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A client's last menstrual period was April 11. Using Nägele's rule, her estimated date of birth (EDB) would be:
- A. 18-Feb
- B. 18-Jan
- C. 8-Jan
- D. 28-Dec
Correct Answer: B
Rationale: Nägele's rule: add 1 year, subtract 3 months, add 7 days. April 11, 2023 + 1 year = April 11, 2024; minus 3 months = January 11, 2024; plus 7 days = January 18, 2024. Other options misapply the rule.
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A pregnant woman undergoes a triple/quadruple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's alpha-fetoprotein (AFP) level is decreased?
- A. Sickle-cell anemia
- B. Cardiac defects
- C. Down syndrome
- D. Respiratory disorders
Correct Answer: C
Rationale: Low AFP suggests Down syndrome, often with altered hCG and estriol. Sickle-cell anemia uses other tests, cardiac defects may raise AFP, and respiratory issues don't typically affect AFP levels.
On the first prenatal visit, an examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as:
- A. Chadwick's sign
- B. Goodell's sign
- C. Hegar's sign
- D. Homan's sign
Correct Answer: A
Rationale: Chadwick's sign is bluish discoloration of the cervix and vagina from increased blood flow, seen early in pregnancy. Goodell's is cervical softening, Hegar's is uterine softening, and Homan's indicates thrombosis, not pregnancy.
A client comes to the prenatal clinic for her first visit. When determining the client's estimated due date, the nurse understands which method is the most accurate.
- A. Nagele's rule
- B. Ultrasound
- C. Gestation wheel
- D. Birth calculator
Correct Answer: B
Rationale: Ultrasound in the first trimester measures fetal size accurately for due date estimation, unlike Nagele's rule, gestation wheel, or calculators, which rely on less precise menstrual data or assumptions.
A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomforts as common during the first trimester? Select all that apply.
- A. Breast tenderness
- B. Urinary frequency
- C. Backache
- D. Cravings
- E. Leg cramps
Correct Answer: A,B,D
Rationale: First trimester discomforts include breast tenderness (hormonal growth), urinary frequency (bladder pressure), and cravings (taste changes). Backache and leg cramps typically occur later due to weight and nerve pressure.
A nurse is preparing to administer penicillin G benzathine 1.2 million units IM now. The amount available is penicillin G benzathine 600,000 units/mL. How many mL should the nurse administer?
- A. 2 mL
- B. 1 mL
- C. 3 mL
- D. 4 mL
Correct Answer: A
Rationale: Formula: volume = dose / concentration. 1,200,000 units / 600,000 units/mL = 2 mL. Other options result from incorrect division or rounding errors.