A nurse is reinforcing teaching with a group of adolescent females who are pregnant about expected changes related to pregnancy.Which of the following client statements indicates understanding of the teaching?
“If I develop striae gravidarum, I need to call my provider immediately.”.
“My nipples and areola will become pale as my breasts enlarge.”.
“I should begin to recognize fetal movement by 10 weeks gestation.”.
“Some nausea and vomiting is normal, but I should call my provider if I am unable to keep food or water down.”.
The Correct Answer is D
Choice A rationale
Striae gravidarum, or stretch marks, are a common occurrence during pregnancy due to the rapid stretching of the skin. They are not a medical emergency and do not require immediate attention from a healthcare provider.
Choice B rationale
During pregnancy, the nipples and areola typically become darker, not paler, as the breasts enlarge. This change is due to hormonal influences and increased blood flow to the area.
Choice C rationale
Fetal movement, also known as quickening, is usually felt by the mother between 18 to 25 weeks of gestation, not as early as 10 weeks. At 10 weeks, the fetus is still too small for its movements to be felt by the mother.
Choice D rationale
Some nausea and vomiting, known as morning sickness, is normal during pregnancy. However, if a pregnant woman is unable to keep food or water down, it is important to contact a healthcare provider to ensure she and the baby are receiving adequate nutrition and hydration.
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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 C
Explanation
Choice A rationale
A blood transfusion just after delivery is not a standard intervention for a client with Rh-negative blood type. The primary concern for Rh-negative clients is the potential for Rh incompatibility with the fetus, which can lead to hemolytic disease of the newborn. This condition is prevented by administering RhO(D) immune globulin during pregnancy.
Choice B rationale
Maternal serum alpha-fetoprotein (MSAFP) testing is used to screen for certain fetal abnormalities, such as neural tube defects, but it is not specifically related to Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin to prevent sensitization.
Choice C rationale
RhO(D) immune globulin is administered at around 28 weeks of gestation to prevent Rh sensitization in Rh-negative clients. This intervention is crucial for preventing the development of antibodies that could harm the fetus in current or future pregnancies.
Choice D rationale
A three-hour glucose tolerance test is used to screen for gestational diabetes, which is a separate concern from Rh incompatibility. The primary intervention for Rh-negative clients is the administration of RhO(D) immune globulin.