Nokea
A nurse is preparing to infuse 1 liter of 0.9% sodium chloride IV over 8 hr with a tubing set that delivers 15 gtts/mL. The nurse should set the manual IV infusion to deliver how many drops/min?
- A. 31 gtts/min
- B. 30 gtts/min
- C. 32 gtts/min
- D. 29 gtts/min
Correct Answer: A
Rationale: Formula: gtts/min = (volume x drop factor) / time. (1000 mL x 15 gtts/mL) / (8 x 60 min) = 15000 / 480 = 31.25, rounded to 31 gtts/min. Other options miscalculate the rate.
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During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as:
- A. Ortolani's sign
- B. Chadwick's sign
- C. Goodell's sign
- D. Hegar's sign
Correct Answer: D
Rationale: Hegar's sign is softening of the lower uterine segment, felt early in pregnancy. Ortolani's tests infant hips, Chadwick's is cervical discoloration, and Goodell's is cervical softening, not uterine.
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.
Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?
- A. Marijuana
- B. Cocaine
- C. Nicotine
- D. Caffeine
Correct Answer: B
Rationale: Cocaine causes tachycardia, hypertension, and vasoconstriction, risking placental abruption and fetal distress. Marijuana causes relaxation, nicotine raises heart rate but vasodilates, and caffeine mildly stimulates but doesn't constrict vessels.
A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating
- A. Hemodilution of pregnancy
- B. A multiple gestation pregnancy
- C. Greater-than-expected weight gain
- D. Iron-deficiency anemia
Correct Answer: A
Rationale: Hemodilution of pregnancy occurs as plasma volume increases more than red blood cell mass, lowering hemoglobin to 10.5-14 g/dL in the second trimester, which includes 11 g/dL. Multiple gestation may raise hemoglobin, weight gain doesn't affect it, and iron-deficiency anemia typically shows lower hemoglobin with symptoms like fatigue.
A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make?
- A. Be sure that your lupus is stable or in remission for 6 months before getting pregnant.
- B. It's probably not a good idea for you to get pregnant since you have lupus.
- C. Your lupus will not have any effect on your pregnancy whatsoever.
- D. When you get pregnant we'll have to add quite a few medications to your normal treatment plan.
Correct Answer: A
Rationale: Stable lupus for 6 months before pregnancy reduces risks like flares or miscarriage. Discouraging pregnancy is insensitive, claiming no effect is false, and adding many medications is inaccurate without specifics.