Question

A nurse in a prenatal clinic is reinforcing teaching with a client about expected physiological changes during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

Answer 1

Correct Answers:

"l may develop discoloration on my cheeks from hormonal changes.

Rationale :

🔷 Hyperpigmentation such as melasma (the "mask of pregnancy") is a normal, hormone-induced change during pregnancy.

🔷 It often presents as brownish patches over the cheeks, forehead, and upper lip due to increased melanocyte-stimulating hormone.

🔷 This is not a sign of infection but rather a benign and expected finding in many pregnant clients.

🔷 The change often fades postpartum but can be exacerbated by sun exposure.

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Answer 2

Correct Answers:

Weight 98 kg (216 lb)

Rationale :

🔶 A body weight over 90 kg (198 lb) is a known contraindication to the use of the transdermal contraceptive patch because it may reduce hormonal absorption.

🔶 In individuals with increased adipose tissue, the effectiveness of the patch is diminished, increasing the risk of unintended pregnancy.

🔶 For example, a client weighing 216 lb may not achieve therapeutic estrogen-progestin levels consistently through transdermal application.

🔶 Alternative methods such as IUDs, injectables, or oral contraceptives should be considered for these clients to ensure reliable contraception.

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Answer 3

Correct Answers:

Suprapubic area

Rationale :

💠 At 12 weeks of gestation, the uterus is still a pelvic organ, and the fetus lies low in the abdomen.

💠 Fetal heart tones are best heard with a Doppler in the suprapubic region, just above the pubic bone.

💠 Attempting to locate the heartbeat higher on the abdomen at this gestational age would likely yield no results.

💠 For instance, auscultating above the umbilicus would be appropriate around 20 weeks, when the uterus reaches that level.

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Answer 4

Correct Answers:

Initiate fundal massage.

Rationale :

💎 A boggy uterus after birth suggests uterine atony, the leading cause of postpartum hemorrhage.

💎 The immediate intervention is to initiate firm, consistent fundal massage to stimulate uterine contraction.

💎 Delaying this action to administer medications or oxygen first can allow more blood loss.

💎 For example, a client bleeding heavily with a soft uterus should first receive manual massage, then possibly methylergonovine.

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Answer 5

Correct Answers:

"l will apply witch hazel pads after urination."

Rationale :

⬖ Witch hazel pads are used to relieve perineal discomfort and hemorrhoid pain postpartum.

⬖ They offer cooling, anti-inflammatory relief and can be applied after urination or cleansing.

⬖ For example, a client with painful hemorrhoids post-episiotomy would benefit from applying witch hazel for local soothing.

⬖ Heat packs and numbing sprays are also used, but witch hazel is a standard, evidence-based perineal care practice.

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Answer 6

Correct Answers:

"Progestin-only birth control pills are preferred for contraception during lactation."

Rationale :

⬗ Progestin-only pills (mini-pills) are recommended for lactating individuals because they do not reduce milk production.

⬗ Estrogen-containing contraceptives can decrease prolactin levels, thereby inhibiting milk supply.

⬗ For example, a breastfeeding mother who starts a combined oral contraceptive may experience a noticeable drop in milk volume.

⬗ The mini-pill must be taken at the same time every day to maintain effectiveness due to its short half-life.

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Answer 7

Correct Answers:

Eat a slice of dry toast before getting out of bed.

Rationale :

⬘ Nausea in the first trimester is linked to low blood sugar and hormonal changes, especially hCG surges.

⬘ Eating a slice of dry toast or crackers before rising helps stabilize blood glucose and calms the stomach.

⬘ Clients should avoid greasy or heavy foods in the morning, as they can worsen nausea.

⬘ For instance, a client who eats toast while still in bed may prevent emesis upon standing.

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Answer 8

Correct Answers:

Ketonuria

Rationale :

⬙ Hyperemesis gravidarum involves persistent vomiting, which leads to dehydration, starvation, and fat breakdown.

⬙ This metabolic shift results in ketone production, detected as ketonuria in urine analysis.

⬙ The presence of ketones indicates that the body is using fat stores for energy due to inadequate glucose intake.

⬙ A client with hyperemesis and ketonuria may require IV fluids and electrolyte replacement to stabilize.

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Answer 9

Correct Answers:

Assist the client to a lateral tilt position prior to the procedure.

Rationale :

◈ In late pregnancy, the weight of the uterus can compress the inferior vena cava, reducing venous return and causing supine hypotension.

◈ Placing the client in a lateral tilt position, typically with a wedge or pillow under the hip, helps maintain uteroplacental perfusion.

◈ For a nonstress test (NST), optimal fetal oxygenation and circulation are required for accurate results.

◈ This positioning prevents dizziness, nausea, or fetal bradycardia that can result from vena cava compression.

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Answer 10

Correct Answers:

Hypotonia

Rationale :

❖ Hypotonia, or reduced muscle tone, in a newborn is an abnormal finding that suggests possible neurologic or metabolic compromise.

