A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands?

Correct Answer: A

Rationale: The correct answer is option A) "Due to my weight, there is a possibility that I may develop gestational diabetes." This response indicates that the patient understands the increased risk of gestational diabetes associated with being overweight. Obesity is a well-known risk factor for gestational diabetes as excess weight can lead to insulin resistance, which is a key factor in the development of diabetes during pregnancy. Option B is incorrect because weight is a significant risk factor for gestational diabetes, regardless of whether the patient considers themselves overweight or not. Option C is irrelevant to the question as it talks about the patient's mother's medical history, which does not directly relate to the patient's risk factors. Option D is incorrect because while a glucose tolerance test may be necessary, it does not address the underlying risk factor of weight in relation to gestational diabetes. Educationally, this question highlights the importance of patient education on risk factors for complications during pregnancy. It emphasizes the need for healthcare providers to educate patients on how factors like weight can impact their pregnancy and the importance of managing these risks to ensure a healthy outcome for both the mother and the baby.

Correct Answer: D

Rationale: The correct answer is D) Her child may have impaired brain development. Smoking during pregnancy is a known risk factor for adverse outcomes in the developing fetus. Nicotine and other harmful chemicals in cigarettes can restrict blood flow to the placenta, leading to decreased oxygen and nutrient delivery to the fetus, which can result in impaired brain development. Option A is incorrect as the patient's smoking habits do not directly correlate with her choice to breastfeed her infant. Option B is incorrect because while smoking can increase the risk of preterm birth, this information was not provided in the scenario. Option C is incorrect as the patient's educational background was not mentioned and is not directly related to the effects of smoking on the developing fetus. In an educational context, it is crucial for healthcare providers, especially nurses, to understand the impact of maternal behaviors such as smoking on fetal development. This knowledge allows nurses to provide appropriate education and support to pregnant women to help them make informed decisions that promote the health and well-being of both the mother and the developing fetus. Understanding the implications of maternal smoking can guide nurses in developing individualized care plans and interventions to mitigate potential risks and promote positive outcomes for both the mother and the newborn.

Correct Answer: D

Rationale: The correct answer is D: "You can do some Kegel exercises today and then slowly increase your toning exercises over the next few weeks." This response is appropriate because it provides the client with specific guidance on postpartum exercises that are safe and beneficial for her recovery. Kegel exercises help strengthen the pelvic floor muscles, which can be done early postpartum to promote healing. Slowly increasing toning exercises over time is important to prevent injury and allow the body to regain strength gradually. Option A is incorrect because the client does not need to wait until the six-week checkup to start any form of exercise. Option B is incorrect as it limits the client to only Kegel exercises when a gradual return to other exercises is safe. Option C is incorrect because returning to the pre-pregnancy exercise routine immediately postpartum can be too strenuous for the body that is still healing. Educationally, it is important for nurses to provide evidence-based guidance on postpartum exercises to promote the physical well-being and recovery of clients. Understanding the physiological changes that occur during pregnancy and childbirth is crucial in tailoring exercise recommendations to each individual's needs. Encouraging gradual progression in exercise routines can help prevent complications and support the client's overall health and fitness goals postpartum.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Anemia. During pregnancy, the maternal blood volume increases to support the growing fetus. This physiological hemodilution commonly leads to a mild decrease in red blood cells and hemoglobin levels, resulting in a state of relative anemia in pregnant individuals. Therefore, a 34-week gestation client would likely exhibit signs of anemia as a normal finding in their laboratory reports. Option B) Thrombocytopenia, a low platelet count, is not a normal finding in a 34-week gestation client. Thrombocytopenia can lead to an increased risk of bleeding, which is particularly concerning during childbirth. Option C) Polycythemia, an elevated red blood cell count, is also not a typical finding in a 34-week gestation client. Polycythemia can lead to complications such as increased blood viscosity, which may impair circulation and oxygen delivery to the fetus. Option D) Hyperbilirubinemia, an increase in bilirubin levels, is not expected in a 34-week gestation client. Hyperbilirubinemia is commonly associated with conditions like jaundice in newborns rather than pregnant individuals. Educationally, understanding the normal physiological changes that occur during pregnancy is crucial for nurses caring for pregnant clients. Recognizing what is considered normal versus abnormal helps in providing appropriate care and identifying potential complications promptly. This knowledge is especially important when interpreting laboratory reports and assessing the overall health status of pregnant clients.

Correct Answer: B

Rationale: In this scenario, option B is correct: "The baby may have an uncommon genetic variant of the disease." This answer is correct because cystic fibrosis can result from various genetic mutations, and not all genetic variants associated with the condition may be detectable through standard prenatal testing like amniocentesis. Option A, "Cystic fibrosis cannot be diagnosed by amniocentesis," is incorrect because while amniocentesis can detect certain genetic disorders, it may not identify all possible genetic variations linked to cystic fibrosis. Option C, "The amniocentesis results were likely inaccurate," is incorrect as it assumes a fault in the testing process, which may not necessarily be the case. Amniocentesis results are generally reliable for the conditions they are designed to detect. Option D, "Cystic fibrosis develops after birth and cannot be detected prenatally," is incorrect as cystic fibrosis is a genetic condition that is present from birth, although symptoms may manifest later. Educationally, this question highlights the complexities of genetic testing and the limitations of prenatal screening methods. It underscores the importance of genetic counseling and the need for parents to understand that not all genetic variations may be identified through prenatal testing, emphasizing the value of ongoing medical surveillance and care for infants at risk for genetic conditions like cystic fibrosis.