The nurse is teaching a prenatal class about breast changes during pregnancy. Which change is expected?

Correct Answer: C

Rationale: In a prenatal class, it is crucial for the nurse to accurately educate expecting mothers about the physiological changes they may experience during pregnancy. The correct answer, option C, darkening of the areola, is expected during pregnancy due to increased estrogen levels which stimulate melanocyte-stimulating hormone, leading to hyperpigmentation. This change is important as it helps the newborn locate the breast for feeding after birth. Option A, decrease in nipple pigmentation, is incorrect as nipple pigmentation often darkens during pregnancy. Option B, reduction in breast size, is also incorrect as breast size typically increases in preparation for lactation. Option D, development of inverted nipples, is incorrect as this is not a common change during pregnancy but rather a preexisting condition in some individuals. Understanding these expected breast changes is essential for pregnant women to alleviate concerns and prepare for breastfeeding. Educating them about these changes empowers them to embrace the journey of motherhood with confidence and knowledge.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Placenta previa. Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to painless vaginal bleeding, especially in the third trimester. This condition is associated with no uterine tenderness or contractions, which aligns with the client's presentation of mild vaginal bleeding and no pain at 35 weeks' gestation. Option A) Abruptio placentae involves the premature separation of the placenta from the uterine wall, leading to painful bleeding. This condition is usually associated with uterine tenderness and contractions, which are absent in the client's case. Option C) Preterm labor involves regular uterine contractions leading to cervical changes and can manifest with vaginal bleeding. However, in this case, the lack of pain and the absence of contractions make preterm labor less likely. Option D) Urinary tract infection is unrelated to the symptoms described by the client and does not present with vaginal bleeding in the absence of other complications. Educationally, understanding the differences between placenta previa, abruptio placentae, preterm labor, and unrelated conditions like urinary tract infections is crucial for nurses caring for pregnant clients. Recognizing the signs and symptoms of each condition is essential for prompt identification, intervention, and ensuring the best outcomes for both the mother and the baby.

Correct Answer: B

Rationale: In the context of pharmacology and maternal newborn health, understanding the signs and symptoms of chorioamnionitis is crucial for nurses to provide timely and appropriate care to pregnant clients. Chorioamnionitis is an infection of the fetal membranes and amniotic fluid that can occur with prolonged rupture of membranes during labor. The correct answer is B) Foul-smelling vaginal discharge. This finding suggests chorioamnionitis because the infection can cause a foul odor due to the presence of bacteria in the amniotic fluid and vaginal discharge. This sign is indicative of an intrauterine infection that requires immediate medical attention to prevent complications for both the mother and the fetus. Option A) Clear amniotic fluid is incorrect because chorioamnionitis typically presents with cloudy or purulent amniotic fluid due to the infection. Option C) Fetal heart rate of 140 beats/minute is a normal fetal heart rate and not specific to chorioamnionitis. Option D) Absence of maternal fever is also incorrect because maternal fever is a common symptom of chorioamnionitis, and its absence does not rule out the presence of the infection. In an educational context, nurses need to be able to recognize the signs and symptoms of chorioamnionitis to initiate prompt interventions such as antibiotics and possibly expedited delivery to prevent maternal and neonatal complications. This knowledge is essential for providing safe and effective care to pregnant clients during labor and birth.

Correct Answer: C

Rationale: In the context of pharmacology and maternal newborn care, understanding the assessment findings in severe preeclampsia is crucial for providing safe and effective care to pregnant patients. In this scenario, the correct answer is C) New-onset confusion and restlessness, indicating a worsening condition in a client with severe preeclampsia. New-onset confusion and restlessness are concerning signs in severe preeclampsia as they can be indicative of neurological involvement, such as eclampsia, which is a severe complication characterized by seizures. Prompt recognition of these symptoms is essential to prevent further progression to eclampsia and ensure the safety of both the mother and the fetus. Option A, proteinuria of +1, is a common finding in preeclampsia, but it is not the most concerning sign of worsening condition in this context. Option B, a respiratory rate of 16 breaths per minute, is within the normal range and does not directly indicate worsening of preeclampsia. Option D, a urine output of 40 mL/hr, is decreased but may not necessarily indicate immediate worsening of the condition compared to neurological symptoms like confusion and restlessness. Educationally, this question highlights the importance of recognizing subtle changes in a client's condition, especially in the context of a high-risk pregnancy complication like severe preeclampsia. Nurses and healthcare providers must be vigilant in monitoring and assessing pregnant patients for signs of deterioration to provide timely and appropriate interventions to prevent adverse outcomes for both the mother and the baby.

Correct Answer: A

Rationale: In the context of pharmacology and maternal newborn care, the priority nursing action when assessing a pregnant client with hyperemesis gravidarum is to monitor for dehydration and electrolyte imbalances (Option A). This is crucial because hyperemesis gravidarum is characterized by severe nausea, vomiting, and electrolyte disturbances, which can lead to dehydration and pose risks to both the mother and the developing fetus. Monitoring for dehydration and electrolyte imbalances is essential to prevent complications such as hypovolemia, metabolic alkalosis, and ketosis. Dehydration can compromise maternal circulation, leading to reduced placental perfusion, which can negatively impact fetal well-being. Therefore, addressing fluid and electrolyte imbalances is the priority to ensure the health and safety of both the mother and the baby. Encouraging the client to eat small, frequent meals (Option B) may be beneficial in managing nausea and vomiting in some cases, but it is not the priority when the client is at risk of dehydration and electrolyte imbalances. Providing antiemetic medication (Option C) can help manage symptoms, but it does not address the underlying issue of fluid and electrolyte imbalances. Assessing for fetal growth restriction (Option D) is important in the long-term management of the client but is not the immediate priority when the client's physiological needs are compromised. In an educational context, understanding the priority nursing actions in managing complications like hyperemesis gravidarum during pregnancy is essential for providing safe and effective care to pregnant clients. Nurses need to prioritize interventions based on the urgency of the situation and the potential risks to both the mother and the fetus. Monitoring for dehydration and electrolyte imbalances is a fundamental aspect of maternal care in such situations and should be addressed promptly to optimize outcomes for both the mother and the baby.