Ati Maternal Newborn Midterm
Total Questions : 72
Showing 25 questions, Sign in for moreThe nurse is counseling a woman who wants to become pregnant. The woman tells the nurse that she has a 28-day menstrual cycle and the first day of her menstrual period was January 8. The nurse correctly calculates that the woman's next fertile period is?
Explanation
Choice A reason: February 6-7 is incorrect. This is too late for the woman's fertile period, which occurs around the time of ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle¹.
Choice B reason: January 22-23 is incorrect. This is too close to the woman's next period, which is expected to start around February 5 for a 28-day cycle. The chances of getting pregnant are very low at this time, as the egg only survives for about 24 hours after ovulation¹.
Choice C reason: January 30-31 is incorrect. This is after the woman's fertile period, which ends about a day after ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle¹.
Choice D reason: January 14-15 is correct. This is within the woman's fertile period, which begins about 5 days before ovulation and ends about a day after ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle¹. Sperm can survive in the female reproductive tract for up to 5 days, so having sex during this time can increase the chance of conception¹.
The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on February 13th. Which date is most accurate?
Explanation
Choice A reason:
Nagele's rule for calculating the estimated date of confinement (EDC) involves subtracting 3 months from the first day of the last menstrual period and adding 7 days. For February 13th, subtracting 3 months gives us November 13th, and adding 7 days gives us November 20th. This is the most accurate calculation for the estimated date of confinement.
Choice B reason:
This choice is not accurate according to Nagele's rule. Adding 7 days to November 13th would give November 20th, not November 27th.
Choice C reason:
This choice is not accurate according to Nagele's rule. Adding 7 days to November 13th would give November 20th, not November 21st.
Choice D reason:
This choice is not accurate according to Nagele's rule. Subtracting 3 months from February 13th would give November 13th, not November 14th.
A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicated that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record?
Explanation
Choice A reason: This is incorrect because it overestimates the number of pregnancies (G) and preterm births (P). The client has had three pregnancies, not four, and two preterm births, not three.
Choice B reason: This is incorrect because it underestimates the number of preterm births (P). The client has had two preterm births, not one.
Choice C reason: This is incorrect because it overestimates the number of abortions (A) and underestimates the number of living children (L). The client has had no abortions, not one, and three living children, not two.
Choice D reason: This is correct because it accurately reflects the client's childbearing history. GTPAL stands for Gravida, Term, Preterm, Abortions, and Living. The client has had three pregnancies (G), one term birth (T), two preterm births (P), no abortions (A), and three living children (L).
During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic patient with limited English proficiency. It is important for the nurse to:
Explanation
Choice A reason: This is incorrect because providing the patient with handouts is not enough to ensure effective communication. The handouts may not be in the patient's preferred language or may use unfamiliar words or concepts. The nurse should also use other methods, such as interpreters, translators, or visual aids, to convey information to the patient.
Choice B reason: This is incorrect because speaking quickly and efficiently may hinder the patient's comprehension and increase the risk of misunderstanding. The nurse should speak slowly and clearly, using simple and common words, and allow time for the patient to ask questions or clarify information.
Choice C reason: This is correct because assessing whether the patient understands the discussion is essential for effective communication and patient education. The nurse should use techniques such as teach-back, ask-me-3, or show-me to verify the patient's understanding and address any gaps or misconceptions.
Choice D reason: This is incorrect because using maternity jargon may confuse the patient and create barriers to communication. The nurse should avoid using medical terms, abbreviations, or slang that the patient may not be familiar with. The nurse should explain any necessary terms in plain language and use examples or analogies to illustrate them.
A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to:
Explanation
Choice A reason: This is incorrect because primary dysmenorrhea is menstrual pain that is not associated with any underlying condition. It usually begins with the onset of menstruation and lasts for a few days. It does not cause pain during intercourse or infertility.
Choice B reason: This is correct because endometriosis is a condition where the endometrial tissue that normally lines the uterus grows outside the uterus, such as on the ovaries, fallopian tubes, or pelvic organs. It causes chronic inflammation, scarring, and adhesions that can result in severe pain during menstruation and intercourse, as well as infertility.
