Nokea
A client's last menstrual period was April 11. Using Naegele's rule, her estimated date of birth (EDB) would be:
- A. 24-Feb
- B. 18-Jan
- C. 25-Jan
- D. 18-Feb
Correct Answer: B
Rationale: Nägele's rule: April 11, 2023 + 1 year = April 11, 2024; minus 3 months = January 11, 2024; plus 7 days = January 18, 2024. Other options incorrectly adjust months or days.
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A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions?
- A. Cervical insufficiency
- B. Uterine fibroids
- C. Fetal genetic abnormalities
- D. Maternal disease
Correct Answer: C
Rationale: Fetal genetic abnormalities, like chromosomal errors, cause ~70% of first trimester abortions. Cervical insufficiency affects later trimesters, fibroids and maternal diseases (e.g., diabetes) are less common causes early on.
When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes which goal as the primary one?
- A. Eliminate anxiety so that they can have an uncomplicated birth
- B. Empower the couple to take control over their pregnancy and birth
- C. Equip a couple with the knowledge to experience a positive birth
- D. Provide knowledge and skills that will help them cope with labor
Correct Answer: C
Rationale: Perinatal education aims to prepare couples for a positive birth by providing knowledge for informed decisions and coping strategies, enhancing satisfaction and well-being. Eliminating anxiety is unrealistic, control is partial, and labor skills are only one aspect.
A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make?
- A. Be sure that your lupus is stable or in remission for 6 months before getting pregnant.
- B. It's probably not a good idea for you to get pregnant since you have lupus.
- C. Your lupus will not have any effect on your pregnancy whatsoever.
- D. When you get pregnant we'll have to add quite a few medications to your normal treatment plan.
Correct Answer: A
Rationale: Stable lupus for 6 months before pregnancy reduces risks like flares or miscarriage. Discouraging pregnancy is insensitive, claiming no effect is false, and adding many medications is inaccurate without specifics.
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication?
- A. Difficulty in arousing
- B. Deep tendon reflexes 2+
- C. Urinary output of 30 mL per hour
- D. Respiratory rate of 10 breaths/minute
Correct Answer: B
Rationale: Deep tendon reflexes at 2+ indicate a therapeutic magnesium level, preventing seizures without toxicity. Difficulty arousing, low urinary output (below 40 mL/hr), or respiratory rate of 10 suggest toxicity, requiring intervention.
A 22-year-old homeless woman arrives at a walk-in clinic seeking pregnancy confirmation. The nurse notes on assessment a 12-week gestational uterus, a BP of 110/70, a BMI of 17.5. The client admits to using cocaine a few times. She has been pregnant before and indicates she 'loses them early.' What characteristics place the client in the high-risk pregnancy category? Select all that apply.
- A. Homelessness
- B. Age
- C. BP 110/70
- D. BMI 17.5
- E. Prenatal care
- F. Prenatal history
Correct Answer: A,D,E,F
Rationale: Homelessness increases risks via poor nutrition and stress; BMI 17.5 indicates malnutrition; lack of prenatal care raises complication risks; prior losses suggest underlying issues. Age (22) is optimal, and BP 110/70 is normal, not risks.