A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage.The nurse's best response is.
"You can have an epidural. You won't feel anything.”.
"It's normal to be anxious about labor. Let's discuss what makes you afraid.”.
"Don't worry about it. You'll do fine.”.
"Labor is scary to think about it, but the actual experience isn't.”.
The Correct Answer is B
Choice A rationale
Offering an epidural as a definitive solution that eliminates all feeling is misleading and dismissive of the patient's emotional state. While an epidural provides significant pain relief, it does not address the underlying psychological fear or anxiety associated with the labor process. Furthermore, some women may still experience pressure or sensations even with an epidural. Providing false reassurances about complete numbness ignores the patient's need for emotional support and clear education regarding her birth plan.
Choice B rationale
Acknowledging that anxiety is normal validates the patient's feelings and opens a therapeutic dialogue. This response encourages the woman to express specific fears, allowing the nurse to provide targeted education and coping strategies. Therapeutic communication is essential for building trust and reducing maternal stress, which can positively impact labor outcomes. By discussing the fears, the nurse can address misconceptions and empower the patient with knowledge about the physiological process of labor and available pain management.
Choice C rationale
Telling a patient not to worry and that they will do fine is a form of non-therapeutic communication known as false reassurance. It minimizes the patient's legitimate concerns and may make her feel that her feelings are being ignored or undervalued. This approach shuts down further communication, preventing the nurse from identifying specific stressors or educational needs. In a clinical setting, valid fears should be met with empathy and factual information rather than generic platitudes.
Choice D rationale
Claiming that the actual experience of labor is not scary is a subjective statement that may not reflect the reality for many women. Labor can be intense, painful, and unpredictable, and minimizing this reality can lead to a lack of preparation or a sense of failure if the experience is difficult. Nurses should avoid imposing their own interpretations of the experience on the patient. Instead, the focus should remain on providing realistic expectations and supporting the patient's unique journey.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Health literacy and understanding medical instructions are common barriers to consistent prenatal attendance. However, in this specific scenario, the patient expresses a desire to attend but feels an external constraint. While cognitive barriers can prevent follow through with care plans, they are often secondary to immediate socioeconomic stressors that physically prevent the patient from arriving at the healthcare facility for her scheduled appointments.
Choice B rationale
Economic instability is frequently the most significant barrier to prenatal care access. Financial concerns encompass not only the direct cost of medical visits but also indirect costs like transportation, childcare for other children, or lost wages from missing work. Assessing financial status helps the nurse identify if the patient requires social work referrals or assistance programs. The national poverty level guidelines often dictate eligibility for these essential supportive services.
Choice C rationale
Maternal age can be a source of psychological stress, especially in very young or older pregnant women. While anxiety regarding age-related risks might cause a patient to avoid care due to fear of bad news, it is statistically less likely to be the primary reason a patient says they simply cannot come. Psychological barriers are complex, yet tangible physical and financial obstacles usually take precedence in missed clinical appointments.
Choice D rationale
Perceived discrimination or a lack of cultural competence within the healthcare system can lead to mistrust and decreased utilization of services. If a patient feels judged or mistreated by staff, they are significantly less likely to return for follow-up care. While this is a critical systemic issue to address, the nurse must screen for all possible barriers, including the immediate financial and logistical ones mentioned in other choices.
Correct Answer is ["B","D"]
Explanation
Choice A rationale
Infertility medications like clomiphene citrate or letrozole are primarily indicated for female partners who experience anovulation or irregular menstrual cycles. In this specific scenario, the female partner is already documented to have regular ovulation and patent fallopian tubes. Therefore, stimulating the ovaries further does not address the primary identified issue, which is the male partner's low sperm motility, making this an inappropriate and unnecessary intervention for this specific couple.
Choice B rationale
Intrauterine insemination is a highly appropriate first-line treatment for male-factor infertility involving low motility. This procedure bypasses the cervical mucus and places a concentrated, washed sample of motile sperm directly into the uterine cavity near the time of ovulation. By reducing the distance the sperm must travel to reach the egg in the fallopian tube, the chances of fertilization are significantly improved despite the decreased swimming ability of the sperm.
Choice C rationale
An intrauterine device is a form of long-acting reversible contraception designed to prevent pregnancy by either releasing progestin or using copper to create a spermicidal environment. Placing an IUD would be entirely counterproductive for a couple that has been actively trying to conceive for eighteen months. The goal of infertility treatment is to facilitate conception, whereas an IUD is specifically indicated for those seeking to avoid pregnancy for an extended period.
Choice D rationale
In-vitro fertilization is a complex assisted reproductive technology where eggs are harvested and fertilized by sperm in a laboratory setting. If less invasive methods like intrauterine insemination fail to result in pregnancy, IVF becomes the next logical step. It is particularly effective for low sperm motility because techniques like intracytoplasmic sperm injection can be used to manually insert a single healthy sperm directly into the mature egg, ensuring fertilization occurs.
Choice E rationale
Gestational surrogacy involves another woman carrying a pregnancy for the couple and is typically reserved for cases where the female partner has no uterus, a severely compromised uterine environment, or life-threatening contraindications to pregnancy. Since the female partner in this case has regular ovulation and patent tubes, there is no clinical evidence suggesting she cannot carry a pregnancy. Surrogacy is an extreme and unnecessary measure for a couple with treatable male-factor motility issues.
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
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.