A nurse is assisting in the plan of care for a client who is pregnant and has phenylketonuria (PKU). Which of the following actions should the nurse include in the plan of care?

Prepare the client for a cesarean birth

Monitor blood glucose levels daily

Reinforce teaching about a protein-free diet.

Administer thyroid hormone replacement.

Answer and Explanation

The Correct Answer is C

A. Prepare the client for a caesarean birth. Caesarean birth is not routinely required for clients with PKU unless there are obstetric indications. Vaginal delivery is usually possible.

B. Monitor blood glucose levels daily. PKU involves the inability to metabolize phenylalanine, not glucose. Monitoring glucose is important in clients with diabetes, not PKU.

C. Reinforce teaching about a protein-free diet. Phenylketonuria (PKU) is a metabolic disorder where the body cannot break down the amino acid phenylalanine. During pregnancy, it is crucial to maintain low phenylalanine levels to prevent harm to the developing fetus. Therefore, a diet low in phenylalanine (not protein-free, but low in phenylalanine) is essential.

D. Administer thyroid hormone replacement. Thyroid hormone replacement is not related to PKU management. It is used for clients with thyroid conditions such as hypothyroidism.

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Correct Answer is D

Explanation

A. 5: Parity refers to the number of pregnancies that have reached viability (around 20 weeks). The elective abortion and spontaneous abortion were before viability, so they do not count towards parity.

B. 3: This number is incorrect based on the client's reproductive history because only viable pregnancies should count toward parity, not each pregnancy event.

C. 4: This number does not align with the medical history. The client's two abortions occurred before 20 weeks, so they should not contribute to parity.

D. 2: Parity refers to the number of pregnancies that reached viability, not the number of fetuses. Since the client delivered twins at 36 weeks (one pregnancy), her parity is 2 (the abortion at 9 and 15 weeks do not count as viable pregnancies).

A. Maternal hypertension B. Maternal battering C. Maternal cigarette smoking D. Maternal cocaine use

Correct Answer is A

Explanation

A. Maternal hypertension: Maternal hypertension is the most common risk factor for placental abruption. High blood pressure can cause stress on the blood vessels in the placenta, leading to premature detachment from the uterine wall.

B. Maternal battering: While trauma, such as maternal battering, can lead to placental abruption, it is not the most common risk factor. It is, however, a significant risk in cases of physical trauma.

C. Maternal cigarette smoking: Cigarette smoking can increase the risk of placental abruption but is not as significant as hypertension.

D. Maternal cocaine use: Cocaine use is a known risk factor for placental abruption, but maternal hypertension remains the most common and significant risk factor.

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A nurse is assisting in the plan of care for a client who is pregnant and has phenylketonuria (PKU). Which of the following actions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is reinforcing teaching with a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse recognizes that which of the following is the most common risk factor for a placental abruption?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who is at 30 weeks of gestation and scheduled for a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?

A nurse is assisting in the plan of care for a client who is pregnant and has phenylketonuria (PKU). Which of the following actions should the nurse include in the plan of care?

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