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1. Answer: B
RATIONALE: Generally, engaging in the usual pattern of sexual activity during pregnancy is safe as long as the client is comfortable and no complications arise. The client needs to be informed that some women find intercourse uncomfortable during the first and third trimesters owing to the common discomforts of pregnancy.
Numerous myths about engaging in sexual activity during pregnancy exist. However, coitus does not harm the fetus. Coitus interruptus is not considered the preferred method of sexual activity.
Avoiding sexual activity until the 16th week of pregnancy is not necessary because coitus does not harm the fetus.
During the third trimester, sexual intercourse is still considered safe. But because of the increased size of the woman’s abdomen, the couple should consider coital positions other than male superior position. Sexual intercourse would be contraindicated only if the woman experiences bleeding or ruptured membranes. Also, after 32 weeks’ gestation, women with a history of preterm labor should be advised that coitus may lead to preterm labor due to the effects of prostaglandin production secondary to sexual intercourse. Stimulation of the breasts and nipples increases the body’s production of oxytocin, which also can initiate labor.
2. Answer: D
RATIONALE: Absorption of supplemental iron and nonmeat sources of iron is enhanced by combining them with meat or a good source of vitamin C. An acidic environment enhances iron absorption. Therefore, taking the iron on an empty stomach or with orange juice would be most effective. If gastrointestinal upset occurs, the client may take the drug with meals. However, doing so reduces iron absorption by 40% to 50%.
Because milk interferes with the absorption of iron, the client should avoid taking the iron with milk.
Tea has been shown to interfere with the absorption of iron. Therefore, the client should avoid taking the iron with tea.
Hot chocolate, a milk product, interferes with iron absorption. Thus, the client should avoid taking the iron with hot chocolate.
3. Answer: A
RATIONALE: Vitamin C is required to promote blood clot and collagen formation. Vitamin C deficiency has been associated with premature rupture of the membranes and pregnancy-induced hypertension.
Folic acid supplementation, not vitamin C, is recommended to prevent neural tube defects. High doses of vitamin C are not recommended because neonates exposed to excessive doses of vitamin C have developed symptoms of scurvy after birth. Also, high doses of vitamin C do not prevent the fetus from becoming infected.
Vitamin C does not help to metabolize carbohydrates. However, thiamine, a B vitamin, is a coenzyme involved with carbohydrate metabolism.
Calcium in conjunction with phosphorus, not vitamin C, plays a role in fetal bone growth.
4. Answer: A
RATIONALE: Pressure on the vena cava from the enlarging uterus, commonly referred to as vena cava syndrome or supine hypotensive syndrome is the most common reason a pregnant client may feel dizzy, become pale, and perspire freely when lying supine. Thus, the nurse needs to relieve this pressure by turning the client onto her left side.
Measuring the client’s blood pressure, pulse, and respirations may be performed once the client is positioned on her left side.
The signs and symptoms manifested by the client are unrelated to vaginal spotting.
Lowering the client’s head is not as helpful or effective as positioning her on her left side.
5. Answer: C
RATIONALE: Based on the description, the client is most likely experiencing round ligament pain. The round ligaments, two fibrous muscular cords passing from the body of the uterus near the attachments of the fallopian tubes through the broad ligaments into the inguinal canal and inserting into the fascia of the vulva, act as stays to steady the uterus. If a pregnant woman moves quickly, she may pull one of these ligaments and feel a quick, sharp pain.
Appendicitis usually causes pain on the right side of the lower abdomen. Typically the client would present with other signs and symptoms such fever, nausea, and vomiting.
Although preterm labor occurs before 37 weeks’ gestation, preterm labor at 16 weeks is highly uncommon. Spontaneous abortions typically occur at 8 to 12 weeks’ gestation. The second trimester is generally uneventful unless trauma occurs.
Generally, fetal movement may be felt as a fluttering feeling between 14 and 20 weeks’ gestation. However, for a primigravida, this feeling is usually not painful. Typically fetal movement is not felt until about 20 weeks’ gestation.
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