Nokea
What does optimal nursing care after an amniocentesis include?
- A. Pushing fluids by mouth
- B. Monitoring uterine activity
- C. Placing the patient in a supine position for 2 hours
- D. Applying a pressure dressing to the puncture site
Correct Answer: B
Rationale: The correct answer is B: Monitoring uterine activity. After an amniocentesis, it is crucial to monitor uterine activity to detect any signs of preterm labor or uterine contractions. This helps in identifying any potential complications early on and ensures prompt intervention if needed.
A: Pushing fluids by mouth is important for hydration but not directly related to optimal nursing care after an amniocentesis.
C: Placing the patient in a supine position for 2 hours is not recommended as it may increase the risk of hypotension and discomfort for the patient.
D: Applying a pressure dressing to the puncture site is not necessary after an amniocentesis as the risk of bleeding is minimal and pressure dressings may increase the risk of infection.
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The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which condition?
- A. Hemophilia
- B. Sickle cell anemia
- C. A neural tube defect
- D. Abnormal lecithin-to-sphingomyelin ratio
Correct Answer: C
Rationale: The correct answer is C: A neural tube defect. Elevated AFP levels in maternal serum are indicative of neural tube defects in the fetus. AFP is produced by the fetal liver and yolk sac, and high levels may suggest a defect in the development of the neural tube. Hemophilia (A), sickle cell anemia (B), and abnormal lecithin-to-sphingomyelin ratio (D) do not directly correlate with AFP levels. Hemophilia is a genetic blood disorder, sickle cell anemia is a genetic blood disorder affecting hemoglobin, and abnormal lecithin-to-sphingomyelin ratio is related to fetal lung maturity.
A client on the obstetric unit is receiving IV medications per physician’s orders. On rounds the nurse notes that the client’s IV has infiltrated. Which of the following actions should the nurse perform first?
- A. Determine whether the infusion is a vesicant.
- B. Stop the infusion and remove the catheter.
- C. Document the occurrence in the medical record.
- D. Elevate the extremity and monitor the site.
Correct Answer: B
Rationale: Stopping the infusion and removing the catheter prevents further tissue damage from the infiltrated medication.
A birth plan is being developed by a pregnant couple. Which of the following items should be included in the plan?
- A. The method of infant feeding the mother plans on using.
- B. The name and address of her health care insurance company.
- C. The couple's baby name preferences.
- D. The couple's cell phone numbers.
Correct Answer: A
Rationale: A birth plan typically includes the mother's preferences for labor, delivery, and postpartum care, including infant feeding methods.
The nurse is discussing the methods of confirming the pregnancy with a patient at the first prenatal visit. What method is used to confirm cardiac activity of the fetus?
- A. bimanual exam
- B. pelvic ultrasound
- C. serum pregnancy test
- D. urine pregnancy test
Correct Answer: B
Rationale: The correct answer is B: pelvic ultrasound. Pelvic ultrasound is used to confirm the presence of cardiac activity in the fetus by visualizing the fetal heartbeat. This method is the most accurate and reliable way to confirm the viability of the pregnancy. A bimanual exam (choice A) is a physical examination technique that assesses the size and shape of the uterus but does not confirm fetal cardiac activity. Serum pregnancy test (choice C) and urine pregnancy test (choice D) detect the presence of human chorionic gonadotropin (hCG) hormone in the blood or urine, indicating pregnancy, but do not confirm fetal cardiac activity.
The nurse is preparing to teach a client how to perform daily fetal kick counts. Which instruction is most important for the nurse to give the client?
- A. Count fetal kicks prior to eating a meal
- B. Lie on back when counting kicks
- C. Call provider if at least three movements are not felt in 1 hour
- D. Count all movements over 1 hour
Correct Answer: C
Rationale: The correct answer is C: Call provider if at least three movements are not felt in 1 hour. This instruction is crucial because decreased fetal movements can indicate potential fetal distress. By advising the client to contact the healthcare provider if fewer than three movements are felt in an hour, the nurse is emphasizing the importance of promptly seeking medical attention when there may be a concern for the baby's well-being.
A: Counting kicks prior to eating a meal is not as important as monitoring the baby's movements consistently throughout the day.
B: Lying on the back when counting kicks is not recommended, as it can reduce blood flow to the uterus and potentially affect the baby.
D: Counting all movements over 1 hour may not capture a decrease in movements that could be a cause for concern, as the focus should be on monitoring a specific minimum number of movements within a set timeframe.
In summary, the correct answer emphasizes the need for prompt action in case of decreased fetal movements, while