Nokea
A nurse is taking a maternal history for a client at her first prenatal visit. Her pregnancy test was positive, she has two living children, she had one spontaneous abortion, and one infant died at the age of 3 months. Which of the following best describes the client at the present?
- A. Gravida 4, para 2, ab 1
- B. Gravida 5, para 3, ab 1
- C. Gravida 5, para 4, ab 0
- D. Gravida 4, para 3, ab 0
Correct Answer: B
Rationale: The client has been pregnant five times (current pregnancy, two living children, one spontaneous abortion, one infant death), delivered three children (two living, one died), and had one abortion.
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A client with a diagnosis of HPV is at increased risk for which of the following?
- A. Hodgkin's lymphoma
- B. Cervical cancer
- C. Multiple myeloma
- D. Ovarian cancer
Correct Answer: B
Rationale: Human papillomavirus (HPV) is a major risk factor for cervical cancer particularly high-risk strains like HPV-16 and HPV-18. It is not strongly associated with Hodgkin’s lymphoma multiple myeloma or ovarian cancer.
The nurse is assessing a client who had a colon resection two days ago. The client states, "I feel like my stitches have burst loose." Upon further assessment, dehiscence of the wound is noted. Which action should the nurse take?
- A. Immediately place the client in the prone position.
- B. Apply a sterile, saline-moistened dressing to the wound.
- C. Administer atropine to decrease abdominal secretions.
- D. Wrap the abdomen with an ACE bandage.
Correct Answer: B
Rationale: Applying a sterile, saline-moistened dressing protects the dehisced wound and prevents infection. Prone positioning (A) is inappropriate, atropine (C) doesn’t address dehiscence, and an ACE bandage (D) may worsen the condition.
A client at 6 months' gestation complains of tiredness and dizziness. Her hemoglobin level is 10 g/dL, and her hematocrit value is 32%. Her nutritional intake is assessed as sufficient. The most likely diagnosis is:
- A. Iron-deficiency anemia
- B. Physiological anemia
- C. Fatigue due to stress
- D. No problem indicated
Correct Answer: A
Rationale: This clinical situation is indicative of iron-deficiency anemia because the client has inadequate nutritional intake. Her blood volume is increasing faster than her red blood cell volume. Anemia is present in the second trimester when the hemoglobin level is <10.5 and the hematocrit value falls below 35%. She needs increased iron supplements with follow-up. The client's values are below levels for physiological anemia. The client is fatigued because of a low hemoglobin level. Her hemoglobin level is low and will probably decrease even more when the blood volume peaks at 28 weeks.
The client is admitted with a diagnosis of preterm labor. Which fetal monitoring technique is most appropriate?
- A. Non-stress test
- B. Biophysical profile
- C. Both A and B
- D. Neither A nor B
Correct Answer: C
Rationale: Preterm labor requires fetal monitoring to assess well-being. Non-stress tests evaluate fetal heart rate and biophysical profiles assess multiple parameters (e.g. movement amniotic fluid). Both are appropriate.
The client with hyperemesis gravidarum is at risk for developing:
- A. Respiratory alkalosis without dehydration
- B. Metabolic acidosis with dehydration
- C. Respiratory acidosis without dehydration
- D. Metabolic alkalosis with dehydration
Correct Answer: B
Rationale: Hyperemesis gravidarum causes prolonged vomiting leading to dehydration and loss of stomach acid resulting in metabolic acidosis. The dehydration exacerbates the acid-base imbalance.