Question

A woman in her third trimester reports heartburn. What nursing advice is most appropriate?

Answer 1

Correct Answers:

Avoid spicy foods and eat small meals.

Rationale :

💎 Heartburn in pregnancy occurs due to progesterone-induced relaxation of the lower esophageal sphincter and upward pressure from the enlarging uterus.

💎 Eating small, frequent meals reduces gastric distension, minimizing reflux episodes.

💎 Avoiding spicy, fatty, and acidic foods decreases gastric irritation and acid secretion.

💎 The nurse should also advise remaining upright for at least 30 minutes after meals to aid digestion and reduce reflux discomfort.

💎 Antacids safe in pregnancy (like calcium carbonate) may be used if symptoms persist under provider guidance.

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Answer 2

Correct Answers:

Category III - Abnormal, requires immediate intervention

Rationale :

🔷 Absent variability and recurrent late decelerations indicate fetal hypoxia or acidosis, requiring urgent intervention.

🔷 Category III fetal heart tracings are nonreassuring and associated with compromised oxygen exchange.

🔷 Immediate actions include repositioning the mother, stopping oxytocin, administering oxygen, and notifying the provider.

🔷 Continuous monitoring and preparation for possible emergency cesarean may be necessary to prevent fetal distress.

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Answer 3

Correct Answers:

G4 T1 P1 A1 L1

Rationale :

♦ Gravida 4 – She has been pregnant four times (including current pregnancy).

♦ Term 1 – One delivery at 41 weeks.

♦ Preterm 1 – One delivery at 36 weeks.

♦ Abortions 1 – One elective abortion at 10 weeks.

♦ Living 1 – Only the first child (boy) is living.

♦ This format helps assess maternal and fetal history accurately for risk evaluation.

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Answer 4

Correct Answers:

"Your fear and tension can slow labor by decreasing uterine contractions."

Rationale :

🔶 Anxiety increases catecholamine release (epinephrine and norepinephrine), which inhibits oxytocin and reduces uterine contractility.

🔶 This results in prolonged labor, increased pain perception, and maternal fatigue.

🔶 Emotional support, breathing techniques, and relaxation can promote effective contractions and labor progress.

🔶 The nurse should create a calm environment and use therapeutic communication to help the client relax.

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Answer 5

Correct Answers:

Perform a fundal massage and assess for bleeding

Rationale :

💠 A boggy uterus indicates uterine atony, the leading cause of postpartum hemorrhage.

💠 The first nursing action is to massage the fundus until it becomes firm, which stimulates uterine contraction.

💠 The nurse should then assess lochia (amount, color, clots) and vital signs for shock.

💠 If the uterus remains boggy, notify the provider and prepare for uterotonic medications like oxytocin or misoprostol.

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Answer 6

Correct Answers:

"Skin-to-skin helps the baby maintain body temperature and promotes bonding."

Rationale :

🔵 Skin-to-skin promotes thermoregulation, reducing the risk of cold stress.

🔵 It enhances oxytocin release, improving maternal-infant bonding and breastfeeding success.

🔵 The baby stabilizes heart rate, respiratory rate, and glucose levels through this contact.

🔵 This practice also fosters maternal confidence and early attachment.

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Answer 7

Correct Answers:

Assess for polyhydramnios or macrosomia

Rationale :

🟢 Fundal height normally correlates with gestational age ±2 cm. A 40 cm height at 36 weeks is excessively large.

🟢 Possible causes include polyhydramnios (excess amniotic fluid) or macrosomia (large fetus).

🟢 These conditions increase the risk of preterm labor and delivery complications.

🟢 The nurse should notify the provider and expect diagnostic testing such as ultrasound to assess fluid and fetal size.

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Answer 8

Correct Answers:

Accurately monitor the amount of fluid infused and the amount returning from the uterus

Rationale :

⚪ During amnioinfusion, monitoring input and output ensures uterine overdistension is avoided.

⚪ Overinfusion can cause uterine rupture or increased uterine tone, compromising fetal oxygenation.

⚪ The nurse must document infused vs. returned fluid and monitor FHR pattern improvements.

⚪ If output is less than input or the patient shows distress, the infusion should be stopped immediately.

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Answer 9

Correct Answers:

Gynecoid

Rationale :

🟣 The gynecoid pelvis has a round inlet and wide pelvic arch, ideal for vaginal delivery.

🟣 It allows proper fetal descent and rotation during labor.

🟣 Other types (android, anthropoid, platypelloid) are less favorable and may cause labor dystocia or operative delivery.

🟣 Most women have a gynecoid pelvis, which supports efficient labor progress.

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Answer 10

Correct Answers:

"Avoid cleaning the cat's litter box or wear gloves and wash hands thoroughly."

