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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?

A.

“I plan to let him hear the baby’s heartbeat at the next prenatal visit.”.

B.

“I have enrolled him in a sibling preparation class at the hospital.”.

C.

“I think that I will just bring the new baby home as a surprise.”.

D.

“I let him pick out a gift for the baby, and have one for him from the baby.”.

Answer and Explanation

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

Heartburn and nausea are common symptoms during pregnancy and are not typically considered warning signs that require immediate medical attention.

Choice B rationale

Amenorrhea, or the absence of menstruation, is a normal sign of pregnancy and does not indicate a complication that needs immediate reporting.

Choice C rationale

Abdominal cramping can be a sign of a serious condition such as ectopic pregnancy or miscarriage, and it is important for the client to report this symptom immediately.

Choice D rationale

Urinary frequency is a common symptom during pregnancy due to hormonal changes and the growing uterus pressing on the bladder. It is not typically a warning sign that requires immediate medical attention.

Correct Answer is B

Explanation

Choice A rationale

Oligohydramnios refers to a condition where there is too little amniotic fluid. An amniotic fluid volume of 1900 mL is above the normal range, indicating that oligohydramnios is not present.

Choice B rationale

Polyhydramnios is the condition of having too much amniotic fluid. The normal range for amniotic fluid volume at 34 weeks gestation is between 800 and 1000 mL. An estimated volume of 1900 mL indicates polyhydramnios, which can be associated with various maternal and fetal conditions.

Choice C rationale

A follow-up glucose test is not directly indicated by the finding of polyhydramnios. While polyhydramnios can be associated with gestational diabetes, the decision to perform a glucose test would depend on other clinical factors and the patient’s history.

Choice D rationale

An amniotic fluid volume of 1900 mL is above the normal range for 34 weeks gestation, so it is not considered normal for gestational age. This finding indicates polyhydramnios rather than a normal fluid level.

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