A pregnant patient at 32 weeks gestation reports severe heartburn. What should the nurse recommend to relieve symptoms?

Correct Answer: B

Rationale: The correct answer is B: Eat smaller, more frequent meals and avoid lying down after eating. This recommendation helps prevent acid reflux by reducing the pressure on the stomach and ensuring that the stomach is not overly full. Eating smaller meals more frequently prevents the stomach from becoming too full, which can trigger heartburn. Avoiding lying down after eating helps prevent stomach acid from flowing back into the esophagus. Options A, C, and D are incorrect. Taking antacids after every meal can lead to excessive intake and potential side effects. Drinking water immediately after meals may exacerbate heartburn by diluting stomach acid further. Increasing caffeine intake can worsen heartburn symptoms due to its ability to relax the lower esophageal sphincter.

Correct Answer: B

Rationale: The correct answer is B: Instruct the patient to increase fluid intake and stand slowly. This recommendation is appropriate because the patient is likely experiencing orthostatic hypotension due to the expanding uterus compressing blood vessels, leading to decreased blood flow to the brain when standing. Increasing fluid intake helps maintain blood volume, while standing slowly helps prevent sudden drops in blood pressure. A: Rising quickly can worsen dizziness by further decreasing blood flow to the brain. C: Resting in bed may not address the underlying issue of orthostatic hypotension and may lead to deconditioning. D: Avoiding standing for long periods may be impractical and may not address the need to maintain adequate blood volume and prevent sudden drops in blood pressure.

Correct Answer: A

Rationale: The correct answer is A: The patient's blood pressure and hydration status should be assessed first because dizziness and lightheadedness can be indicative of hypotension or dehydration, common issues during pregnancy. Monitoring blood pressure will help determine if the symptoms are related to low blood pressure, and assessing hydration status can identify if the patient needs to increase fluid intake. Summary of other choices: B: Assessing fetal heart rate and activity is important but not the priority in this situation as the focus should be on the maternal health first. C: Checking hemoglobin and hematocrit levels is important for detecting anemia, but it is not the initial assessment for dizziness and lightheadedness. D: Monitoring weight gain and diet history are essential aspects of prenatal care but are not the immediate concerns when a pregnant patient is experiencing dizziness and lightheadedness.

Correct Answer: A

Rationale: The correct answer is A. Leg cramps and lower back pain in pregnancy can be relieved by taking a warm bath and performing leg stretches. Warm water helps relax muscles, while stretching can alleviate muscle tension. This is safe and effective for pregnant patients. Choice B is incorrect because applying a heating pad may not be recommended during pregnancy due to the risk of overheating. Resting in bed may provide temporary relief but does not address the underlying cause. Choice C is incorrect because increasing calcium intake and taking over-the-counter pain medications may not specifically target muscle cramps and back pain. It is essential to address the symptoms directly. Choice D is incorrect because encouraging light physical activity may be beneficial, but avoiding long periods of rest may not be necessary. Stretching and warm baths are more specific interventions for muscle cramps and back pain.

Correct Answer: B

Rationale: The correct answer is B: ultrasound. Ultrasound is the most accurate and non-invasive method to determine the presentation of the fetus by visualizing the position of the baby in the womb. It allows the nurse to see if the fetus is in a cephalic (head-down) or breech (feet or buttocks down) position. This information is crucial for assessing the progress of labor and planning appropriate interventions. A: Vaginal exam is not typically used to determine fetal presentation as it does not provide a clear view of the baby's position. C: Palpation of contractions helps assess the strength and frequency of contractions but does not directly determine fetal presentation. D: Laboring person interview may provide valuable information about symptoms and history but does not offer direct insight into fetal presentation.