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1) A nurse in a woman's health clinic is providing teaching about nutritional intake to a
client who is at 8 weeks of gestation. The nurse should
instruct the client to increase her daily intake of which of the following nutrients?
Calcium
The recommendation for calcium intake during pregnancy is the same as that for women
who are not pregnant: 1,300 mg/day for women younger than 19 years old and 1,000
mg/day for women between the ages of 19 and 50 years old. Vitamin E
The recommendation for vitamin E intake during pregnancy is 15 mg/day, the same as that
for women who are not pregnant. Iron
The recommendation for iron intake during pregnancy is higher than that for women who are
not pregnant. For women who are pregnant, it is 27 mg/day. For women who are not
pregnant, it is 15 mg/day for women younger than 19 years old and 18 mg/day for women
between the ages of 19 and 50 years old. Vitamin D
The recommendation for vitamin D intake during pregnancy is 600 IU/day, the same as
2) A nurse is caring for a client who has uterine hypotonicity and is experiencing
postpartum hemorrhage. Which of the following actions is the nurse's priority?
Check the client's capillary refill.
It is important for the nurse to monitor capillary refill in order to track baseline data for this
client. However, another action is the nurse's priority. Massage the client's fundus.
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,Uterine hypotonicity and postpartum hemorrhage indicate that this client is at the
greatest risk for hypovolemic shock. This can compromise the perfusion to the client's
vital organs, causing death to occur. Therefore, the nurse's priority is to massage the
client's fundus in order to minimize blood loss. Insert an indwelling urinary catheter for
the client.
It is important for the nurse to insert an indwelling urinary catheter in order to assess the client
for hypovolemia. However, another action is the nurse's priority. Prepare the client for a blood
transfusion.
It is important for the nurse to prepare the client for a blood transfusion in order to replace
the amount of blood lost from postpartum hemorrhage. However, another action is the
nurse's priority.
3) A nurse is providing discharge teaching to a parent whose newborn has just had a
circumcision. Which of the following instructions should the nurse include?
Apply slight pressure with a sterile gauze pad for mild bleeding.
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,The nurse should instruct the client to attempt to stop mild bleeding by applying pressure with
sterile gauze. If bleeding continues, the client should notify the provider.
Inspect the circumcision site every 6 to 8 hr.
The client should change the newborn's diaper and examine the circumcision site at least
every 4 hr.
Use baby wipes containing alcohol to cleanse the penis with each diaper change.
Baby wipes containing alcohol can irritate the skin and should be avoided until the
circumcision has healed, which usually takes 5 to 6 days. During each diaper change, the penis
should be washed gently with warm water and have petroleum jelly applied to the glans.
Remove yellow exudate daily using a warm, wet washcloth.
The client should not attempt to remove any yellow exudate from the circumcision site
because it is part of the healing process, which begins within 24 hr and continues for 2 to 3
days. Disrupting it can cause pain and bleeding.
4) A nurse is teaching about effective breastfeeding to a client who is 3 days postpartum.
Which of the following information should the nurse include?
"Your milk will replace colostrum in about 10 days."
The nurse should inform the client that milk production occurs 3 or 4 days postpartum. The
breasts will feel firm and heavy. The client should continue to feed the newborn on demand
during this period.
"Your breasts should feel firm after breastfeeding."
The nurse should inform the client that her breasts should feel softer after feeding.
This change indicates that the newborn has emptied the breasts of milk. "Your
newborn should urinate at least 10 times per day."
The nurse should inform the client that the newborn should void six to eight times per
day. The newborn should also have at least three stools per day. It is not uncommon for
breastfed newborns to have a stool with each feeding. "Your newborn should appear
content after each feeding."
The nurse should inform the client that a baby who is sated will appear content after feedings.
A baby who continues to show indications of hunger (for example, rooting, sucking on the
hands, or crying) might not be effectively emptying the breasts during
feedings.
5) A nurse is teaching a client who has pregestational type 1 diabetes mellitus about
management during pregnancy. Which of the following
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, statements by the client indicates an understanding of the teaching? "I should
have a goal of maintaining my fasting blood glucose between 100 and
120."
The nurse should teach the client to maintain her fasting blood glucose level between 60 and
99 mg/dL.
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