A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but 'I still think I am pregnant.' Which of the following statements would be appropriate for the nurse to make at this time?

Correct Answer: B

Rationale: In this scenario, option B, "We could do a blood test to check," is the most appropriate response for the nurse to make. This is because a blood test for pregnancy, specifically measuring the hormone human chorionic gonadotropin (hCG), is more sensitive and accurate than a home pregnancy test, especially in early pregnancy. By suggesting a blood test, the nurse can provide a more definitive answer to the client's uncertainty. Option A, "Your period is probably just irregular," is incorrect because it dismisses the client's concerns without further investigation. Option C, "Home pregnancy test results are very accurate," is incorrect as it may mislead the client into trusting the negative result without considering other factors. Option D, "My recommendation would be to repeat the test in one week," is less ideal than option B because it delays the client from seeking a more accurate test promptly. Educationally, this question highlights the importance of understanding the limitations of home pregnancy tests and the significance of healthcare professionals guiding clients towards more reliable diagnostic methods, such as blood tests, to confirm pregnancy accurately. It emphasizes the role of nurses in providing evidence-based care and promoting informed decision-making for clients.

Correct Answer: D

Rationale: The correct answer is D) The test should take one hour to complete. Rationale: The preprocedure teaching for a glucose challenge test (GCT) is crucial for the patient to understand what to expect during the test. The correct answer, D, is essential because it informs the pregnant woman about the expected duration of the test, which is approximately one hour. This information helps the patient plan accordingly and manage their time efficiently on the day of the test. Option A, fasting for 12 hours before the test, is incorrect because a GCT does not require fasting. In fact, fasting can affect the results of the test, leading to inaccurate findings. Option B, bringing a urine specimen to the laboratory on the day of the test, is also incorrect as a GCT does not involve testing urine. The test primarily involves blood samples to measure glucose levels. Option C, being prepared to have 4 blood specimens taken on the day of the test, is incorrect as well. Typically, a GCT requires only one or two blood samples to be drawn at specific time points during the test, not four. Educational context: Understanding the instructions for a GCT is vital for pregnant women as it helps in ensuring accurate test results and a smooth testing experience. By providing clear and accurate preprocedure teaching, healthcare providers can help alleviate anxiety, improve patient compliance, and enhance the overall quality of care provided to pregnant women undergoing this test.

Correct Answer: B

Rationale: The correct answer is B) Nodular breast tissue is normal during pregnancy. This response is based on the understanding that hormonal changes during pregnancy can lead to breast changes, including nodularity and lumps, which are usually benign and part of the normal physiological process of pregnancy. Educating the client about these normal changes can help alleviate her fears and concerns. Option A is incorrect because breast cancer is not typically triggered by pregnancy itself, although changes in the breasts during pregnancy may lead to concerns about cancer. Option C is incorrect as there is no evidence in the scenario provided to suggest that the woman is exhibiting signs of a psychotic break. Her fear and anxiety are understandable given her gestational stage and lack of knowledge about normal breast changes. Option D is incorrect as anxiety attacks are not specifically associated with the second trimester of pregnancy. While anxiety and stress can occur at any point during pregnancy, the woman's concerns about breast changes should be addressed with accurate information rather than generalized statements about anxiety. In an educational context, it is crucial for healthcare providers to have a thorough understanding of the normal physiological changes that occur during pregnancy to provide appropriate support and information to pregnant individuals. Addressing fears and concerns with accurate knowledge and empathy is essential in promoting the well-being of both the mother and the baby.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Fundal height. During pregnancy, fundal height measurement is a crucial parameter to monitor fetal growth and development. In this case, the client's complaint of dyspnea when lying flat could be indicative of supine hypotensive syndrome, a condition where the weight of the uterus compresses the inferior vena cava when the mother is lying on her back, leading to decreased venous return and subsequent hypotension. Option A) Maternal hypertension is incorrect as dyspnea when lying flat is not a typical symptom of hypertension. Option C) Hydramnios refers to excessive amniotic fluid, which may present with other symptoms such as abdominal discomfort or rapid uterine growth, but not necessarily dyspnea when lying flat. Option D) Congestive heart failure is less likely in a 36-week pregnant client without a history of cardiac issues. Educationally, understanding the significance of fundal height measurement in monitoring fetal well-being and recognizing signs and symptoms of complications during pregnancy are essential skills for healthcare providers involved in maternity care. It is vital to differentiate between normal discomforts of pregnancy and potential warning signs that require prompt assessment and intervention to ensure the well-being of both the mother and baby.

Correct Answer: D

Rationale: The correct answer is D) How do you feel about having an episiotomy? During labor, it is crucial for the nurse to discuss interventions that may be necessary, such as an episiotomy, with the mother. An episiotomy is a surgical incision made during childbirth to enlarge the vaginal opening. This question is essential as it directly pertains to the woman's birthing experience and involves her in decision-making regarding her care. Option A) Do you plan to breastfeed your baby? While breastfeeding is important, this question is not directly relevant to monitoring the baby during labor. Option B) What do you plan to name the baby? Naming the baby is a personal decision that does not impact the monitoring of the baby during labor. Option C) Which pediatrician do you plan to use? Selecting a pediatrician is important but is not directly related to monitoring the baby during labor. In an educational context, this question highlights the importance of discussing interventions with the mother during labor to ensure her informed decision-making and involvement in her care. By addressing concerns like episiotomy, healthcare providers can provide individualized care and support to mothers during childbirth.