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?

“I have begun to smooth cocoa butter on my belly.”.

“I am resting several times a day, lying on my left side.”.

“I have started to do nipple stimulation.”.

“I will drink at least eight glasses of water a day.”.

Answer and Explanation

The Correct Answer is C

The correct answer is choice C and explain why. Nipple stimulation can cause uterine contractions and increase the risk of preterm labor, especially in a twin gestation.

The client should avoid nipple stimulation until term or as instructed by the provider.

Choice A is wrong because cocoa butter can help moisturize the skin and prevent itching and dryness.

It does not prevent stretch marks, but it is not harmful.

Choice B is wrong because resting several times a day, lying on the left side, can improve blood flow to the uterus and reduce swelling in the lower extremities.

It is a recommended self-care measure for the third trimester of pregnancy.

Choice D is wrong because drinking at least eight glasses of water a day can prevent dehydration, constipation, and urinary tract infections.

It can also help regulate body temperature and amniotic fluid volume.

Normal ranges for twin gestation are similar to singleton gestation, except for fundal height and weight gain.

The fundal height should be measured in centimeters from the pubic symphysis to the top of the uterus.

It should be approximately equal to the number of weeks of gestation plus or minus 4 cm until 32 weeks, then it may plateau or decrease slightly.

The weight gain should be between 35 and 45 pounds for a normal-weight woman, 25 to 42 pounds for an overweight woman, and 15 to 25 pounds for an obese woman.

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Correct Answer is A

Explanation

The correct answer is choice A. The newborn’s nostrils flare slightly during respiration.This is a sign of respiratory distress in a newborn.

Flaring nostrils indicate that the newborn is working hard to breathe and may not be getting enough oxygen.

Choice B is wrong because the newborn’s hands and feet are blue and feel cool.This is a normal finding called acrocyanosis, which occurs due to immature peripheral circulation.

It usually resolves within 24 to 48 hours after birth.

Choice C is wrong because the newborn’s eyes move randomly when his head is turned to the side.This is a normal finding called nystagmus, which occurs due to immature eye muscles and coordination.

It usually disappears by 6 months of age.

Choice D is wrong because the newborn’s tongue thrusts forward when it is lightly touched.This is a normal finding called the extrusion reflex, which helps the newborn to suck and swallow.

It usually fades by 4 months of age.

A. Plan to remain flat in bed for six hours after the test. B. Expect some vaginal bleeding after the test. C. Empty your bladder prior to the test. D. Do not consume any solid foods for sixteen hours prior to the test.

Correct Answer is C

Explanation

The correct answer is choice C. Empty your bladder prior to the test.This is because a full bladder can interfere with the insertion of the needle and increase the risk of complications.Amniocentesis is a test that involves removing and testing a small sample of cells from amniotic fluid, the fluid that surrounds the baby in the womb.It is done to check for genetic or chromosomal conditions, such as Down’s syndrome, Edwards’ syndrome or Patau’s syndrome.

Choice A is wrong because there is no need to remain flat in bed for six hours after the test.You can resume your normal activities after a few hours of rest.

Choice B is wrong because vaginal bleeding is not a normal outcome of amniocentesis.If you experience any bleeding, leaking of fluid, fever or severe pain after the test, you should contact your doctor immediately.

Choice D is wrong because there is no restriction on eating before the test.You can have your normal meals and drinks before amniocentesis.

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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?

Nursing Test Bank

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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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?