A nurse is caring for a client who delivered vaginally 26 hours ago. When palpating the client's abdomen, where should the nurse expect to find the uterine fundus during her assessment?

One cm above the symphysis pubis

Midline at the umbilicus

Midline, 1cm above the umbilicus

Midline, 2 cm above the umbilicus.

Answer and Explanation

The Correct Answer is C

A. One cm above the symphysis pubis is typical immediately postpartum (within a few hours) for a fundus that has already begun involuting, but by 26 hours, the uterus is expected to have risen slightly above the umbilicus, so this is too low for this timeframe.

B. Midline at the umbilicus occurs approximately 12 hours postpartum, when the uterus has involuted upward to the level of the umbilicus. At 26 hours, the fundus is expected to have slightly involuted from the umbilicus, but still slightly above it.

C. Midline, 1 cm above the umbilicus is the expected location about 24 hours postpartum. The uterus remains firm and midline but gradually descends approximately 1 cm per day as involution continues. This finding is considered normal for a client 26 hours after delivery.

D. Midline, 2 cm above the umbilicus would be expected closer to immediately postpartum, not 26 hours later. By this time, the fundus has already begun to descend as part of the normal involution process.

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Correct Answer is ["A","D","E"]

Explanation

A. Maintain euglycemia is the most important preconception recommendation for women with pregestational diabetes. Achieving optimal blood glucose control before conception and during early pregnancy significantly reduces the risk of congenital anomalies, spontaneous abortion, and other maternal-fetal complications.

B. Increasing weight by 45 pounds is incorrect. Excessive weight gain is not recommended prior to conception. Weight should be optimized based on BMI and individual health status, not arbitrary high gain. Overweight or obesity can worsen insulin resistance and increase pregnancy risks.

C. Weight loss of at least 40% is unrealistic and unnecessary. Modest, goal-directed weight loss before conception may improve glycemic control, but an extreme reduction like 40% of body weight is unsafe and not recommended.

D. Workout at least 3 times a week is recommended to improve insulin sensitivity, maintain a healthy weight, and support cardiovascular health. Physical activity is a safe and effective strategy for preconception glycemic management unless contraindicated.

E. Dietary management is critical in diabetes care. A balanced, individualized nutrition plan helps maintain euglycemia, prevent excessive weight gain, and ensure adequate nutrient intake for maternal and fetal health.

A. Deep red or orange vegetables B. White breads and rice C. Meat, poultry, and fish D. Dark green leafy vegetables

Correct Answer is D

Explanation

A. Deep red or orange vegetables, such as carrots, red peppers, and sweet potatoes, are excellent sources of vitamin A, beta-carotene, and fiber, but they are not significant sources of calcium. While they contribute to overall nutritional intake, relying on them for calcium needs during pregnancy would be inadequate.
B. White breads and rice primarily provide carbohydrates and some B vitamins if enriched. They contain minimal amounts of calcium and are not effective alternatives for meeting daily calcium requirements, which are about 1,000 mg per day for most pregnant adults.
C. Meat, poultry, and fish are rich in protein, iron, and other essential nutrients. Certain types of fish, such as canned salmon and sardines with bones, are high in calcium. However, typical servings of meat, poultry, or fish without edible bones do not provide enough calcium to meet daily needs, making them less reliable for this purpose.
D. Dark green leafy vegetables such as kale, collard greens, bok choy, and broccoli are rich in calcium and can serve as excellent alternatives for clients who do not consume dairy products. These vegetables provide bioavailable calcium that supports fetal skeletal development and helps maintain maternal bone health during pregnancy. Encouraging the inclusion of a variety of these vegetables, along with other calcium-fortified foods (e.g., plant-based milks or juices), helps ensure adequate calcium intake without relying on milk.

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A nurse is caring for a client who delivered vaginally 26 hours ago. When palpating the client's abdomen, where should the nurse expect to find the uterine fundus during her assessment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","D","E"]

Explanation

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Correct Answer is D

Explanation

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