A nurse is caring for a client who is in the transition phase of labor. Which of the following...

Correct Answer: B

Rationale: The correct answer is B: Monitor contractions every 30 min. During the transition phase of labor, contractions are typically intense and frequent. Monitoring contractions every 30 minutes allows the nurse to assess the progress of labor and ensure the safety of both the mother and the baby. This helps in identifying any abnormalities or complications that may arise during this critical stage. A: Assisting the client to void every 3 hr is important, but it is not specific to the transition phase of labor. C: Placing the client into a lithotomy position is not recommended during the transition phase as it can restrict blood flow and increase the risk of complications. D: Encouraging the client to use a pant-blow breathing pattern is a relaxation technique more suited for the earlier stages of labor, not the transition phase.

Correct Answer: B

Rationale: The correct answer is B: Risk for injury. This is because families with special needs in childbearing may face unique challenges leading to potential risks of injury, such as physical limitations or difficulties in providing adequate care. Option A is incorrect as spiritual distress is not directly related to physical safety. Option C is incorrect as enhanced nutrition readiness does not directly address safety concerns. Option D is incorrect as ineffective breathing pattern is a specific health issue not necessarily related to the family's safety. Therefore, B is the most appropriate nursing diagnosis for addressing safety concerns in the childbearing family with special needs.

Correct Answer: D

Rationale: The correct answer is D: Heartburn may be relieved by sitting up after. This is because during pregnancy, the growing uterus can push stomach acids upward, causing heartburn. Sitting up after eating can help prevent acid reflux by allowing gravity to keep stomach contents down. Choice A is incorrect as increased saliva production during pregnancy is not related to toothbrush hardness. Choice B is incorrect because uteroplacental insufficiency is not related to the client's gastrointestinal system. Choice C is incorrect as umbilical cord compression is a separate issue and not related to heartburn relief.

Correct Answer: A

Rationale: The correct answer is A: Correctly positioning the infant for feedings. This is the most appropriate intervention as it addresses the specific issue of increased oral mucus in an infant, which can be a sign of difficulty feeding and potential aspiration. Positioning the infant correctly can help facilitate safe and effective feeding, reducing the risk of complications. Summary of why other choices are incorrect: B: IV fluid replacement with 5% dextrose - This choice does not directly address the issue of increased oral mucus and hypovolemic shock due to postpartum hemorrhage. C: Initiating cardiopulmonary resuscitation - This choice is not indicated for the given scenario and is more appropriate for a life-threatening emergency situation. D: Administration of oxygen with a nonrebreather - While oxygen may be necessary in certain cases, it does not address the specific issue of increased oral mucus and hypovolemic shock due to postpartum hemorrhage.

Correct Answer: A

Rationale: The correct answer is A: as a novel approach to pregnancy where low-intervention, medication-free births were the goal. The Bradley Method was introduced in the late 1940s by Dr. Robert Bradley with the aim of empowering women to have natural childbirth experiences without unnecessary medical interventions. This method promotes education and preparation for childbirth, emphasizing relaxation techniques, partner involvement, and natural pain management strategies. The other choices, B, C, and D, are incorrect because they do not align with the fundamental principles of the Bradley Method, which focuses on promoting low-intervention, medication-free births through education and empowerment of expectant parents.