Nokea
A newborn assessment reveals spina bifida occulta. Which maternal factor should the nurse identify as having the greatest impact on the development of this newborn complication?
- A. Tobacco use.
- B. Folic acid deficiency.
- C. Short interval between pregnancies.
- D. Preeclampsia.
Correct Answer: B
Rationale: Folic acid deficiency during pregnancy is strongly associated with neural tube defects like spina bifida occulta. Adequate folic acid intake before and during early pregnancy significantly reduces the risk of such complications. Tobacco use (Choice A) is linked to other adverse outcomes but not specifically spina bifida occulta. Short intervals between pregnancies (Choice C) can increase the risk of preterm birth and low birth weight but are not directly linked to spina bifida occulta. Preeclampsia (Choice D) is a hypertensive disorder that poses risks to both the mother and baby but is not the primary factor contributing to spina bifida occulta development.
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The nurse places one hand above the symphysis while massaging the fundus of a multiparous client whose uterine tone is boggy 15 minutes after delivering a 7-pound, 10-ounce (3220-gram) infant. Which information should the nurse provide to the client about these findings?
- A. The uterus should be firm to prevent an intrauterine infection.
- B. Both the lower uterine segment and the fundus must be massaged.
- C. A firm uterus prevents the endometrial lining from being sloughed.
- D. Clots may form inside a boggy uterus and need to be expelled.
Correct Answer: D
Rationale: After childbirth, a boggy uterus indicates poor uterine tone, which can lead to the formation of clots. Massaging the fundus helps the uterus contract and expel clots, reducing the risk of postpartum hemorrhage. Choices A, B, and C are incorrect because the main concern with a boggy uterus is the risk of clot formation and postpartum hemorrhage, not solely preventing intrauterine infection, massaging the lower uterine segment, or preventing the endometrial lining from sloughing.
What causes sickle-cell anemia?
- A. A chromosomal abnormality.
- B. A single segment found only on the Y chromosome.
- C. A recessive gene.
- D. A decrease in estrogen levels.
Correct Answer: C
Rationale: Sickle-cell anemia is a genetic disorder caused by inheriting two copies of a recessive gene, one from each parent. The correct answer is C. Choice A is incorrect because sickle-cell anemia is not primarily caused by a chromosomal abnormality. Choice B is incorrect as the condition is not linked to a single segment found only on the Y chromosome. Choice D is unrelated as it mentions a decrease in estrogen levels, which is not a cause of sickle-cell anemia.
At 31 weeks gestation, a client with a fundal height measurement of 25 cm is scheduled for a series of ultrasounds to be performed every two weeks. Which explanation should the nurse provide?
- A. Assessment for congenital anomalies
- B. Recalculation of gestational age
- C. Evaluation of fetal growth
- D. Determination of fetal presentation
Correct Answer: C
Rationale: The correct answer is C: 'Evaluation of fetal growth.' A fundal height measurement smaller than expected may indicate intrauterine growth restriction (IUGR), requiring serial ultrasounds to monitor fetal growth. Assessing for congenital anomalies (choice A) is usually done through detailed anatomy scans earlier in pregnancy. Recalculating gestational age (choice B) is typically unnecessary at this stage unless there are concerns about accuracy. Determining fetal presentation (choice D) is usually done closer to term to plan for the mode of delivery.
_____ are environmental agents that can harm the embryo or fetus.
- A. Mutations
- B. Autosomes
- C. Teratogens
- D. Androgens
Correct Answer: C
Rationale: Teratogens are environmental agents, such as drugs, chemicals, or infections, that can cause harm to a developing embryo or fetus. Mutations (Choice A) refer to changes in the DNA sequence and are not environmental agents. Autosomes (Choice B) are chromosomes that are not involved in determining an individual's sex and are not environmental agents that harm the embryo or fetus. Androgens (Choice D) are a group of hormones that are more related to male sexual development and function, not environmental agents that harm the embryo or fetus.
Which procedure is used to detect neural tube defects such as spina bifida and certain chromosomal abnormalities?
- A. Artificial insemination
- B. Amniocentesis
- C. Endometriosis
- D. Alpha-fetoprotein (AFP) assay
Correct Answer: D
Rationale: The correct answer is the Alpha-fetoprotein (AFP) assay. This blood test measures the level of AFP in a pregnant woman's blood, aiding in the detection of neural tube defects and certain chromosomal abnormalities in the fetus. Choice A, artificial insemination, is a method used to facilitate fertilization and is not related to detecting fetal abnormalities. Choice B, amniocentesis, involves collecting amniotic fluid for genetic testing, not directly measuring AFP levels. Choice C, endometriosis, is a medical condition involving abnormal tissue growth and is not a procedure for detecting fetal abnormalities. Therefore, the Alpha-fetoprotein (AFP) assay is the most appropriate option for detecting neural tube defects such as spina bifida and certain chromosomal abnormalities.