Choice C reason: This is incorrect because secondary dysmenorrhea is menstrual pain that is caused by an underlying condition, such as fibroids, pelvic inflammatory disease, or adenomyosis. It usually develops later in life and lasts longer than primary dysmenorrhea. It may or may not cause pain during intercourse or infertility, depending on the condition.
Choice D reason: This is incorrect because PMS stands for premenstrual syndrome, which is a group of physical and emotional symptoms that occur before menstruation. It may include mood swings, irritability, bloating, headaches, or breast tenderness. It does not cause severe pain during menstruation or intercourse, or infertility.
Care management of a woman diagnosed with acute pelvic inflammatory disease (PID) most likely would include:
Explanation
Choice A reason: This is incorrect because oral antiviral therapy is not effective for PID, which is caused by bacterial infection. Antiviral therapy is used for viral infections, such as herpes or HIV.
Choice B reason: This is incorrect because antibiotics only until symptoms subside is not sufficient for PID, which can cause serious complications, such as infertility, ectopic pregnancy, or chronic pelvic pain. Antibiotics should be continued for the full course of treatment, usually 14 days, to ensure complete eradication of the infection.
Choice C reason: This is incorrect because frequent pelvic examination to monitor the progress of healing is not recommended for PID, which can cause inflammation and irritation of the pelvic organs. Pelvic examination should be avoided or minimized to prevent further trauma or spread of the infection.
Choice D reason: This is correct because bed rest in a semi-Fowler position is beneficial for PID, which can cause fluid accumulation and pressure in the pelvic cavity. Bed rest helps to reduce inflammation and pain, while semi-Fowler position helps to drain the fluid and prevent abscess formation.
What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?
Explanation
Choice A reason: This is incorrect because venipuncture for blood work should be avoided on the affected arm. The mastectomy may have involved the removal of lymph nodes, which can impair the lymphatic drainage and increase the risk of lymphedema (swelling) in the arm. Venipuncture can cause further damage or infection to the arm.
Choice B reason: This is correct because the BP cuff should not be applied to the affected arm. The BP cuff can exert pressure on the arm and interfere with the blood and lymph flow. This can also increase the risk of lymphedema or pain in the arm.
Choice C reason: This is incorrect because the affected arm should not be held down close to the woman's side. The woman should be encouraged to elevate the arm above the level of the heart and perform gentle exercises to promote circulation and prevent stiffness. The arm should not be immobilized or restricted.
Choice D reason: This is incorrect because the affected arm should not be used for IV therapy. IV therapy can introduce fluids or medications into the arm that can affect the blood and lymph flow. It can also cause irritation or infection to the arm.
In vitro fertilization-embryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or unexplained infertility and for men with very low sperm counts. A husband and wife have arrived for their preprocedural interview. The husband asks the nurse to explain what the procedure entails. The nurse's most appropriate response is:
Explanation
hoice A reason: This is incorrect because a donor embryo is not used in IVF-ET. A donor embryo is an embryo that was created from another couple's gametes and donated to an infertile couple. IVF-ET uses the couple's own gametes to create an embryo.
Choice B reason: This is incorrect because it is dismissive and unprofessional. The nurse should respect the husband's curiosity and provide accurate and clear information about the procedure. The nurse should also address any concerns or questions that the couple may have.
Choice C reason: This is correct because it is a concise and accurate description of the IVF-ET procedure. The nurse explains the main steps and the purpose of the procedure in simple terms.
Choice D reason: This is incorrect because donor sperm is not used in IVF-ET. Donor sperm is sperm that was obtained from another man and donated to an infertile couple. IVF-ET uses the husband's own sperm to fertilize the wife's eggs.
A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have
Explanation
Choice A reason: Chadwick's sign is a bluish discoloration of the cervix, vagina, and vulva that occurs around the sixth week of pregnancy. It is a probable sign of pregnancy, not a presumptive sign.
Choice B reason: Hegar's sign is a softening of the lower uterine segment that occurs around the sixth week of pregnancy. It is also a probable sign of pregnancy, not a presumptive sign.
Choice C reason: A positive pregnancy test is a presumptive sign of pregnancy, as it indicates the presence of human chorionic gonadotropin (hCG) in the urine or blood. However, it is not a definitive sign, as other conditions can cause elevated hCG levels.
