Nokea
16wks gestation reports for a triple screen test. What statements determines understanding?
- A. "This test can be used as a screening for spina bifida."
- B. "This test is a screen test, and I will need other testing if I have abn results."
- C. "this test can indicate if I may be at an increased risk for having a child with down syndrome."
- D. A triple screen test is a screening tool. Maternal blood is drawn and alpha-fetoprotein, hcg, and estriol values are assessed to determine if the mother is at an increased risk for neural tube defects or chromosomal trisomy's. Spina bifida and downs syndrome are the two most common risks.
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct:
1. A triple screen test includes assessing alpha-fetoprotein, hCG, and estriol levels.
2. These values help determine the risk for neural tube defects and chromosomal trisomies.
3. The test does not directly diagnose spina bifida but assesses neural tube defects.
4. Down syndrome risk is also evaluated, not diagnosed directly.
5. Answer D provides a comprehensive explanation of the test components and its purpose, aligning with the test's actual function.
Summary of why other choices are incorrect:
A. Incorrect because the test screens for neural tube defects and chromosomal trisomies, not just spina bifida.
B. Incorrect because the test is a screening tool for specific conditions, not a definitive diagnostic test.
C. Incorrect because the test assesses multiple conditions, not just Down syndrome specifically.
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A client at 37 weeks' gestation reports severe itching without a rash. What condition should the nurse suspect?
- A. Preeclampsia.
- B. Cholestasis of pregnancy.
- C. Gestational diabetes.
- D. Fungal infection.
Correct Answer: B
Rationale: The correct answer is B: Cholestasis of pregnancy. Severe itching without a rash in a pregnant client at 37 weeks' gestation is concerning for cholestasis of pregnancy, a condition characterized by impaired bile flow. This can lead to elevated bile acids, causing itching. Preeclampsia (choice A) presents with hypertension and proteinuria. Gestational diabetes (choice C) manifests with high blood sugar levels. Fungal infection (choice D) typically presents with visible skin changes like a rash, which is absent in this case. In summary, cholestasis of pregnancy is the most likely explanation for severe itching in this scenario.
A nurse is reviewing the laboratory results for a client who is at 29 weeks.... the provider?
- A. WBC count
- B. 11,000/mm³ Hgb
- C. 11,2 g/Dl
- D. Hct 34% Platelets 140,000/mm³
Correct Answer: B
Rationale: The correct answer is B: 11,000/mm³ Hgb. At 29 weeks of gestation, hemoglobin (Hgb) levels are crucial to monitor for anemia in pregnant women. A Hgb level of 11,000/mm³ is within the normal range for a pregnant woman. Anemia during pregnancy can lead to adverse outcomes for both the mother and the baby, such as preterm birth and low birth weight.
Rationale for other choices:
A: WBC count - While monitoring white blood cell (WBC) counts is important for detecting infections, it is not the most relevant parameter to review in this scenario.
C: 11,2 g/Dl - This choice is incomplete and doesn't provide a specific parameter or context for interpretation.
D: Hct 34% Platelets 140,000/mm³ - Hematocrit (Hct) and platelet levels are important, but in this case, the Hgb level is more pertinent
A 45-year-old woman presents to the clinic for advice about contraception. What is the most appropriate contraception method for a woman who is nearing menopause?
- A. Oral contraceptives with estrogen
- B. Contraceptive injections
- C. IUD with progestin
- D. Barrier methods like condoms
Correct Answer: C
Rationale: The most appropriate contraception method for a woman nearing menopause is an IUD with progestin (Choice C). Progestin-containing IUDs are effective, long-lasting, and suitable for women of various ages. As women approach menopause, the hormonal changes make progestin-containing IUD a favorable option as it offers reliable contraception without the need for daily administration. Additionally, progestin can also help alleviate symptoms like heavy periods that women may experience during perimenopause.
Choices A and B are not ideal as oral contraceptives with estrogen can increase the risk of blood clots in older women, and contraceptive injections may not be as convenient for someone nearing menopause. Barrier methods like condoms (Choice D) are less effective and may not provide the level of protection needed during this stage of life.
A charge nurse is teaching a group of staff nurses about fetal monitoring during labor. Which of the following findings should the charge nurse instruct the staff members to report to the provider?
- A. Contraction durations of 95 to 100 seconds
- B. Contraction frequency of 2 to 3 min apart
- C. Absent early deceleration of fetal heart rate
- D. Fetal heart rate is 140/min
Correct Answer: A
Rationale: The correct answer is A: Contraction durations of 95 to 100 seconds. Prolonged contractions can indicate uterine hyperstimulation, leading to decreased fetal oxygenation. Staff should report this to the provider for further evaluation and management.
Explanation:
1. Contraction durations of 95 to 100 seconds are prolonged and may indicate uterine hyperstimulation, potentially compromising fetal oxygenation.
2. Reporting this finding to the provider allows for timely intervention to prevent fetal distress.
3. Choices B, C, and D do not directly indicate a concern for fetal well-being during labor and would not require immediate reporting to the provider.
A new mother asks the nurse why newborns receive an injection of vit. K after delivery. What will be the best response from the nurse?
- A. Newborns are given vit K to help with the digestion to help them absorb fat soluble vitamins
- B. Newborns are given vit K and erythromycin ointment to help prevent ophthalmia neonatorum
- C. Newborns lack the intestinal flora needed to produce vit K, so it is given to prevent bleeding episodes
- D. This vitamin substitutes for vitamin C and newborns will strengthen their immune system
Correct Answer: C
Rationale: The correct answer is C. Newborns lack the intestinal flora needed to produce vitamin K, so it is given to prevent bleeding episodes. Vitamin K is essential for blood clotting, and newborns have lower levels at birth. Without enough vitamin K, newborns are at risk of bleeding issues. Giving them a vitamin K injection helps prevent potential bleeding disorders.
Choice A is incorrect because vitamin K is not given for digestion or fat absorption. Choice B is incorrect as erythromycin ointment is used for preventing eye infections, not related to vitamin K injections. Choice D is incorrect as vitamin K does not substitute for vitamin C, and it is not primarily for strengthening the immune system.