Nokea
A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began one hour ago. The nurse's assessment reveals approximately 30ML of bright red vaginal bleeding, fetal heart rate of 130 - 140 beats per minute, no contractions, and no complaints of pain. What is the most likely cause of this client's bleeding?
- A. Abruptio Placenta
- B. Placenta Previa
- C. Normal bloody show indicating induction of labor
- D. A ruptured blood vessel in the vaginal vault
Correct Answer: B
Rationale: Placenta previa, a condition where the placenta covers the cervix, can cause painless, bright red vaginal bleeding in the third trimester. In this scenario, the absence of contractions and pain, along with the presence of significant bright red bleeding, is more indicative of placenta previa rather than abruptio placenta or a ruptured vessel. A normal bloody show typically occurs closer to the onset of labor and is not associated with the amount of bleeding described in the question.
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A healthcare professional is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the healthcare professional include in the plan of care?
- A. Dress the newborn in lightweight clothing.
- B. Avoid using lotion or ointment on the newborn's skin.
- C. Keep the newborn supine throughout treatment.
- D. Measure the newborn's temperature every 8 hours.
Correct Answer: B
Rationale: When a newborn is receiving phototherapy, it is important to avoid using lotions or ointments on their skin as these products can lead to skin irritation and burns under the phototherapy lights. Dressing the newborn in lightweight clothing helps ensure proper exposure to the phototherapy lights. Keeping the newborn supine during treatment helps maximize exposure to the light. However, the key consideration in this scenario is to prevent skin irritation and burns by avoiding lotions or ointments.
The client who is 40 weeks gestation seems upset and tells the nurse that the physician told her she needs to have a nonstress test. The client asks why she needs the test. The nurse's best response would be:
- A. This is a test to see if your stress level is affecting your baby's growth and well-being.
- B. This is a test to see if your baby will be able to withstand the stress of labor.
- C. This is a test to assess your baby's well-being now that you are due to deliver soon.
- D. This is a test to let us know if your baby needs to be delivered to avoid a bad outcome.
Correct Answer: C
Rationale: The correct response is C because the nonstress test is specifically used to assess the baby's well-being close to the due date. It helps determine if the baby is receiving enough oxygen and nutrients in the womb. Choice A is incorrect as the test does not assess the mother's stress level but focuses on fetal well-being. Choice B is incorrect as the test does not predict the baby's ability to withstand labor. Choice D is incorrect because the test does not solely indicate if the baby needs to be delivered to avoid a bad outcome; rather, it assesses the current well-being of the baby.
A client with hyperemesis gravidarum is being cared for by a nurse. Which of the following laboratory tests should the nurse anticipate?
- A. Urine Ketones
- B. Rapid plasma reagin
- C. Prothrombin time
- D. Urine culture
Correct Answer: A
Rationale: Urine ketones should be anticipated as a laboratory test for a client with hyperemesis gravidarum because it helps assess the severity of dehydration and malnutrition, which are common complications of this condition. Choice B, rapid plasma reagin, is a test for syphilis and is not relevant to hyperemesis gravidarum. Choice C, prothrombin time, is a measure of blood clotting function and is not typically indicated for hyperemesis gravidarum. Choice D, urine culture, is used to identify bacteria in the urine and is not directly related to assessing dehydration and malnutrition in clients with hyperemesis gravidarum.
A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effects should the nurse include?
- A. Tinnitus
- B. Urinary Frequency
- C. Breast Tenderness
- D. Chills
Correct Answer: C
Rationale: The correct answer is C: 'Breast Tenderness.' Clomiphene citrate is known to cause breast tenderness as a common side effect due to its hormonal effects on the body. Tinnitus (choice A), which is a ringing in the ears, is not typically associated with clomiphene citrate. Urinary frequency (choice B) is not a common adverse effect of this medication. Chills (choice D) are also not commonly linked to clomiphene citrate use.
_______ is a genetic disorder in which blood does not clot properly.
- A. Cystic fibrosis
- B. Hemophilia
- C. Lymphoma
- D. Huntington's disease
Correct Answer: B
Rationale: Hemophilia is a genetic disorder characterized by a deficiency in blood clotting factors, leading to prolonged bleeding. Cystic fibrosis is a genetic disorder that affects the lungs and digestive system, not blood clotting. Lymphoma is a type of cancer originating in the lymphatic system and is not related to blood clotting abnormalities. Huntington's disease is a neurodegenerative genetic disorder that affects a person's ability to move, think, and behave.