Question 1

The nurse is planning an education session for pregnant adolescents. Which topics should the nurse include that incorporate the 2020 National Health Goals for pregnant women with special needs? (Select all that apply.)

A) Importance of an adequate fluid intake
B) Effects of alcohol on the developing fetus
C) Use of complementary therapy for delivery
D) Abstinence from illicit drugs while pregnant
E) Impact of cigarette smoking on the developing fetus

Effects of alcohol on the developing fetus
Abstinence from illicit drugs while pregnant
Impact of cigarette smoking on the developing fetus

Accepted Answer

The 2020 National Health Goals for pregnant women with special needs focus on teaching unintentional injury prevention, the dangers and complications of substance dependency, and both the psychological and physical concerns of teenage pregnancy. The nurse should include the topics that focus on alcohol, illicit drugs, and cigarette smoking. An adequate fluid intake is not a topic specific to a pregnant woman with special needs. The use of complementary therapy for delivery might not be appropriate for a pregnant adolescent because of cephalopelvic disproportion.

Question 2

A pregnant adolescent asks if the father of the baby can come into the room during the examination. Based on both the pregnant adolescent's and the father's needs, which is the best response for the nurse to make?

A) "If your parents approve."
B) "If you want him to come in."
C) "Adolescent fathers have no legal right in regard to a child."
D) "Not participating will help him be more responsible in the future."

"If you want him to come in."

Accepted Answer

If the baby's father attends prenatal care, help him to feel welcome. Because he is not married, he does not have a legal right to participate in decisions concerning the pregnancy, abortion, or adoption, but he may not be devoid of feelings for the girl or the baby. If a complication occurs, he may feel genuine grief things are not going well.
Allowing him to offer support in the current pregnancy can help him learn more about himself as well as better define his role. In addition, be sure he receives compassionate education on preventing further pregnancies until he is more mature. The nurse does not need the parent's approval for the father of the baby to be present during the examination.

Question 3

The nurse is identifying nursing diagnoses appropriate for a pregnant patient who is substance dependent. Which diagnosis should the nurse identify as applicable to this patient's needs?&#10;A) Impaired home maintenance related to a sensory challenge&#10;B) Risk for disruption of social interaction related to unclear speech&#10;C) Risk for injury to self and fetus related to chronic substance dependency&#10;D) Readiness for enhanced family coping, related to commitment to have a child in the face of a disabling condition

Accepted Answer

Illicit drugs can pass through the placenta and affect the developing fetus. The patient is also being harmed by the drugs. The most appropriate diagnosis for the patient would be risk for injury to self and fetus related to chronic substance dependency. Impaired home maintenance, risk for disruption of social interaction, and readiness for enhanced family coping would be appropriate for the pregnant patient who is physically or cognitively challenged.

Question 4

When planning care for a pregnant adolescent, what nursing action supports the developmental task of this age group?&#10;A) Allow to weigh self at clinic visits.&#10;B) Insist that no further sexual relations occur during pregnancy.&#10;C) Suggest that schooling be delayed until the pregnancy is over.&#10;D) Encourage deciding on the total weight gain for her pregnancy.

Accepted Answer

Helping adolescents to make their own health care decisions at health care visits helps to foster a sense of independence. During a visit, the adolescent can weigh herself to feel independent. Insisting that no further sexual relations occur and delaying school do not foster a sense of independence. Permitting the pregnant adolescent to determine the total weight gain for the pregnancy would not be safe considering the patient is still developing physically.

Question 5

The nurse is reviewing nutritional needs with a pregnant adolescent. Which topic should the nurse include in the teaching plan for this patient?&#10;A) Ways to remember to take an iron supplement daily&#10;B) Ways to obtain good pregnancy nutrition in restaurants&#10;C) Nutritional advantages of fresh foods over frozen foods&#10;D) Ways the pregnant adolescent can learn to cook her own food

Accepted Answer

Adolescents traditionally do not take medicine conscientiously, so they may need frequent reminders to take their vitamin or iron supplement. Stress these are intended to complement nutrition during pregnancy. For a reminder system, girls may need to post a medication reminder chart at home or in her school locker or set a reminder on her phone in order to increase adherence. Obtaining good pregnancy nutrition in restaurants, advantages of fresh foods, and learning to cook may or may not be appropriate to meet the nutritional needs of the pregnant adolescent.

Question 6

A pregnant adolescent is upset because she is not permitted to deliver the baby at an alternative birthing center. Why is the use of an alternative birthing center contraindicated for this patient?&#10;A) High risk for pelvic disproportion&#10;B) The patient's parents disapproved of the center&#10;C) Alternative birth centers admit only married women&#10;D) Alternative birthing centers only admit patients over the age of 21 years

Accepted Answer

Pregnant adolescents are prone to cephalopelvic disproportion because of the patient's incomplete pelvic growth. Using a birthing center could be dangerous for the patient and the fetus. The use of a birthing center is not contraindicated because the patient's parents disapprove of the center. There are no restrictions such as marital status or age on the use of a birthing center.

Question 7

A pregnant adolescent has many questions and concerns about the pregnancy and birthing process. What should the nurse recommend to this patient?&#10;A) Talk to her mother.&#10;B) Attend childbirth classes.&#10;C) Obtain books from the library.&#10;D) Ask the health care provider the questions.

