A pregnant woman asks why she needs to take a folic acid supplement. What is the nurse's best explanation for the administration of folic acid?

Correct Answer: B

Rationale: Folic acid is essential for pregnant women as it plays a crucial role in preventing neural tube defects in the developing fetus. Neural tube defects are serious birth defects that affect the brain, spine, or spinal cord of the baby. By taking a folic acid supplement, the pregnant woman ensures that her baby's neural tube develops properly, reducing the risk of these defects. Choice A is incorrect because folic acid does not prevent the development of contractions. Contractions are a natural part of the labor process and are not influenced by folic acid intake. Choice C is incorrect because folic acid does not build strong fetal bones. While calcium and vitamin D are important for bone development, folic acid primarily focuses on preventing neural tube defects, not bone health. Choice D is incorrect because folic acid does not decrease nausea and vomiting. Nausea and vomiting, commonly known as morning sickness, are common symptoms of pregnancy and are not directly influenced by folic acid intake. In summary, the correct answer is B because folic acid is crucial for preventing neural tube defects in the developing fetus. The other choices are incorrect as they do not accurately explain the role of folic acid in pregnancy.

Correct Answer: D

Rationale: Magnesium sulfate is commonly used to prevent seizures in patients with preeclampsia or to stop preterm labor. At elevated levels, magnesium can lead to toxicity, which can present with various signs and symptoms. In this scenario, the patient's serum magnesium level is high at 11 mg/dL. Option A: Tachypnea is not typically associated with magnesium toxicity. Instead, respiratory depression is more common due to the central nervous system depression caused by high magnesium levels. Option B: Muscle rigidity is not a typical sign of magnesium toxicity. Instead, magnesium toxicity is more likely to manifest as muscle weakness or paralysis due to its neuromuscular effects. Option C: Tachycardia is not a common sign of magnesium toxicity. In fact, magnesium sulfate is often used to treat certain types of tachycardias by stabilizing the cardiac cell membrane. Option D: Depressed deep tendon reflexes is the correct answer. High levels of magnesium can lead to neuromuscular blockade, causing decreased muscle tone and reflexes. This is a hallmark sign of magnesium toxicity and warrants immediate medical intervention. In conclusion, the patient with an elevated serum magnesium level of 11 mg/dL is likely to present with depressed deep tendon reflexes as a sign of magnesium toxicity. It is crucial for healthcare providers to monitor magnesium levels closely and be aware of the signs and symptoms of magnesium toxicity to prevent adverse outcomes.

Correct Answer: B

Rationale: When administering magnesium sulfate, it is crucial for the nurse to assess for respiratory depression. Magnesium sulfate is a central nervous system depressant that can lead to respiratory depression, especially if given in high doses or too rapidly. This can result in decreased respiratory rate, shallow breathing, and even respiratory arrest. Therefore, monitoring the patient's respiratory status is essential to prevent any potential complications. Dry, pale skin (choice A) is not a common side effect or assessment finding associated with magnesium sulfate administration. Instead, magnesium sulfate may cause flushing or warmth of the skin due to vasodilation. Agitation (choice C) is also not a typical assessment finding related to magnesium sulfate administration. In fact, magnesium sulfate is often used to treat agitation in conditions such as pre-eclampsia or eclampsia by exerting a calming effect on the central nervous system. Tachycardia (choice D) is not a common side effect of magnesium sulfate. In fact, magnesium sulfate is known to have a negative chronotropic effect, meaning it can slow down the heart rate. Therefore, monitoring for bradycardia rather than tachycardia would be more appropriate when administering magnesium sulfate.

Correct Answer: C

Rationale: Gastroesophageal reflux is a common issue during pregnancy due to hormonal changes and increased intra-abdominal pressure. Ranitidine (Zantac) is the most highly recommended medication for a pregnant woman experiencing GERD. A: Terbutaline (Brethine) is a bronchodilator used to relax smooth muscles in the airways, not to treat GERD. It is not recommended for this condition during pregnancy. B: Diphenoxylate (Lomotil) is an antidiarrheal medication used to treat diarrhea, not GERD. It is not appropriate for managing GERD symptoms in a pregnant woman. D: Chlorothiazide (Diuril) is a diuretic medication used to treat high blood pressure and edema by increasing urine output. It has no direct effect on GERD symptoms and is not recommended for pregnant women with GERD. Ranitidine (Zantac) is a histamine-2 blocker that reduces stomach acid production, providing relief from GERD symptoms. It is considered safe for use during pregnancy and is commonly recommended for pregnant women experiencing gastroesophageal reflux. It helps alleviate symptoms without posing significant risks to the developing fetus.

Correct Answer: D

Rationale: Dinoprostone (Cervidil) is the correct answer for promoting cervical ripening in a woman at 42 weeks of gestation. Dinoprostone is a prostaglandin E2 analog that helps soften and dilate the cervix, making it more favorable for labor induction. It can be administered intravaginally, leading to cervical ripening within hours. This medication is commonly used in post-term pregnancies to initiate labor and reduce the risk of complications associated with prolonged gestation. A: Calcium gluconate is not used for cervical ripening. Calcium gluconate is a mineral supplement used to treat calcium deficiencies or to prevent complications of hyperkalemia or hypermagnesemia. It is not indicated for labor induction or cervical ripening. B: Magnesium sulfate is a tocolytic agent used to prevent preterm labor by relaxing uterine smooth muscle. It is not used for cervical ripening in post-term pregnancies. Magnesium sulfate is commonly used to prevent seizures in preeclampsia or to reduce uterine contractions in preterm labor. C: Terbutaline (Brethine) is a beta-agonist medication used to relax uterine smooth muscle and inhibit uterine contractions. It is primarily used as a tocolytic agent to delay preterm labor. Terbutaline is not indicated for cervical ripening in post-term pregnancies.