Nokea
Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?
- A. Marijuana
- B. Cocaine
- C. Nicotine
- D. Caffeine
Correct Answer: B
Rationale: Cocaine causes tachycardia, hypertension, and vasoconstriction, risking placental abruption and fetal distress. Marijuana causes relaxation, nicotine raises heart rate but vasodilates, and caffeine mildly stimulates but doesn't constrict vessels.
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It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time?
- A. 24 hours before delivery and 24 hours after delivery
- B. In the first trimester and within 2 hours of delivery
- C. At 28 weeks gestation and again within 72 hours after delivery
- D. At 32 weeks gestation and immediately before discharge
Correct Answer: C
Rationale: Rho(D) immune globulin at 28 weeks and within 72 hours post-delivery prevents Rh isoimmunization effectively. Other schedules miss critical windows for blocking maternal antibody response.
A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomforts as common during the first trimester? Select all that apply.
- A. Breast tenderness
- B. Urinary frequency
- C. Backache
- D. Cravings
- E. Leg cramps
Correct Answer: A,B,D
Rationale: First trimester discomforts include breast tenderness (hormonal growth), urinary frequency (bladder pressure), and cravings (taste changes). Backache and leg cramps typically occur later due to weight and nerve pressure.
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.
When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find?
- A. Ambivalence
- B. Emotional lability
- C. Introversion
- D. Acceptance
Correct Answer: B
Rationale: Emotional lability, with mood swings, is common in the first trimester due to hormonal shifts and stress. Ambivalence may occur if unplanned, introversion is a trait, and acceptance develops later.