A client is in the 10th week of her pregnancy. Which of the following symptoms would the nurse expect the client to exhibit? Select all that apply.

Correct Answer: A

Rationale: In the 10th week of pregnancy, a client may experience backache due to the growing uterus putting pressure on the lower back muscles and ligaments. This symptom is common and expected during early pregnancy. Urinary frequency is more commonly associated with early pregnancy, but it typically occurs in the first trimester due to hormonal changes and the growing uterus pressing on the bladder. Dyspnea on exertion and fatigue are symptoms that may be more commonly experienced in later stages of pregnancy, typically in the second and third trimesters, as the body undergoes more physiological changes to support the growing fetus. Educationally, understanding the timing and typical symptoms of pregnancy is crucial for nurses and healthcare providers to provide appropriate care and support to pregnant clients. Recognizing the expected symptoms at different stages of pregnancy allows for timely interventions and reassurance for the client. It is important for nurses to differentiate between normal pregnancy symptoms and potential complications to ensure the well-being of both the mother and the developing fetus.

Correct Answer: C

Rationale: In the context of pharmacology, understanding weight gain during pregnancy is crucial for monitoring maternal health. During a normal pregnancy, weight gain is expected due to the growing fetus, amniotic fluid, placenta, and increased blood volume. The recommended weight gain for a woman of normal weight with a singleton pregnancy is around 25-35 pounds. In this scenario, the correct answer is option C) 133 to 134 lb. This is because, by 24 weeks' gestation, a woman with a starting weight of 128 lb would typically have gained around 12-14 pounds. Therefore, her weight would be expected to be around 140-142 lb at 24 weeks. Option A) 129 to 130 lb and Option B) 131 to 132 lb are too low considering the normal weight gain trajectory during pregnancy. Option D) 135 to 136 lb is too high based on the expected weight gain by 24 weeks. Educationally, understanding weight gain patterns in pregnancy is essential for nurses and healthcare providers to monitor maternal and fetal well-being, assess for complications like gestational diabetes or hypertension, and provide appropriate interventions and counseling for optimal pregnancy outcomes. It also highlights the importance of individualized care and regular monitoring to ensure the health and safety of both the mother and the baby.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Reassure the mother that this is normal in the third trimester. This response is correct because the white liquid leaking from the client's breasts is most likely colostrum, which is the first milk produced by the mammary glands during pregnancy. This occurrence is normal in the third trimester as the body prepares for breastfeeding. Option A) Advise the woman that she may have a galactocele is incorrect because a galactocele is a milk-filled cyst, which is not typically associated with the white liquid seen in this situation. Option B) Encourage the woman to pump her breasts to stimulate an adequate milk supply is incorrect as pumping is not necessary at this stage of pregnancy and may not be effective in stimulating milk production. Option C) Assess the liquid because a breast discharge is diagnostic of a mammary infection is incorrect because the white liquid in this case is most likely colostrum and not a sign of infection. Educationally, understanding the normal physiological changes in pregnancy, including breast changes such as colostrum production, is crucial for healthcare providers working with pregnant individuals. It is important to reassure and educate expectant mothers about these changes to alleviate concerns and promote confidence in the natural processes of pregnancy.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Dizziness. When a 36-week gestation gravid lies flat on her back, she may experience dizziness due to the supine hypotensive syndrome. This condition occurs because the weight of the uterus compresses the inferior vena cava when the mother is in a supine position, leading to decreased venous return and cardiac output, resulting in dizziness. Option A) Hypertension is incorrect because lying flat on the back does not typically cause hypertension in this context. Option C) Rales refers to abnormal crackling sounds heard on auscultation of the lungs and is not directly related to the scenario described. Option D) Chloasma is a skin condition characterized by hyperpigmentation, which is unrelated to the positional change described in the question. Educationally, it is crucial for healthcare providers to be aware of the potential complications associated with maternal positioning, especially in advanced maternal age pregnancies. Understanding the physiological changes that occur during pregnancy and how they can impact maternal well-being is essential for providing safe and effective care to pregnant individuals. By recognizing the signs and symptoms of supine hypotensive syndrome, healthcare providers can take appropriate measures to ensure maternal comfort and safety during pregnancy.

Correct Answer: B

Rationale: The correct answer is B) Develop a preliminary birth plan. This option is the most appropriate because it focuses on proactive preparation and empowerment of the couple during their pregnancy journey. Developing a birth plan allows the couple to articulate their preferences and expectations for labor and delivery, fostering communication with healthcare providers and ensuring their wishes are considered. Option A) Take a tour of hospital delivery areas may be beneficial in familiarizing the couple with the physical environment, but it does not directly address their care provider selection process. Option C) Making appointments with multiple obstetric care providers is important for evaluating and selecting the most suitable provider based on the couple's preferences and needs. However, this step should come after initial preparation, like developing a birth plan. Option D) Searching the Internet for malpractice histories of providers is not a recommended approach as it may not provide a comprehensive or accurate assessment of a provider's competency or quality of care. In an educational context, this question emphasizes the importance of proactive and informed decision-making in choosing obstetric care providers. It highlights the significance of early preparation and communication in the prenatal care process, ultimately aiming to empower expectant parents to actively participate in their healthcare decisions for a positive pregnancy experience.