The health care provider reports that the primigravida's fundus can be palpated at the umbilicus. Which priority question will the nurse include in the patient's assessment?

Correct Answer: C

Rationale: The correct answer is C: "Have you felt a fluttering sensation in your lower pelvic area yet?" This is the correct question to ask because feeling a fluttering sensation in the lower pelvic area is indicative of quickening, which typically occurs around 18-20 weeks of pregnancy. Quickening is an important milestone in pregnancy that signifies fetal movement. Palpating the fundus at the umbilicus suggests the pregnancy is around 20 weeks, so asking about quickening confirms fetal viability and normal development. Choice A is incorrect because fundal height does not correlate with ease of breathing. Choice B is incorrect as hearing the baby's heartbeat for the first time is not directly related to fundal height. Choice D is incorrect as unusual cravings are not typically associated with fundal height assessment.

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

Correct Answer: B

Rationale: The correct answer is B: VDRL. At the first prenatal visit, screening for syphilis is essential to prevent adverse outcomes. VDRL is a standard test for syphilis. GBS (Group B Streptococcus) testing is typically done later in pregnancy to prevent neonatal infection. Chlamydia culture is important but not typically done at the first visit; it is usually part of routine prenatal care. Hepatitis B testing is crucial during pregnancy but not specifically for sexually transmitted infections.