Accepted Answer

Peer companionship is a strong need for most adolescents. When girls become pregnant, because they are suddenly so different, they may find themselves cut off from fellow classmates. This is the prime opportunity to join a class of other adolescents in preparation for childbirth. The pregnant adolescent may or may not have a good relationship with her mother. The pregnant adolescent needs more than reading books about the pregnancy and childbirth. The health care provider may or may not be able to answer all of the pregnant adolescent's questions.

Question 8

An adolescent patient delivers an 8-lb baby after being in labor for 12 hours. During the postpartal period, which assessment is a priority for the nurse to complete?&#10;A) Endometritis&#10;B) Thrombophlebitis&#10;C) Amniotic embolus&#10;D) Postpartum hemorrhage

Accepted Answer

Adolescents are more prone to postpartum hemorrhage than the average woman because if the patient's uterus is not yet fully developed, it becomes overdistended by pregnancy. An overdistended uterus will not contract as readily as a normally distended uterus in the postpartum period. This can lead to hemorrhage. Endometriosis, thrombophlebitis, and amniotic embolus are not expected postpartal complications for the adolescent patient.

Question 9

A postpartum patient who is severely hearing impaired is silently holding the newborn. What should the nurse suggest the patient do when caring for the baby?&#10;A) Avoid speaking to her newborn.&#10;B) Put on the television to make noise.&#10;C) Use a radio as a source of sound for the baby.&#10;D) Speak and sing to the child as care is being given.

Accepted Answer

If the baby hears, urge the patient to talk to the infant as care is given so the baby is introduced to sounds and words. Some patients whose speech is severely affected by a hearing disorder are reluctant to speak to strangers. Assure the patient that the infant welcomes the sound of her voice and will quiet readily to the sound. Being spoken to and sung to during the first year is important for overall development. The patient should not avoid speaking to the newborn. The sound of the mother's voice is preferred over the sound of television or radio.

Question 10

The nurse is caring for a 41-year-old patient who is pregnant with her first child. What can the nurse suggest to reduce the development of varicosities from the pregnancy? (Select all that apply.)&#10;A) Jog in place.&#10;B) Take walk breaks.&#10;C) Rest in the Sims position.&#10;D) Increase the intake of vitamin D.&#10;E) Rest with the legs on a foot stool.

Accepted Answer

Interventions to reduce the development of varicosities while pregnant include taking walk breaks, resting in the Sims position, and resting with the legs elevated on a foot stool. Jogging in place will not reduce the onset of varicosities and might harm the patient and fetus. The patient should increase the intake of vitamin C, and not vitamin D, because vitamin C strengthens vein walls.

Question 11

A pregnant patient with a thoracic-level spinal cord injury from a skiing accident is confined to a wheelchair for ambulation. What should the nurse encourage the patient to do during pregnancy?&#10;A) Raise the buttocks off the wheelchair seat every hour.&#10;B) Hold the breath hourly to cause descent of the diaphragm.&#10;C) Tense abdominal muscles hourly to maintain abdominal tone.&#10;D) Do pelvic rocking movements every hour to maintain vertebral mobility.

Accepted Answer

The answer of A pregnant patient with a thoracic-level spinal...

Question 12

A postpartum patient with a high spinal cord injury has an indwelling urinary catheter placed for a cesarean birth. The patient's face is red and is complaining of a headache. A current blood pressure measurement is 160/120 mmHg. What should the nurse do first?

A) Immediately cut and remove the indwelling catheter.
B) Sit the patient up abruptly and massage the lower back.
C) Raise the head of the bed and assess the catheter for blockage.
D) Lower the head of the bed and coach to breathe slowly in and out.

Accepted Answer

The answer of A postpartum patient with a high spinal...

Question 13

The nurse instructs a pregnant patient on ways to reduce unintentional injuries while pregnant. Which patient statement indicates that teaching has been effective?&#10;A) &#34;I should clean a puncture wound with cold water.&#34;&#10;B) &#34;I should wear a seat belt when in a motor vehicle at all times.&#34;&#10;C) &#34;I should lie down and rest if someone kicks or punches my abdomen.&#34;&#10;D) &#34;I should flush an animal bite with warm water and then wash with soap.&#34;

Accepted Answer

The answer of The nurse instructs a pregnant patient on...

Question 14

A pregnant patient slipped and fell on an icy sidewalk a few weeks ago. During labor, the patient is experiencing extreme pain at the region of the symphysis pubis. What should be done to help this patient?

A) Elevate the legs.
B) Position on the side.
C) Apply heat to the region.
D) Provide additional pain medication.

Accepted Answer

The answer of A pregnant patient slipped and fell on...

Question 15

The nurse is concerned that a pregnant patient is using cocaine. What should the nurse suggest to the health care provider to confirm this suspicion?&#10;A) Urinalysis&#10;B) Electrocardiogram&#10;C) Complete blood count&#10;D) Stool test for occult blood

Accepted Answer

The answer of The nurse is concerned that a pregnant...

Deck 22: Nursing Care of a Pregnant Family With Special Needs