Nokea
Which teaching is most critical for a mother with gestational diabetes?
- A. Encourage a high-protein diet
- B. Teach the importance of blood glucose monitoring
- C. Advise on the importance of physical activity
- D. Monitor for preterm labor signs
Correct Answer: B
Rationale: The correct answer is B because monitoring blood glucose levels is crucial in managing gestational diabetes to prevent complications for both the mother and baby. By regularly monitoring blood glucose levels, the mother can adjust her diet and insulin intake accordingly to maintain optimal blood sugar levels. This helps in reducing the risk of adverse outcomes such as macrosomia and neonatal hypoglycemia.
Choice A is incorrect because while a balanced diet is important, focusing solely on high-protein intake may not address the specific needs of gestational diabetes management.
Choice C is also important for overall health, but blood glucose monitoring takes precedence in managing gestational diabetes.
Choice D is incorrect as monitoring for preterm labor signs is important in pregnancy but is not directly related to managing gestational diabetes.
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The nurse is assessing a client at 10 weeks' gestation with hyperemesis gravidarum. What is the priority nursing action?
- A. Encourage small, frequent meals.
- B. Monitor for signs of dehydration.
- C. Administer antiemetics as prescribed.
- D. Encourage fluid intake between meals.
Correct Answer: B
Rationale: The correct answer is B: Monitor for signs of dehydration. Dehydration is a serious complication of hyperemesis gravidarum and can lead to electrolyte imbalances and maternal-fetal complications. By monitoring for signs of dehydration, the nurse can intervene promptly to prevent further complications. Encouraging small, frequent meals (choice A) may help manage nausea but does not address the risk of dehydration. Administering antiemetics (choice C) may be necessary, but monitoring for dehydration takes precedence. Encouraging fluid intake between meals (choice D) is important, but assessing for dehydration is more critical in this situation.
The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. Which statement by the student indicates an understanding?
- A. It connects the pulmonary artery to the aorta.
- B. It is an opening between the right and left atria.
- C. It connects the umbilical vein to the inferior vena cava.
- D. It connects the umbilical artery to the inferior vena cava.
Correct Answer: C
Rationale: The correct answer is C because the ductus venosus is a fetal vessel that connects the umbilical vein to the inferior vena cava, allowing oxygenated blood from the placenta to bypass the liver and flow directly to the fetal heart. Choice A is incorrect because the ductus arteriosus connects the pulmonary artery to the aorta. Choice B is incorrect as it refers to the foramen ovale, which is an opening between the right and left atria. Choice D is incorrect as it describes the ductus deferens, a part of the male reproductive system.
What is the most critical sign of fetal distress during labor?
- A. Accelerations in fetal heart rate
- B. Decreased variability in fetal heart rate
- C. Early decelerations in fetal heart rate
- D. Late decelerations in fetal heart rate
Correct Answer: D
Rationale: The correct answer is D: Late decelerations in fetal heart rate. Late decelerations indicate uteroplacental insufficiency, where the fetus is not receiving enough oxygen during contractions. This is critical as it can lead to fetal hypoxia and acidosis, posing a risk to the baby's well-being. Early decelerations (C) are generally benign and result from head compression during contractions. Accelerations (A) are a reassuring sign indicating fetal well-being. Decreased variability (B) can be concerning but is not as critical as late decelerations in indicating fetal distress.
A client at 37 weeks' gestation reports sudden gush of clear fluid. What is the nurse's priority action?
- A. Assess for fetal heart rate changes.
- B. Check maternal vital signs.
- C. Perform a sterile vaginal examination.
- D. Notify the healthcare provider.
Correct Answer: A
Rationale: The correct answer is A: Assess for fetal heart rate changes. This is the priority action because the sudden gush of clear fluid may indicate rupture of membranes, potentially leading to fetal distress. Assessing fetal heart rate changes helps determine the urgency of the situation and guides further interventions. Checking maternal vital signs (B) is important but not the priority in this scenario. Performing a sterile vaginal examination (C) should only be done after confirming rupture of membranes to prevent infection. Notifying the healthcare provider (D) can be done after assessing fetal well-being.
A nurse in the emergency department is admitting a client who is at 40 weeks of gestation, has ruptured membranes, and the nurse observes the newborn's head is crowning. The client tells the nurse she wants to push. Which of the following statements should the nurse make? to
- A. "You should go ahead and push to assist the delivery."
- B. "You should try to pant as the delivery proceeds."
- C. "You should try to perform slow-paced breathing."
- D. "You should take a deep, cleansing breath and breathe naturally."
Correct Answer: A
Rationale: The correct answer is A because the newborn's head crowning indicates imminent delivery, and the client's urge to push aligns with the natural progression of labor. By encouraging the client to push, the nurse facilitates the safe and timely delivery of the baby. Panting (choice B) or slow-paced breathing (choice C) may not be effective in this advanced stage of labor. Taking a deep cleansing breath (choice D) can delay the delivery and is not recommended when the baby is crowning.