The nurse is assessing a client in their first trimester of pregnancy. When assessing the client's breasts, which finding would the nurse likely observe?
Darkened, enlarged breast areola
Deeply fissured nipples
Enlarged axillary lymph nodes
Slack, soft breast tissue
The Correct Answer is A
A. Darkened, enlarged breast areola: During the first trimester of pregnancy, hormonal changes cause the areolas to darken and enlarge. This is a common and normal finding as the body prepares for breastfeeding.
B. Deeply fissured nipples: Fissured or cracked nipples are not typically observed in the first trimester of pregnancy. This may occur later when the breasts begin to produce milk, especially during breastfeeding.
C. Enlarged axillary lymph nodes: While some mild enlargement of lymph nodes may occur in response to hormonal changes, this is not a typical or significant finding during the first trimester. Any enlarged lymph nodes should be assessed to rule out other conditions.
D. Slack, soft breast tissue: Breast tissue during the first trimester tends to be firm and may feel more tender or swollen due to hormonal changes, rather than slack and soft. This is a normal part of early pregnancy as the body prepares for future lactation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "I could give Kaopectate as long as I follow the directions on the bottle": Kaopectate and other anti-diarrheal medications should not be given to infants, as they can have serious side effects and may not be safe for young children with gastroenteritis.
B. "I should take the baby's temperature and call my health care provider": While taking the baby's temperature is a good assessment measure, and calling the healthcare provider for concerning symptoms is always appropriate, this statement focuses on seeking medical attention rather than the immediate actions.
C. "I should offer milk after each episode of diarrhea": Offering milk right after each episode of diarrhea may irritate the stomach and worsen symptoms. It is generally better to offer clear fluids like oral rehydration solutions to prevent dehydration first, then gradually reintroduce milk as the child improves.
D. "I should offer foods and fluid frequently to prevent dehydration": Offering fluids, especially oral rehydration solutions, frequently and in small amounts helps prevent dehydration, which is a major concern in infants with gastroenteritis. Fluids should be offered regularly, and solids can be reintroduced slowly as tolerated.
Correct Answer is ["A","B","C","D"]
Explanation
A. Fetal tone: Fetal tone is a key component of the BPP. This assessment evaluates the fetus's muscle tone by observing spontaneous extension and flexion of an extremity or the trunk. A normal score indicates good neurological function and fetal well-being.
B. Fetal breathing movement: Fetal breathing movement in BPP involves observing episodes of fetal breathing movements over a certain period, typically at least one episode lasting 30 seconds within 30 minutes. Normal breathing movements indicates a mature and healthy central nervous system.
C. Amniotic fluid volume: The amniotic fluid volume (AFV) is assessed as part of the BPP, usually by measuring the amniotic fluid index (AFI) or the single deepest pocket. Adequate amniotic fluid indicates good renal perfusion and placental function, reflecting long-term fetal well-being.
D. Non-stress test: The non-stress test evaluates fetal heart rate and its response to fetal movements, which provides information about fetal well-being. A reactive NST, characterized by accelerations of the fetal heart rate, indicates a healthy, well-oxygenated fetus with an intact neurological system.
E. Fetal gender: Fetal gender is not part of the biophysical profile, it can often be determined during an ultrasound examination. The BPP focuses on fetal health and well-being, not gender identification.
F. Fetal neck translucency: Fetal neck translucency (also known as nuchal translucency) is measured during the first trimester screening for Down syndrome, not during the BPP. The BPP does not include this component.
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