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Exam (elaborations)

Pregnancy, labor, childbirth, postpartum- uncomplicated Exam Solution 2022/2023

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Pregnancy, labor, childbirth, postpartum- uncomplicated Exam Solution 2022/2023 Before a postpartum client is discharged, the nurse advises her about problems that should be reported and then asks her to recall these problems. Identification of which problem identified by the client indicates that the teaching has been effective? 1. Breast engorgement with feelings of fullness 2. Urgency, frequency, and burning on urination 3.Increased amount of lochia after physical activity 4. Dryness and tenderness when intercourse is first resumed - ANS-2. Urgency, frequency, and burning on urination **These clinical findings are indicative of a urinary tract infection and should be reported immediately. Engorgement is expected and should subside in a few days. A client at 22 weeks' gestation asks the nurse how to prevent back pain as her pregnancy progresses. What does the nurse suggest that she wear? 1. Maternity girdle 2. Support stockings 3. Low-heeled shoes 4. Loose-fitting clothing - ANS-3. Low-heeled shoes **Low-heeled supportive shoes help maintain the body's center of gravity over the hips, limiting arching of the back that compensates for the increased weight in the abdominal area. A 36-year-old multigravida who is at 14 weeks' gestation is scheduled for an α- fetoprotein test. She asks the nurse, "What does this test do?" The nurse bases the response on the knowledge that this test can reveal: 1. Kidney defects 2. Cardiac anomalies 3. Neural tube defects 4. Urinary tract anomalies - ANS-3. Neural tube defects A pregnant client uses a computer almost continuously during her working hours. This has implications for her plan of care during pregnancy. What should the nurse recommend? 1. "Try to walk around every few hours during the workday." 2. "Ask for time in the morning and afternoon to elevate your legs." 3. "Tell your boss that you won't be able to work beyond the second trimester." 4. "Ask for time in the morning and afternoon so you can go get something to eat." - ANS-1. "Try to walk around every few hours during the workday." A pregnant client at 37 weeks' gestation is taught about signs and symptoms that should be reported immediately to the primary care provider. The nurse determines that the client understands the information presented when she states that she will immediately report: 1. Lower back pain 2. White vaginal discharge 3. Irregular strong contractions 4. Leakage of fluid from the vagina - ANS-4. Leakage of fluid from the vagina **Leakage may indicate rupture of the amniotic membranes; the client is at risk for an ascending infection from the vagina if birth does not occur within 24 hours or if early treatment is not instituted. After a client gives birth, what physiological occurrence indicates to the nurse that the placenta is beginning to separate from the uterus and is ready to be expelled? 1. Relaxation of the uterus 2. Descent of the uterus in the abdomen 3. Appearance of a sudden gush of blood 4. Retraction of the umbilical cord into the vagina - ANS-3. Appearance of a sudden gush of blood **When the placenta separates from the uterine wall, it tears blood vessels, resulting in a gush of blood from the vagina. A client is receiving an epidural anesthetic during labor. For which side effect should the nurse monitor the client? 1. Hypertension 2. Urine retention 3. Subnormal temperature 4. Decreased level of consciousness - ANS-2. Urine retention When is it most important for a female client to know that a fetus may be structurally damaged by the ingestion of drugs? 1. During early adolescence 2. Throughout the entire pregnancy 3. When she is planning to become pregnant 4. At the beginning of the first trimester - ANS-3. When she is planning to become pregnant A client at 35 weeks' gestation calls the prenatal clinic, concerned that she has "not felt the baby move as much as usual." The most appropriate recommendation by the nurse is to have the client call the clinic with the results after she has: 1. Drunk a glass of orange juice and timed 10 fetal movements 2. Sat in a tub filled with warm water and then timed 30 fetal movements 3. Taken a nap and counted the number of fetal movements for 20 minutes...

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