The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence?

Correct Answer: C

Rationale: The correct answer is C: Alcohol abuse. During adolescence, children of parents who have substance abuse issues, like alcohol, are at an increased risk of developing similar problems. This is due to genetic predisposition, environmental factors, and learned behavior. Children tend to model the behavior of their parents, and if they are exposed to alcohol abuse at a young age, they are more likely to engage in alcohol abuse themselves as they grow older. Incorrect choices: A: Hypertension - This choice is not directly related to the situation described and is not typically a risk factor associated with parental alcohol abuse. B: Diabetes - Similar to choice A, diabetes is not directly linked to parental alcohol abuse and is not a common risk factor during adolescence in this scenario. D: Intraventricular bleeding - This is a medical condition that is not typically influenced by parental alcohol abuse and is not a common risk factor during adolescence.

Correct Answer: B

Rationale: The correct answer is B: Encourage the patient to walk or change positions. This intervention helps to promote gravity-assisted descent of the fetus, aiding in cervical dilation and labor progression. Walking and changing positions can also help alleviate pain and discomfort, facilitate optimal fetal positioning, and prevent maternal exhaustion. Administering a sedative (A) can potentially slow down labor progress. Administering oxytocin (C) may be indicated in certain situations, but it is not the most appropriate initial intervention for promoting labor progression in this case. Performing a cesarean section (D) is not warranted unless there are specific medical indications for it, as it is a major surgical procedure with potential risks.

Correct Answer: A

Rationale: The correct answer is A because current guidelines suggest that consuming up to 200 mg of caffeine per day is considered safe during pregnancy. This amount is unlikely to harm the developing fetus. Excessive caffeine intake has been associated with an increased risk of miscarriage and low birth weight. Option B is incorrect as complete avoidance of caffeine is not necessary, but rather moderation is key. Option C is partially correct in emphasizing moderation but the recommendation to avoid coffee in the afternoon is not supported by evidence. Option D is incorrect as caffeine does have an impact on pregnancy, and unrestricted consumption is not advisable.

Correct Answer: B

Rationale: The correct answer is B: Headaches and blurred vision. These symptoms can indicate a serious condition called preeclampsia, which can be life-threatening for both the mother and the baby. Headaches and blurred vision are signs of increased blood pressure and potential organ damage. Immediate medical attention is crucial to monitor and manage preeclampsia. A: Mild swelling in the feet and ankles is common in pregnancy and not necessarily indicative of a serious issue. C: Occasional lower back pain is also common in pregnancy and may not require immediate medical attention. D: Fatigue and slight nausea are common pregnancy symptoms and do not typically indicate a need for immediate medical attention.

Correct Answer: B

Rationale: The correct answer is B: The patient's cervical dilation and effacement. At 37 weeks gestation with contractions every 10 minutes, assessing cervical dilation and effacement is crucial to determine if the patient is in active labor. This information will guide the nurse in determining the appropriate next steps for the patient's care, such as the need for further monitoring or interventions. Assessing vital signs and fetal heart rate (Choice A) is important but not the priority in this scenario. Urinary output and fluid balance (Choice C) are important considerations but not the immediate priority. Emotional status and support system (Choice D) are also important but not the first assessment to be made in this situation.