A nurse is caring for a client who is pregnant.

Medical History 1100:

Gravida 4 Para 3

32 weeks of gestation BMI 32
History of two newborns weighing over 4.5 kg (10 lb) Family history of type one diabetes mellitus (maternal) Fetal heart tones 140/min via doppler
Which of the following provider prescriptions should the nurse plan to implement? Select the 3 actions the nurse should plan to take.

Encourage the client to limit carbohydrate intake to 40% of their daily calories.

Instruct the client to check a random blood glucose level once daily.

Anticipate a prescription for metformin.

Conduct a non-stress test twice per week.

Answer and Explanation

Correct Answer : A,C,D

A.The client should limit carbohydrate intake to reduce the risk of gestational diabetes and its complications both in the mother and the fetus.
Glucose monitoring should be done 4 times daily.

C.   Metformin is commonly prescribed to manage glucose levels in pregnant individuals with GDM.
D.   The client's history of macrosomic newborns and family history of type 1 diabetes mellitus indicate an increased risk for complications such as fetal macrosomia and fetal distress. Nonstress tests are used to assess fetal well-being by monitoring fetal heart rate patterns.
E.   With a BMI of 32 and a history of macrosomic newborns, the client is at an increased risk for developing gestational diabetes mellitus (GDM). Regular exercise is important in managing blood glucose levels and reducing the risk of GDM.

Nursing Test Bank

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Correct Answer is C

Explanation

Allowing the baby to drain one breast at each feeding helps ensure effective milk removal, which can alleviate breast engorgement. Emptying the breast thoroughly promotes milk flow and prevents milk stasis, which contributes to engorgement.
A Cold compresses provide temporary relief from discomfort but does not address the underlying cause of engorgement.
B Drinking herbal tea, may have limited evidence supporting its efficacy in reducing engorgement. While hydration is important for breastfeeding, relying solely on herbal tea may not be as effective as other strategies.
D Feeding the baby every 2 hours, is important for maintaining milk supply and preventing engorgement. However, it's essential to ensure the breast is fully drained at each feeding, regardless of the time interval between feedings.

A. Insert a urinary catheter. B. Massage the fundus. C. Have the client urinate. D. Administer an analgesic

Correct Answer is C

Explanation

A firm, displaced fundus to the right of midline indicates a full bladder. A distended bladder can prevent the uterus from contracting properly and can lead to uterine atony, increasing the risk of postpartum hemorrhage. Therefore, the priority action is to have the client empty her bladder.
This can often be achieved by encouraging the client to urinate or by assisting her with toileting if necessary. Palpating a fundus that is firm and displaced does not indicate the need for fundal massage, as the fundus is already firm. Inserting a urinary catheter may be necessary if the client is unable to void spontaneously, but this should be done after attempting to have the client

urinate voluntarily. Administering an analgesic is not indicated based on the information provided.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A home health nurse is teaching a client who is breastfeeding about managing breast engorgement. Which of the following client statements indicates understanding of the teaching?

Correct Answer is C

Explanation

A nurse is caring for a client who experienced a vaginal birth 3 hr ago. Upon palpation, the fundus is displaced to the right of midline, is firm, and is two fingerbreadths above the umbilicus. Which of the following actions should the nurse complete at this time?

Correct Answer is C

Explanation

A nurse is caring for a client who gave birth 2 hr ago. The nurse notes that the client's blood pressure is 60/50 mm Hg. Which of the following actions should the nurse take first?

A nurse is assessing a client in labor who has had epidural anesthesia for pain relief. Which of the following findings should the nurse identify as a complication from the epidural block?

A nurse is assessing a client who is 4 hr postpartum following a vaginal delivery. Which of the following findings should the nurse identify as the priority?

A nurse in a prenatal clinic is teaching a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?

A nurse is caring for a client who is 2 hr postpartum following a vaginal birth. Which of the following findings indicates the client's bladder is distended?

A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following?