Choice A rationale

Evaluating the fetal heart rate does not address maternal symptoms of supine hypotensive syndrome. Moving the client first corrects the underlying issue. Fetal evaluation can follow once maternal circulation improves, ensuring both are assessed.

Choice B rationale

Checking recent food and fluid intake does not immediately address the likely cause of supine hypotensive syndrome. Correcting maternal positioning is urgent to improve venous return and prevent adverse effects, then other assessments can follow.

Choice C rationale

Measuring blood pressure and pulse can confirm hypotension but does not address its cause. Immediate repositioning to lateral position alleviates the compression on the inferior vena cava, improving blood flow before measuring vitals.

Choice D rationale

Turning to a lateral position relieves the vena cava from compression by the gravid uterus, reducing symptoms of supine hypotensive syndrome. This action improves venous return, stabilizing maternal hemodynamics and alleviating dizziness and pallor.

The correct sequence of maternal changes from first to last is:

1. Amenorrhea (A) – This is usually the first sign of pregnancy, occurring due to increased progesterone levels and the absence of a menstrual period.
2. Goodell’s sign (B) – This refers to the softening of the cervix, which typically occurs around 6-8 weeks of pregnancy due to increased vascularization.
3. Quickening (C) – This is the first perception of fetal movement by the mother, usually felt between 16-20 weeks of pregnancy.
4. Lightening (D) – This occurs late in pregnancy (around 37-40 weeks) when the fetus descends into the pelvis in preparation for birth.

So, the correct order is:
A → B → C → D.

Choice A rationale

Fasting for 8 hours before the AFP test is not required. This misinformation might cause unnecessary patient anxiety. Understanding test protocols helps in providing accurate and reassuring patient education, reducing pre-test stress.

Choice B rationale

AFP test is a screening tool to identify potential anomalies such as neural tube defects or chromosomal abnormalities. It does not provide a definitive diagnosis but indicates if further diagnostic testing is warranted for confirming anomalies.

Choice C rationale

Absence of chronic illnesses does not guarantee normal AFP test results. This statement is misleading, as AFP levels can be affected by a variety of factors, including gestational age and fetal conditions, requiring comprehensive analysis.

Choice D rationale

Bed rest is not necessary after an AFP test. This misinformation may cause unnecessary concern or inconvenience for the patient. Proper understanding of post-test care helps in providing correct patient instructions and alleviating fears.

Choice A rationale

The type of contraceptive used is not directly relevant for a hysterosalpingogram test. The test focuses on the structure and patency of the uterine cavity and fallopian tubes, not contraceptive history.

Choice B rationale

While the number of past pregnancies might be clinically relevant, it does not directly impact the hysterosalpingogram procedure. This test is typically used to evaluate tubal patency and uterine abnormalities regardless of pregnancy history.

Choice C rationale

The patient's age of menarche is not pertinent to a hysterosalpingogram test. Menarche age relates more to puberty and menstrual cycle history, which are not focal points of this imaging procedure.

Choice D rationale

Iodine allergy is crucial to identify before a hysterosalpingogram, as the procedure often involves the use of an iodine-based contrast dye. Identifying allergies helps prevent potential allergic reactions to the dye.

Choice A rationale

Ballottement refers to the movement of the fetus felt by the provider when pushing on the cervix, causing the fetus to rise and then return to its original position. This is a probable sign of pregnancy.

Choice B rationale

Goodell’s sign refers to the softening of the cervix, which occurs due to increased vascularization during pregnancy. It is not related to the movement of the fetus felt by the provider.

Choice C rationale

Lightening refers to the sensation of the fetus moving down into the pelvis, usually occurring in the later stages of pregnancy. It is not related to the specific movement of the fetus felt by the provider.

Choice D rationale

Chadwick’s sign is the bluish discoloration of the cervix, vagina, and labia due to increased blood flow during pregnancy. It is not associated with the movement of the fetus felt by the provider.

Choice A rationale

Frequent urination is common in early pregnancy due to hormonal changes and increased blood flow to the pelvic area. It is not typically a sign of an urgent complication requiring immediate attention.

Choice B rationale

Menstrual-like cramps at 25 weeks gestation could indicate preterm labor, which is a potential emergency. Prompt evaluation is necessary to ensure the health and safety of both the mother and the fetus.

Choice C rationale

Leg cramps while reclining are common in later stages of pregnancy due to changes in circulation and increased pressure on the veins. They are usually not a sign of an urgent complication.

Choice D rationale

A reddened, pruritic lower abdominal rash could indicate a skin condition or allergic reaction, but it is generally not an urgent complication during pregnancy unless accompanied by other severe symptoms.

The correct answer is 0503.

Choice A rationale

Amniocentesis assesses fetal lung maturity, genetic disorders, and infections, not preeclampsia. Preeclampsia diagnosis involves blood pressure, proteinuria, and other lab tests. Normal blood pressure: <120/80 mm Hg. Proteinuria: >300 mg/day.

Choice B rationale

A non-stress test measures fetal heart rate response to movements, evaluating fetal well-being. Normal fetal heart rate: 110-160 bpm. Accelerations: 15 bpm increase for at least 15 seconds.

Choice C rationale

Chorionic villus sampling assesses chromosomal abnormalities, genetic disorders, not neural tube defects. Neural tube defect screening: maternal serum alpha-fetoprotein levels, ultrasound. Normal alpha-fetoprotein: 0.5-2.5 MoM.

Choice D rationale

A full bladder helps lift the uterus for better visualization during ultrasound, especially in early pregnancy. This improves image quality for assessing fetal development and other structures.

Choice E rationale

Oral glucose tolerance test assesses gestational diabetes by measuring blood glucose levels, not fetal activity. Normal fasting blood glucose: <95 mg/dL. 1-hour post-glucose: <180 mg/dL.

Choice A rationale

Avoiding fried and spicy foods can reduce nausea by preventing gastric irritation and reflux, common in pregnancy due to hormonal changes. Ginger, bland foods are better alternatives.

Choice B rationale

Lying down after eating may exacerbate nausea and acid reflux due to the relaxation of the lower esophageal sphincter caused by pregnancy hormones. Remain upright for at least 30 minutes.

Choice C rationale

Eating dry crackers before getting out of bed helps stabilize blood glucose levels, reducing morning sickness. This is effective due to hormonal fluctuations affecting digestion in pregnancy.

Choice D rationale

Avoiding overfilling the stomach prevents excessive distension, reducing pressure on the stomach and lower esophageal sphincter, thus minimizing nausea and reflux. Smaller, frequent meals are recommended.

Choice E rationale

This choice is invalid, as it does not directly correlate with recommended nausea management strategies in pregnancy. Focus on dietary adjustments and hydration instead.

Choice A rationale

High-protein, low-carbohydrate diets are not recommended during pregnancy as they can lead to ketone production, which may harm fetal development. A balanced diet is crucial for maternal and fetal health.

Choice B rationale

Although breastfeeding can help with postpartum weight loss, it is not advisable to use pregnancy as a reason to overeat. Healthy weight gain during pregnancy is essential for fetal development.

Choice C rationale

Gaining 1 lb (0.5 kg) per week is recommended during the second trimester for a client with a normal BMI to ensure proper fetal growth and development.

Choice D rationale

Exercise is beneficial, but it cannot prevent all weight gain during pregnancy. Appropriate weight gain is necessary for fetal health and development.