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Client pregnant for the fourth time, delivered two full-term newborns, had one spontaneous abortion at 10 weeks of gestation.
A nurse is caring for a client who is pregnant for the fourth time. The client delivered two full-term newborns and had one spontaneous abortion at 10 weeks of gestation. The nurse should document the client's obstetrical history as which of the following?
- A. Gravida 3, Para 2.
- B. Gravida 3, Para 3.
- C. Gravida 4, Para 2.
- D. Gravida 4, Para 3.
Correct Answer: C
Rationale: Gravida 4 reflects the client's total pregnancies, including the current one and her abortion, while Para 2 accounts for her two full-term live births, accurately documenting her obstetrical history.
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Client at 33 weeks of gestation with preeclampsia.
A nurse is reviewing a laboratory report for a client who is at 33 weeks of gestation and has preeclampsia. Which of the following laboratory results should the nurse expect?
- A. BUN level of 30 mg/dL (normal range: 10 to 20 mg/dL).
- B. Hemoglobin level of 9.9 g/dL (normal range: 11 to 16 g/dL).
- C. Serum uric acid level of 2.5 mg/dL (normal range: 2.7 to 7.3 mg/dL).
- D. Casual blood glucose level of 228 mg/dL (normal range: less than 200 mg/dL).
Correct Answer: A
Rationale: A BUN level of 30 mg/dL is above the normal range of 10 to 20 mg/dL. Elevated BUN is consistent with renal involvement in preeclampsia, which is caused by vascular constriction and reduced renal perfusion.
Parents of a newborn with an uncircumcised penis.
A nurse is teaching the parents of a newborn how to care for their child's uncircumcised penis. Which of the following instructions should the nurse include?
- A. Retract the foreskin until you feel resistance.
- B. Use a cotton swab to clean under the foreskin.
- C. Apply petroleum jelly to the foreskin.
- D. Wash the penis once per day with soap and water.
Correct Answer: D
Rationale: Daily washing with mild soap and water ensures proper hygiene and prevents infection. This method maintains cleanliness without causing harm to sensitive tissues.
Drag words from the choices below to fill in each blank in the following sentence: The nurse should [option] as a potential complication.
- A. The nurse should plan to discuss with the client the risk for hypothyroidism.
- B. The nurse should include fallopian tube rupture as a potential complication.
- C. The nurse should explain hypovolemic shock as a life-threatening risk.
- D. The nurse should elaborate on the development of an invasive mole.
Correct Answer: B
Rationale: Fallopian tube rupture is a critical complication of conditions like ectopic pregnancy, emphasizing the importance of timely diagnosis and intervention to prevent life-threatening internal bleeding and sepsis.
Client who is breastfeeding and has mastitis.
A nurse is planning care for a client who is breastfeeding and has mastitis. Which of the following interventions should the nurse include?
- A. Instruct the client to wash their hands prior to breastfeeding.
- B. Teach the client about proper latching-on techniques.
- C. Encourage the client to alternate breastfeeding with formula feeding.
- D. Encourage the client to allow their nipples to air dry after feedings.
Correct Answer: A,B,D
Rationale: Handwashing (A) minimizes pathogen transmission. Proper latching techniques (B) reduce nipple trauma and facilitate milk drainage. Allowing nipples to air dry (D) promotes healing and reduces infection risk.
Client who is Rh-negative.
A nurse is teaching a pregnant client who is Rh-negative about Rho(D) immune globulin. Which of the following statements by the client indicates an understanding of the teaching?
- A. This shot may be given after birth to protect future pregnancies.
- B. If my partner is Rh-negative, I will not receive the shot.
- C. I will receive the shot after delivery if my baby is Rh-negative.
- D. I should not receive any immunizations for 3 months after the shot.
Correct Answer: A
Rationale: Rho(D) immune globulin administered postpartum prevents maternal sensitization to Rh-positive fetal blood cells, reducing risks of hemolytic disease in subsequent pregnancies by suppressing maternal immune response.