Nokea
A female patient with a history of infertility is scheduled to have a hysterosalpingogram. Which findings can be detected with this procedure? Select all that apply.
- A. Tubal occlusions
- B. Uterine fibroids
- C. Cervical irritation
- D. Bicornate uterus
Correct Answer: A
Rationale: The correct answer is A: Tubal occlusions. Hysterosalpingogram is a diagnostic imaging procedure used to evaluate the uterus and fallopian tubes. It can detect tubal occlusions by visualizing the flow of contrast dye through the fallopian tubes. Choice B, uterine fibroids, is incorrect as hysterosalpingogram does not specifically assess uterine fibroids. Choice C, cervical irritation, is also incorrect as this procedure focuses on the uterus and fallopian tubes, not the cervix. Choice D, bicornuate uterus, is incorrect as hysterosalpingogram primarily evaluates tubal patency and uterine cavity shape, not specific uterine anomalies like a bicornuate uterus.
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At 16 weeks of gestation a pregnant person states, 'The most dangerous time is the first 3 months, so I shouldn’t have to worry from now on about any dangers to the baby.' What is the nurse's most appropriate response?
- A. There are teratogens with the potential to harm your baby at any time during the pregnancy.
- B. We really won’t be able to say for sure before you have an ultrasound.
- C. You are correct. You are past the critical point.
- D. You don’t seem very concerned about your baby’s welfare.
Correct Answer: A
Rationale: The correct answer is A because teratogens, substances that can harm the developing fetus, can have negative effects on the baby at any point during pregnancy, not just in the first trimester. The nurse's response should educate the pregnant person about the ongoing risks and the importance of avoiding harmful substances throughout pregnancy.
Option B is incorrect because an ultrasound is not used to assess the risk of teratogens. Option C is incorrect as it provides incorrect information that the risk is past, which is not true. Option D is incorrect as it is judgmental and does not address the pregnant person's misconception about the risks throughout pregnancy.
In practical terms regarding genetic health care, nurses should be aware that:
- A. Genetic disorders affect people of all socioeconomic backgrounds, races, and ethnic groups equally.
- B. Genetic health care is more concerned with populations than individuals.
- C. The most important of all nursing functions is providing emotional support to the family during counseling.
- D. Taking genetic histories is the province of large universities and medical centers.
Correct Answer: C
Rationale: Nurses should be prepared to help with various stress reactions from a couple facing the possibility of a genetic disorder.
What is the purpose of chorionic villus sampling (CVS) in the first trimester?
- A. to measure the amount of amniotic fluid
- B. to confirm pregnancy
- C. to assess the risk of chromosomal abnormalities in the fetus
- D. to assess for potential maternal infection
Correct Answer: C
Rationale: Rationale: CVS is done in the first trimester to assess the risk of chromosomal abnormalities in the fetus by obtaining a sample of cells from the placenta. This allows for genetic testing to detect conditions such as Down syndrome. Other choices are incorrect as CVS is not used to measure amniotic fluid quantity (A), confirm pregnancy (B), or assess maternal infection (D).
The nurse is reviewing the schedule for the OB/GYN she works for. In reviewing a patient’s chart, the nurse notes the patient is 32 weeks pregnant, has hypertension, and had a previous fetal death. What test does the nurse anticipate the provider will order?
- A. a contraction stress test
- B. amniotic fluid index
- C. nonstress test
- D. fetal movement count
Correct Answer: C
Rationale: The correct answer is C: nonstress test. A nonstress test is used to assess fetal well-being by monitoring the baby's heart rate in response to its own movements. In this case, the patient's history of hypertension and previous fetal death indicate a higher risk pregnancy, making it important to monitor the baby's well-being. A contraction stress test (choice A) is not suitable for a patient with hypertension as it can induce contractions and potentially harm the baby. An amniotic fluid index (choice B) is used to evaluate amniotic fluid levels and is not specific to this patient's situation. Fetal movement count (choice D) assesses the baby's movements but does not provide real-time information on fetal well-being like a nonstress test does.
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.