Nokea
A patient has tested HIV-positive and has now discovered that she is pregnant. Which statement indicates that she understands the risks of this diagnosis?
- A. “I know I will need to have an abortion as soon as possible.”
- B. “Even though my test is positive, my baby might not be affected.”
- C. “My baby is certain to have AIDS and die within the first year of life.”
- D. “This pregnancy will probably decrease the chance that I will develop AIDS.”
Correct Answer: B
Rationale: The correct answer is B because it shows understanding that a positive HIV test in the mother doesn't guarantee transmission to the baby. This reflects knowledge of the possibility of preventing mother-to-child transmission with proper medical care. Option A is incorrect as abortion is not the standard recommendation for HIV-positive pregnant women. Option C is incorrect as not all babies born to HIV-positive mothers will have AIDS or die within the first year. Option D is incorrect as pregnancy does not decrease the mother's chance of developing AIDS.
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A patient with preeclampsia is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs indicate
- A. gastrointestinal upset.
- B. effects of magnesium sulfate.
- C. anxiety caused by hospitalization.
- D. worsening disease and impending convulsion.
Correct Answer: D
Rationale: The correct answer is D because the symptoms described (headache, visual changes, epigastric pain) are classic signs of worsening preeclampsia, indicating impending eclampsia with seizures. This requires urgent intervention to prevent serious complications. Option A is incorrect as gastrointestinal upset does not typically present with these specific signs. Option B is incorrect as magnesium sulfate is used to prevent seizures in preeclampsia, not cause the symptoms described. Option C is incorrect as anxiety would not cause the specific symptoms mentioned. In summary, the signs described point towards worsening disease and the likelihood of impending convulsions, necessitating immediate medical attention.
Which cardiac disease has the lowest risk for maternal mortality?
- A. Endocarditis
- B. Aortic stenosis
- C. Patent ductus arteriosus
- D. Pulmonary hypertension
Correct Answer: C
Rationale: The correct answer is C: Patent ductus arteriosus. This condition typically does not pose a significant risk for maternal mortality because it is a relatively benign cardiac defect that does not significantly impact maternal health during pregnancy. Other choices, such as endocarditis, aortic stenosis, and pulmonary hypertension, have higher risks for maternal mortality due to complications like heart failure, arrhythmias, and increased risk of thromboembolic events. Therefore, patent ductus arteriosus is the lowest risk for maternal mortality among the given options.
A patient at 32 weeks' gestation is diagnosed with polyhydramnios. The patient asks the nurse if polyhydramnios can affect the baby. What is the nurse's response to the patient's question?
- A. No, polyhydramnios commonly occurs toward the end of pregnancy.
- B. No, polyhydramnios is a sign that the lungs are maturing.
- C. Yes, polyhydramnios increases the risk of a preterm delivery.
- D. Yes, polyhydramnios causes umbilical cord compression.
Correct Answer: C
Rationale: The correct answer is C: Yes, polyhydramnios increases the risk of a preterm delivery. Polyhydramnios, an excess of amniotic fluid, can lead to uterine overdistension, which may trigger premature labor. The increased pressure from the excess fluid can also cause premature rupture of membranes. This complication can potentially result in a preterm delivery, which carries risks for the baby's health and development. Choices A and B are incorrect because polyhydramnios is not a normal occurrence at the end of pregnancy nor a sign of lung maturity. Choice D is incorrect as umbilical cord compression is a potential complication of polyhydramnios but not the primary risk associated with it.
Which instructions should the nurse include when teaching a pregnant patient with Class II heart disease?
- A. Advise her to gain at least 30 lb.
- B. Instruct her to avoid strenuous activity.
- C. Inform her of the need to limit fluid intake.
- D. Explain the importance of a diet high in calcium.
Correct Answer: B
Rationale: The correct answer is B: Instruct her to avoid strenuous activity. For a pregnant patient with Class II heart disease, avoiding strenuous activity is crucial to prevent excessive strain on the heart. Strenuous activities can lead to increased heart rate and blood pressure, which can worsen the heart condition. Advising her to gain at least 30 lb (choice A) may put additional strain on the heart. Limiting fluid intake (choice C) can lead to dehydration, affecting blood volume and circulation. A diet high in calcium (choice D) is beneficial for overall health but is not specifically related to managing Class II heart disease during pregnancy.
Several hours after delivery, a new mother expresses ambivalence regarding her infant. How will the nurse promote bonding?
- A. Having the mother feed the infant
- B. Removing the infant from the mother's arms if it cries
- C. Positioning the infant so its head rests on the mother's shoulder
- D. Encouraging the mother to sleep for 4 to 6 hours before interacting with the infant
Correct Answer: A
Rationale: The correct answer is A, having the mother feed the infant. This helps promote bonding through physical closeness, eye contact, and the release of oxytocin. Feeding also fosters a sense of responsibility and nurturing. Choice B may disrupt bonding by creating separation anxiety. Choice C is a comforting position but not as interactive as feeding. Choice D delays bonding and can impact the establishment of a strong maternal-infant relationship.