Nurse Is Caring for a Client Who Is 34 Weeks of Gestation. While Lying Flat on Her Back During

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Sample questions from Nurse Is Caring for a Client Who Is 34 Weeks of Gestation. While Lying Flat on Her Back During

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the labor and delivery unit, a 29-year-old client at 34 weeks of gestation reports sudden nausea and lightheadedness while lying flat on her back for an ultrasound. Her blood pressure has fallen from 118/72 mm Hg to 86/50 mm Hg, and her pulse is 112/min. Which action should the nurse take first?

   • A.Obtain a urine specimen for protein testing.
   • B.Turn the client onto her left side.
   • C.Apply oxygen by face mask and leave the client supine.
   • D.Raise the head of the bed to 90 degrees.

   Rationale: Turning the client onto her left side relieves pressure of the gravid uterus on the vena cava and can quickly improve venous return and maternal blood pressure. Sitting fully upright may worsen symptoms or be difficult to tolerate, and urine testing does not address the acute change. Oxygen may be appropriate if hypoxemia is present, but leaving the client supine maintains the likely cause.

2. 2.Refer to the client's chart. Which actions should the nurse take in response to the client's change in condition? Select all that apply.

   • A.Document the client's position, symptoms, interventions, and response.
   • B.Continue the procedure while monitoring the fetal heart rate, because the maternal blood pressure change is expected.
   • C.Reassess blood pressure, pulse, and symptoms after repositioning.
   • D.Notify the obstetric provider if symptoms or hypotension persist despite repositioning.
   • E.Reposition the client onto the left side.

   Rationale: Left lateral repositioning addresses the likely aortocaval compression, and reassessment shows whether maternal perfusion is improving. Persistent hypotension or symptoms require escalation to the obstetric provider, and documenting the sequence and response supports continuity of care. Continuing the procedure without correcting the client's position is unsafe; the change is not an expected finding to ignore.

3. 3.During a prenatal clinic visit, a 24-year-old client at 32 weeks of gestation says, "I get dizzy when I lie flat for my back massage." Her symptoms resolve when she sits up. Which instruction is most appropriate?

   • A.Lie on your side, preferably the left, during the massage.
   • B.Take an over-the-counter medicine for motion sickness before each massage.
   • C.Avoid all massage until after the baby is born.
   • D.Keep your legs elevated and remain flat on your back.

   Rationale: A side-lying position reduces uterine pressure on major vessels and helps prevent dizziness associated with lying supine later in pregnancy. Elevating the legs while remaining flat does not reliably relieve the compression. Avoiding all massage is unnecessarily restrictive, and medication is not the first-line response to a positional symptom.

4. 4.At change of shift on the antepartum unit, the nurse receives report on four pregnant clients. Which client should the nurse assess first?

   • A.A 33-year-old at 30 weeks who reports a mild headache that resolved after drinking water.
   • B.A 26-year-old at 35 weeks who felt briefly lightheaded while supine but is now alert with BP 112/68 mm Hg after turning onto her side.
   • C.A 21-year-old at 38 weeks who reports fetal movement is less than usual today.
   • D.A 28-year-old at 32 weeks who has new vaginal bleeding and abdominal pain.

   Answer and rationale are in the full material.

5. 5.The charge nurse is assigning care on an antepartum unit. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP) for a stable 30-year-old client at 33 weeks of gestation who previously became dizzy while supine?

   • A.Teach the client how to recognize symptoms of supine hypotension.
   • B.Evaluate whether the client's blood pressure improved after repositioning.
   • C.Assist the client to maintain a side-lying position while the nurse is present for assessment.
   • D.Assess the client for recurrent dizziness during a scheduled ultrasound.

   Answer and rationale are in the full material.