Nokea
A 39-week-gestation client is admitted to the labor and delivery unit for a scheduled cesarean delivery. The nurse should inform the surgeon regarding which of the following admission laboratory findings?
- A. Potassium 4.9 mEq/L.
- B. Sodium 136 mEq/L.
- C. Platelet count 75,000 cells/mm3.
- D. White blood cell count 15,000 cells/mm3.
Correct Answer: C
Rationale: A platelet count of 75,000 cells/mm3 is low and could increase the risk of bleeding during surgery. The surgeon should be informed to take appropriate precautions.
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Use Naegele's rule to determine the EDD (estimated day of birth) for a patient whose last menstrual period started on April 12.
- A. 19-Feb
- B. 19-Jan
- C. 21-Jan
- D. 7-Feb
Correct Answer: B
Rationale: To calculate EDD using Naegele's rule, add 7 days to the first day of the last menstrual period, then count back 3 months and add 1 year. For this question, starting with April 12, adding 7 days gives April 19. Counting back 3 months gives January 19 of the following year. Therefore, the estimated day of birth (EDD) is January 19. Choice B (19-Jan) is correct.
Choice A (19-Feb): Incorrect as it does not follow the correct calculation method for Naegele's rule.
Choice C (21-Jan): Incorrect as the calculation does not match the steps of Naegele's rule.
Choice D (7-Feb): Incorrect as it does not align with the correct application of Naegele's rule.
The umbilical cord is being clamped by the obstetrician. Which of the following physiological changes is taking place at this time?
- A. The baby’s blood bypasses its pulmonary system.
- B. The baby’s oxygen level begins to drop.
- C. Bacteria begin to invade the baby’s bowel.
- D. Bilirubin rises in the baby’s bloodstream.
Correct Answer: A
Rationale: Clamping the umbilical cord initiates the transition from fetal to neonatal circulation, allowing blood to bypass the pulmonary system as the lungs take over oxygen exchange.
A 4-day-old breastfeeding neonate, whose birth weight was 2,678 grams, has lost 286 grams since its cesarean birth. Which of the following actions should the nurse take?
- A. Nothing, because this is an acceptable weight loss.
- B. Advise the mother to stop breastfeeding and give formula.
- C. Notify the neonatologist of the excessive weight loss.
- D. Give the baby dextrose water between breast feedings.
Correct Answer: A
Rationale: A weight loss of up to 10% of birth weight in the first week is considered normal for breastfed neonates.
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.
What is the rationale for a woman in her first trimester of pregnancy to expect to visit her health care provider every 4 weeks?
- A. Problems can be eliminated.
- B. She develops trust in the health care team.
- C. Her questions about labor can be answered.
- D. The conditions of the expectant mother and fetus can be monitored.
Correct Answer: D
Rationale: The correct answer is D because in the first trimester, regular monitoring is crucial to ensure the health and well-being of both the mother and fetus. Visiting every 4 weeks allows the healthcare provider to monitor the progress of the pregnancy, detect any potential issues early on, and provide appropriate interventions if needed. This frequency enables timely adjustments to care plans, such as dietary recommendations or medication changes, to optimize outcomes. Choices A, B, and C are incorrect as they do not directly relate to the primary reason for the regular visits during the first trimester, which is to monitor the conditions of the expectant mother and fetus.