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A 29-year-old low-risk primiparous patient has just placental abruption?
- A. Mild: Grade 1
- B. Moderate: Grade 2
- C. Marked: Grade 3
- D. Severe: Grade 4
Correct Answer: B
Rationale: Placental abruption is classified based on the severity of symptoms and extent of separation of the placenta from the uterine wall. In a low-risk primiparous patient like the one described, a moderate placental abruption (Grade 2) is likely when there is some vaginal bleeding, mild to moderate abdominal pain, and signs of fetal distress such as abnormal fetal heart rate patterns.
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The nurse is caring for a child brought to the emergency department by a babysitter. The child needs an emergency appendectomy and the parents cannot be contacted. What would be the nurse's best response to this situation?
- A. Have the babysitter sign the consent form even if she does not have signed papers to do so.
- B. Have the primary care physician for the child sign the consent form.
- C. Document failed attempts to obtain consent to allow emergency care.
- D. Delay medical care until the child's next of kin can be contacted.
Correct Answer: C
Rationale: Health care providers can provide emergency treatment to a child without consent if they have made reasonable attempts to contact the child's parent or legal guardian.
Parents who recently experienced the death of their unborn child ask the nurse, 'What is a fetal death?' What is the nurse's best response?
- A. Fetal deaths occur later in pregnancy after 20 weeks' gestation.
- B. It refers to the intrauterine fetal death at any time during pregnancy.
- C. Fetal deaths occur earlier in pregnancy before 20 weeks' gestation.
- D. Fetal death occurs only at the birth of the newborn.
Correct Answer: B
Rationale: Fetal death refers to the spontaneous intrauterine death of a fetus at any time during pregnancy. Fetal deaths later in pregnancy (after 20 weeks of gestation) are referred to as stillbirths, and deaths earlier than 20 weeks are referred to as a miscarriage.
The nurse is functioning in the primary role to care for a 12-year-old boy with metastatic cancer in the liver. Which activity is typical of advocacy?
- A. Instructing parents about proper home care
- B. Educating the family about choices they have
- C. Telling parents about clinical guidelines
- D. Teaching the family about types of cancers
Correct Answer: B
Rationale: Educating the family about choices they have regarding therapies for the cancer in the child's liver is an example of advocacy, in which the nurse advances the interests of the child and family by informing them of options and assisting them to make informed decisions.
What should the nurse advise the client regarding Depo-Provera (medroxyprogesterone acetate)?
- A. Take the pill at the same time each day.
- B. Refrain from breastfeeding while using the method.
- C. Expect to have no periods as long as she takes the medicine.
- D. Consider switching to another birth control method in a year or so.
Correct Answer: B
Rationale: Depo-Provera can reduce milk supply and thus breastfeeding should be avoided.
A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for an induction of labor with misoprostol?
- A. A client who has active genital herpes
- B. A client who has gestational diabetes mellitus
- C. A client who has a previous uterine incision
- D. A client who has placenta previa
Correct Answer: C
Rationale: Misoprostol is a prostaglandin E1 analog that is commonly used for labor induction. It is particularly useful in clients with a previous uterine incision, such as a cesarean section scar, because it helps soften the cervix and promote uterine contractions, which can lead to successful vaginal birth after cesarean (VBAC). Misoprostol can be an effective method for inducing labor in these clients while minimizing the risk of uterine rupture. However, it is important to closely monitor clients for signs of uterine hyperstimulation when using misoprostol for labor induction.