A nurse is caring for a 16-year-old primigravida who is in the last month of an uncomplicated pregnancy.
Which measure is most appropriate to include in the patient’s plan of care?
Remind her that an increase in fetal activity will require an increase in her need to rest.
Explain to her that she is likely to have back labor.
Arrange for her to meet the staff who will be caring for her during labor and delivery.
Teach her how to test her urine for the presence of glucose.
The Correct Answer is C
The correct answer is choice C. Arrange for her to meet the staff who will be caring for her during labor and delivery. This measure can help reduce the anxiety and fear of the unknown that a primigravida may have in the last month of pregnancy. Meeting the staff can also help establish rapport and trust, which are essential for a positive birth experience.
Choice A is wrong because an increase in fetal activity does not necessarily require an increase in the need to rest.
Fetal activity is normal and expected, and the mother should monitor it regularly. Resting may help with some discomforts of pregnancy, but it is not directly related to fetal activity.
Choice B is wrong because back labor is not likely for a primigravida with an uncomplicated pregnancy.
Back labor occurs when the fetus is in an occiput posterior position, which puts pressure on the mother’s spine and causes intense pain in the lower back. This position is more common in multiparous women than primigravidas.
Choice D is wrong because testing urine for glucose is not a routine measure for a primigravida with an uncomplicated pregnancy.
Urine glucose testing is done for women who have gestational diabetes or are at risk of developing it. It is not necessary for women who have normal blood glucose levels.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A.Making a loud sound within close range of the newborn will elicit the Moro reflex, which is an involuntary protective motor response against abrupt disruption of body balance or extremely sudden stimulation.The Moro reflex involves three distinct components: spreading out the arms (abduction), pulling the arms in (adduction), and crying (usually).
Choice B is wrong because firmly stroking the soles of the newborn’s feet with a thumb nail will elicit the Babinski reflex, which is a normal response in infants that involves fanning out and curling of the toes.
Choice C is wrong because using the newborn’s hands to raise the baby from a supine position without supporting the head will elicit the traction response, which is a normal response in infants that involves flexion of the elbows and shoulders.
Choice D is wrong because holding the newborn in an upright position so that the infant’s feet touch a cool, flat surface will elicit the stepping reflex, which is a normal response in infants that involves alternating steps with each foot.
Correct Answer is C
Explanation
The correct answer is choice C: Related to the influence of maternal hormones.This is because breast milk contains many hormones that pass into it from the mother’s body, such as prolactin, thyroid hormones, and estrogen.
These hormones can affect the baby’s growth and development, and sometimes cause temporary breast enlargement and milk secretion in newborns of both sexes.This is called neonatal galactorrhea or “witch’s milk” and it is harmless and usually resolves within a few weeks
Choice A is wrong because neonatal galactorrhea is not a symptom of an endocrine disorder.It is a normal physiological response to maternal hormones that cross the placenta during pregnancy and are present in breast milk
Choice B is wrong because neonatal galactorrhea is not related to the need for chromosomal determination of gender identity.Gender identity is determined by a complex interaction of genetic, hormonal, and environmental factors, and it is not influenced by breast milk production in newborns
Choice D is wrong because neonatal galactorrhea is not a symptom of an abnormal proliferation of mammary alveoli.
Mammary alveoli are the milk-producing cells in the breast, and they are stimulated by prolactin to secrete milk.Neonatal galactorrhea does not indicate any abnormality in the structure or function of the mammary glands
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