Client teaching is an important part of the maternity nurse's role. Which factor has the greatest influence on successful teaching of the gravid
... [Show More] client?
a. The client's readiness to learn.
b. The client's educational background.
c. The order in which the information is presented.
d. The extent to which the pregnancy was planned.
A
When teaching any client, readiness to learn (A) is the most important criterion. For example, the client with severe morning sickness in the first trimester may not be "ready to learn" about labor and delivery but is probably very "ready to learn" about ways to relieve morning sickness. (B and C) are factors that may influence learning, but they are not as influential as (A). Even if a pregnancy is planned and very desirable (D), the client must be ready to learn the content presented.
A 38-week primigravida who works as a secretary and sits at a computer 8 hours each day tells the nurse that her feet have begun to swell. Which instruction would be most effective in preventing pooling of blood in the lower extremities?
a. Wear support stockings.
b. Reduce salt in her diet.
c. Move about every hour.
d. Avoid constrictive clothing.
C
Pooling of blood in the lower extremities results from the enlarged uterus exerting pressure on the pelvic veins. Moving about every hour (C) will straighten out the pelvic veins and increase venous return. (A) increase venous return from varicose veins in the lower extremities but are little help with swelling. (B) might be helpful with generalized edema (which could be an indication of PIH) but is not specific for edematous lower extremities. (D) does not specifically address venous return in this particular case.
During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have
a. lower Apgar scores.
b. lower birth weights.
c. respiratory distress.
d. a higher rate of congenital anomalies.
B
Smoking is associated with low-birth-weight infants (B). Mothers are encouraged not to smoke during pregnancy. To date, significant relationships have not been found between smoking and options (A, C, or D).
A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks gestation in preterm labor. She is given 3 doses of terbutaline sulfate (Brethine) 0.25 mg subcutaneously to stop her labor contractions. The nurse plans to monitor for which primary side effect of terbutaline sulfate?
a. Drowsiness and bradycardia.
b. Depressed reflexes and increased respirations.
c. Tachycardia and a feeling of nervousness.
d. A flushed, warm feeling and a dry mouth.
C
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-adrenergic receptors in the uterine muscle to stop contractions. The beta-adrenergic agonist properties of the drug may cause tachycardia, increased cardiac output, restlessness, headache, and a feeling of "nervousness" (C). Hypotension, hypertension, and/or drowsiness may occur, but tachycardia, not (A), is a primary side effect. (B and D) are side effects of magnesium sulfate.
A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective to prevent nipple soreness?
a. Wear a cotton bra.
b. Increase nursing time gradually.
c. Correctly place the infant on the breast.
d. Manually express a small amount of milk before nursing.
C
The most common cause of nipple soreness is incorrect positioning (C) of the infant on the breast, e. g., grasping too little of the areola or grasping only the nipple. (A) helps prevent chafing. (B) is important but is not necessary for all women. (D) helps soften an engorged breast and encourages correct infant attachment but is not the BEST answer.
A full term infant is transferred to the nursery from labor and delivery. Which information is most important for the nurse to receive when planning immediate care for the newborn?
a. Length of labor and method of delivery.
b. Infant's condition at birth and treatment received.
c. Feeding method chosen by the parents.
d. History of drugs given to the mother during labor.
B
Immediate care is most dependent on the infant's current status (i. e., Apgar scores at 1 and 5 minutes) and any treatment or resuscitation that was indicated. The transitional care nurse needs the information listed in the choices (A, C, and D), but the priority is (B).
In developing a teaching plan for expectant parents, the nurse plans to include information about when the parents can expect the infant's fontanels to close. The nurse bases the explanation on knowledge that for the normal newborn, the
a. anterior fontanel closes at 2 to 4 months and the posterior by the end of the first week.
b. anterior fontanel closes at 5 to 7 months and the posterior by the end of the second week.
c. anterior fontanel closes at 8 to 11 months and the posterior by the end of the first month.
d. anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month.
D
In the normal infant the anterior fontanel closes at 12 to 18 months of age and the posterior fontanel by the end of the second month (D). These growth and development milestones should be memorized to prepare for the NCLEX. [Show Less]