A woman states that she frequently awakens with 'painful leg cramps' during the night. Which of the following assessments should the nurse make?

Correct Answer: A

Rationale: In this scenario, the correct assessment the nurse should make is A) Dietary evaluation. Leg cramps can be caused by various factors, including electrolyte imbalances like low levels of potassium, calcium, or magnesium. By conducting a dietary evaluation, the nurse can assess the woman's intake of these essential minerals and identify any deficiencies that could be contributing to the leg cramps. Option B) Goodell’s sign and option C) Hegar’s sign are both physical assessments used in obstetrics and gynecology to evaluate cervical changes during pregnancy, which are not relevant to the woman's complaint of leg cramps. Option D) Posture evaluation is also not directly related to the issue of leg cramps upon waking. In an educational context, understanding the importance of conducting a thorough assessment is crucial for nurses to provide holistic care to their patients. By choosing the correct assessment, the nurse can address the root cause of the woman's leg cramps and provide appropriate interventions to alleviate her symptoms and improve her quality of life.

Correct Answer: C

Rationale: The correct answer is C) Vaginal and rectal cultures. During prenatal visits at 36 weeks’ gestation, it is important to perform vaginal and rectal cultures to screen for Group B Streptococcus (GBS) colonization. GBS colonization in pregnant women can pose a risk of transmitting the bacteria to the newborn during delivery, which can lead to serious infections in the baby. By identifying GBS colonization during prenatal care, appropriate measures can be taken during labor to reduce the risk of transmission to the newborn, such as administering antibiotics. Option A) Glucose challenge test is typically done earlier in pregnancy to screen for gestational diabetes and is not specifically indicated at 36 weeks' gestation. Option B) Amniotic fluid volume assessment is usually performed in the third trimester to monitor amniotic fluid levels, but it is not a routine test at 36 weeks unless there are specific concerns such as decreased fetal movements. Option D) Karyotype analysis is a genetic test that is not routinely done during prenatal visits unless there are specific indications or risk factors identified through other testing or screening. Educationally, understanding the rationale behind each prenatal test is crucial for healthcare professionals involved in maternal-fetal monitoring. It ensures that appropriate screenings are conducted at the right times to optimize maternal and fetal health outcomes. Regular prenatal visits and appropriate testing are essential components of prenatal care to monitor and address any potential risks during pregnancy.

Correct Answer: A

Rationale: The correct answer is A) Whether or not the father will be present during labor should be considered nonnegotiable by the parents. This decision is crucial for the emotional support of the mother and the bonding experience for the family. Research consistently shows that the presence of a supportive partner during labor can positively impact the mother's emotional well-being, reduce stress, and improve birth outcomes. Option B) Whether or not the woman will have an episiotomy is a medical decision that should be made based on the healthcare provider's assessment of the situation during labor. It is not typically a decision for the parents to make in their birth plan. Option C) Whether or not the woman will be able to have an epidural is a personal choice that should be discussed with the healthcare provider based on the woman's preferences and medical indications. It is not necessarily a nonnegotiable decision for the parents to make. Option D) Whether or not the father will be able to take pictures of the delivery is a personal preference and does not typically fall under nonnegotiable decisions for the parents. While capturing the moment through photos can be important for some families, it is not a critical aspect of the birth plan that cannot be negotiated. In an educational context, it is important for nurses to guide parents in making informed decisions for their birth plan by providing evidence-based information and supporting their choices while also emphasizing the importance of certain key factors, like the presence of a supportive partner during labor, which can significantly impact the birth experience.

Correct Answer: C

Rationale: In this question, the correct answer is C) June 27, 2013. This date is obtained by using Nagele's rule, which involves adding 7 days to the first day of the last menstrual period, subtracting 3 months, and then adding 1 year. The incorrect options can be explained as follows: - Option A) May 30, 2013: This date is too early as it does not account for the full term of a pregnancy. - Option B) June 20, 2013: This date is also too early and does not align with the calculation using Nagele's rule. - Option D) July 3, 2013: This date is too late as it exceeds the typical 40-week gestation period. Educationally, understanding how to calculate the estimated date of delivery using Nagele's rule is crucial for healthcare providers working in obstetrics. This knowledge helps in planning prenatal care, monitoring fetal development, and ensuring the well-being of both the mother and the baby. By mastering this calculation, nurses and other healthcare professionals can provide accurate information and support to pregnant women throughout their pregnancy journey.

Correct Answer: D

Rationale: In the context of pharmacology and maternal-fetal health, the correct B vitamin that a vegan should supplement is B12 (cobalamin). This is because vitamin B12 is primarily found in animal products, and vegans who exclude these sources from their diet are at a higher risk of developing a deficiency. Vitamin B12 plays a crucial role in DNA synthesis, red blood cell formation, neurological function, and overall fetal development during pregnancy. A deficiency in B12 can lead to serious complications such as anemia, developmental delays in infants, and neurological issues in both the mother and the fetus. Regarding the other options: - B1 (thiamine) is important for energy metabolism and nerve function but is commonly found in plant-based foods. - B2 (niacin) is involved in energy production and metabolism but can be obtained from plant-based sources. - B6 (pyridoxine) is essential for brain development and immune function but is also present in plant foods. Educationally, this question highlights the importance of understanding specific nutrient needs, especially for vulnerable populations like pregnant women following restrictive diets. It emphasizes the significance of informed dietary choices and the potential consequences of nutrient deficiencies during pregnancy. By knowing which vitamins are crucial and potentially lacking in certain diets, healthcare providers can better guide their patients to ensure optimal maternal and fetal health outcomes.