A 34-week gestation multigravida comes to the clinic for her bimonthly appointment.
Which assessment finding should the nurse report to the healthcare provider (HCP)?
Weight gain of 2 pounds (0.91 kg).
1+ edema on her lower extremities.
Fundal height of 30 cm.
Fetal heart rate of 110 beats/minute.
The Correct Answer is C
Choice A rationale
A weight gain of 2 pounds (0.91 kg) in a 34-week gestation multigravida is generally considered normal. During the third trimester, it is typical for a pregnant woman to gain around 0.5 to 1 pound per week. This weight gain helps support the growing fetus and prepare the mother's body for labor and breastfeeding. However, sudden or excessive weight gain could indicate fluid retention or preeclampsia, but a 2-pound gain alone is not necessarily a concern.
Choice B rationale
1+ edema on the lower extremities is a common finding during pregnancy, especially in the later stages. It is usually due to increased blood volume and pressure on the pelvic veins from the growing uterus, which can slow the return of blood from the legs. While some degree of edema is normal, particularly in the ankles and feet, it is important to monitor for sudden or severe swelling, which could be a sign of preeclampsia.
Choice C rationale
A fundal height of 30 cm at 34 weeks gestation is concerning because it is less than the expected measurement. Fundal height typically corresponds to gestational age in centimeters (±2 cm). Therefore, at 34 weeks, the expected fundal height would be between 32 and 36 cm. A smaller fundal height could indicate intrauterine growth restriction (IUGR), oligohydramnios, or other fetal development issues, which require further evaluation by the healthcare provider.
Choice D rationale
A fetal heart rate (FHR) of 110 beats per minute (bpm) is within the normal range for a fetus. The normal FHR typically ranges from 110 to 160 bpm. Although 110 bpm is on the lower end of the normal range, it is still considered acceptable. Significant deviations from the normal range, either too low (bradycardia) or too high (tachycardia), could indicate fetal distress and require immediate attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While encouraging quiet activities like watching television can provide some distraction and temporary relief, it does not address the underlying need for consistent pain management in juvenile idiopathic arthritis. Distraction techniques should be used as an adjunct to proper pain medication rather than a replacement for it. This condition can cause chronic pain, which may negatively impact the child's quality of life if not managed appropriately.
Choice B rationale
Resting when experiencing pain is a common recommendation, but for juvenile idiopathic arthritis, it's essential to balance rest with physical activity to maintain joint mobility and muscle strength. Only encouraging rest can lead to muscle atrophy and joint stiffness, which can exacerbate the condition in the long term. Regular pain management can help the child stay more active.
Choice C rationale
Hot baths can help to some extent by relaxing muscles and reducing stiffness, but they are not sufficient as a sole method for managing pain in juvenile idiopathic arthritis. The condition often requires consistent medication to control inflammation and pain. Non-pharmacological methods like hot baths should be used in conjunction with prescribed medication rather than as an alternative.
Choice D rationale
Giving pain medication around the clock helps control the pain effectively by maintaining a steady level of medication in the body, preventing breakthrough pain. Consistent pain management allows the child to participate in daily activities and physical therapy, which is essential for maintaining joint function and overall quality of life.
Correct Answer is ["25"]
Explanation
Step 1: Calculate the total daily dose in mg: 25 kg × 10 mg/kg/day = 250 mg/day.
Step 2: Determine how many mL are needed to administer the 250 mg dose: (250 mg ÷ 50 mg) × 5 mL = (5) × 5 mL = 25 mL. Final calculated answer: 25 mL.v
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