Choice D reason: Amenorrhea is the absence of menstrual periods, which is a common presumptive sign of pregnancy. However, it is not a reliable sign, as other factors can cause amenorrhea, such as stress, illness, or hormonal imbalance.
The maternity nurse understands that vascular volume increases 40% to 45% during pregnancy to:
Explanation
Choice A reason: Vascular volume increases during pregnancy to meet the increased oxygen and nutrient demands of the fetus, not to compensate for decreased renal plasma flow. In fact, renal plasma flow increases by 50% to 80% during pregnancy to facilitate the excretion of metabolic wastes.
Choice B reason: Vascular volume increases during pregnancy to ensure adequate blood supply to the uterus and other organs, not to prevent maternal and fetal dehydration. Dehydration can occur due to vomiting, diarrhea, or inadequate fluid intake, and it can be prevented by drinking enough fluids and replacing electrolytes.
Choice C reason: Vascular volume increases during pregnancy to provide adequate perfusion of the placenta, which is the main organ of gas exchange and nutrient delivery for the fetus. The placenta receives about 10% of the maternal cardiac output at term.
Choice D reason: Vascular volume increases during pregnancy to support the growth and development of the fetus and the maternal tissues, not to eliminate metabolic wastes of the mother. Metabolic wastes are eliminated by the kidneys, lungs, skin, and gastrointestinal tract.
Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI) include: (Select all that apply.)
Explanation
Choice A reason: Abstinence is the avoidance of sexual activity, which reduces the risk of exposure to STIs. It is not a sexual risk behavior.
Choice B reason: Multiple sex partners increases the likelihood of exposure to STIs, especially if the partners are not tested or treated. It is a sexual risk behavior.
Choice C reason: Unprotected anal intercourse exposes the mucous membranes of the rectum and anus to potential pathogens, which can cause STIs such as gonorrhea, chlamydia, syphilis, and HIV. It is a sexual risk behavior.
Choice D reason: Oral sex involves contact between the mouth and the genitals or anus, which can transmit STIs such as herpes, HPV, gonorrhea, and syphilis. It is a sexual risk behavior.
Choice E reason: Dry kissing is the contact between the lips without the exchange of saliva, which does not transmit STIs. It is not a sexual risk behavior.
The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:
Explanation
Choice A reason: Braxton Hicks contractions are irregular, painless uterine contractions that occur throughout pregnancy. They are a probable sign of pregnancy, not a positive sign.
Choice B reason: Fetal movement palpated by the nurse-midwife is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. It can be detected as early as 16 to 20 weeks of gestation.
Choice C reason: A positive pregnancy test is a probable sign of pregnancy, as it indicates the presence of human chorionic gonadotropin (hCG) in the urine or blood. However, it is not a definitive sign, as other conditions can cause elevated hCG levels.
Choice D reason: Quickening is the first perception of fetal movement by the mother, which usually occurs between 16 and 20 weeks of gestation. It is a presumptive sign of pregnancy, not a positive sign.
Signs and symptoms that a pregnant woman should report immediately to her health care provider include: (Select all that apply.)
Explanation
Choice A reason: Urinary frequency is a common symptom of pregnancy, especially in the first and third trimesters, due to the increased pressure of the uterus on the bladder. It is not a sign of complication and does not need to be reported immediately.
Choice B reason: Rupture of membranes is the breaking of the amniotic sac, which can occur spontaneously or artificially before or during labor. It is a sign of impending delivery and can increase the risk of infection. It should be reported immediately to the health care provider.
Choice C reason: Heartburn accompanied by severe headache can indicate preeclampsia, a serious condition characterized by high blood pressure and proteinuria in pregnancy. It can lead to eclampsia, which is a life-threatening seizure disorder. It should be reported immediately to the health care provider.
Choice D reason: Decreased libido is a normal change in pregnancy, due to hormonal fluctuations, physical discomfort, and emotional stress. It is not a sign of complication and does not need to be reported immediately.
Choice E reason: Vaginal bleeding can indicate various complications in pregnancy, such as placenta previa, placental abruption, or miscarriage. It can pose a threat to the mother and the fetus. It should be reported immediately to the health care provider.
