Nokea
A client at 38 weeks gestation is admitted to labor and delivery with a complaint of contractions 5 minutes apart. While the client is in the bathroom changing into a hospital gown, the nurse hears the noise of a baby. What should the nurse do first?
- A. Push the call light for help
- B. Inspect the client's perineum
- C. Notify a healthcare provider
- D. Turn on the infant warmer
Correct Answer: B
Rationale: Inspecting the client's perineum immediately is necessary to assess if the baby is being delivered, which would require urgent action. Pushing the call light for help (Choice A) may delay the assessment and immediate action needed. Notifying a healthcare provider (Choice C) might cause further delays, as the situation requires urgent attention. Turning on the infant warmer (Choice D) is not the priority; ensuring safe delivery and assessment of the baby's condition come first.
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A primigravida arrives at the observation unit of the maternity unit because she thinks she is in labor. The nurse applies the external fetal heart monitor and determines that the fetal heart rate is 140 beats per minute and contractions are occurring irregularly every 10 to 15 minutes. Which assessment finding confirms to the nurse that the client is not in labor at this time?
- A. Membranes are intact.
- B. 2+ pitting edema in lower extremities.
- C. Contractions decrease with walking.
- D. Cervical dilation is 1 centimeter.
Correct Answer: C
Rationale: The correct answer is C. Contractions that decrease with walking are typically indicative of false labor, as true labor contractions tend to intensify with activity. Choices A, B, and D are incorrect. A) Intact membranes are a normal finding and do not confirm the absence of labor. B) 2+ pitting edema in lower extremities is a sign of fluid retention and not directly related to labor status. D) Cervical dilation of 1 centimeter indicates some cervical changes, but it alone does not confirm active labor.
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.
Is Duchenne muscular dystrophy a sex-linked abnormality?
- A. TRUE
- B. FALSE
- C. Sometimes
- D. Always
Correct Answer: A
Rationale: The correct answer is A: TRUE. Duchenne muscular dystrophy is an X-linked recessive disorder, primarily affecting males. This is due to the inheritance of the mutated gene on the X chromosome. Choices B, C, and D are incorrect because Duchenne muscular dystrophy is specifically classified as a sex-linked disorder affecting males due to the inheritance pattern.
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.
Individuals with Klinefelter syndrome produce:
- A. less estrogen than normal males.
- B. less testosterone than normal males.
- C. less adenine than normal males.
- D. less thymine than normal males.
Correct Answer: B
Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY), leading to reduced production of testosterone, the primary male sex hormone. This deficiency can result in various physical and developmental characteristics associated with the syndrome. Estrogen levels may actually be relatively elevated due to the imbalance between testosterone and estrogen. Choices C and D are incorrect as adenine and thymine are nucleotide bases found in DNA and are not related to hormone production.