Nokea
A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions?
- A. Cervical insufficiency
- B. Uterine fibroids
- C. Fetal genetic abnormalities
- D. Maternal disease
Correct Answer: C
Rationale: Fetal genetic abnormalities, like chromosomal errors, cause ~70% of first trimester abortions. Cervical insufficiency affects later trimesters, fibroids and maternal diseases (e.g., diabetes) are less common causes early on.
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It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time?
- A. 24 hours before delivery and 24 hours after delivery
- B. In the first trimester and within 2 hours of delivery
- C. At 28 weeks gestation and again within 72 hours after delivery
- D. At 32 weeks gestation and immediately before discharge
Correct Answer: C
Rationale: Rho(D) immune globulin at 28 weeks and within 72 hours post-delivery prevents Rh isoimmunization effectively. Other schedules miss critical windows for blocking maternal antibody response.
When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find?
- A. Ambivalence
- B. Emotional lability
- C. Introversion
- D. Acceptance
Correct Answer: B
Rationale: Emotional lability is typical in the first trimester from hormonal changes causing irritability or crying. Ambivalence is less common unless conflicted, introversion isn't pregnancy-specific, and acceptance grows over time.
After reviewing the information provided in the client's medical record, which of the following complications should the nurse identify that the client is at risk of developing?
- A. Preeclampsia; uric acid
- B. Gestational diabetes; glucose
- C. Eclampsia; magnesium
- D. Placenta previa; hemoglobin
Correct Answer: B
Rationale: Gestational diabetes risk is linked to glucose intolerance, detectable by serum glucose levels, causing complications like macrosomia. Preeclampsia involves hypertension, not uric acid alone; eclampsia isn't tied to magnesium levels; placenta previa relates to prior surgeries, not hemoglobin.
A client's last menstrual period was April 11. Using Nägele's rule, her estimated date of birth (EDB) would be:
- A. 18-Feb
- B. 18-Jan
- C. 8-Jan
- D. 28-Dec
Correct Answer: B
Rationale: Nägele's rule: add 1 year, subtract 3 months, add 7 days. April 11, 2023 + 1 year = April 11, 2024; minus 3 months = January 11, 2024; plus 7 days = January 18, 2024. Other options misapply the rule.
When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes which goal as the primary one?
- A. Eliminate anxiety so that they can have an uncomplicated birth
- B. Empower the couple to take control over their pregnancy and birth
- C. Equip a couple with the knowledge to experience a positive birth
- D. Provide knowledge and skills that will help them cope with labor
Correct Answer: C
Rationale: Perinatal education aims to prepare couples for a positive birth by providing knowledge for informed decisions and coping strategies, enhancing satisfaction and well-being. Eliminating anxiety is unrealistic, control is partial, and labor skills are only one aspect.