Nokea
Which of the patient health behaviors in the first trimester would the nurse identify as a risk factor in pregnancy?
- A. Sexual intercourse two or three times weekly
- B. Moderate exercise for 30 minutes daily
- C. Working 40 hours a week as a secretary in a travel agency
- D. Relaxing in a hot tub for 30 minutes a day, several days a week
Correct Answer: D
Rationale: The correct answer is D because relaxing in a hot tub for 30 minutes a day, several days a week can increase the body temperature, which is harmful during the first trimester and can lead to birth defects. Choice A is not a risk factor as it promotes a healthy sexual relationship. Choice B is beneficial as moderate exercise is recommended during pregnancy. Choice C is not necessarily a risk factor unless it involves exposure to harmful substances or excessive stress.
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The nurse is caring for a client with a suspected breech presentation. When the nurse performs Leopold's maneuvers, which maneuvers determine the fetal presentation? Select all that apply.
- A. First
- B. Second
- C. Third (Pawlik's maneuver)
- D. Fourth
Correct Answer: C
Rationale: First, the nurse applies gentle pressure just above the symphysis pubis to determine the presenting part (First). Second, the nurse palpates the sides of the uterus to identify the fetal back and small parts (Second). Third, Pawlik’s maneuver involves locating the fetal head in the fundus to confirm the fetal presentation. This maneuver determines the fetal presentation definitively (Correct - C). Fourth, the nurse feels for the fetal buttocks or cephalic prominence to determine the position of the back or head (Fourth). Pawlik's maneuver is crucial in identifying the fetal presentation accurately, making it the correct answer. Other choices are incorrect as they do not directly determine the fetal presentation like Pawlik's maneuver does.
The triage nurse is interviewing a client, 19 years old, unmarried, who states, 'I felt a hard thing on the lip of my vagina this morning. It doesn’t hurt.' Which of the following questions is most important for the nurse to ask at this time?
- A. Have any of your partners ever hurt you?'
- B. Do you ever have unprotected intercourse?'
- C. Have you ever had a baby?'
- D. Do you think you may be pregnant?'
Correct Answer: B
Rationale: Unprotected intercourse increases the risk of sexually transmitted infections (STIs), which could explain the hard lump.
A school nurse is discussing the male reproductive system with the students in a high school health class. Which of the following information about the hormone testosterone should be included in the discussion?
- A. Testosterone is what makes boys more muscular than girls.'
- B. The level of testosterone in boys changes every month like female hormones do.'
- C. Testosterone is produced by the male prostate gland.'
- D. The production of testosterone usually stops by the time a man is fifty years old.'
Correct Answer: A
Rationale: Testosterone is responsible for the development of male secondary sexual characteristics, including increased muscle mass.
When is the earliest interval that chorionic villus sampling (CVS) can be performed during pregnancy?
- A. 4 weeks
- B. 8 weeks
- C. 10 weeks
- D. 14 weeks
Correct Answer: C
Rationale: The correct answer is C: 10 weeks. CVS is typically performed between 10-12 weeks of gestation. At this time, there is enough fetal tissue for sampling without significant risk to the pregnancy. Performing CVS earlier (options A, B) may result in insufficient tissue for accurate testing, while performing it later (option D) may increase the risk of procedure-related complications. Option C provides the optimal balance between ensuring accurate results and minimizing potential risks to the pregnancy.
The nurse is caring for a 45-year-old client who is scheduled to have a chorionic villus sampling. Which information is most important for the nurse to obtain from the client before the procedure?
- A. NPO status
- B. Blood type and Rh
- C. Weeks of gestation
- D. Maternal bleeding disorders
Correct Answer: D
Rationale: The correct answer is D: Maternal bleeding disorders. This information is crucial before a chorionic villus sampling to assess the risk of excessive bleeding during the procedure due to potential clotting issues. Maternal bleeding disorders can increase the risk of complications during the procedure.
A: NPO status is not as critical for this procedure as it does not typically require fasting.
B: Blood type and Rh are important for other purposes but not specifically needed before a chorionic villus sampling.
C: Weeks of gestation is important for determining the timing of the procedure but does not directly impact the safety or success of the procedure.