What should the nurse do first if a pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured and her skin is pale and moist?

Raise the woman's legs.

Have the woman breathe into a paper bag.

Turn the woman on her side.

Assess the woman's blood pressure and pulse.

Answer and Explanation

The Correct Answer is C

Choice A reason: Raising the woman's legs is not the best initial response, as it may worsen the dizziness and light-headedness. This is because raising the legs can increase the blood flow to the lower extremities and decrease the blood flow to the brain, which can cause hypotension (low blood pressure) and hypoxia (low oxygen) in the woman and the fetus.

Choice B reason: Having the woman breathe into a paper bag is not the best initial response, as it may not address the underlying cause of the dizziness and light-headedness. This technique is usually used for hyperventilation (rapid breathing), which can cause respiratory alkalosis (high blood pH) and reduce the carbon dioxide levels in the blood. However, the woman may not be hyperventilating, but rather experiencing supine hypotensive syndrome (low blood pressure when lying on the back) due to the pressure of the uterus on the inferior vena cava (a large vein that returns blood to the heart)².

Choice C reason: Turning the woman on her side is the best initial response, as it can relieve the dizziness and light-headedness by improving the blood flow to the brain and the fetus. This is because turning the woman on her side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output (the amount of blood pumped by the heart) and the blood pressure. The left lateral position is preferred, as it can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.

Choice D reason: Assessing the woman's blood pressure and pulse is an important response, but not the first one. After turning the woman on her side, the nurse should monitor the vital signs and the fetal heart rate to evaluate the condition of the woman and the fetus. The nurse should also check for other signs and symptoms of supine hypotensive syndrome, such as nausea, sweating, and visual disturbances.

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Correct Answer is ["A","B","C"]

Explanation

Choice A reason: Normal weight women should gain 11.5 to 16 kg during pregnancy, according to the Institute of Medicine (IOM) guidelines. This is based on the body mass index (BMI) of 18.5 to 24.9 before pregnancy.

Choice B reason: Underweight women should gain 12.5 to 18 kg during pregnancy, according to the IOM guidelines. This is based on the BMI of less than 18.5 before pregnancy. Underweight women are at risk of having low birth weight infants, so they need to gain more weight to support fetal growth and development.

Choice C reason: Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale, according to the IOM guidelines. This is because adolescents are still growing themselves and need extra nutrients and calories to meet their own needs and those of the fetus.

Choice D reason: In twin gestations, the weight gain recommended for a single fetus pregnancy should not be simply doubled. The IOM guidelines suggest that women with twin gestations should gain 16.5 to 24.5 kg if they have a normal weight before pregnancy, 14 to 22.5 kg if they are overweight, and 11 to 19 kg if they are obese.

Choice E reason: Obese women should gain at least 7 to 11.5 kg during pregnancy, according to the IOM guidelines. This is based on the BMI of 30 or more before pregnancy. Obese women are at risk of having complications such as gestational diabetes, preeclampsia, and cesarean delivery, so they need to limit their weight gain to avoid further complications.

A. Nonreactive B. Reactive C. Positive D. Negative

Correct Answer is B

Explanation

Choice A reason: Nonreactive is not the correct result, as it indicates that the FHR does not show adequate accelerations with fetal movement. A nonreactive NST means that the FHR does not increase by at least 15 beats/min for at least 15 seconds in a 20-minute period. A nonreactive NST may suggest fetal hypoxia (low oxygen) or fetal sleep.

Choice B reason: Reactive is the correct result, as it indicates that the FHR shows adequate accelerations with fetal movement. A reactive NST means that the FHR increases by at least 15 beats/min for at least 15 seconds twice or more in a 20-minute period. A reactive NST is reassuring and suggests that the fetus is well-oxygenated and healthy.

Choice C reason: Positive is not the correct result, as it is not used to describe the NST. Positive is a term used for the contraction stress test (CST), which is a different test that measures the FHR in response to uterine contractions. A positive CST means that the FHR shows late decelerations (decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends) with at least 50% of the contractions. A positive CST indicates uteroplacental insufficiency (a condition where the placenta does not deliver enough oxygen and nutrients to the fetus) and fetal distress.

Choice D reason: Negative is not the correct result, as it is also not used to describe the NST. Negative is another term used for the CST, which is a different test that measures the FHR in response to uterine contractions. A negative CST means that the FHR does not show any late decelerations during at least three contractions in a 10-minute period. A negative CST is reassuring and suggests that the fetus is well-oxygenated and can tolerate labor.

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What should the nurse do first if a pregnant woman at 32 weeks of gestation complains of feeling dizzy and light-headed while her fundal height is being measured and her skin is pale and moist?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? (Select all that apply)

Correct Answer is ["A","B","C"]

Explanation

What is the result of a nonstress test (NST) in which two or more fetal heart rate (FHR) accelerations of 15 beats/min or more occur with fetal movement in a 20-minute period?

Correct Answer is B

Explanation

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