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A healthcare professional is assisting with the care for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this condition?
- A. No alteration in menses
- B. Transvaginal ultrasound indicating a fetus in the uterus
- C. Blood progesterone greater than the expected reference range
- D. Report of severe shoulder pain
Correct Answer: D
Rationale: The correct answer is D: Report of severe shoulder pain. In a ruptured ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tube. As the tube ruptures, there is internal bleeding which can irritate the diaphragm, causing referred pain to the shoulder. This phenomenon is known as Kehr's sign. The other choices are incorrect because with a ruptured ectopic pregnancy, there would typically be altered menses due to the pregnancy disruption, a transvaginal ultrasound would not show a fetus in the uterus, and blood progesterone levels would not be elevated.
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A client at 8 weeks of gestation with iron deficiency anemia is prescribed iron supplements. Which beverage should the nurse reinforce the client to take the supplements with for better absorption?
- A. Ice water
- B. Low-fat or whole milk
- C. Tea or coffee
- D. Orange juice
Correct Answer: D
Rationale: The correct answer is D: Orange juice. Vitamin C enhances iron absorption by converting non-heme iron to a more absorbable form. The acidity in orange juice aids in this process. Ice water (choice A) does not contain any nutrients to enhance iron absorption. Low-fat or whole milk (choice B) contains calcium, which can inhibit iron absorption. Tea or coffee (choice C) contains tannins that can also inhibit iron absorption. In summary, orange juice is the best choice due to its vitamin C content that helps improve iron absorption.
When reviewing postpartum nutrition needs with breastfeeding clients, which statement indicates an understanding of the teaching?
- A. I am glad I can have my morning coffee.
- B. I should take folic acid to increase my milk supply.
- C. I will continue adding 330 calories per day to my diet.
- D. I will continue my calcium supplements because I don't like milk.
Correct Answer: D
Rationale: The correct answer is D because it demonstrates an understanding of the importance of calcium intake for breastfeeding mothers. Calcium is essential for both the mother's health and the baby's bone development. Continuing calcium supplements shows a commitment to meeting nutritional needs.
Incorrect choices:
A: Having coffee is fine, but it's not directly related to postpartum nutrition needs.
B: Folic acid is important for pregnancy but not specifically for increasing milk supply.
C: While additional calories are needed during breastfeeding, the specific amount varies and is not always 330 calories per day.
During preterm labor, a client is scheduled for an amniocentesis. The nurse should review which of the following tests to assess fetal lung maturity?
- A. Alpha-fetoprotein (AFP)
- B. Lecithin/sphingomyelin (L/S) ratio
- C. Kleihauer-Betke test
- D. Indirect Coombs' test
Correct Answer: B
Rationale: The correct answer is B: Lecithin/sphingomyelin (L/S) ratio. This test is used to assess fetal lung maturity by determining the ratio of two substances present in amniotic fluid. An L/S ratio of 2:1 or higher indicates mature fetal lungs, reducing the risk of respiratory distress syndrome in preterm infants.
A: Alpha-fetoprotein (AFP) is used to screen for neural tube defects, not fetal lung maturity.
C: Kleihauer-Betke test is used to detect fetal-maternal hemorrhage.
D: Indirect Coombs' test is used to detect antibodies in maternal blood that may attack fetal red blood cells, not assess fetal lung maturity.
In summary, the L/S ratio test is the most appropriate choice to assess fetal lung maturity during preterm labor, as it directly correlates with the development of the fetal lungs.
A client in an obstetrical clinic is discussing using an IUD for contraception with a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?
- A. An IUD should be replaced annually during a pelvic exam.
- B. I cannot get an IUD until after I've had a child.
- C. I should plan on regaining fertility 5 months after the IUD is removed.
- D. I will check to ensure the strings of the IUD are still present after my periods.
Correct Answer: D
Rationale: The correct answer is D. Checking the strings of the IUD after periods ensures that the device is in place. This indicates understanding of IUD maintenance. Choice A is incorrect because IUDs usually last 3-10 years and do not need annual replacement. Choice B is incorrect because nulliparous women can also use IUDs. Choice C is incorrect as fertility typically returns quickly after IUD removal, not necessarily after 5 months.
When caring for a client in labor, which of the following infections can be treated during labor or immediately following birth? (Select all that apply)
- A. Gonorrhea
- B. Chlamydia
- C. HIV
- D. All of the Above
Correct Answer: D
Rationale: The correct answer is D: All of the Above. All three infections - Gonorrhea, Chlamydia, and HIV - can be treated during labor or immediately following birth to prevent transmission to the newborn. Antibiotics can be administered for Gonorrhea and Chlamydia, while antiretroviral medications can be given for HIV. Prompt treatment is crucial to reduce the risk of vertical transmission. The other choices are incorrect because each infection listed can be effectively managed during labor or post-birth, making choice D the most comprehensive and accurate option.