The nurse is caring for a client pregnant with twins. Which statement indicates that the client needs additional information?

Correct Answer: A

Rationale: In this pharmacology question related to maternal newborn care, the correct answer is option A: "Because both of my twins are boys, I know that they are identical." This statement indicates a misunderstanding of the concept of twins and their zygosity. Identical twins result from a single fertilized egg splitting into two embryos, regardless of their gender. Therefore, the statement made by the client is incorrect and shows a need for additional information. Option B states the correct information that if twins come from one fertilized egg that split, they are identical, which is accurate. Option C is also correct in stating that if the client has one boy and one girl, they came from two separate eggs, indicating fraternal twins. Option D is incorrect as it states that it is rare for both twins to be within the same amniotic sac, which is actually common in monoamniotic twins. From an educational perspective, this question assesses the nurse's understanding of twin zygosity, which is important in providing appropriate care and education to the client. Understanding the difference between identical and fraternal twins helps in anticipating potential complications and providing accurate information to the client. It highlights the significance of clear communication and accurate knowledge in maternal newborn nursing practice.

Correct Answer: A

Rationale: In the context of pharmacology and prenatal assessment, understanding the different signs of pregnancy is crucial for healthcare professionals. In this scenario, the correct answer is A) Positive pregnancy test. This is considered a probable sign of pregnancy because the presence of human chorionic gonadotropin (hCG) hormone in the urine or blood indicates a developing pregnancy. Option B) Fetal movement felt by the mother is known as a quickening, which is considered a presumptive sign of pregnancy and occurs later in the second trimester. This is not a probable sign as it is subjective and can be influenced by various factors. Option C) Visualization of the fetus on ultrasound is a diagnostic sign, not a probable sign, as it provides definitive evidence of pregnancy but usually occurs later than probable signs. Option D) Auscultation of fetal heart tones is another diagnostic sign and is not considered a probable sign of pregnancy. It confirms the presence of a fetus but does not indicate early pregnancy like a positive pregnancy test. Understanding the difference between probable, presumptive, and diagnostic signs of pregnancy is essential for accurate prenatal assessments and patient care in pharmacology and obstetrics. Healthcare providers need to be able to differentiate between these signs to provide appropriate care and support to pregnant women.

Correct Answer: A

Rationale: In the context of maternal newborn care, uterine atony, which is the inability of the uterus to contract effectively after delivery, can lead to excessive postpartum bleeding. The nurse's first action should be to massage the fundus until it is firm. This helps the uterus to contract, control bleeding, and prevent complications such as postpartum hemorrhage. Massage of the fundus stimulates contractions, promoting the expulsion of clots and reducing the risk of hemorrhage. Increasing IV fluid rate (option B) can support circulation but does not directly address the underlying issue of uterine atony. Notifying the healthcare provider (option C) is important but may cause a delay in immediate intervention. Administering oxytocin (option D) may be indicated but is typically done after fundal massage to enhance uterine contractions. Educationally, it is crucial for nurses to prioritize interventions based on the urgency of the situation. Understanding the pathophysiology of uterine atony and the rationale behind fundal massage empowers nurses to provide timely and effective care to postpartum clients. This scenario highlights the importance of quick decision-making and hands-on skills in managing obstetric emergencies.

Correct Answer: C

Rationale: In a laboring client with oxytocin infusion, a fetal heart rate of 100 beats/minute requires immediate intervention. This finding indicates fetal distress, which could be a sign of hypoxia or other complications. Monitoring fetal well-being is crucial during labor, and a heart rate of 100 beats/minute is below the normal range, necessitating prompt action to prevent potential harm to the baby. Contractions lasting 60 seconds are within a normal range and are not typically a cause for immediate concern. Contractions every 2 minutes could indicate tachysystole, but alone may not always require immediate intervention unless associated with other signs of distress. The client reporting back pain is a common occurrence during labor and does not typically require immediate intervention unless it is severe or accompanied by other concerning symptoms. Educationally, this scenario highlights the importance of continuous fetal monitoring during labor and the need for nurses to recognize signs of fetal distress promptly. Understanding normal labor parameters and variations is essential for providing safe and effective care to laboring patients and their babies.

Correct Answer: B

Rationale: In this scenario, option B, "I can resume sexual activity when I stop bleeding," is the statement that indicates the need for further teaching. This statement is incorrect because resuming sexual activity should not be based solely on when the bleeding stops; it's essential to wait until after the postpartum check-up to ensure the body has adequately healed. Option A, "I will avoid heavy lifting for at least 6 weeks," is correct because postpartum women need to allow their bodies to heal, and heavy lifting can strain the healing process. Option C, "I should call my doctor if I experience a fever or foul-smelling discharge," is also correct as these symptoms can indicate an infection requiring medical attention. Option D, "I will schedule my postpartum visit in 6 weeks," is correct because postpartum visits are crucial for monitoring the mother's and baby's health. Educationally, this question emphasizes the importance of proper postpartum care and highlights common misconceptions that postpartum women may have regarding their recovery process. It underscores the significance of providing accurate information to ensure the well-being of both the mother and the newborn.