The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks’ gestation. What sample will be collected for the initial screening process?

Correct Answer: B

Rationale: In the context of advanced maternal age monitoring, the correct sample for the initial screening process of alpha-fetoprotein (AFP) testing at 16 weeks' gestation is option B) Blood. AFP screening is a vital component of prenatal care in assessing the risk of certain fetal abnormalities, particularly neural tube defects. Blood is the appropriate sample for this procedure as AFP is a protein produced by the fetal liver that circulates in the maternal bloodstream. By measuring AFP levels in the maternal blood, healthcare providers can gain valuable insights into the health of the fetus. Option A) Urine is not the correct sample for AFP screening as AFP is not typically detected in urine in a reliable manner for this purpose. Option C) Saliva also does not contain AFP in concentrations suitable for screening purposes. Option D) Amniotic fluid is a more invasive sample collection method and is typically used for diagnostic procedures like amniocentesis, not for initial screening tests like AFP. In an educational context, understanding the rationale behind the choice of sample for specific screening tests like AFP is crucial for nurses and healthcare providers working in maternal health. It enables them to accurately collect and interpret samples, provide appropriate patient education, and offer quality care to pregnant individuals, especially those of advanced maternal age who may have increased risks that necessitate specialized monitoring.

Correct Answer: A

Rationale: In the 10th week of pregnancy, the client may experience a backache due to the growing uterus putting pressure on the lower back and pelvic area. This symptom is common as the body adjusts to the changes of pregnancy. Urinary frequency is more commonly associated with early pregnancy due to hormonal changes and the growing uterus pressing on the bladder, rather than specifically in the 10th week. Dyspnea on exertion, or shortness of breath with activity, typically occurs later in pregnancy as the uterus grows and pushes against the diaphragm. Fatigue is a common symptom in early pregnancy due to hormonal changes and increased metabolic demands, but it is not specific to the 10th week. Educationally, understanding the timing of common pregnancy symptoms is crucial for nurses caring for pregnant clients. This knowledge helps in providing appropriate support and guidance to expectant mothers. By recognizing the expected symptoms at different stages of pregnancy, nurses can offer targeted interventions and reassurance to promote maternal well-being.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) An enlarged ovary. Explanation: During early pregnancy, the ovary from which the egg was released (corpus luteum) will enlarge and persist for a while as it continues to support the developing pregnancy by producing progesterone. This physiological process is known as the corpus luteum cyst of pregnancy. Therefore, during a vaginal examination at 6 weeks of pregnancy, the practitioner would expect to find an enlarged ovary due to the presence of the corpus luteum cyst. Why the other options are incorrect: A) Thin cervical muscle: The cervical muscle thickness is not typically a significant finding during a vaginal examination in early pregnancy. C) Thick cervical mucus: While cervical mucus changes consistency throughout the menstrual cycle, thick cervical mucus alone would not be a specific finding at 6 weeks of pregnancy. D) Pale pink vaginal wall: The color of the vaginal wall is not a specific indicator of pregnancy at 6 weeks, and pale pink color is not a characteristic finding related to early pregnancy. Educational Context: Understanding the physiological changes that occur in early pregnancy and their clinical manifestations is crucial for healthcare providers, especially those involved in obstetrics and gynecology. Recognizing the presence of an enlarged ovary due to the corpus luteum cyst is a key aspect of monitoring and assessing early pregnancy development. This knowledge helps practitioners provide appropriate care and support to pregnant individuals, ensuring optimal maternal and fetal outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) 133 to 134 lb. The rationale behind this is based on the physiological changes that occur during pregnancy, specifically weight gain. On average, a pregnant woman with a normal BMI is expected to gain around 1 lb per week during the second and third trimesters. At 24 weeks of gestation, which is 4 weeks after the initial visit at 20 weeks, the client would be expected to have gained approximately 4 lbs (1 lb per week x 4 weeks). Therefore, starting at 128 lb, the client would likely weigh around 132 lb at 24 weeks. Options A, B, and D are incorrect because they do not account for the expected weight gain during pregnancy. Option A is too conservative, while options B and D overestimate the weight gain. Understanding the pattern of weight gain in pregnancy is crucial for monitoring maternal and fetal well-being, assessing for complications like gestational diabetes or hypertension, and providing appropriate prenatal care. This question highlights the importance of monitoring maternal weight during pregnancy to ensure the health and well-being of both the mother and the developing fetus. It also emphasizes the need for healthcare providers to have a good understanding of normal physiological changes during pregnancy to provide optimal care and support to pregnant individuals.

Correct Answer: D

Rationale: In this scenario, option D is the correct answer because it is normal for pregnant women to experience colostrum leakage from their breasts in the third trimester. Colostrum is the first milk produced by the mammary glands in late pregnancy and is a sign that the body is preparing for breastfeeding. Option A is incorrect because a galactocele is a benign breast mass filled with milk and usually not associated with leaking. Option B is incorrect because pumping breasts to stimulate milk supply is not necessary or recommended in this situation as the leakage is a normal physiological process. Option C is incorrect because not all breast discharge indicates an infection, and in this case, the discharge is likely colostrum. Educationally, this scenario highlights the importance of understanding normal physiological changes during pregnancy, including breast changes. It is crucial for healthcare providers to educate pregnant individuals about these changes to alleviate concerns and promote a better understanding of their bodies during pregnancy.