A nurse is assisting with a pelvic examination of a client during their first prenatal visit. Which of the following actions should the nurse take?
Ensure the client has a full bladder before the procedure.
Instruct the client to bear down when the speculum is inserted.
Encourage the client to take rapid, shallow breaths during the procedure.
Apply povidone-iodine to the provider's fingers prior to bimanual examination.
The Correct Answer is B
Choice A rationale
Ensuring the client has a full bladder before the procedure is incorrect. A full bladder can cause discomfort during the pelvic examination and may obscure the pelvic organs, making the examination more challenging for the provider.
Choice B rationale
Instructing the client to bear down when the speculum is inserted is correct. Bearing down helps relax the pelvic muscles, making it easier to insert the speculum and perform the examination with minimal discomfort.
Choice C rationale
Encouraging the client to take rapid, shallow breaths during the procedure is incorrect. This can increase anxiety and tension in the pelvic muscles, making the examination more uncomfortable.
Choice D rationale
Applying povidone-iodine to the provider's fingers prior to bimanual examination is incorrect. The standard procedure involves using gloves and lubricant to prevent infection and ensure patient comfort, not povidone-iodine.
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Correct Answer is B
Explanation
Choice A rationale
Disabling the driver-side airbags is not advisable as airbags provide crucial protection in the event of a collision. Proper seating position is a safer alternative.
Choice B rationale
Moving the seat as far away as possible from the steering wheel reduces the risk of injury from airbag deployment and allows ample space for the growing abdomen, providing better safety for both mother and baby.
Choice C rationale
Wearing the lap belt high across the abdomen is incorrect and dangerous as it can cause injury to the fetus. The belt should be low across the hips.
Choice D rationale
Placing the shoulder harness across the gravid uterus is incorrect. The harness should go between the breasts and to the side of the belly, not across it, to avoid compression injuries in the event of a crash.
Correct Answer is D
Explanation
Choice A rationale
A maternal age of 30 years is not a significant risk factor for preeclampsia. Preeclampsia is more common in very young mothers or those over the age of 35.
Choice B rationale
A prepregnancy BMI of 19 is within the normal range and is not considered a risk factor for preeclampsia, which is more commonly associated with higher BMI or obesity.
Choice C rationale
Being in the third pregnancy (multiparity) is not a strong risk factor for preeclampsia. The risk factors are more closely related to the individual's health conditions and first pregnancies.
Choice D rationale
Chronic hypertension is a well-known risk factor for preeclampsia as it indicates pre-existing cardiovascular issues that can predispose one to developing preeclampsia during preg