A nurse in a prenatal clinic is attending to a group of clients. Which client’s weight gain should the nurse be concerned about?

A client with an 18kg (4 lb) weight gain in her first trimester.

A client with a 68 kg (15 lb) weight gain in her second trimester.

A client with a 13 kg (25 lb) weight gain in her third trimester.

A client with a 3.6 kg (8 lb) weight gain in her first trimester.

Answer and Explanation

The Correct Answer is A

Choice A rationale
The nurse should be concerned about a client with an 18kg (4 lb) weight gain in her first trimester. This is because the expected weight gain for a client in the first trimester is usually around 1.8 kg (4 lb)1. A weight gain of 18 kg in the first trimester significantly exceeds this expectation, which could indicate a potential health issue such as gestational diabetes or multiple pregnancies. It’s important for the nurse to report this finding to the healthcare provider for further evaluation and management.
Choice B rationale
A client with a 68 kg (15 lb) weight gain in her second trimester does not necessarily pose a concern. Weight gain during pregnancy varies among individuals and can be influenced by factors such as the mother’s body mass index (BMI) before pregnancy, the baby’s growth rate, and the mother’s diet and lifestyle. However, it’s always important to monitor weight gain throughout pregnancy to ensure it’s within a healthy range.
Choice C rationale
A client with a 13 kg (25 lb) weight gain in her third trimester does not necessarily pose a concern. Weight gain during the third trimester can be influenced by factors such as the baby’s growth rate, amniotic fluid volume, and the mother’s increased blood volume. However, it’s always important to monitor weight gain throughout pregnancy to ensure it’s within a healthy range.
Choice D rationale
A client with a 3.6 kg (8 lb) weight gain in her first trimester does not necessarily pose a concern. This is within the expected weight gain range for the first trimester. However, it’s always important to monitor weight gain throughout pregnancy to ensure it’s within a healthy range.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A rationale
Maternal bradycardia refers to a slower than normal heart rate in the mother. While it can affect the baby’s health, it doesn’t cause late decelerations on the fetal monitor.
Choice B rationale
Late decelerations are caused by uteroplacental insufficiency, which is a decrease in the blood flow to the placenta that reduces the amount of oxygen and nutrients transferred to the fetus. This is why the nurse would interpret late decelerations as indicating uteroplacental insufficiency.
Choice C rationale
Umbilical cord compression can cause variable decelerations, not late decelerations. Variable decelerations are abrupt decreases in the fetal heart rate, typically associated with contractions, and they vary in onset, depth, and duration.
Choice D rationale
Fetal head compression typically causes early decelerations, not late decelerations. Early decelerations are a mirror image of the contraction and are generally not a concern.

A. Keep the head of the bed at a 30-degree angle. B. Initiate the use of a PCA pump for pain control. C. Reposition the client by log rolling every 4 hours. D. Place the client in protective isolation.

Correct Answer is B

Explanation

Choice A rationale
Keeping the head of the bed at a 30-degree angle is not typically necessary following scoliosis repair with Harrington rod instrumentation. The position of the bed is usually determined by the patient’s comfort and the surgeon’s specific post-operative instructions.
Choice B rationale
Initiating the use of a PCA (Patient-Controlled Analgesia) pump for pain control is a common intervention following scoliosis repair with Harrington rod instrumentation. This allows the patient to self-administer pain medication as needed, providing effective and individualized pain control.
Choice C rationale
Repositioning the client by log rolling every 4 hours is a common practice after spinal surgery to prevent pressure ulcers and maintain alignment of the spine. However, it is not the primary intervention in this case.
Choice D rationale
Placing the client in protective isolation is not typically necessary following scoliosis repair with Harrington rod instrumentation. Isolation is usually reserved for patients who are at high risk of infection or who have an infection that could be transmitted to others.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse in a prenatal clinic is attending to a group of clients. Which client’s weight gain should the nurse be concerned about?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a laboring patient with an external fetal monitor. The nurse notices late decelerations on the monitor strip. What does the nurse interpret this as indicating?

Correct Answer is B

Explanation

A nurse is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is assessing a postpartum client who is exhibiting tearfulness, insomnia, lack of appetite, and a feeling of letdown. The nurse knows these findings are characteristics of:

A nurse is caring for a child who is having a seizure. Which of the following actions should the nurse take? (Select all that apply.)

A nurse is caring for a pregnant client and reviewing signs of complications that should be promptly reported to the provider. Which of the following should be included?

Can you identify the structural anomalies that make up Tetralogy of Fallot?

A nurse is educating the parents of a child who has iron deficiency anemia and is taking iron supplements. Which statement by the parents indicates they understand the teaching?

A nurse is caring for an infant diagnosed with Tetralogy of Fallot. The infant has been feeding poorly and has difficulty gaining weight. What actions should the nurse plan to take? (Select all that apply.)

A nurse is providing care for a client who is in preterm labor at 32 weeks of gestation. Which medication should the nurse expect the provider to prescribe to accelerate fetal lung maturity?

A nurse is attending to an 8-year-old child diagnosed with acute rheumatic fever. What should be the nurse’s immediate priority assessment after admission?