A client asks a nurse about breastfeeding, and the nurse discusses the topic with her.
Which statement by the client indicates she needs further instruction?

“A breastfed baby is likely to gain weight more rapidly in the first month of life.”.

“I will still need birth control while I breastfeed to avoid pregnancy.”.

“A breastfed baby is less likely to develop allergies.”.

“I will need to increase the amount of fluid I drink while I breastfeed.”.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. A breastfed baby is likely to gain weight more rapidly in the first month of life. This statement is wrong because breastfed babies generally gain weight faster than formula-fed babies for the first 3 months of life. They also double their birth weight by 3-4 months and triple it by one year.

Therefore, a breastfed baby’s weight gain in the first month of life is not unusual or concerning.

Choice B is correct because breastfeeding is not a reliable method of birth control. A woman can still ovulate and become pregnant while breastfeeding, especially if she feeds her baby less frequently or supplements with formula or solids.

Choice C is correct because breastfeeding has been shown to reduce the risk of allergies in babies. Breast milk contains antibodies and other immune factors that protect the baby from infections and allergic reactions.

Choice D is correct because breastfeeding mothers need to drink enough fluids to stay hydrated and produce enough milk. The recommended fluid intake for breastfeeding mothers is about 13 cups (3 liters) per day.

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Correct Answer is C

Explanation

This is because a normal fetal heart rate is between 110 and 160 beats per minute, and the range of 136 to 143 indicates that the fetus is well-oxygenated and not experiencing hypoxia or acidosis. The nurse should reassure the patient and explain that fetal movement may decrease during labor due to the pressure of the contractions on the uterus and the fetus.

Choice A is wrong because asking the patient about alcohol consumption is irrelevant and insensitive.

Alcohol can affect fetal development and growth, but it does not directly affect fetal movement or heart rate.

Choice B is wrong because bloody vaginal discharge, or bloody show, is a normal sign of cervical dilation and effacement during labor.

It does not indicate fetal distress or placental abruption.

Choice D is wrong because explaining the relationship between anxiety and fetal movement does not address the patient’s concern or provide any factual information.

Anxiety can affect maternal perception of fetal movement, but it does not cause fetal movement to decrease.

The nurse should validate the patient’s feelings and provide factual reassurance.

A. “I weighed less than 5 lb (2,268 gm) at birth.”. B. “I had an ectopic pregnancy one year ago.”. C. “I have a mitral valve prolapse.”. D. “My husband, the infant’s father, is 42 years old.”.

Correct Answer is A

Explanation

The correct answer is choice A. A patient who weighed less than 5 lb (2,268 gm) at birth is at risk for having an infant with intrauterine growth retardation (IUGR).This is because low birth weight is a possible indicator of genetic factors or placental insufficiency that can affect fetal growth.

Choice B is wrong because an ectopic pregnancy one year ago does not increase the risk of IUGR.An ectopic pregnancy is when the fertilized egg implants outside the uterus, usually in the fallopian tube.It does not affect the placental function or fetal development in a subsequent pregnancy.

Choice C is wrong because a mitral valve prolapse does not increase the risk of IUGR.

A mitral valve prolapse is when the valve between the left atrium and left ventricle of the heart does not close properly.It usually does not cause any symptoms or complications during pregnancy, unless it is associated with severe regurgitation or arrhythmias.

Choice D is wrong because the father’s age of 42 years old does not increase the risk of IUGR.The father’s age may affect the risk of chromosomal abnormalities or congenital anomalies in the fetus, but not the fetal growth.

Some of the other risk factors for IUGR include maternal smoking, alcohol, or drug use, medical conditions like anemia or lupus, infections such as rubella or syphilis, carrying twins or multiples, high blood pressure, gestational diabetes, and placenta problems.

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A client asks a nurse about breastfeeding, and the nurse discusses the topic with her. Which statement by the client indicates she needs further instruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who is 42 weeks pregnant is admitted to the hospital in active labor.The patient is upset and says to the nurse, "I haven't felt the baby move for about three or four hours." The fetal heart rate is ranging between 136 and 143. Which action should the nurse take?

Correct Answer is C

Explanation

A patient who is 17 weeks pregnant shares several pieces of information with the nurse. Which statement made by the patient would indicate the patient is at risk for having an infant with intrauterine growth retardation (IUGR)?

Correct Answer is A

Explanation

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A nurse is caring for a newborn with a gestational age of 42 weeks. Which finding would the nurse expect during the assessment of this newborn?

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A client who is 22 weeks pregnant with a twin gestation comes to the clinic. The nurse instructs the client in self-care for the third trimester of pregnancy. Which statement made by the client would indicate the need for further teaching?

A client asks a nurse about breastfeeding, and the nurse discusses the topic with her.
Which statement by the client indicates she needs further instruction?