Nokea
A client, 6 cm and 80% effaced, has just received Demerol (meperidine) 50 mg IV for pain. Which of the following fetal heart changes would the nurse expect to observe on the internal fetal monitor tracing?
- A. Drop in baseline heart rate.
- B. Increase in number of variable decelerations.
- C. Decrease in variability.
- D. Rise in number of early decelerations.
Correct Answer: C
Rationale: Demerol can cross the placenta and cause decreased variability in the fetal heart rate.
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A woman, who is in pain from a diagnosis of mastitis, has abruptly weaned her baby to a bottle. Her actions place the woman at high risk for which of the following?
- A. Mammary rupture.
- B. Postpartum psychosis.
- C. Supernumerary nipples.
- D. Breast abscess.
Correct Answer: D
Rationale: Abrupt weaning can lead to milk stasis, increasing the risk of a breast abscess due to bacterial infection.
In which type of health care facility does the nurse want to work if applying for a position with a home care organization that specializes in spinal cord injury?
- A. Secondary acute
- B. Continuing
- C. Restorative
- D. Tertiary
Correct Answer: C
Rationale: Patients recovering from an acute or chronic illness or disability often require additional services (restorative care) to return to their previous level of function or reach a new level of function limited by their illness or disability.
Which finding indicates the best quality improvement process?
- A. Staff identifies the wait time in the emergency department is too long.
- B. Administration identifies the design of the facility’s lobby increases patient stress.
- C. Director of the hospital identifies the payment schedule does not pay enough for overtime.
- D. Health care providers identify the inconsistencies of some of the facility’s policy and procedures.
Correct Answer: A
Rationale: The quality improvement process begins at the staff level, where problems are defined by the staff. It is not identified by administration, the hospital director, or health care providers.
A nurse is reading a research study that states, 'There is a strong negative correlation between the independent and dependent variables (r = --0.85).' The nurse interprets the statement as which of the following?
- A. The dependent variable caused a change in the independent variable.
- B. The independent and dependent variables are significantly different.
- C. As values of the independent variable go up, values of the dependent variable go down.
- D. When the confidence interval is computed, the negative value will change to positive.
Correct Answer: C
Rationale: A negative correlation means that as one variable increases, the other decreases. The strength of the correlation is indicated by the absolute value of r.
A patient who smokes one pack of cigarettes daily has a positive pregnancy test. The nurse will explain that smoking during pregnancy increases the risk of which condition?
- A. Congenital anomalies
- B. Death before or after birth
- C. Neonatal hypoglycemia
- D. Neonatal withdrawal syndrome
Correct Answer: B
Rationale: The correct answer is B: Death before or after birth. Smoking during pregnancy increases the risk of fetal death, both before and after birth, due to the harmful effects of nicotine and other toxins on the developing fetus. Smoking can lead to complications such as placental abruption, preterm birth, low birth weight, and stillbirth.
A: Congenital anomalies - While smoking during pregnancy can increase the risk of certain birth defects, the primary concern related to smoking is not congenital anomalies.
C: Neonatal hypoglycemia - Smoking during pregnancy is not directly linked to neonatal hypoglycemia, which is usually related to maternal diabetes or other factors.
D: Neonatal withdrawal syndrome - Although smoking during pregnancy can lead to nicotine exposure in the fetus, resulting in withdrawal symptoms after birth, the immediate risk of death is a more critical concern associated with smoking during pregnancy.