NC1 SET 3

A primigravida at 12 weeks requests guidance on prenatal vitamins and nausea. Which advice is most appropriate today?

• Begin iron at 60-120 mg elemental daily and avoid vitamin B6 entirely

• Use prenatal with folic acid 400-800 µg daily; try small meals and B6 as tolerated

• Delay all supplements until the second trimester for better tolerance

• Replace prenatal vitamins with high-dose herbal ginger formulations exclusively

A 22-week client asks about exercise while pregnant. Which action is best?

• Discontinue all aerobic activity until 36 weeks

• Continue moderate activity most days if no contraindication; avoid contact or high-fall sports

• Start high-intensity interval training to reduce gestational weight

• Begin hot yoga classes to improve flexibility and sleep

At 18 weeks, a client reports lightheadedness when supine. What should the nurse teach first?

• Increase dietary sodium at dinner to raise intravascular volume

• Lie in left lateral tilt when resting to relieve vena cava compression

• Wear a tight abdominal binder during sleep for support

• Reduce fluid intake after 1700 to limit nocturia

A 26-week client asks whether new mild ankle edema is normal. What response is best?

• Physiologic edema can occur; elevate legs, use left-side rest, and evaluate if sudden or with symptoms

• Any leg swelling is a red flag and requires ED triage now

• Salt tablets should be taken twice daily to improve swelling

• Diuretics should be started to prevent skin breakdown

A 28-week client asks about fetal movement counting. What instruction is most accurate?

• Movements must reach 15 in 30 minutes to be normal

• Aim for 10 movements within up to 2 hours during usual active times

• Count only after large meals to standardize results

• Stop counting after 30 weeks because patterns stabilize

During routine prenatal labs, which tests are standard in low-risk pregnancy at the first visit? Select all that apply.

• ABO/Rh type and antibody screen

• HIV, Hep B surface antigen, and syphilis screening

• Rubella immunity and varicella history or titer as indicated

• D-dimer and troponin to establish baseline values

• CBC and urine culture to screen for anemia and asymptomatic bacteriuria

A 32-week client with a healthy pregnancy asks about air travel for a 2-hour domestic flight. What should the nurse recommend?

• Avoid all flights after 28 weeks due to thrombosis risk

• Travel is acceptable if uncomplicated; hydrate, walk periodically, and wear a seatbelt low across hips

• Use sedatives to sleep through turbulence and contractions

• Choose an aisle seat and decline seatbelt use to reduce pressure

At 34 weeks, the client asks about TDaP timing. What is the best response?

• Postpone TDaP to the postpartum period for passive transfer

• Receive TDaP during 27-36 weeks to optimize neonatal antibody levels

• Avoid TDaP in third trimester due to maternal syncope risk

• Give TDaP only if there is a local pertussis outbreak

A 39-week client in early labor requests nonpharmacologic pain measures. Which nursing action is best now?

• Keep the client supine to reduce fatigue and conserve energy

• Encourage upright and mobile positions, rhythmic breathing, heat or counter-pressure as desired

• Begin directed Valsalva breathing between contractions

• Start restriction of oral fluids to limit gastric contents

A healthy term newborn in the first hour of life is vigorous and crying. Which immediate actions support a physiologic transition? Select all that apply.

• Dry thoroughly and place skin-to-skin with the mother if stable

• Delay cord clamping when feasible per protocol

• Routine separation for a full bath before feeding

• Initiate breastfeeding when infant shows feeding cues

• Provide glucose water to prevent early hypoglycemia