Nokea
A nurse is preparing to administer chlordiazepoxide 50 mg PO every 8 hours to a client. The amount available is chlordiazepoxide 25 mg per capsule. How many capsules should the nurse administer per dose?
- A. 2 capsules
- B. 1 capsule
- C. 3 capsules
- D. 4 capsules
Correct Answer: A
Rationale: Dose (50 mg) / concentration (25 mg/capsule) = 2 capsules per dose. Other options miscalculate the number needed to achieve 50 mg.
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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 by neutralizing fetal Rh-positive cells. Earlier or later timing risks ineffective prevention or antibody formation.
A nurse suspects that a pregnant client may be experiencing placenta abruption based on which finding? Select all that apply.
- A. Absence of pain
- B. Insidious onset
- C. Dark red vaginal bleeding
- D. Rigid uterus
- E. Absent fetal heart tones
Correct Answer: C,D,E
Rationale: Placental abruption involves sudden separation of the placenta, causing severe pain, a rigid uterus from bleeding, dark red vaginal bleeding due to clotted blood, and absent fetal heart tones if the fetus is compromised. Absence of pain and insidious onset are not typical, as abruption is acute and painful.
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.
During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as:
- A. Ortolani's sign
- B. Chadwick's sign
- C. Goodell's sign
- D. Hegar's sign
Correct Answer: D
Rationale: Hegar's sign is softening of the lower uterine segment, felt early in pregnancy. Ortolani's tests infant hips, Chadwick's is cervical discoloration, and Goodell's is cervical softening, not uterine.
A pregnant woman undergoes a triple/quadruple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's alpha-fetoprotein (AFP) level is decreased?
- A. Sickle-cell anemia
- B. Cardiac defects
- C. Down syndrome
- D. Respiratory disorders
Correct Answer: C
Rationale: Decreased AFP, with altered hCG and estriol, suggests Down syndrome (trisomy 21). Sickle-cell anemia, cardiac defects, and respiratory disorders don't typically lower AFP; cardiac defects may raise it.