Nokea
A nurse in a provider’s office is assessing a client at her first antepartum visit. The client states that the first day of her last menstrual period was March 8. Use Negele’s rule to calculate the estimated date of delivery. (Use the MMDD format with four numerals and no spaces or punctuation.)
- A. December 15
- B. October 30
- C. January 15
- D. Nov 30
Correct Answer: A
Rationale: To calculate the estimated due date using Negele's rule, we add 7 days to the first day of the last menstrual period, subtract 3 months, and then add a year. March 8 + 7 days = March 15. Subtracting 3 months gives us December 15. Adding a year gives the estimated due date as December 15. This is the correct answer as it follows the standard calculation method. Other choices are incorrect as they do not follow the correct formula or have errors in calculation.
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A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors paces the client at risk for infection.
- A. Meconium – start fluid
- B. placenta previa
- C. Midline episiotomy
- D. Prolonged labor
Correct Answer: C
Rationale: The correct answer is C: Midline episiotomy. Midline episiotomies are associated with a higher risk of infection due to the location being close to the anal canal, which harbors bacteria. The incision can become contaminated during bowel movements or urination, increasing the risk of infection. Placenta previa (B) is a condition related to the positioning of the placenta, not directly associated with infection risk. Meconium-stained amniotic fluid (A) may indicate fetal distress but does not directly increase the mother's risk of infection. Prolonged labor (D) can lead to increased risk of infection due to prolonged exposure to vaginal flora, but it is not as direct a risk factor as a midline episiotomy.
A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following clients should the nurse assess first?
- A. A client who has diabetes mellitus and an HbA1c of 5.8%
- B. A client who has preeclampsia and a creatinine level of 1.1 mg/ dL
- C. A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L
- D. A client who has placenta previa and a hematocrit of 36%
Correct Answer: C
Rationale: The correct answer is C. The nurse should assess the client with hyperemesis gravidarum and a sodium level of 110 mEq/L first. This client is at risk for severe dehydration and electrolyte imbalance, which can lead to serious complications such as metabolic acidosis or organ dysfunction. Prompt assessment and intervention are crucial to stabilize the client's condition.
Choice A is not the priority as a client with diabetes mellitus and an HbA1c of 5.8% is within the target range indicating good glycemic control. Choice B, a client with preeclampsia and a creatinine level of 1.1 mg/dL, requires monitoring but is not as urgent as the client with hyperemesis gravidarum. Choice D, a client with placenta previa and a hematocrit of 36%, also needs monitoring but is not as urgently concerning as electrolyte imbalance.
A nurse is assisting with an amniotomy on a client who is in labor. Which of the following situations should the nurse take?
- A. Place the client in the left lateral position
- B. Ensure that the fetal head is engaged
- C. Give the provider clean gloves during the procedure
- D. Check the clients temperature every 4 hours after the procedure
Correct Answer: B
Rationale: The correct answer is B: Ensure that the fetal head is engaged. This is crucial before performing an amniotomy to prevent umbilical cord prolapse. If the fetal head is not engaged, there is a risk of cord compression. Placing the client in the left lateral position (choice A) is not directly related to the amniotomy procedure. Giving the provider clean gloves (choice C) is important for infection control but not specifically related to ensuring fetal head engagement. Checking the client's temperature (choice D) is important for monitoring but not a priority before an amniotomy.
A nurse is caring for a newborn who is 24 hr old. Which of the following Laboratory findings should the nurse report to the provider?
- A. Hgb 20 g/dL
- B. Bilirubin 2mg/dL
- C. Platelets 200 .000/mm3
- D. WBC count 32.000/mm3
Correct Answer: D
Rationale: The correct answer is D: WBC count 32,000/mm3. A newborn with a WBC count of 32,000/mm3 indicates a potential infection, as newborns typically have a higher WBC count initially due to stress of birth. It is important to report this finding to the provider for further evaluation and possible treatment. Choices A, B, and C are within normal range for a 24-hour-old newborn, so they do not require immediate reporting. Choice D, Hgb 20 g/dL, is not a typical laboratory finding for a newborn and would require further investigation, but it is not as urgent as a high WBC count indicating infection.
A nurse is assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider?
- A. Transient circumoral cyanosis
- B. Single palmar creases
- C. Subconjunctival hemorrhage
- D. Rust-stained urine
Correct Answer: B
Rationale: The correct answer is B: Single palmar creases. This finding may indicate the presence of Down syndrome or other genetic disorders. The presence of single palmar creases warrants further evaluation by the provider to rule out any underlying conditions. Transient circumoral cyanosis, subconjunctival hemorrhage, and rust-stained urine are common and typically benign findings in newborns that do not require immediate reporting.