A nurse is reinforcing teaching with a client who is at weeks of gestation and scheduled for a non-stress test (NST). Which of the following statements by the client indicates a need for further teaching?
I need to schedule the test when the baby is usually active
I have to lie on my back during the test
The baby’s heart rate will be monitored during the test
I will be able to go to the bathroom during the test if necessary
The Correct Answer is B
Rationale for Choice A:
It is accurate that scheduling the NST when the baby is usually active is beneficial. This is because fetal movement is expected to cause accelerations in the fetal heart rate, which is a positive sign of fetal well-being.
By scheduling the test during a time of typical fetal activity, the chances of obtaining a reactive NST (a normal result) are increased.
Therefore, this statement does not indicate a need for further teaching.
Rationale for Choice B:
Lying on the back during the NST is not recommended.
This position can cause the weight of the uterus to compress the major blood vessels (the inferior vena cava and aorta), potentially reducing blood flow to the placenta and fetus.
Reduced blood flow can, in turn, lead to a decrease in fetal heart rate and movement.
To avoid this, the recommended position for NST is a semi-Fowler's position, which involves being partially reclined with the head and upper body elevated.
This position helps to promote uterine perfusion and prevent supine hypotension.
Rationale for Choice C:
It is accurate that the baby's heart rate will be monitored during the NST.
This is the primary purpose of the test: to assess the fetal heart rate response to fetal movement. Therefore, this statement does not indicate a need for further teaching.
Rationale for Choice D:
It is accurate that the client will be able to go to the bathroom during the NST if necessary. The test is noninvasive and does not require strict immobility.
The client can move around and use the bathroom as needed, as long as the fetal heart rate monitor is not disconnected.
Therefore, this statement does not indicate a need for further teaching.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is Choice A.
Choice A rationale: The recommended weight gain for a woman with a normal BMI (18.5-24.9) during pregnancy is 25-35 pounds. This range ensures adequate nutrition for both the mother and the developing baby, supporting optimal fetal growth and maternal health.
Choice B rationale: A weight gain of 11-20 pounds is recommended for women with a high BMI (≥30) during pregnancy. This range helps minimize the risk of complications such as gestational diabetes and hypertension, but it is not applicable for a woman with a normal BMI.
Choice C rationale: While a healthy diet is crucial, specific weight gain guidelines are essential to ensure the health of both mother and baby. Weight gain recommendations are based on evidence to support optimal outcomes, making it important to follow them.
Choice D rationale: A weight gain of 15-25 pounds is recommended for women with an overweight BMI (25-29.9) during pregnancy. This range helps support fetal growth while minimizing the risk of complications, but it is not applicable for a woman with a normal BMI.
Correct Answer is C
Explanation
Choice A: Scrambled eggs
While eggs contain protein and iron, they do not significantly enhance iron absorption.
Consuming eggs alongside ferrous sulfate has not been shown to significantly improve iron uptake. Therefore, scrambled eggs are not the most effective choice to promote iron absorption from ferrous sulfate.
Choice B: A high fiber meal
High-fiber foods can interfere with iron absorption.
Fiber binds to iron, making it less available for absorption in the small intestine. Consuming ferrous sulfate with a high-fiber meal can potentially reduce its effectiveness.
Choice C: Orange juice
Orange juice is a rich source of vitamin C, which significantly enhances iron absorption.
Vitamin C converts non-heme iron (the form of iron in ferrous sulfate) into a more easily absorbed form.
Studies have shown that consuming vitamin C with iron supplements can increase iron absorption by up to 300%.
This makes orange juice the optimal choice to accompany ferrous sulfate, ensuring optimal absorption and effectiveness in treating iron deficiency anemia.
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