A nurse in a prenatal clinic is caring for a client who reports that her menstrual period is 2 weeks late. The client appears anxious and asks the nurse if she is pregnant. Which of the following responses should the nurse make?
"You can miss your period for several other reasons. Describe your typical menstrual cycle
"If you have been sexually active and haven't used protection it is likely that you are pregnant
"Let's check to see if you have any other signs of pregnancy. Have you noticed any abdominal enlargement yet?
"Because you have missed your period, you should try taking a home pregnancy test before you start worrying
The Correct Answer is A
Choice A Reason:
"You can miss your period for several other reasons. Describe your typical menstrual cycle." This response acknowledges that a missed period can result from various factors other than pregnancy, such as stress, changes in weight, hormonal fluctuations, or certain medical conditions. Understanding the client's typical menstrual cycle can help the nurse gather more information about potential reasons for the late period.
Choice B Reason:
"If you have been sexually active and haven't used protection, it is likely that you are pregnant. “This response assumes pregnancy without exploring other possibilities or the client's individual situation.
Choice C Reason:
"Let's check to see if you have any other signs of pregnancy. Have you noticed any abdominal enlargement yet?" While considering other signs of pregnancy is reasonable, focusing on abdominal enlargement may not be the most accurate early indicator, and it's essential to explore a broader range of symptoms.
Choice D Reason:
"Because you have missed your period, you should try taking a home pregnancy test before you start worrying. "While suggesting a home pregnancy test is reasonable, it may be more beneficial to gather additional information about the client's menstrual cycle and potential symptoms before jumping directly to a test.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
"I will get injections of the medication once daily until my labor stops." Terbutaline is typically administered as a subcutaneous injection or orally, but the frequency can vary. It is often given as needed or on a scheduled basis, depending on the healthcare provider's instructions. However, "once daily until labor stops" is not a typical approach.
Choice B Reason:
"My blood sugar may be low while I'm on this medication." While terbutaline can affect glucose metabolism, it is more commonly associated with hyperglycemia (high blood sugar) rather than hypoglycemia (low blood sugar).
Choice C Reason:
"I will have blood tests because my potassium might decrease." Terbutaline, a beta-2 adrenergic agonist, can potentially lead to hypokalemia (a decrease in potassium levels). Monitoring potassium levels through blood tests is important during terbutaline therapy.
Choice D Reason:
"My blood pressure may increase while I'm on this medication." Terbutaline is known to cause cardiovascular side effects, but an increase in blood pressure is not a common effect. It is more associated with tachycardia (increased heart rate) and potential hypotension. Monitoring blood pressure is still important, but an increase is less likely compared to other cardiovascular effects.
Correct Answer is C
Explanation
The correct answer is C.
A. Calcium: While calcium is important for bone health, it is not specifically increased during early pregnancy. Adequate calcium intake is important throughout pregnancy, but the focus on increased intake typically occurs later in pregnancy to support fetal bone development.
B. Vitamin E: Vitamin E is important for overall health, but there is not a specific emphasis on increasing vitamin E intake in the early stages of pregnancy. It is generally included as part of a balanced diet.
C. Iron: This is the correct answer. Iron needs increase during pregnancy to support the increased blood volume and prevent iron-deficiency anemia. Adequate iron is crucial for the transport of oxygen to the developing fetus.
D. Vitamin D: While vitamin D is important for bone health and immune function, its increase is not specific to the early stages of pregnancy. Adequate vitamin D intake is essential throughout pregnancy, but it is not singled out as needing a significant increase at 8 weeks of gestation.
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