Nokea
Which condition is most commonly associated with late decelerations of the fetal heart rate?
- A. Head compression
- B. Maternal hypothyroidism
- C. Uteroplacental insufficiency
- D. Umbilical cord compression
Correct Answer: C
Rationale: Late decelerations of the fetal heart rate are most commonly associated with uteroplacental insufficiency. During contractions, there is reduced blood flow to the placenta, leading to hypoxia and acidosis in the fetus, resulting in late decelerations. Head compression (A) typically causes early decelerations. Maternal hypothyroidism (B) does not directly affect fetal heart rate. Umbilical cord compression (D) can cause variable decelerations, not late decelerations. Therefore, the correct answer is C.
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The nurse admits a client with preeclampsia to the high-risk prenatal unit. Which is the next nursing action after the vital signs have been obtained?
- A. Calling the primary health care provider
- B. Checking the client's reflexes
- C. Determining the client's blood type
- D. Establishing an intravenous (IV) line
Correct Answer: B
Rationale: The correct answer is B: Checking the client's reflexes. This is important in assessing for signs of worsening preeclampsia, such as hyperreflexia. It helps determine the severity of the condition and guides further interventions. Calling the primary health care provider (A) may be necessary but not the immediate next step. Determining the client's blood type (C) is important but not urgent in this situation. Establishing an IV line (D) is important for treatment but assessing reflexes takes priority in preeclampsia management.
Which finding would indicate concealed hemorrhage in abruptio placentae?
- A. Bradycardia
- B. Hard boardlike abdomen
- C. Decrease in fundal height
- D. Decrease in abdominal pain
Correct Answer: B
Rationale: The correct answer is B: Hard boardlike abdomen. This finding indicates concealed hemorrhage in abruptio placentae because it suggests intra-abdominal bleeding causing rigidity and firmness. This is due to blood pooling in the abdomen, leading to a tense, boardlike feeling upon palpation. The other choices are incorrect because: A) Bradycardia is not a specific indicator of concealed hemorrhage in this context; C) Decrease in fundal height is more characteristic of a missed miscarriage or intrauterine fetal demise; D) Decrease in abdominal pain is not typically associated with concealed hemorrhage, which often presents with severe abdominal pain.
A patient, who delivered her third child yesterday, has just learned that her two school-age children have contracted chickenpox. What should the nurse tell her?
- A. Her two children should be treated with acyclovir before she goes home from the hospital.
- B. The baby will acquire immunity from her and will not be susceptible to chickenpox.
- C. The children can visit their mother and baby in the hospital as planned but must wear gowns and masks.
- D. She must make arrangements to stay somewhere other than her home until the children are no longer contagious.
Correct Answer: D
Rationale: The correct answer is D because the patient, having just given birth, is at a higher risk of complications from chickenpox. By staying away from her home until her children are no longer contagious, she reduces the risk of contracting the illness and potentially passing it on to her newborn. This is crucial for the safety of both the mother and the baby.
Choice A is incorrect because treating the children with acyclovir does not prevent the mother from contracting chickenpox. Choice B is incorrect as immunity is not transferred from the children to the mother or newborn. Choice C is incorrect because even with gowns and masks, the risk of transmission is still present, especially for a postpartum mother and a newborn.
Which clinical intervention is the only known cure for preeclampsia?
- A. Magnesium sulfate
- B. Delivery of the fetus
- C. Antihypertensive medications
- D. Administration of aspirin (ASA) every day of the pregnancy
Correct Answer: B
Rationale: The correct answer is B: Delivery of the fetus. Preeclampsia is a serious condition that can only be cured by delivering the baby and placenta. This is because the placenta is the source of the problem in preeclampsia. Other options like magnesium sulfate, antihypertensive medications, and aspirin can help manage symptoms but do not cure the underlying condition. Magnesium sulfate is used to prevent seizures in severe cases, antihypertensive medications control high blood pressure, and aspirin may be used for prevention but not as a cure. Delivery is the definitive treatment to resolve preeclampsia and prevent further complications for both the mother and the baby.
Which factor is most important in diminishing maternal, fetal, and neonatal complications in a pregnant patient with diabetes?
- A. Evaluation of retinopathy by an ophthalmologist
- B. The patient's stable emotional and psychological status
- C. Degree of glycemic control before and during the pregnancy
- D. Total protein excretion and creatinine clearance within normal limits
Correct Answer: C
Rationale: The correct answer is C, the degree of glycemic control before and during the pregnancy. Proper management of blood sugar levels is crucial in reducing complications in pregnant patients with diabetes. Uncontrolled blood sugar levels can lead to adverse outcomes for both the mother and the baby. Monitoring and maintaining optimal glycemic control before and during pregnancy can help prevent complications such as birth defects, preterm birth, macrosomia, and neonatal hypoglycemia.
Choice A, evaluation of retinopathy by an ophthalmologist, is important for diabetic patients but is not the most critical factor in reducing maternal, fetal, and neonatal complications.
Choice B, the patient's stable emotional and psychological status, is important for overall well-being but does not directly impact maternal, fetal, and neonatal complications in the same way as glycemic control.
Choice D, total protein excretion and creatinine clearance within normal limits, is important for assessing kidney function in diabetic patients but is not as directly related to