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Saunders Comprehensive Review for theNCLEX-RN 8th Edition Maternity Nursing
Chapter 22 Risk Conditions Related to Pregnancy
The nurse is providing instructions to a pregnant client with HIV infection regarding care to the newborn after delivery. The client asks the nurse about the feeding options that are available. Which response should the nurse make to the client? 1. "You will need to bottle-feed your newborn."
2. "You will need to feed your newborn by nasogastric tube feeding."
3. "You will be able to breast-feed for 6 months and then will need to switch to bottle-
feeding."
4. "You will be able to breast-feed for 9 months and then you will need to switch to bottle-feeding." - answer1. "You will need to bottle-feed your newborn."
Rationale: Perinatal transmission of HIV can occur during the antepartum period, during
labor and birth, or in the postpartum period if the mother is breast-feeding. Clients who have HIV will most likely be advised not to breast-feed; however, PHCPs recommendations regarding breast-feeding are always followed. There is no physiological reason why the newborn needs to be fed by nasogastric tube.
The home care nurse visits a pregnant client who has a diagnosis of preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the primary health care provider (PHCP)?
1. Urinary output has increased
2. Dependent edema has resolved
3. Blood pressure reading is at the prenatal baseline
4. The client complains of a headache and blurred vision. - answer4. The client complains of a headache and blurred vision.
Rationale: If the client complains of a headache and blurred vision, the PHCP should be
notified because these are signs of worsening preeclampsia. Options 1, 2, and 3 are normal findings. A stillborn baby was delivered in the birthing suite a few hours ago. After the deliver, the
family remained together, holding and touching the baby. Which statement by the nurse would assist the family in their period of grief?
1. "What can I do for you?"
2. "Now you have an angel in heaven."
3. "Don't worry, there is nothing you could have done to prevent this from happening."
4. "We will see to it that you have an early discharge so that you don't have to be reminded of this experience." - answer1. "What can I do for you?"
Rationale: When a loss or death occurs, the nurse should ensure that the parents have been honestly told about the situation by their PHCP or others on the health care team. It is important for the nurse to be with the parents at this time and to use therapeutic communication techniques. The nurse must also consider cultural and religious/spiritual practices and beliefs. The correct option provides a supportive, giving, and caring response. Options 2, 3, and 4 are blocks to communication and devalue the parents' feelings.
The nurse implements a teaching plan for a pregnant client who is newly diagnosed with
gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching?
1. "I should stay on a diabetic diet."
2. "I should perform glucose monitoring at home."
3. "I should avoid exercise because of the negative effects on insulin production."
4. "I should be aware of any infections and report signs of infection immediately to my obstetrician." - answer3. "I should avoid exercise because of the negative effects on insulin production."
Rationale: Exercise is safe for a client with gestational diabetes mellitus and is helpful in
lowering blood glucose level. Dietary modifications are the mainstay of treatment, and the client is placed on a standard diabetic diet. Many clients are taught to perform blood glucose monitoring. If the client is not performing the blood glucose monitoring at home,
it is performed at the clinic or OB's office. Signs of infection need to be reported to the OB.
The nurse is performing an assessment on a pregnant client in the last trimester with a diagnosis of preeclampsia. The nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis?
1. Enlargement of the breasts
2. Complaints of feeling hot when the room is cool
3. Periods of fetal movement followed by quiet periods.
4. Evidence of bleeding, such as in the gums, petechiae, and purpura - answer4. Evidence of bleeding, such as in the gums, petechiae, and purpura
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