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The patient is 34 weeks pregnant and during a regular prenatal visit she asks how to do kick counts. The best response by the nurse would be:
Select one:

Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel ten fetal movements in 2 hours.

Here is a computer printed information packet on how to do kick counts.

Fetal kick counts are not a reliable indicator of fetal well-being in the third trimester.

It is not important to do kick counts because you have a low-risk pregnancy.

Answer and Explanation

The Correct Answer is A

Choice A Reason: Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel ten fetal movements in 2 hours. This is because this response provides accurate and clear instructions on how to perform kick counts, which are a simple and non-invasive method of monitoring fetal activity and health. Kick counts can help detect changes in fetal movement paterns that may indicate fetal distress or hypoxia.

Choice B Reason: Here is a computer printed information packet on how to do kick counts. This is an insufficient answer that does not address the patient's question or demonstrate eﬀective communication skills. Providing writen information alone may not ensure the patient's understanding or compliance with kick counts.

Choice C Reason: Fetal kick counts are not a reliable indicator of fetal well-being in the third trimester. This is an incorrect answer that contradicts the evidence and guidelines on kick counts. Kick counts are recommended for all pregnant women, especially in the third trimester, when fetal movements are more noticeable and consistent.

Choice D Reason: It is not important to do kick counts because you have a low-risk pregnancy. This is an incorrect answer that discourages the patient from performing kick counts and may give her a false sense of security. Kick counts are important for all pregnant women, regardless of their risk status, as they can help identify potential problems that may require further evaluation or intervention.

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Correct Answer is C

Explanation

Choice A Reason: Enhance uterine contractions. This is an incorrect answer that contradicts the eﬀect of narcotic analgesia on uterine activity. Narcotic analgesia can reduce uterine contractions by decreasing maternal catecholamine levels, which can prolong labor or increase bleeding.

Choice B Reason: Be used in place of preoperative sedation. This is an irrelevant answer that does not apply to this scenario. Preoperative sedation is a medication given before surgery to reduce anxiety, pain, or nausea. Narcotic analgesia can be used as a preoperative sedative, but it is not related to labor or delivery.

Choice C Reason: Result in neonatal respiratory depression. This is because narcotic analgesia can cross the placenta and aﬀect the fetal central nervous system, which can cause decreased respiratory drive, apnea, bradycardia, or hypotonia in the newborn. The risk of neonatal respiratory depression is higher when narcotic analgesia is administered close to delivery, as there is less time for placental clearance or maternal metabolism.

Choice D Reason: Prevent the need for anesthesia with an episiotomy. This is an inaccurate answer that overestimates the eﬀect of narcotic analgesia on perineal pain. Narcotic analgesia can provide some relief of labor pain, but it does not block pain sensation completely or locally. An episiotomy is a surgical incision made in the perineum to enlarge the vaginal opening during delivery, which requires local anesthesia or regional anesthesia (such as epidural or spinal). Narcotic analgesia does not prevent or replace anesthesia with an episiotomy.

A. Physiologic anemia due to maternal increased plasma volume. B. Pressure of the gravid uterus on the maternal inferior vena cava and aorta. C. Pressure of the presenting fetal part on the maternal diaphragm. D. A 50% increase in maternal blood volume during pregnancy.

Correct Answer is B

Explanation

Choice A Reason: Physiologic anemia due to maternal increased plasma volume. This is an incorrect answer that refers to a diﬀerent condition that aﬀects hemoglobin levels, not blood pressure. Physiologic anemia is a condition where the maternal plasma volume increases more than the red blood cell mass during pregnancy, which dilutes the hemoglobin concentration and lowers the hematocrit value. Physiologic anemia does not cause significant symptoms or complications in pregnant women, as it is an adaptive mechanism that enhances oxygen delivery and prevents ﬂuid overload.

Choice B Reason: Pressure of the gravid uterus on the maternal inferior vena cava and aorta. This is because this statement explains the cause of supine hypotensive syndrome, which is a condition where lying ﬂat on the back causes compression of the major blood vessels by the gravid uterus, which reduces venous return and cardiac output, which lowers blood pressure and perfusion to vital organs. Supine hypotensive syndrome can cause symptoms such as dizziness, lightheadedness, nausea, pallor, or syncope in pregnant women, especially in the third trimester.

Choice C Reason: Pressure of the presenting fetal part on the maternal diaphragm. This is an incorrect answer that indicates a diﬀerent condition that aﬀects respiratory function, not blood pressure. Pressure of the presenting fetal part on the maternal diaphragm is a result of cephalic engagement or lightening, which occurs when the fetal head descends into the pelvis and occupies more space in the abdominal cavity. Pressure of the presenting fetal part on the maternal diaphragm can cause symptoms such as dyspnea, heartburn, or rib pain in pregnant women.

Choice D Reason: A 50% increase in maternal blood volume during pregnancy. This is an incorrect answer that describes a normal physiological change that occurs during pregnancy, not a cause of supine hypotensive syndrome. A 50% increase in maternal blood volume during pregnancy is due to increased production of plasma and red blood cells, which helps meet the increased oxygen and nutrient demands of the fetus and placenta, and prepares the mother for blood loss during delivery. A 50% increase in maternal blood volume during pregnancy does not cause hypotension or dizziness in pregnant women.

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The patient is 34 weeks pregnant and during a regular prenatal visit she asks how to do kick counts. The best response by the nurse would be: Select one:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Narcotic analgesia is administered to a laboring client at 10:00 a.m. The infant is delivered at 10:35 A.M. The nurse would anticipate that the narcotic analgesia could: Select one:

Correct Answer is C

Explanation

In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down ﬂat on my back". The nurse explains that this is due to: Select one:

Correct Answer is B

Explanation

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Assessment of a pregnant woman reveals a pigmented vertical line between the umbilicus and the pubis. The nurse documents this finding as: Select one:

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In caring for the premature infant, the nurse must continually assess hydration status. Parameters to assess would include all of the following except: Select one:

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Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:

After the birth of a newborn, the nursing intervention that most eﬀectively promotes parental atachment is: Select one:

The patient is 34 weeks pregnant and during a regular prenatal visit she asks how to do kick counts. The best response by the nurse would be:
Select one: