A nurse is caring for a client during an initial prenatal visit.
The client's last menstrual period was 18 weeks ago. Which of the following actions should the nurse plan to take? (Select All that Apply.)
Calculate the estimated date of birth.
Obtain the client's personal and family medical history.
Obtain information about prior pregnancies.
Check the client's urine with a reagent strip.
Schedule the client for prenatal laboratory testing.
Discuss chorionic villus sampling with the client.
Correct Answer : A,B,C,D,E
Choice A rationale
Calculating the estimated date of birth (EDB) is a fundamental component of the initial prenatal visit. Given the last menstrual period (LMP) was 18 weeks ago, using Naegele's rule (LMP minus 3 months plus 7 days) or a gestational wheel provides an approximate due date, crucial for planning prenatal care and monitoring fetal development.
Choice B rationale
Obtaining the client's personal and family medical history is vital for comprehensive prenatal care. This includes identifying pre-existing conditions, genetic predispositions, and potential risks that could affect the pregnancy, such as diabetes, hypertension, or a family history of chromosomal abnormalities, allowing for early intervention and personalized care.
Choice C rationale
Gathering information about prior pregnancies, including outcomes, complications, and types of deliveries, provides valuable insight into the client's obstetric history. This helps in identifying potential recurrent issues, assessing risk factors for current pregnancy complications, and tailoring a care plan based on past experiences and previous uterine healing.
Choice D rationale
Checking the client's urine with a reagent strip is a standard procedure at initial and subsequent prenatal visits. This screening tool detects proteinuria, glucosuria, ketonuria, and signs of urinary tract infections, which can impact maternal and fetal health. For example, proteinuria may indicate preeclampsia, while glucosuria suggests gestational diabetes.
Choice E rationale
Scheduling the client for prenatal laboratory testing is essential for baseline assessment and screening for various conditions. This typically includes blood type and Rh factor, complete blood count (CBC), rubella titer, hepatitis B screen, syphilis screen, HIV testing, and sometimes genetic screening tests, all crucial for managing pregnancy and fetal health.
Choice F rationale
Chorionic villus sampling (CVS) is a diagnostic procedure typically performed between 10 and 13 weeks of gestation to detect chromosomal abnormalities or genetic disorders. Given the client's last menstrual period was 18 weeks ago, this gestational age falls outside the recommended window for CVS, making it an inappropriate discussion point at this stage. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Bullying, especially when prolonged, can lead to chronic stress and emotional distress, often manifesting as symptoms of depression. The consistent negative social interactions, feelings of helplessness, social isolation, and decline in academic performance are all classic indicators of major depressive disorder, characterized by persistent sadness, anhedonia, and functional impairment.
Choice B rationale
Bullying systematically erodes an individual's self-worth and confidence. The constant criticism, exclusion, and targeting by peers lead to feelings of inadequacy and shame, directly contradicting any notion of increased self-esteem. Over time, victims often internalize negative messages, resulting in a significant decrease in their overall self-perception and personal value.
Choice C rationale
Bullying typically leads to social withdrawal, not enhanced social skills. Victims often develop anxiety around social interactions due to fear of further judgment or aggression. This avoidance behavior prevents them from practicing and refining social skills, leading to a decline in their ability to engage effectively with peers and form healthy relationships.
Choice D rationale
Bullying causes significant psychological distress, including anxiety, depression, and difficulty concentrating. These factors directly interfere with cognitive functions necessary for learning, such as attention and memory. Consequently, academic performance often declines as the student struggles to focus in class and complete assignments, leading to lower grades. .
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
Support during labor has been shown to significantly decrease the perception of pain. Continuous presence of a supportive individual, such as a doula or partner, provides comfort, encouragement, and various coping mechanisms, which can physiologically reduce stress hormone release and enhance the body's natural pain-modulating systems, leading to a less painful experience.
Choice B rationale
A supportive presence during labor contributes to an improved overall experience for the client. The emotional, physical, and informational support provided can alleviate anxiety, empower the client, and foster a sense of control and confidence, leading to a more positive and satisfying childbirth experience, often with lasting beneficial psychological impacts.
Choice C rationale
Support during labor can contribute to better fetal outcomes by reducing maternal stress and anxiety. Lower maternal stress levels can lead to improved uterine blood flow and oxygenation to the fetus. Additionally, continuous support can lead to fewer interventions, such as operative deliveries, which are associated with potential risks to the fetus.
Choice D rationale
Research indicates that continuous support during labor is associated with improved client outcomes. This includes a reduced likelihood of medical interventions, such as epidural anesthesia, synthetic oxytocin for augmentation, and cesarean sections. Enhanced emotional well-being and reduced maternal stress hormones also contribute to a more positive physiological response during labor.
Choice E rationale
Support during labor is known to decrease, not increase, anxiety. The presence of a supportive individual provides reassurance, reduces fear of the unknown, and offers comfort. This contributes to a calm environment, which can physiologically mitigate the stress response, thereby lowering anxiety levels and promoting a more relaxed labor progression for the client.
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