Nokea
A couple just learned they are expecting their first child and are curious if they are having a boy or a girl. At what point of development can the couple first expect to see the sex of their child on ultrasound?
- A. 4 weeks’ gestational age
- B. 6 weeks’ gestational age
- C. 10 weeks’ gestational age
- D. 16 weeks’ gestational age
Correct Answer: C
Rationale: The fetal period begins at the ninth week, and by the tenth week the external genitalia are visible to ultrasound examination.
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When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent?
- A. Congenital heart defects
- B. Neural tube defects
- C. Mental retardation
- D. Premature birth
Correct Answer: B
Rationale: It is now known that folic acid supplements can prevent neural tube defects such as spina bifida.
A patient at 36 weeks gestation is undergoing a nonstress test (NST). The nurse observes the fetal heart rate baseline at 135 bpm and four nonepisodic patterns of the fetal heart rate reaching 160 bpm for 20-25 seconds each. How will the nurse record these findings?
- A. NST positive, nonreassuring
- B. NST negative, reassuring
- C. NST reactive, reassuring
- D. NST nonreactive, nonreassuring
Correct Answer: C
Rationale: An NST is reactive and reassuring when two or more accelerations occur within 20 minutes, indicating fetal well-being.
How often should the nurse assess the blood pressure, pulse, and respirations of the birthing person during the first hour of the fourth stage of labor?
- A. every 15 minutes
- B. every 30 minutes
- C. not until after the first hour
- D. once, then hourly
Correct Answer: A
Rationale: The correct answer is A: every 15 minutes. During the first hour of the fourth stage of labor, immediate postpartum assessment is crucial to monitor for any signs of complications such as hemorrhage or shock. Assessing vital signs every 15 minutes allows for early detection of any abnormalities and prompt intervention. This frequency ensures close monitoring of the birthing person's condition and helps in early identification of any potential issues. Choices B, C, and D are incorrect because less frequent assessments may delay the identification of complications, potentially leading to serious consequences. Option C, in particular, is dangerous as it suggests delaying assessments when immediate postpartum monitoring is essential.
A 36-week gestation gravid client is complaining of dyspnea when lying flat.
- A. Maternal hypertension.
- B. Fundal height.
- C. Hydramnios.
- D. Congestive heart failure.
Correct Answer: B
Rationale: As the uterus grows, the fundal height increases, which can press on the diaphragm and lead to shortness of breath when lying flat.
A pregnant patient is at 30 weeks gestation and is experiencing difficulty breathing, especially when lying flat. What is the nurse's priority action?
- A. Encourage the patient to rest in an upright position.
- B. Administer oxygen and prepare the patient for delivery.
- C. Monitor the fetal heart rate for signs of distress.
- D. Instruct the patient to take deep breaths and stay in bed.
Correct Answer: A
Rationale: The correct answer is A - Encourage the patient to rest in an upright position. This is the priority action because the patient is likely experiencing supine hypotensive syndrome due to pressure on the vena cava when lying flat. This can compromise blood flow to the fetus. By having the patient rest in an upright position, the pressure on the vena cava is reduced, improving blood flow and oxygenation for both the patient and the fetus. Administering oxygen and preparing for delivery (option B) is not the immediate priority. Monitoring fetal heart rate (option C) is important but not the initial action. Instructing the patient to take deep breaths and stay in bed (option D) does not address the underlying issue of supine hypotensive syndrome.