A nurse is assisting in obtaining the fundal height measurement for a client who is at 32 weeks of gestation. Which of the following images indicates where the nurse should expect the client's fundus to be located?
The fundal height corresponds with approximately 16 weeks.
The fundal height corresponds with approximately 20 weeks.
The fundal height corresponds with approximately 32 weeks.
The fundal height corresponds with approximately 24 weeks.
The Correct Answer is C
A) Incorrect- the fundal height corresponds with approximately 16 weeks. At around 16 weeks of gestation, the fundal height is usually located approximately at the midpoint between the symphysis pubis (pubic bone) and the belly button (umbilicus). This measurement corresponds to the anatomical level of the uterus at this stage.
B) Incorrect- the fundal height corresponds with approximately 20 weeks. By 20 weeks of gestation, the fundus has typically reached the level of the umbilicus. The fundal height measurement is around the same level as the belly button.
C) Correct- the fundal height corresponds with approximately 32 weeks. Around 32 weeks of gestation, the fundal height has increased significantly compared to earlier stages of pregnancy. The fundus of the uterus is located above the belly button, and the measurement is typically about 32 centimeters (or roughly 12.6 inches) above the symphysis pubis.
D) Incorrect- the fundal height corresponds with approximately 24 weeks. Around 24 weeks of gestation, the fundal height is usually about 1 to 2 fingerbreadths above the
umbilicus. This represents the ongoing upward growth of the uterus as the pregnancy progresses.
E) Incorrect- the fundal height corresponds with approximately 18 weeks. At around 18 weeks of pregnancy, the fundal height is typically located just above the pubic bone, below the belly button (umbilicus). The fundus of the uterus is still relatively low in the abdomen at this point. The fundal height measurement at 18 weeks is usually around the midpoint between the symphysis pubis (pubic bone) and the belly button.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
A) Incorrect- Hydrocortisone ointment is not typically recommended for treating mastitis, as it might not address the underlying infection.
B) Incorrect- Wearing a well-fitting, supportive nursing bra can actually help alleviate discomfort and is not typically contraindicated in cases of mastitis.
C) Correct - Applying warm compresses to the affected breast can help reduce pain and discomfort associated with mastitis. Warmth can improve blood flow and promote milk flow.
D) Incorrect- Encouraging the client to limit oral fluid intake to decrease milk production is not a recommended approach, as maintaining proper hydration is important, especially when dealing with infection.
Correct Answer is A
Explanation
A) Correct - Reporting crackles is important because they can indicate fluid retention in the lungs, which can be a serious adverse effect of terbutaline.
B) Incorrect- Dizziness is a common side effect of terbutaline and might not warrant immediate reporting unless severe.
C) Incorrect- Nausea is a common side effect of terbutaline and might not warrant immediate reporting unless severe.
D) Incorrect- Tremors are a common side effect of terbutaline and might not warrant immediate reporting unless severe.
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