❖ Unlike transient findings like acrocyanosis or molding, hypotonia often indicates central nervous system depression, infection, or hypoxia.

❖ For example, a newborn exposed to maternal medications or born with hypoglycemia may present with floppy extremities and weak reflexes.

❖ Immediate evaluation is necessary to determine the underlying cause and initiate appropriate interventions.

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QLexNursing

1 :
A nurse in a prenatal clinic is reinforcing teaching with a client about expected physiological changes during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

2 :
A nurse in a provider's office is collecting data from a client who is requesting a prescription for a transdermal contraceptive patch. The nurse should recognize which of the following client findings is a contraindication for this method of contraception.

3 :
A nurse is auscultating fetal heart tones with a Doppler device for a client who is at 12 weeks of gestation. Where should the nurse expect to auscultate the fetal heart tones?

4 :
A nurse is caring for a client who is postpartum. The client is experiencing excessive vaginal bleeding and has a boggy uterus. Which of the following actions should the nurse take first?

5 :
A nurse is reinforcing teaching about perineal care to a client who is 2 hr postpartum and has an episiotomy and hemorrhoids. Which of the following statements by the client indicates an understanding of the teaching?

6 :
A nurse is collecting data from a client at a 6-week postpartum checkup. The client tells the nurse, "I am breastfeeding and would like to use a birth control pill." Which of the following statements should the nurse make?

7 :
A nurse is reinforcing teaching with a client about how to minimize nausea in the first trimester of pregnancy. Which of the following instructions should the nurse give to the client?

8 :
A nurse is caring for a client who has hyperemesis gravidarum. The nurse should identify that the client is at risk for which of the following conditions?

9 :
A nurse is caring for a client who is at 34 weeks of gestation and is preparing to undergo a nonstress test. Which of the following actions should the nurse take?

10 :
A nurse is collecting data from a newborn who was born 2 hr ago. Which of the following findings should the nurse report to the provider?

QLexNursing

1 : A nurse in a prenatal clinic is reinforcing teaching with a client about expected physiological changes during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

2 : A nurse in a provider's office is collecting data from a client who is requesting a prescription for a transdermal contraceptive patch. The nurse should recognize which of the following client findings is a contraindication for this method of contraception.

3 : A nurse is auscultating fetal heart tones with a Doppler device for a client who is at 12 weeks of gestation. Where should the nurse expect to auscultate the fetal heart tones?

4 : A nurse is caring for a client who is postpartum. The client is experiencing excessive vaginal bleeding and has a boggy uterus. Which of the following actions should the nurse take first?

5 : A nurse is reinforcing teaching about perineal care to a client who is 2 hr postpartum and has an episiotomy and hemorrhoids. Which of the following statements by the client indicates an understanding of the teaching?

6 : A nurse is collecting data from a client at a 6-week postpartum checkup. The client tells the nurse, "I am breastfeeding and would like to use a birth control pill." Which of the following statements should the nurse make?

7 : A nurse is reinforcing teaching with a client about how to minimize nausea in the first trimester of pregnancy. Which of the following instructions should the nurse give to the client?

8 : A nurse is caring for a client who has hyperemesis gravidarum. The nurse should identify that the client is at risk for which of the following conditions?

9 : A nurse is caring for a client who is at 34 weeks of gestation and is preparing to undergo a nonstress test. Which of the following actions should the nurse take?

10 : A nurse is collecting data from a newborn who was born 2 hr ago. Which of the following findings should the nurse report to the provider?

1 :
A nurse in a prenatal clinic is reinforcing teaching with a client about expected physiological changes during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

2 :
A nurse in a provider's office is collecting data from a client who is requesting a prescription for a transdermal contraceptive patch. The nurse should recognize which of the following client findings is a contraindication for this method of contraception.

3 :
A nurse is auscultating fetal heart tones with a Doppler device for a client who is at 12 weeks of gestation. Where should the nurse expect to auscultate the fetal heart tones?

4 :
A nurse is caring for a client who is postpartum. The client is experiencing excessive vaginal bleeding and has a boggy uterus. Which of the following actions should the nurse take first?

5 :
A nurse is reinforcing teaching about perineal care to a client who is 2 hr postpartum and has an episiotomy and hemorrhoids. Which of the following statements by the client indicates an understanding of the teaching?

6 :
A nurse is collecting data from a client at a 6-week postpartum checkup. The client tells the nurse, "I am breastfeeding and would like to use a birth control pill." Which of the following statements should the nurse make?

7 :
A nurse is reinforcing teaching with a client about how to minimize nausea in the first trimester of pregnancy. Which of the following instructions should the nurse give to the client?

8 :
A nurse is caring for a client who has hyperemesis gravidarum. The nurse should identify that the client is at risk for which of the following conditions?

9 :
A nurse is caring for a client who is at 34 weeks of gestation and is preparing to undergo a nonstress test. Which of the following actions should the nurse take?

10 :
A nurse is collecting data from a newborn who was born 2 hr ago. Which of the following findings should the nurse report to the provider?