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A charge nurse is teaching a newly licensed nurse about substance use disorders during pregnancy.
Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

A.

Encourage clients who are prescribed methadone to breastfeed.

B.

Methamphetamine use during pregnancy is associated with fetal macrosomia.

C.

Environmental stimuli should be increased during the neonatal period.

D.

Increased head circumference is an expected finding in a newborn who has fetal alcohol syndrome.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Methadone is often prescribed to pregnant women with opioid use disorder and is considered safe for breastfeeding. Breastfeeding can provide additional benefits such as bonding

and transferring antibodies to the infant.

 

Choice B rationale

Methamphetamine use during pregnancy is linked to fetal growth restriction, preterm birth, and low birth weight, not fetal macrosomia (large body size).

 

Choice C rationale

Reducing environmental stimuli is essential for neonates exposed to substances in utero. Increased stimuli can overwhelm their underdeveloped nervous systems, leading to stress

and adverse outcomes.

 

Choice D rationale

Fetal alcohol syndrome is characterized by growth deficiencies, facial abnormalities, and central nervous system dysfunction. An increased head circumference is not a typical

feature; rather, microcephaly (small head circumference) is more common.


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Correct Answer is C

Explanation

Choice A rationale

Gaining 2 pounds per week throughout the rest of pregnancy is excessive and not recommended. Normal weight gain is approximately 1 pound per week in the second and third trimesters.

Choice B rationale

Dieting during pregnancy can lead to inadequate nutrient intake for both the mother and the developing fetus. It is essential to focus on a balanced diet rather than trying to lose weight.

Choice C rationale

Meeting with a dietitian can help the client assess their nutritional needs and develop a healthy eating plan to support their pregnancy, ensuring both maternal and fetal health.

Choice D rationale

Eating an additional 700 calories per day is too high. Generally, an additional 300-500 calories per day is recommended during the second and third trimesters to support pregnancy.

Correct Answer is B

Explanation

Choice A rationale

Cesarean birth is not necessarily required for GBS-positive clients as long as IV antibiotic prophylaxis is administered during labor to prevent transmission to the newborn.

Choice B rationale

IV antibiotic prophylaxis, typically with penicillin or ampicillin, is given to GBS-positive clients during labor to prevent neonatal GBS infection.

Choice C rationale

Obtaining a vaginal culture at 39 weeks of gestation is not necessary if the client was already screened and found positive for GBS at 36 weeks.

Choice D rationale

Metronidazole is used to treat bacterial vaginosis or trichomoniasis, not GBS infection; thus, it is not appropriate for this scenario. .

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