The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:
Explanation
Choice A reason: Cramping is a common symptom of pregnancy, especially in the third trimester, due to the stretching of the ligaments and muscles that support the uterus. It is not a specific sign of abruptio placentae, which is the premature separation of the placenta from the uterine wall.
Choice B reason: Uterine activity is a normal phenomenon of pregnancy, as the uterus contracts and relaxes periodically. It is not a specific sign of abruptio placentae, which is associated with increased uterine tone and tenderness.
Choice C reason: Bleeding is a possible sign of both abruptio placentae and placenta previa, which is the implantation of the placenta over or near the cervical os. However, bleeding is more common and severe in placenta previa than in abruptio placentae, as the latter can have concealed hemorrhage.
Choice D reason: Intense abdominal pain is the most prevalent clinical manifestation of abruptio placentae, as the blood accumulates behind the placenta and causes pressure and irritation of the uterine nerves. It is a distinguishing sign from placenta previa, which is usually painless.
A pregnant woman's diet may not meet her need for folates. A good source of this nutrient is:
Explanation
Choice A reason: Cheese is a good source of calcium, protein, and vitamin B12, but not folates. Folate is a water-soluble vitamin that is essential for the synthesis of DNA and the prevention of neural tube defects in the fetus.
Choice B reason: Potatoes are a good source of carbohydrates, potassium, and vitamin C, but not folates. Folate is found mainly in plant-based foods, especially dark green vegetables.
Choice C reason: Chicken is a good source of protein, iron, and zinc, but not folates. Folate is more abundant in legumes, nuts, and seeds than in animal products.
Choice D reason: Green leafy vegetables are a good source of folates, as well as vitamin A, vitamin K, and fiber. Folate is also known as folic acid when it is added to fortified foods or supplements. Pregnant women need at least 600 micrograms of folate per day
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on the knowledge that:
Explanation
Choice A reason: She will not be unable to conceive in the future, as ectopic pregnancy does not necessarily affect her fertility. However, she may have a higher risk of having another ectopic pregnancy or infertility if the fallopian tube is damaged or removed.
Choice B reason: A D&C (dilation and curettage) will not be performed to remove the products of conception, as this procedure is used to empty the uterus, not the fallopian tube. The treatment for ectopic pregnancy may include medication, surgery, or expectant management, depending on the location, size, and viability of the pregnancy.
Choice C reason: Bed rest and analgesics are not the recommended treatment for ectopic pregnancy, as they do not address the underlying cause or prevent complications. Ectopic pregnancy is a medical emergency that requires prompt intervention to prevent rupture, bleeding, and shock.
Choice D reason: Hemorrhage is the major concern for ectopic pregnancy, as the pregnancy can rupture the fallopian tube and cause severe bleeding into the abdominal cavity. This can lead to hypovolemic shock, which is a life-threatening condition.
Which pregnant woman should restrict her weight gain during pregnancy?
Explanation
Choice A reason: Woman shorter than 62 inches or 157 cm should not restrict her weight gain during pregnancy, as she may have a higher risk of delivering a low birth weight infant. She should follow the recommended weight gain guidelines based on her pre-pregnancy body mass index (BMI).
Choice B reason: Woman in early adolescence should not restrict her weight gain during pregnancy, as she is still growing and developing herself. She may need more calories and nutrients than an adult woman to support her own health and the fetal growth.
Choice C reason: Woman who was 30 lbs overweight before pregnancy should restrict her weight gain during pregnancy, as she may have a higher risk of developing gestational diabetes, hypertension, or preeclampsia. She should aim for a lower weight gain range than a woman with a normal BMI.
Choice D reason: Woman pregnant with twins should not restrict her weight gain during pregnancy, as she needs more energy and nutrients to support the growth of two fetuses. She should aim for a higher weight gain range than a woman with a singleton pregnancy.
The most common cause of decreased variability in the fetal heart rate (FHR) that lasts 30 minutes or less is:
Explanation
Choice A reason: Fetal sleep cycles are a normal physiological cause of decreased variability in the FHR, which is the fluctuation of the baseline FHR above and below 2 cycles per minute. Fetal sleep cycles usually last 20 to 40 minutes and do not affect the fetal well-being.
