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What is the recommended method of screening for hepatitis B during pregnancy?
- A. Hepatitis B surface antigen (HBsAg) test
- B. Hepatitis B core antibody (HBcAb) test
- C. Hepatitis B e antigen (HBeAg) test
- D. All of the above
Correct Answer: A
Rationale: The HBsAg test is the recommended method for screening for hepatitis B during pregnancy.
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A nurse is reviewing laboratory findings for a client who is at 20 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Hematocrit 37% (37% to 47%)
- B. Creatinine 0.9 mg/dL (0.5 to 1 mg/dL)
- C. WBC count 11,000/mm3 (5,000 to 10,000/mm3)
- D. Fasting blood glucose 180 mg/dL (74 to 106 mg/dL)
Correct Answer: D
Rationale: The correct answer is D: Fasting blood glucose 180 mg/dL (74 to 106 mg/dL). Elevated fasting blood glucose levels during pregnancy can indicate gestational diabetes, which requires immediate attention to prevent complications for both the mother and the baby. The normal range for fasting blood glucose is 74 to 106 mg/dL; a value of 180 mg/dL is significantly elevated. The nurse should report this finding to the provider for further evaluation and management.
Choice A (Hematocrit 37%) falls within the normal range for a pregnant woman. Choice B (Creatinine 0.9 mg/dL) is within the normal range. Choice C (WBC count 11,000/mm3) is slightly elevated but not typically concerning during pregnancy. The focus should be on managing the high blood glucose level to ensure the health of the mother and baby.
A nurse is assessing a newborn who has neonatal abstinence syndrome. Which of the following findings should the nurse expect?
- A. Diminished deep tendon reflexes
- B. Excessive crying
- C. Decreased muscle tone
- D. Absent Moro reflex
Correct Answer: B
Rationale: The correct answer is B: Excessive crying. Neonatal abstinence syndrome (NAS) occurs in newborns exposed to addictive substances in utero. The newborn may exhibit symptoms such as excessive crying due to neurologic irritability. Diminished deep tendon reflexes (A) are not typically associated with NAS. Decreased muscle tone (C) is not a common finding in NAS; infants may actually have increased muscle tone. An absent Moro reflex (D) is not a typical finding in NAS, as hyperreflexia is more common.
Which of the following is a potential complication of a vacuum-assisted delivery?
- A. Fetal distress
- B. Maternal hemorrhage
- C. Intra-abdominal injury
- D. All of the above
Correct Answer: C
Rationale: The correct answer is C: Intra-abdominal injury. During a vacuum-assisted delivery, the vacuum extractor can potentially apply excessive force leading to intra-abdominal injury to the mother. This can include injuries to the uterus, bladder, or other abdominal organs. Fetal distress (choice A) and maternal hemorrhage (choice B) are potential complications of vacuum-assisted delivery as well, but they are not directly related to the mechanical trauma that can cause intra-abdominal injury. Therefore, the correct answer is C as it specifically addresses a unique complication associated with vacuum-assisted delivery.
Which of the following is a potential complication of gestational diabetes?
- A. Polyhydramnios
- B. Preterm labor
- C. Neonatal hypoglycemia
- D. All of the above
Correct Answer: D
Rationale: Gestational diabetes can lead to polyhydramnios, preterm labor, and neonatal hypoglycemia.
A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?
- A. Administer broad-spectrum antibiotics.
- B. Monitor the rectal temperature every 4 hr.
- C. Cleanse the site with povidone-iodine.
- D. Prepare for surgical closure after 72 hr.
Correct Answer: A
Rationale: The correct answer is A: Administer broad-spectrum antibiotics. This is crucial in preventing infection, as the leaking cerebrospinal fluid puts the newborn at risk for meningitis. Antibiotics help reduce the risk of infection until surgical closure can be performed. Monitoring rectal temperature (B) is important but not the priority. Cleansing the site with povidone-iodine (C) may further irritate the area. Planning for surgical closure after 72 hr (D) is important, but immediate infection prevention is the priority.