Rationale :

🔴 Toxoplasmosis is caused by Toxoplasma gondii found in cat feces, contaminated soil, or undercooked meat.

🔴 Infection during pregnancy can cause fetal brain and eye defects or miscarriage.

🔴 The nurse should instruct to avoid handling litter boxes, or if unavoidable, to wear gloves and wash hands carefully.

🔴 Also, advise to avoid undercooked meat and wash fruits/vegetables thoroughly.

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QLexNursing

1 :
A woman in her third trimester reports heartburn. What nursing advice is most appropriate?

2 :
Nurse is monitoring a laboring client. The fetal heart rate tracing shows absent variability and recurrent late decelerations. How should the nurse interpret this finding?

3 :
A client is now pregnant. Her obstetric history includes:
Delivered a boy at 41 weeks, living
Delivered a girl at 36 weeks, who died at birth
One elective abortion at 10 weeks
What is the client's GTPAL

4 :
On labor A laboring client is extremely anxious and tense. She reports fear about the labor process and is unable to relax between contractions. The nurse explains the effects of anxiety. Which statement by the nurse is most accurate?

5 :
A nurse is assessing a client 1 hour after a vaginal birth. The client's fundus feels soft and boggy. The nurse's priority action should be

6 :
A nurse is caring for a client immediately after a full-term vaginal birth. The newborn is healthy, vigorous, and crying. The nurse plans to place the baby skin-to-skin on the mother's chest. Which statement best explains the primary benefit of this intervention?

7 :
A client at 36 weeks has a fundal height of 40 cm. What is the priority nursing action?

8 :
A nurse is caring for a laboring client receiving an amnioinfusion to relieve variable decelerations. Which nursing action is most important during this procedure?

9 :
Which pelvic type is most favorable for vaginal delivery?

10 :
A pregnant client asks the nurse how to avoid toxoplasmosis during pregnancy. Which instruction should the nurse provide?

QLexNursing

1 : A woman in her third trimester reports heartburn. What nursing advice is most appropriate?

2 : Nurse is monitoring a laboring client. The fetal heart rate tracing shows absent variability and recurrent late decelerations. How should the nurse interpret this finding?

3 : A client is now pregnant. Her obstetric history includes:Delivered a boy at 41 weeks, livingDelivered a girl at 36 weeks, who died at birthOne elective abortion at 10 weeksWhat is the client's GTPAL

4 : On labor A laboring client is extremely anxious and tense. She reports fear about the labor process and is unable to relax between contractions. The nurse explains the effects of anxiety. Which statement by the nurse is most accurate?

5 : A nurse is assessing a client 1 hour after a vaginal birth. The client's fundus feels soft and boggy. The nurse's priority action should be

6 : A nurse is caring for a client immediately after a full-term vaginal birth. The newborn is healthy, vigorous, and crying. The nurse plans to place the baby skin-to-skin on the mother's chest. Which statement best explains the primary benefit of this intervention?

7 : A client at 36 weeks has a fundal height of 40 cm. What is the priority nursing action?

8 : A nurse is caring for a laboring client receiving an amnioinfusion to relieve variable decelerations. Which nursing action is most important during this procedure?

9 : Which pelvic type is most favorable for vaginal delivery?

10 : A pregnant client asks the nurse how to avoid toxoplasmosis during pregnancy. Which instruction should the nurse provide?

1 :
A woman in her third trimester reports heartburn. What nursing advice is most appropriate?

2 :
Nurse is monitoring a laboring client. The fetal heart rate tracing shows absent variability and recurrent late decelerations. How should the nurse interpret this finding?

3 :
A client is now pregnant. Her obstetric history includes:
Delivered a boy at 41 weeks, living
Delivered a girl at 36 weeks, who died at birth
One elective abortion at 10 weeks
What is the client's GTPAL

4 :
On labor A laboring client is extremely anxious and tense. She reports fear about the labor process and is unable to relax between contractions. The nurse explains the effects of anxiety. Which statement by the nurse is most accurate?

5 :
A nurse is assessing a client 1 hour after a vaginal birth. The client's fundus feels soft and boggy. The nurse's priority action should be

6 :
A nurse is caring for a client immediately after a full-term vaginal birth. The newborn is healthy, vigorous, and crying. The nurse plans to place the baby skin-to-skin on the mother's chest. Which statement best explains the primary benefit of this intervention?

7 :
A client at 36 weeks has a fundal height of 40 cm. What is the priority nursing action?

8 :
A nurse is caring for a laboring client receiving an amnioinfusion to relieve variable decelerations. Which nursing action is most important during this procedure?

9 :
Which pelvic type is most favorable for vaginal delivery?

10 :
A pregnant client asks the nurse how to avoid toxoplasmosis during pregnancy. Which instruction should the nurse provide?