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"You will be prescribed diazepam." Diazepam is a benzodiazepine used for anxiety and seizures, but it is not the recommended treatment for opioid use disorder in pregnancy. Prolonged use can lead to neonatal withdrawal symptoms, respiratory depression, and sedation. Additionally, benzodiazepine dependence can develop, complicating the management of opioid withdrawal.

"You will be prescribed naloxone." Naloxone is an opioid antagonist used for reversing opioid overdose, but it is not appropriate for long-term treatment of opioid use disorder. When administered to an opioid-dependent pregnant client, naloxone can induce sudden withdrawal, increasing the risk of fetal distress, uterine contractions, and preterm labor. Instead, opioid agonist therapy with methadone or buprenorphine is preferred.

"You will be prescribed aripiprazole." Aripiprazole is an atypical antipsychotic used for conditions such as schizophrenia, bipolar disorder, and depression. It has no role in managing opioid dependence, as it does not reduce opioid cravings or withdrawal symptoms. While some clients with opioid use disorder may have coexisting psychiatric conditions requiring antipsychotics, aripiprazole alone does not address opioid addiction.

"You will not be able to eat or drink anything for 8 hours prior to the test." A nonstress test (NST) is a noninvasive procedure that does not require fasting. Clients are encouraged to eat before the test because fetal movement can be stimulated by food intake. Unlike some other prenatal tests, such as glucose tolerance tests or certain ultrasounds, there are no dietary restrictions before an NST.

"You will receive medication through an IV line to stimulate contractions." An NST does not involve medication or contraction stimulation. It is designed to monitor fetal heart rate in response to spontaneous fetal movement. If contractions need to be stimulated for further evaluation, a contraction stress test (CST) or oxytocin challenge test may be performed instead.

"You will be required to lie flat on your back for the duration of the test." Lying flat on the back is not recommended, especially in later pregnancy, as it can cause supine hypotensive syndrome by compressing the inferior vena cava. Instead, the client is typically positioned in a semi-Fowler’s position or left lateral position to promote optimal blood flow and comfort during the NST.

Round ligament pain. Round ligament pain typically occurs in the second trimester as the uterus expands and stretches the supporting ligaments. It presents as sharp, stabbing pain or a pulling sensation in the lower abdomen or groin, especially with movement. It is not a common discomfort during the first trimester.

Perineal discomfort and pressure. Perineal pressure is more common in the third trimester as the fetus grows and descends into the pelvis. Increased fetal weight and engagement in the pelvis contribute to this sensation, but it is not a typical complaint during the first trimester.

Tingling in the fingers. Tingling or numbness in the fingers, known as carpal tunnel syndrome, can develop later in pregnancy due to fluid retention and nerve compression. While some clients may experience mild symptoms early on, it is more frequently reported in the second or third trimester.

Tell the client to apply hydrocortisone ointment to the affected area of the breast. Hydrocortisone ointment is not recommended for mastitis, as it does not treat the infection or relieve symptoms effectively. Mastitis is a bacterial infection that requires antibiotics if severe, and management focuses on continued breastfeeding, warm compresses, and pain relief.

Encourage the client to limit oral fluid intake to decrease milk production. Decreasing fluid intake is not recommended, as hydration is essential for milk production and overall recovery. Instead, the client should continue to drink adequate fluids to maintain milk supply and prevent dehydration.

Recommend the client avoid wearing a nursing bra until symptoms resolve. A well-fitting, supportive nursing bra can help reduce breast discomfort and prevent further complications. Avoiding a bra may lead to increased breast engorgement and worsening symptoms rather than relief.

"Wash your nipples with soap and water daily." Washing the nipples with soap can cause dryness and irritation, leading to cracked skin that increases the risk of infection. Instead, the client should clean the breasts with warm water and pat them dry to maintain nipple integrity and prevent mastitis.

"Cover your breasts immediately after feedings." Allowing the nipples to air dry after breastfeeding helps prevent moisture buildup, which can create an environment for bacterial growth. Instead of immediately covering the breasts, the client should let them dry naturally before putting on clothing or nursing pads.

"Wear an underwire bra between feedings." An underwire bra can put excessive pressure on breast tissue, leading to blocked milk ducts and increasing the risk of mastitis. A well-fitting, non-restrictive nursing bra is recommended to provide support without compressing milk ducts.

Place the newborn supine and apply pressure to the soles of the feet. Applying pressure to the soles of the feet does not elicit the Babinski reflex but may trigger the stepping reflex. In this reflex, the newborn responds by making stepping movements, mimicking walking. The stepping reflex is typically present at birth and disappears around 2 months of age as the baby gains neuromuscular control.

Pull the newborn up by the wrist from a supine position. This maneuver assesses the traction or pull-to-sit reflex, which evaluates muscle tone and head control. A normal response is initial head lag followed by flexion of the arms and an effort to stabilize the head. This reflex helps assess neuromuscular development but does not test for the Babinski reflex.

Touch the corner of the newborn's mouth. Touching the corner of the newborn’s mouth elicits the rooting reflex, which causes the baby to turn the head toward the stimulus with an open mouth. This reflex is important for feeding, as it helps the newborn locate the breast or bottle. It is present at birth and typically disappears around 4 months of age.

Collect a dietary history. While nutritional status is important for overall health, it is not a primary factor in selecting a contraceptive method. Certain conditions, such as obesity or vitamin deficiencies, may influence contraceptive choices, but dietary history alone does not determine the best option.

Select the best method of contraception for the client. The decision on contraception should be made by the client, not the nurse. The nurse’s role is to provide information and guidance while respecting the client’s autonomy. Clients have the right to choose a method that aligns with their values, health conditions, and reproductive goals.

Assess the client's socioeconomic status. While socioeconomic factors can influence contraceptive access and affordability, they do not determine the best method for the client. The nurse should focus on providing options that fit the client’s needs and ensure they are aware of resources available for contraceptive access if cost is a concern.

CBC. A complete blood count (CBC) can help assess for anemia, infection, or hemoconcentration due to dehydration. However, it is not the priority test for hyperemesis gravidarum. The immediate concern is assessing the severity of dehydration and ketosis, which directly impact maternal and fetal health.

Serum bilirubin. Serum bilirubin levels are typically measured when liver dysfunction or hemolysis is suspected. Hyperemesis gravidarum is primarily a condition of severe nausea and vomiting, leading to dehydration and ketosis rather than liver impairment. Jaundice and abnormal bilirubin levels would be more indicative of conditions such as HELLP syndrome or cholestasis of pregnancy.

Liver enzymes. Liver enzyme tests may be elevated in hyperemesis gravidarum but are not the most immediate concern. While abnormal liver function can occur, it is more commonly associated with conditions such as intrahepatic cholestasis of pregnancy or HELLP syndrome. Evaluating hydration status and ketosis takes precedence in the initial assessment.