A patient who smokes one pack of cigarettes daily has a positive pregnancy test. The nurse will explain that smoking during pregnancy increases the risk of which condition?

Correct Answer: B

Rationale: The correct answer is B: Death before or after birth. Smoking during pregnancy increases the risk of fetal death, both before and after birth, due to the harmful effects of nicotine and other toxins on the developing fetus. Smoking can lead to complications such as placental abruption, preterm birth, low birth weight, and stillbirth. A: Congenital anomalies - While smoking during pregnancy can increase the risk of certain birth defects, the primary concern related to smoking is not congenital anomalies. C: Neonatal hypoglycemia - Smoking during pregnancy is not directly linked to neonatal hypoglycemia, which is usually related to maternal diabetes or other factors. D: Neonatal withdrawal syndrome - Although smoking during pregnancy can lead to nicotine exposure in the fetus, resulting in withdrawal symptoms after birth, the immediate risk of death is a more critical concern associated with smoking during pregnancy.

Correct Answer: C

Rationale: The correct answer is C: Coping with common discomforts of pregnancy. Early pregnancy classes in the first and second trimesters focus on providing expecting mothers with strategies to manage common physical and emotional challenges during pregnancy. This includes information on dealing with nausea, fatigue, backaches, and emotional changes. Understanding and coping with these discomforts can help pregnant women have a more comfortable and healthy pregnancy. A: Methods of pain relief are typically covered in childbirth preparation classes closer to the due date, not in early pregnancy classes. B: The phases and stages of labor are usually discussed in depth in childbirth education classes taken later in pregnancy, not in early pregnancy classes. D: Prebirth and postbirth care of a patient having a cesarean birth is a specific topic that may be covered in a separate class for women who are planning or have been recommended to have a cesarean birth, not typically in early pregnancy classes.

Correct Answer: B

Rationale: The correct answer is B: Effleurage. Effleurage is a type of massage technique involving long, gentle strokes on the skin. Massaging the abdomen with effleurage can help improve circulation, relax muscles, and promote digestion. Imagery (A) is a technique involving mental visualization, not physical touch. Mental stimulation (C) refers to cognitive activities, not physical touch. Thermal stimulation (D) involves the application of temperature changes, not massage. Therefore, effleurage is the most suitable choice for massage of the abdomen.

Correct Answer: D

Rationale: Step-by-step rationale for why answer D is correct: 1. Breathing techniques help in managing pain perception during labor. 2. By assisting the patient in breathing methods, she gains control over her pain perception. 3. Controlled breathing can help distract from the intensity of contractions. 4. By focusing on breathing patterns, the patient can stay calm and manage pain effectively. Summary: A, B, and C are incorrect because they do not address pain management directly through breathing techniques. Option A relies on distraction, B focuses on isolation rather than coping mechanisms, and C suggests heavy reliance on medication rather than self-control.

Correct Answer: A

Rationale: The correct answer is A: During labor, when she can no longer talk through contractions. This is the best time to encourage slow, deep chest breathing as it helps the laboring patient stay calm, focused, and manage pain effectively during the intense active phase of labor. When a woman reaches the point where she can no longer talk through contractions, it indicates that she is in the active phase of labor and may benefit from slow, deep breathing to help cope with the intensity of contractions. Explanation for why other choices are incorrect: B: During the first stage of labor, when the contractions are 3 to 4 minutes apart - Contractions being 3 to 4 minutes apart may not necessarily indicate the active phase of labor requiring slow, deep breathing. C: Between contractions, during the transitional phase of the first stage of labor - Transitional phase contractions are typically intense and close together, making it less ideal for relaxation breathing between contractions. D: Between her efforts