Nokea
Which analysis of maternal serum is the best predictor of chromosomal abnormalities in the fetus?
- A. Biophysical profile
- B. Multiple-marker screening
- C. Lecithin-to-sphingomyelin ratio
- D. Blood type and crossmatch of maternal and fetal serum
Correct Answer: B
Rationale: The correct answer is B: Multiple-marker screening. This analysis measures levels of certain proteins and hormones in maternal serum to assess the risk of chromosomal abnormalities in the fetus. It is considered the best predictor because abnormal levels of these markers can indicate conditions like Down syndrome. Biophysical profile (A) assesses fetal well-being but does not directly predict chromosomal abnormalities. Lecithin-to-sphingomyelin ratio (C) is used to assess fetal lung maturity, not chromosomal abnormalities. Blood type and crossmatch (D) are important for identifying Rh incompatibility but do not predict chromosomal abnormalities.
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The nurse is providing patient teaching to a client who plans to bottle feed her newborn infant. Which of the following information should be included in the education session?
- A. The baby should be burped after every 3 ounces of formula.
- B. If the bottle nipple is not filled throughout the feeding, the baby may take in a large amount of air.
- C. The best way to heat formula for the baby is in the microwave.
- D. If the mother is busy with her other children, she can prop the baby bottle up on a blanket or towel.
Correct Answer: B
Rationale: The bottle nipple should be filled with formula throughout the feeding to prevent the baby from taking in air, which can cause discomfort and gas.
Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one infant at 32 weeks' gestation, and one infant at 38 weeks' gestation.
- A. G5 T1 P2 A2 L 2
- B. G5 T1 P1 A1 L2
- C. G5 T0 P2 A2 L2
- D. G5 T1 P1 A2 L2
Correct Answer: D
Rationale: Rationale for Answer D (G5 T1 P1 A2 L2):
- G (Gravida): The patient is in her fifth pregnancy
- T (Term births): She has had one infant at 38 weeks' gestation
- P (Preterm births): She has had one infant at 32 weeks' gestation
- A (Abortions): She has had two spontaneous abortions in the first trimester
- L (Living children): She has 2 living children
Summary of other choices:
- A: Incorrect as it states 2 living children, which is not accurate
- B: Incorrect as it only accounts for one abortion and one living child
- C: Incorrect as it indicates no living children, which is not true based on the given information
Therefore, Answer D is the correct option based on the patient's obstetric history.
A 36-week-gestation client is having an amniocentesis. For which of the following reasons is the test likely being conducted?
- A. Genetic evaluation.
- B. Assessment of intrauterine growth restriction.
- C. Assessment of fetal lung maturation.
- D. Hormonal studies.
Correct Answer: C
Rationale: Amniocentesis at 36 weeks is often performed to assess fetal lung maturity before delivery.
What is the term for a nonstress test in which there are two or more fetal heart rate accelerations of 15 or more beats per minute (BPM) with fetal movement in a 20-minute period?
- A. Positive
- B. Negative
- C. Reactive
- D. Nonreactive
Correct Answer: C
Rationale: The correct answer is C: Reactive. In a nonstress test, a reactive result is considered normal and indicates a healthy fetus. This is because it shows two or more fetal heart rate accelerations of 15 or more BPM with fetal movement in a 20-minute period, which signifies a responsive and healthy fetal heart rate pattern. The other choices are incorrect because:
A: Positive typically indicates a concerning result in medical contexts.
B: Negative signifies an abnormal result in this context.
D: Nonreactive suggests a lack of desired fetal heart rate accelerations with movement, which is not ideal.
A nurse should monitor a client who is postpartum from a forceps delivery for which of the following complications?
- A. Placental abruption.
- B. Seizure.
- C. Idiopathic thrombocytopenia.
- D. Infection.
Correct Answer: D
Rationale: Forceps delivery increases the risk of trauma and infection due to potential tissue damage.