adverse outcomes for both the mother and the fetus. Removing the IUD allows for safer management of the pregnancy and reduces potential harm.
Summary:
A: Incorrect. Fetal damage is not inevitable, and a therapeutic abortion is not the immediate action required in this situation.
B: Incorrect. Hormonal analyses are not the priority when a positive pregnancy test with an IUD in place is detected.
D: Incorrect. Leaving the IUD in place can lead to complications and is not the recommended course of action.
What is the term for a nonstress test in which there are two or more fetal heart rate accelerations of 15 or more beats per minute (BPM) with fetal movement in a 20-minute period?
- A. Positive
- B. Negative
- C. Reactive
- D. Nonreactive
Correct Answer: C
Rationale: The correct answer is C: Reactive. In a nonstress test, a reactive result is considered normal and indicates a healthy fetus. This is because it shows two or more fetal heart rate accelerations of 15 or more BPM with fetal movement in a 20-minute period, which signifies a responsive and healthy fetal heart rate pattern. The other choices are incorrect because:
A: Positive typically indicates a concerning result in medical contexts.
B: Negative signifies an abnormal result in this context.
D: Nonreactive suggests a lack of desired fetal heart rate accelerations with movement, which is not ideal.