A 36-week gestation gravid client is complaining of dyspnea when lying flat.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Fundal height. Dyspnea when lying flat in a 36-week gestation gravid client is indicative of supine hypotensive syndrome, also known as aortocaval compression syndrome. This occurs when the gravid uterus compresses the inferior vena cava and abdominal aorta when the client lies flat on her back. Fundal height measurement helps to assess the size of the uterus and the position of the fetus, which is crucial in determining the risk of aortocaval compression syndrome. Option A) Maternal hypertension is incorrect because dyspnea when lying flat is not typically associated with hypertension. Option C) Hydramnios (excessive amniotic fluid) is incorrect as it is not directly related to the client's symptom of dyspnea when lying flat. Option D) Congestive heart failure is incorrect in this context as the symptom is more likely related to the mechanical compression of the vena cava by the gravid uterus rather than heart failure. Educationally, understanding the significance of fundal height measurement in assessing gestational age, fetal growth, and potential complications like aortocaval compression syndrome is essential for healthcare providers involved in monitoring pregnant clients during labor. Recognizing and addressing issues like supine hypotensive syndrome promptly can help prevent complications and ensure the well-being of both the mother and the baby.

Correct Answer: A

Rationale: The correct answer is A) Promote communication between the couple and health care professionals. This is the most appropriate option as it aligns with the best practice of involving the couple in decision-making and ensuring effective communication between all parties involved in the birth process. Option B) Enable the couple to learn about the types of pain medicine used in labor is not the best choice because while it is important for the couple to be informed about pain management options, the primary focus during preconception counseling is on overall birth planning and communication. Option C) Provide the couple with a list of items that they should take to the hospital for the labor and delivery is not as essential as promoting communication between the couple and healthcare professionals. While it is important to be prepared for the hospital stay, it is not as critical in the context of preconception counseling. Option D) Give the high-risk couple a sense of control over the likelihood of having a surgical delivery is not the most appropriate choice as preconception counseling should focus on general birth planning and communication rather than specific outcomes related to high-risk situations. In an educational context, promoting communication between the couple and healthcare professionals is crucial for ensuring a positive birth experience, informed decision-making, and effective collaboration between all parties involved. Encouraging open dialogue and involvement in the birth planning process can lead to better outcomes and increased satisfaction for both the couple and healthcare providers.

Correct Answer: C

Rationale: In the context of monitoring a pregnant woman during labor, the nurse should highlight petechiae as a skin change to the health care practitioner. Petechiae are small, pinpoint hemorrhages that can occur due to increased pressure during labor, indicating potential issues with blood clotting or vascular health. This information is crucial for the healthcare provider to assess the woman's overall health status and intervene if necessary. Linea nigra and melasma are common skin changes during pregnancy caused by hormonal fluctuations and do not necessarily have direct implications for labor monitoring. Spider nevi, also known as spider veins, are dilated blood vessels that can appear during pregnancy but are not typically associated with labor complications unless they are particularly severe. Educationally, understanding these skin changes in pregnancy is important for nurses and healthcare providers to provide comprehensive care to pregnant women. Recognizing the significance of petechiae in the context of labor monitoring can help prevent potential complications and ensure the well-being of both the mother and the baby.

Correct Answer: B

Rationale: In pregnancy, it is essential to monitor vitamin intake to ensure the health of both the mother and the baby. Vitamin D should be avoided in excess during pregnancy because excessive amounts can lead to hypercalcemia in the fetus, which can result in developmental issues. Vitamin D is important for bone health and immune function, but too much can be harmful. Regarding the other options: A) Vitamin C is generally safe in pregnancy and is important for tissue repair and iron absorption. C) Vitamin B2 (niacin) is a B vitamin that is essential for metabolism and overall health, and it is safe to consume during pregnancy. D) Vitamin B12 (cobalamin) is crucial for nervous system function and red blood cell production, and adequate intake is necessary during pregnancy. Educationally, it is important for healthcare professionals and expectant mothers to be aware of the potential risks associated with excessive vitamin intake during pregnancy. Proper education and monitoring can help prevent any adverse effects on the developing baby and promote a healthy pregnancy.

Correct Answer: D

Rationale: In the context of pharmacology and pregnancy, it is crucial for healthcare providers to address the safety and efficacy of herbal supplements. The correct answer, option D, "Discuss everything with a healthcare provider," is the most appropriate advice to give regarding herbal supplements during pregnancy. This response is accurate because herbal supplements, despite being natural, can have potential risks and interactions with conventional medications that could harm both the mother and the baby. Option A, "Herbals are safe because they're natural," is incorrect because the natural origin of a substance does not guarantee its safety, as many herbs can have potent pharmacological effects. Option B, "Licorice and cat’s claw are safe," is incorrect as well because even specific herbs that are generally considered safe can still pose risks during pregnancy due to individual variations and lack of comprehensive research. Option C, "The FDA has approved herbals for pregnancy," is also incorrect because herbal supplements are not regulated by the FDA for safety and efficacy as strictly as pharmaceutical drugs. As an educator, it is essential to emphasize to nursing students the importance of consulting healthcare providers before taking any herbal supplements during pregnancy due to the potential risks involved. This ensures that pregnant individuals receive accurate information tailored to their specific health needs, promoting the well-being of both the mother and the baby.