A patient who is at 34 weeks gestation reports having discomfort from hemorrhoids.
The nurse discusses with the patient strategies for pregnant women who have hemorrhoids.The patient returns to the clinic in 2 weeks.Which patient statement indicates a need for further teaching regarding hemorrhoid management?

I’m walking at least a mile a day.

I found taking a small amount of mineral oil each night is helpful.

I include foods high in fiber in my diet.

I’ve started to drink one extra glass of water before I have breakfast each morning.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Taking mineral oil each night is not recommended for pregnant women who have hemorrhoids because it can interfere with the absorption of fat-soluble vitamins and cause diarrhea, which can worsen hemorrhoids.

The patient should avoid laxatives and stool softeners unless prescribed by a health care provider.

Choice A is wrong because walking at least a mile a day can help improve blood circulation and prevent constipation, which are both beneficial for hemorrhoid management.

Choice C is wrong because including foods high in fiber in the diet can help soften stools and prevent straining, which can aggravate hemorrhoids.

Choice D is wrong because drinking one extra glass of water before breakfast each morning can help hydrate the body and prevent dehydration, which can cause hard stools and increase pressure on the anal veins.

The nurse should teach the patient other strategies for hemorrhoid management, such as applying ice packs or witch hazel pads to the affected area, using sitz baths or warm water baths, avoiding prolonged sitting or standing, and wearing cotton underwear.

The nurse should also advise the patient to report any signs of infection or bleeding to the health care provider.

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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.

A. They need less supplemental iron than women who have been menstruating longer because their reserves are generally greater. B. They have less need for simple carbohydrates than older women because they are able to convert fat stores into usable glucose. C. Their need for protein exceeds that of pregnant women over 20 years of age. D. Their need for vitamin C is greater than that of pregnant women over 20 years of age.

Correct Answer is C

Explanation

The correct answer is choice C.Adolescents need more protein than older pregnant women because they are still growing themselves and need to support the growth of the baby and the placenta.Protein can be found in meat, poultry, fish, eggs, dairy products, beans, nuts, and fortified cereals.

Choice A is wrong because adolescents need more supplemental iron than older women, not less.This is because they have lower iron stores due to rapid growth and menstruation.Iron deficiency can cause anemia and increase the risk of infections and bleeding.Iron can be found in meat, poultry, fish, eggs, dairy products, beans, nuts, and fortified cereals.

Choice B is wrong because adolescents need more carbohydrates than older women, not less.Carbohydrates provide energy for the mother and the baby and spare protein for other functions.Carbohydrates can be found in grains, fruits, vegetables, and dairy products.

Choice D is wrong because adolescents need the same amount of vitamin C as older pregnant women, which is 85 milligrams per day.Vitamin C helps with wound healing, collagen formation, iron absorption, and immune function.Vitamin C can be found in citrus fruits, tomatoes, peppers, broccoli, potatoes, and fortified juices.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

A 14-year-old patient is 10 weeks pregnant. In order to plan nutritional counseling for this patient, the nurse should have which understanding about adolescents’ nutritional needs during pregnancy?

Correct Answer is C

Explanation

A nurse is caring for a patient being evaluated for sexually transmitted infection (STI).A negative rapid plasma reagin (RPR) indicates that a patient is probably not infected with which STI?

The nurse suspects drug abuse in a patient admitted with no prenatal care and a diagnosis of abruptio placentae.Which question would elicit the most information from the patient concerning the suspected drug use?

A 14-year-old client who is pregnant has a low result from a rubella serology test.Which notation should be made on this client’s care plan?

A 38-year-old primigravida returns to the clinic at 16 weeks gestation for an alpha-fetoprotein test.She asks a nurse, "Why do lI need this test?".Which response would be most appropriate for the nurse to make?

A patient has been instructed to increase the protein in her diet. Which statement by the patient shows a need for further instruction?

A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun. A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

A nurse is caring for a client with gestational diabetes.Which guideline should the nurse use when providing nutritional counseling to this client?

The nurse is assigned to care for the postpartum client during her shift. The nurse knows one of the most common risk factors for early (PPH) postpartum hemorrhage is uterine atony. When providing care, the nurse would plan to:.