A mother has a child who is 4 years of age, and she is expecting another child.The mother expresses concern to the nurse about how the older sibling will receive the newborn.Which intervention shared by the mother would require follow-up by the nurse?
“I plan to let him hear the baby’s heartbeat at the next prenatal visit.”.
“I have enrolled him in a sibling preparation class at the hospital.”.
“I think that I will just bring the new baby home as a surprise.”.
“I let him pick out a gift for the baby, and have one for him from the baby.”.
The Correct Answer is C
Choice A rationale
Allowing the older sibling to hear the baby’s heartbeat at a prenatal visit can help them feel involved and connected to the new baby. This can be a positive experience and does not require follow-up by the nurse.
Choice B rationale
Enrolling the older sibling in a sibling preparation class at the hospital is a good way to prepare them for the arrival of the new baby. These classes often provide valuable information and help older siblings understand what to expect.
Choice C rationale
Bringing the new baby home as a surprise can be problematic. It may cause the older sibling to feel excluded or unprepared for the new addition to the family. It is important to involve the older sibling in the process and prepare them for the changes that will come with the new baby.
Choice D rationale
Allowing the older sibling to pick out a gift for the baby and having a gift for them from the baby can help foster a positive relationship between the siblings. This approach can make the older sibling feel valued and included.
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Correct Answer is C
Explanation
Choice A rationale
The umbilical cord does not typically contain one artery and one vein. This configuration would not provide the necessary blood flow to support fetal development. The umbilical cord must have two arteries to carry deoxygenated blood and waste products from the fetus to the placenta, and one vein to carry oxygenated blood and nutrients from the placenta to the fetus.
Choice B rationale
Two veins and one artery is also incorrect. The umbilical cord must have two arteries to ensure that deoxygenated blood and waste products are efficiently transported from the fetus to the placenta. Having only one artery would not suffice for the required blood flow.
Choice C rationale
Two arteries and one vein is the correct configuration of the umbilical cord. The two arteries carry deoxygenated blood and waste products from the fetus to the placenta, while the single vein carries oxygenated blood and nutrients from the placenta to the fetus. This arrangement is essential for maintaining proper fetal circulation during pregnancy.
Choice D rationale
Two arteries and two veins is incorrect. The umbilical cord only needs one vein to carry oxygenated blood and nutrients from the placenta to the fetus. Having two veins would be redundant and unnecessary for fetal development.
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale
Blood pressure is a critical parameter to monitor during pregnancy. Elevated blood pressure, as seen in this case (149/91 mmHg), can indicate the onset of hypertensive disorders such as preeclampsia, which can have severe consequences for both the mother and the fetus. Preeclampsia is characterized by high blood pressure and signs of damage to another organ system, often the kidneys. It is essential to report elevated blood pressure to the provider for further evaluation and management.
Choice B rationale
Gastrointestinal complaints, such as nausea and vomiting, are common during pregnancy due to hormonal changes. However, they are typically not a priority unless they are severe or accompanied by other concerning symptoms. In this case, the gastrointestinal complaints are mild and have been present for 2-3 weeks, which is consistent with normal early pregnancy symptoms.
Choice C rationale
Lower abdominal cramping can be a sign of various conditions, including normal uterine growth, gastrointestinal issues, or more serious concerns such as ectopic pregnancy or miscarriage. Given the patient’s report of vaginal spotting and mild abdominal cramping, it is crucial to report this to the provider to rule out any potential complications.
Choice D rationale
The hCG result is important for confirming pregnancy and monitoring its progression. However, in this context, it is not the most immediate priority compared to other symptoms. Elevated or abnormal hCG levels can indicate potential issues, but the presence of other symptoms such as spotting and cramping takes precedence.
Choice E rationale
Vaginal spotting during early pregnancy can be a sign of implantation bleeding, but it can also indicate more serious conditions such as threatened miscarriage or ectopic pregnancy. Given the patient’s report of spotting and cramping, it is essential to report this to the provider for further evaluation and management.
Choice F rationale
Heart rate is an important vital sign to monitor, but in this case, the patient’s heart rate is within the normal range for pregnancy. Therefore, it is not a priority to report unless there are other concerning symptoms or significant changes in heart rate.
Choice G rationale
Dysuria, or painful urination, can indicate a urinary tract infection (UTI), which is common during pregnancy and can lead to complications if left untreated. UTIs can cause discomfort and may lead to more serious infections such as pyelonephritis. It is important to report dysuria to the provider for appropriate testing and treatment.