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A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility?
- A. The patient works as a ballroom dance instructor.
- B. The patient is turning 37 years old this year.
- C. The patient has hot flashes and mood swings.
- D. The patient was treated for a pelvic inflammatory disease while in college.
Correct Answer: C
Rationale: The correct answer is C because hot flashes and mood swings can indicate hormonal imbalances, which are common causes of infertility. This symptom suggests potential issues with ovulation or other reproductive system functions. Choice A is irrelevant to infertility. Choice B, age alone does not indicate infertility. Choice D, a history of pelvic inflammatory disease can cause infertility, but symptoms indicating current hormonal imbalances are of more immediate concern.
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The nurse is providing care to a pregnant person at 32 weeks’ gestation. The nurse expects to observe what change in the pregnant person’s spine?
- A. sclerosis
- B. scoliosis
- C. kyphosis
- D. lordosis
Correct Answer: D
Rationale: The correct answer is D: lordosis. At 32 weeks' gestation, the pregnant person's center of gravity shifts forward, causing an increased lumbar lordosis to compensate. This change helps maintain balance and support the growing uterus. Sclerosis (choice A) refers to hardening of tissues, not a typical change in the spine during pregnancy. Scoliosis (choice B) is a lateral curvature of the spine, not typically related to pregnancy. Kyphosis (choice C) is an exaggerated outward curve in the upper spine, not a common change in pregnancy.
Which immunoglobulin is the only one that crosses the placenta during pregnancy?
- A. IgG
- B. IgA
- C. IgM
- D. IgD
Correct Answer: A
Rationale: The correct answer is A: IgG. IgG is the only immunoglobulin that can cross the placenta due to its small size and ability to bind to the neonatal Fc receptor. This transfer provides passive immunity to the fetus, protecting it from infections. IgA primarily functions in mucosal immunity and is found in secretions like breast milk. IgM is too large to cross the placenta and is mainly produced in response to acute infections. IgD is primarily found on the surface of B cells and functions in the activation of these cells.
Which statement best describes the changes that occur during the fetal period of development?
- A. Maturation of organ systems
- B. Development of basic organ systems
- C. Resistance of organs to damage from external agents
- D. Development of placental oxygen–carbon dioxide exchange
Correct Answer: A
Rationale: The correct answer is A because during the fetal period, organ systems continue to mature and develop to become fully functional. This includes refining the structures and functions of organs that have already been formed during the embryonic period. Option B is incorrect because basic organ systems are already formed during the embryonic period. Option C is incorrect as organs are still susceptible to damage during the fetal period. Option D is incorrect because the development of placental oxygen–carbon dioxide exchange primarily occurs during the early stages of pregnancy, not specifically during the fetal period.
The nurse caring for the laboring woman should know that meconium is produced by:
- A. Fetal intestines.
- B. Fetal kidneys.
- C. Amniotic fluid.
- D. The placenta.
Correct Answer: A
Rationale: As the fetus nears term, fetal waste products accumulate in the intestines as dark green-to-black, tarry meconium.
The nurse is counseling a couple who just learned their 16-week fetus tested positive for a serious genetic disorder. Which action by the nurse is inappropriate upon learning that the couple plan to continue the pregnancy?
- A. Determine whether termination is still a consideration.
- B. Explain they will experience grief, which is normal.
- C. Provide additional information about the disorder.
- D. Refer them to a disorder-specific support group.
Correct Answer: A
Rationale: The correct answer is A because it respects the couple's decision-making autonomy. The nurse should support their choice to continue the pregnancy without suggesting termination. Providing information, emotional support, and connecting them with a support group are appropriate actions. It is crucial to respect the couple's decision and provide compassionate care regardless of their choice. The other choices are incorrect because they may undermine the couple's autonomy and may not be aligned with their wishes.