Choice B reason: Umbilical cord compression is an abnormal cause of decreased variability in the FHR, as it reduces the blood flow and oxygen delivery to the fetus. It can also cause variable decelerations, which are abrupt decreases in the FHR below the baseline.
Choice C reason: Altered cerebral blood flow is an abnormal cause of decreased variability in the FHR, as it indicates a compromise in the fetal central nervous system. It can also cause late decelerations, which are gradual decreases in the FHR after the peak of a contraction.
Choice D reason: Fetal hypoxemia is an abnormal cause of decreased variability in the FHR, as it reflects a severe lack of oxygen in the fetal blood. It can also cause sinusoidal pattern, which is a smooth, undulating waveform in the FHR.
A pregnant woman's biophysical profile score is 8. She asks the nurse to explain the results. The nurse's best response is:
Explanation
Choice A reason: Further testing will not be performed to determine the meaning of this score, as the biophysical profile score is a reliable indicator of fetal well-being. It is a combination of five parameters: fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and fetal heart rate. Each parameter is scored as 0 (abnormal) or 2 (normal), and the total score ranges from 0 to 10.
Choice B reason: The test results are within normal limits, as a biophysical profile score of 8 or higher indicates a healthy fetus with a low risk of hypoxia or acidosis. It also suggests that the placenta is functioning adequately and the pregnancy can continue safely.
Choice C reason: An obstetric specialist will not evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery, as the biophysical profile score is interpreted by the nurse or the health care provider who performed the test. It is not a diagnostic test that requires a consultation with a specialist.
Choice D reason: Immediate delivery by cesarean birth is not being considered, as the biophysical profile score of 8 does not indicate any fetal distress or complication that would warrant an urgent intervention. Cesarean birth may be indicated for other reasons, such as malpresentation, placenta previa, or failure to progress in labor.
Compared with contraction stress test (CST), nonstress test (NST) for antepartum fetal assessment:
Explanation
Choice A reason: The NST has no known contraindications, as it is a noninvasive and safe test that does not stimulate uterine contractions or cause fetal distress. It is the most widely used method of antepartum fetal surveillance.
Choice B reason: The NST is not slightly more expensive than the CST, as it requires less time and equipment. The NST usually takes 20 to 40 minutes, while the CST may take up to 2 hours. The NST only needs a fetal monitor, while the CST also needs an intravenous line and oxytocin infusion.
Choice C reason: The NST does not have fewer false-positive results than the CST, as it has a higher rate of nonreactive results that may indicate fetal compromise when there is none. A nonreactive NST is one that does not show at least two accelerations of the fetal heart rate of 15 beats per minute or more lasting 15 seconds or more in a 20-minute period.
Choice D reason: The NST is not more sensitive in detecting fetal compromise than the CST, as it has a lower predictive value for fetal well-being. A reactive NST is one that shows at least two accelerations of the fetal heart rate of 15 beats per minute or more lasting 15 seconds or more in a 20-minute period. However, a reactive NST does not rule out the possibility of fetal hypoxia or acidosis.
Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?
Explanation
Choice A reason: Biophysical profile is a test that assesses the fetal well-being by measuring five parameters: fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and fetal heart rate. It does not predict chromosomal abnormalities in the fetus.
Choice B reason: Lecithin/sphingomyelin [L/S] ratio is a test that measures the amount of two phospholipids in the amniotic fluid. It is used to evaluate the fetal lung maturity and the risk of respiratory distress syndrome. It does not predict chromosomal abnormalities in the fetus.
Choice C reason: Type and crossmatch of maternal and fetal serum is a test that determines the blood type and Rh factor of the mother and the fetus. It is used to identify the risk of hemolytic disease of the newborn due to Rh incompatibility. It does not predict chromosomal abnormalities in the fetus.
Choice D reason: Multiple-marker screening is a test that measures the levels of four substances in the maternal serum: alpha-fetoprotein, human chorionic gonadotropin, unconjugated estriol, and inhibin A. It is used to estimate the risk of Down syndrome, trisomy 18, and neural tube defects in the fetus.
Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for:
Explanation
Choice A reason: Low birth weight is not a common complication of GDM, as the fetus tends to grow larger than normal due to the excess glucose and insulin in the blood. Low birth weight is more likely to occur in infants of mothers with preexisting diabetes or other conditions that affect placental function.
Choice B reason: Preterm birth is a possible complication of GDM, as the increased fetal size and the risk of maternal hypertension or infection may induce labor before term. However, it is not the greatest risk for the fetus, as preterm infants can survive with proper care and treatment.
Choice C reason: Macrosomia is the greatest risk for the fetus of a mother with GDM, as it is defined as a birth weight of more than 4000 g or 8 lb 13 oz. Macrosomia can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, or cesarean birth. It can also increase the risk of neonatal hypoglycemia, jaundice, or respiratory distress.
Choice D reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester of pregnancy, before GDM is diagnosed or develops. Congenital anomalies are more likely to occur in infants of mothers with preexisting diabetes or other genetic or environmental factors.
Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?
Explanation
Choice A reason: Hypoinsulinemia is not a major neonatal complication of the infant of a diabetic mother. It is a condition of low insulin levels in the blood, which can cause hyperglycemia.
Choice B reason: Hypercalcemia is not a major neonatal complication of the infant of a diabetic mother. It is a condition of high calcium levels in the blood, which can cause muscle weakness, confusion, and kidney stones.
Choice C reason: Hypobilirubinemia is not a major neonatal complication of the infant of a diabetic mother. It is a condition of low bilirubin levels in the blood, which can cause pale skin and eyes.
Choice D reason: Hypoglycemia is a major neonatal complication of the infant of a diabetic mother. It is a condition of low blood sugar levels, which can cause seizures, lethargy, and brain damage.
Choice E reason: None of the above is not a correct answer. There is one major neonatal complication of the infant of a diabetic mother, which is hypoglycemia.
A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure?
Explanation
Choice A reason: Amniocentesis for fetal lung maturity is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid, which can be used to assess the fetal lung development. It is usually done in late pregnancy or preterm labor, not in the second trimester.
Choice B reason: Contraction stress test (CST) is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that involves stimulating uterine contractions, either by nipple stimulation or oxytocin infusion, to evaluate the fetal heart rate response. It is used to assess fetal well-being and placental function, not to diagnose the cause of bleeding.
Choice C reason: Internal fetal monitoring is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a method of measuring the fetal heart rate and uterine contractions using electrodes or catheters that are inserted through the cervix and attached to the fetal scalp or the amniotic sac. It is usually done during labor, not in the second trimester.
Choice D reason: Ultrasound for placental location is an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that uses sound waves to create an image of the uterus, the placenta, and the fetus. It can help to determine the position and attachment of the placenta, which can be the cause of bleeding if it is low-lying or covering the cervix (placenta previa).
Choice E reason: None of the above is not a correct answer. There is one expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding, which is ultrasound for placental location.
A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman: (Select the one most appropriate answer).
Explanation
Choice A reason: Eating five small meals daily can help reduce heartburn in pregnancy by preventing overeating and reducing the pressure on the stomach from the growing uterus. It can also help maintain a steady blood glucose level and prevent nausea and vomiting.
Choice B reason: Lying down after each meal can worsen heartburn in pregnancy by allowing the stomach acid to reflux into the esophagus. It can also cause breathing difficulties and increase the risk of aspiration. The woman should avoid lying down for at least two hours after eating and elevate her head and chest when sleeping.
Choice C reason: Reducing the amount of fiber she consumes can cause constipation and hemorrhoids in pregnancy, which can increase the discomfort and pain. Fiber is important for maintaining a healthy digestive system and preventing gestational diabetes and preeclampsia. The woman should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, beans, and nuts.
Choice D reason: Substituting other calcium sources for milk in her diet can deprive the woman and the baby of essential nutrients, such as protein, vitamin D, and riboflavin. Milk is not a common cause of heartburn in pregnancy, unless the woman is lactose intolerant or allergic to dairy products. The woman should consume at least three servings of dairy products per day or take calcium supplements as prescribed.
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