NCLEX Question for Priority Nursing Diagnosis for Para 2 eight weeks pregnant

Mrs. C., age 40, gravida 3 para 2 is eight weeks pregnant. She is a full-time office manager, states she “usually unwinds with a few glasses of wine” with dinner, smokes about five cigarettes a day, and was “surprised” by his pregnancy. After the assessment, which of the following would the nurse select as the priority nursing diagnosis?

a. High risk for an alteration in bonding related to an unplanned pregnancy
b. High risk for injury to the fetus related to advanced age.
c. Ineffective individual coping related to low self-esteem
d. Knowledge deficit related to effects of substance abuse.

Correct Answer: d . Evidence exists that smoking, consuming alcohol, or using social drugs during pregnancy may be harmful to the fetus.

Initially, even if the pregnancy is planned, there is an element of surprise that conception has occurred.  This feeling of ambivalence does not, in itself, indicate that acceptance and normal bonding will not occur.
A major risk for the older expectant couple relates to the increased incidence of Down syndrome in children born to women over age 35 or 40; however, the risk for injury to the fetus is greater from substance abuse.
No data support this nursing diagnosis.

Posted in: MCN NCLEX