Nokea
A nurse is assessing a client during her first prenatal visit. The client reports March 20th as her last menstrual period. Use Nagele's rule to calculate the estimated date of delivery.
- A. 03/20
- B. 12/27
- C. 11/27
- D. 10/03
Correct Answer: B
Rationale: The correct answer is B: 12/27. Nagele's rule calculates the estimated due date by adding 7 days to the first day of the last menstrual period, then subtracting 3 months and adding 1 year. In this case, March 20th + 7 days = March 27th. Subtracting 3 months gives us December 27th. Adding 1 year, we get December 27th of the current year as the estimated due date. Choice A is incorrect because it does not follow Nagele's rule. Choice C is incorrect as it is not 3 months subtracted from the reported last menstrual period. Choice D is incorrect as it does not account for the necessary adjustments according to Nagele's rule.
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A nurse is assessing a newborn upon admission to the nursery. Which of the following should the nurse expect?
- A. Bulging Fontanels
- B. Nasal Flaring
- C. Length from head to heel of 40 cm (15.7 in)
- D. Chest circumference 2 cm (0.8 in) smaller than the head circumference
Correct Answer: D
Rationale: The correct answer is D because a chest circumference smaller than the head circumference is a normal finding in a newborn due to the larger head size compared to the chest. This is known as head sparing and is essential for brain development. Bulging fontanels (choice A) are abnormal and may indicate increased intracranial pressure. Nasal flaring (choice B) is a sign of respiratory distress. A length of 40 cm (choice C) is within the average range but not a specific expectation upon admission. Therefore, choice D is the most appropriate expectation for a newborn assessment.
A nurse is planning care immediately following birth for a newborn who has myelomeningocele that is leaking cerebrospinal fluid.
- A. Administer broad-spectrum antibiotics
- B. Cleans the site with povidone-iodine
- C. Monitor the rectal temperature every 4 hours
- D. Prepare for surgical closure after 72 hours
Correct Answer: A
Rationale: The correct answer is A. Administering broad-spectrum antibiotics is crucial to prevent infection since the exposed spinal cord increases the risk. Antibiotics help reduce the risk of meningitis and sepsis. Choice B is incorrect as povidone-iodine can be irritating to the sensitive skin around the defect. Choice C is incorrect as monitoring rectal temperature is not directly related to the immediate care needed for a myelomeningocele. Choice D is incorrect because surgical closure should be done as soon as possible to prevent further complications.
A nurse is teaching a prenatal class regarding false labor. Which of the following information should the nurse include?
- A. your contraction will become more intense when walking
- B. you will have dilation and effacement of the cervix
- C. You will have bloody show
- D. Your contraction will become temporally regular
Correct Answer: A
Rationale: The correct answer is A: your contractions will become more intense when walking. This is because false labor contractions typically decrease in intensity or stop completely when the individual changes positions or engages in physical activity. This is a key characteristic that helps differentiate false labor from true labor. Choices B, C, and D are incorrect as they are more indicative of true labor, where there is cervical dilation, effacement, bloody show, and regular contractions. It is important for the nurse to emphasize this distinction to ensure pregnant individuals can recognize the signs of true labor and seek appropriate care.
A nurse in a woman’s health clinic is obtaining a health history from a client. Which of the following findings should the nurse identify as increasing the client’s risk for developing pelvic inflammatory disease (PID)?
- A. Recurrent Cystitis
- B. Frequent Alcohol Use
- C. Use of Oral Contraceptives
- D. Chlamydia Infection
Correct Answer: D
Rationale: The correct answer is D: Chlamydia Infection. Chlamydia is a common sexually transmitted infection that can lead to PID if left untreated. The bacteria can ascend from the cervix to the upper genital tract, causing inflammation and scarring. This increases the risk of PID. Recurrent Cystitis (A) is a urinary tract infection and not directly related to PID. Frequent Alcohol Use (B) does not directly increase the risk of developing PID. Use of Oral Contraceptives (C) actually decreases the risk of PID by reducing the chances of getting sexually transmitted infections.
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.