Nokea
A client asks the nurse, “Could you explain how the baby’s blood and my blood separate at delivery?” Which of the following responses is appropriate for the nurse to make?
- A. “When the placenta is born, the circulatory systems separate.”
- B. “When the doctor clamps the cord, the blood stops mixing.”
- C. “The separation happens after the baby takes the first breath. The baby’s oxygen no longer has to come from you.”
- D. “The blood actually never mixes. Your blood supply and the baby’s blood supply are completely separate.”
Correct Answer: D
Rationale: The maternal and fetal blood supplies are separate throughout pregnancy, with oxygen and nutrients exchanged through the placenta.
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The nurse is providing education to a patient at 16 weeks' gestation who is undecided about consenting to the quad screen. How can the nurse explain the purpose of the quad screen to the patient?
- A. It indicates the risk of the fetus for heart defects.
- B. It indicates the risk of the fetus for neural tube defects.
- C. It indicates the risk of the fetus for neural tube defects and chromosome abnormalities.
- D. It indicates the risk of the fetus for chromosome abnormalities.
Correct Answer: C
Rationale: The correct answer is C because the quad screen is a prenatal screening test that assesses the risk of the fetus for neural tube defects and chromosome abnormalities. At 16 weeks' gestation, this test helps identify potential issues early on, allowing for further diagnostic testing and appropriate interventions if needed. Choice A is incorrect because the quad screen does not specifically target heart defects. Choice B is incorrect as the quad screen does not solely focus on neural tube defects. Choice D is incorrect because the quad screen assesses both neural tube defects and chromosome abnormalities, not just chromosome abnormalities alone. Therefore, choice C is the most comprehensive and accurate explanation of the purpose of the quad screen for the patient at 16 weeks' gestation.
A laboring woman, G4 P3003, who was 6 cm dilated 1 hour ago cries, 'Hurry. I have to go to the bathroom to have a bowel movement.' The nurse notes that there is an increase in bloody show. Which of the following actions by the nurse is appropriate?
- A. Assess cervical dilation.
- B. Help the woman to the bathroom.
- C. Ask the woman if she needs pain medicine.
- D. Check the fetal heart rate.
Correct Answer: A
Rationale: The urge to have a bowel movement and increased bloody show could indicate that the woman is entering the second stage of labor. The nurse should assess cervical dilation to confirm.
When should the nurse begin discharge planning?
- A. When the patient is ready
- B. Close to the time of discharge
- C. Upon admission to the hospital
- D. After an order is written/prescribed
Correct Answer: C
Rationale: Discharge planning begins the moment a patient is admitted to a health care facility.
A young man is planning to use the condom as a contraceptive device. The nurse should teach him that which of the following actions is needed to maximize the condom's effectiveness?
- A. Use only water-soluble lubricants.
- B. Use only natural lambskin condoms.
- C. Apply the condom to a flaccid penis.
- D. Apply it tightly to the tip of the penis.
Correct Answer: A
Rationale: Water-soluble lubricants should be used with condoms to prevent breakage. Natural lambskin condoms do not protect against STIs, and condoms should be applied to an erect penis.
In a prenatal education class, the nurse is reviewing the importance of using relaxation techniques during labor. Which patient statement will the nurse need to correct?
- A. We will practice relaxation techniques only in a quiet setting so I can focus.'
- B. Relaxation is important during labor because it will help me conserve my energy.'
- C. If I relax in between contractions, my baby will get more oxygen during labor.'
- D. My partner and I will practice relaxation throughout the remainder of my pregnancy.'
Correct Answer: A
Rationale: The correct answer is A because relaxation techniques should be practiced not just in quiet settings but also during labor, regardless of the environment. This is important to help manage pain and promote a smoother labor process. Choice B is correct as relaxation can indeed help conserve energy. Choice C is incorrect as oxygenation to the baby is not directly related to the mother's relaxation between contractions. Choice D is also incorrect as relaxation techniques should be practiced specifically during labor as well, not just throughout the pregnancy.