A nurse is assessing a pregnant patient who is at 34 weeks gestation and reports swelling in the legs and feet. What is the nurse's priority action?

Correct Answer: A

Rationale: The correct answer is A: Monitor the patient's blood pressure and assess for signs of preeclampsia. At 34 weeks gestation, swelling in the legs and feet can be a sign of preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. The priority action is to assess for signs of preeclampsia, as it can lead to severe complications for both the mother and the baby. Monitoring blood pressure is crucial in identifying preeclampsia early. Choice B is incorrect because while elevating the feet may provide some relief from swelling, it does not address the potential underlying issue of preeclampsia. Choice C is incorrect because administering a diuretic without assessing for preeclampsia can be dangerous and potentially harmful to the patient and the baby. Choice D is incorrect because reducing fluid intake can lead to dehydration, which is not a recommended approach in pregnancy without proper assessment and guidance from healthcare providers.

Correct Answer: D

Rationale: The correct answer is D: Discussing the signs and symptoms of preterm labor. This is crucial at 20 weeks gestation as preterm labor can occur. By educating the patient on the signs and symptoms, the nurse can empower her to recognize and seek prompt medical attention if needed. Assessing for gestational hypertension (A) is important but typically done later in pregnancy. Encouraging avoidance of all forms of exercise (B) is not recommended as moderate exercise is beneficial during pregnancy. Reviewing newborn care practices and breastfeeding options (C) is important but not the priority at this stage.

Correct Answer: B

Rationale: The correct answer is B: Increased blood volume and decreased blood pressure. At 28 weeks gestation, the pregnant patient's blood volume significantly increases to support the developing fetus, causing a relative decrease in blood pressure when standing up (orthostatic hypotension). This can lead to lightheadedness and fainting. Dehydration and electrolyte imbalance (choice A) can contribute to these symptoms but are less likely in a pregnant patient. Iron-deficiency anemia (choice C) can cause similar symptoms but is less common at 28 weeks gestation. Hyperglycemia from gestational diabetes (choice D) typically presents with other symptoms like excessive thirst and urination, rather than lightheadedness and fainting.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's hemoglobin and hematocrit levels to check for anemia. Fatigue and weakness in pregnancy can be symptoms of anemia, a common condition due to increased blood volume demands. By checking hemoglobin and hematocrit levels, the nurse can confirm or rule out anemia as the cause. Resting alone may not address the underlying issue, and high-calorie diet or regular exercise may not be appropriate if anemia is present. It is crucial to identify the root cause to provide the most effective intervention.

Correct Answer: C

Rationale: The correct answer is C because excessive weight gain during pregnancy can indeed increase the risk of complications such as gestational diabetes and preeclampsia. By emphasizing this point, the nurse can help the patient understand the importance of monitoring their weight gain to promote a healthy pregnancy. Choice A is not as strong because it focuses more on discussing concerns with the healthcare provider rather than the specific risks associated with excessive weight gain. Choice B is incorrect as weight gain during pregnancy should be monitored and managed appropriately. Choice D is also incorrect as it suggests limiting caloric intake, which may not be safe or appropriate for the patient and her developing fetus.