Nokea
A nurse is completing a health history for a client who is at 6-week gestation. The client informs the nurse that she smokes one park of cigarettes per day. The nurse should advise the client that smoking places the client9s newborn at risk for what complication?
- A. Hearing loss
- B. Intrauterine growth restriction
- C. Type 1 diabetes mellitus
- D. Congenital heart defects
Correct Answer: B
Rationale: The correct answer is B: Intrauterine growth restriction (IUGR). Smoking during pregnancy can restrict blood flow to the fetus, leading to inadequate oxygen and nutrients, resulting in IUGR. This can lead to low birth weight and potential health complications for the newborn. Hearing loss (A) is not directly associated with smoking during pregnancy. Type 1 diabetes mellitus (C) is an autoimmune condition not caused by maternal smoking. Congenital heart defects (D) can be a risk with smoking during pregnancy, but the most direct risk is IUGR.
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Which assessment finding suggests that the laboring client's
- B. Reflex grade 0
- C. Urine output 60
- D. Generalized seizure
Correct Answer: D
Rationale: The correct answer is D, Generalized seizure. During labor, a generalized seizure is a critical finding that indicates eclampsia, a severe complication of pregnancy characterized by seizures, hypertension, and proteinuria. This requires immediate medical intervention to prevent harm to the mother and baby. Reflex grade 0 (choice B) is not a typical assessment finding during labor, and it does not indicate any immediate life-threatening condition. Urine output of 60 (choice C) is within the normal range and does not suggest any immediate critical issue. Therefore, choice D is the correct answer due to the urgency and severity of the condition it represents.
After several hours of labor, the fetal heart monitor shows
- A. The nurse would interpret this deceleration to be consistent with which presentation?
- B. Umbilical cord compression
- C. Uteroplacental insufficiency
- D. Compression of fetal head
Correct Answer: B
Rationale: The correct answer is B: Umbilical cord compression. When the fetal heart monitor shows deceleration after several hours of labor, it indicates reduced oxygen supply to the fetus. Umbilical cord compression can restrict blood flow and oxygen delivery to the fetus, leading to decelerations. This is a common cause during labor. Choices A, C, and D do not directly relate to the decreased oxygen supply indicated by decelerations on the fetal heart monitor.
The nurse is assessing a client with suspected preterm labor. Which finding confirms the diagnosis?
- A. Regular uterine contractions every 10 minutes.
- B. Cervical dilation of 3 cm.
- C. Lower back pain and cramping.
- D. Positive fetal fibronectin test.
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation of 3 cm. This finding confirms preterm labor as it indicates cervical changes associated with labor progression. Regular uterine contractions every 10 minutes (choice A) may suggest labor but alone doesn't confirm preterm labor. Lower back pain and cramping (choice C) are common symptoms but not specific to preterm labor. A positive fetal fibronectin test (choice D) may indicate an increased risk of preterm labor but doesn't confirm the diagnosis definitively.
Many teens wait until the second or even third trimester to seek prenatal care. The nurse should understand that the reasons behind this delay include which of the following? (Select all that apply.)
- A. Continuing to deny the pregnancy
- B. Uncertainty about where to go for care
- C. Lack of realization that they are pregnant
- D. A desire to gain control over their situation
Correct Answer: A
Rationale: The correct answer is A: Continuing to deny the pregnancy. This is because some teens may struggle to come to terms with their pregnancy and deny it, leading to delays in seeking prenatal care. The other choices are incorrect. B: Uncertainty about where to go for care is not a common reason for delaying prenatal care as resources and information are usually available. C: Lack of realization that they are pregnant is unlikely as most teens eventually become aware of their pregnancy. D: A desire to gain control over their situation does not usually lead to delaying prenatal care as seeking care is a proactive step towards gaining control.
The nurse is preparing a client for cesarean delivery. What is the priority nursing action before surgery?
- A. Obtain baseline vital signs.
- B. Insert an indwelling urinary catheter.
- C. Administer prophylactic antibiotics.
- D. Verify signed informed consent.
Correct Answer: D
Rationale: The correct answer is D, verifying signed informed consent. This is the priority because it ensures the client's understanding and agreement to the procedure, respecting their autonomy. Obtaining baseline vital signs (A) is important but not the priority before surgery. Inserting a urinary catheter (B) may be needed but is not the priority over informed consent. Administering antibiotics (C) is important for preventing infection but should not take precedence over confirming the client's informed consent.