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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A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which findings would the nurse most likely assess? Select all that apply.
- A. Ultrasound visualization of the fetus
- B. Softening of the cervix
- C. Positive pregnancy test
- D. Absence of menstruation
- E. Ballottement
- F. Auscultation of a fetal heart beat
Correct Answer: B,C,D,E
Rationale: Probable signs include softening of the cervix (Goodell's), positive pregnancy test (hCG), amenorrhea, and ballottement (fetal rebound). Ultrasound and fetal heartbeat are positive signs, confirming pregnancy definitively.
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition?
- A. Maternal diabetes
- B. Fetal anencephaly
- C. Placental abruption
- D. Neural tube defects
Correct Answer: B
Rationale: Oligohydramnios (low amniotic fluid) is linked to fetal anencephaly, where absent brain development reduces fetal urine, a fluid source. Maternal diabetes causes polyhydramnios, abruption affects bleeding, and neural tube defects don't directly reduce fluid.
A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year-old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as:
- A. 3-2-1-0-3
- B. 4-1-1-1-3
- C. 4-2-1-3-1
- D. 3-1-2-2-3
Correct Answer: B
Rationale: GTPAL: Gravida (4 pregnancies: twins, son, abortion, current), Term (1 at 39 weeks), Preterm (1 at 34 weeks), Abortions (1 at 6 weeks), Living (3 children). Thus, 4-1-1-1-3 is correct. Other options miscalculate pregnancies, preterm births, or living children.
On the first prenatal visit, an examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as:
- A. Chadwick's sign
- B. Goodell's sign
- C. Hegar's sign
- D. Homan's sign
Correct Answer: A
Rationale: Chadwick's sign is bluish discoloration of the cervix and vagina from increased blood flow, seen early in pregnancy. Goodell's is cervical softening, Hegar's is uterine softening, and Homan's indicates thrombosis, not pregnancy.
A pregnant woman undergoes a triple/quadruple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's alpha-fetoprotein (AFP) level is decreased?
- A. Sickle-cell anemia
- B. Cardiac defects
- C. Down syndrome
- D. Respiratory disorders
Correct Answer: C
Rationale: Low AFP suggests Down syndrome, often with altered hCG and estriol. Sickle-cell anemia uses other tests, cardiac defects may raise AFP, and respiratory issues don't typically affect AFP levels.