Nokea
A patient, who delivered her third child yesterday, has just learned that her two school-age children have contracted chickenpox. What should the nurse tell her?
- A. Her two children should be treated with acyclovir before she goes home from the hospital.
- B. The baby will acquire immunity from her and will not be susceptible to chickenpox.
- C. The children can visit their mother and baby in the hospital as planned but must wear gowns and masks.
- D. She must make arrangements to stay somewhere other than her home until the children are no longer contagious.
Correct Answer: D
Rationale: The correct answer is D because the patient, having just given birth, is at a higher risk of complications from chickenpox. By staying away from her home until her children are no longer contagious, she reduces the risk of contracting the illness and potentially passing it on to her newborn. This is crucial for the safety of both the mother and the baby.
Choice A is incorrect because treating the children with acyclovir does not prevent the mother from contracting chickenpox. Choice B is incorrect as immunity is not transferred from the children to the mother or newborn. Choice C is incorrect because even with gowns and masks, the risk of transmission is still present, especially for a postpartum mother and a newborn.
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Which clinical intervention is the only known cure for preeclampsia?
- A. Magnesium sulfate
- B. Delivery of the fetus
- C. Antihypertensive medications
- D. Administration of aspirin (ASA) every day of the pregnancy
Correct Answer: B
Rationale: The correct answer is B: Delivery of the fetus. Preeclampsia is a serious condition that can only be cured by delivering the baby and placenta. This is because the placenta is the source of the problem in preeclampsia. Other options like magnesium sulfate, antihypertensive medications, and aspirin can help manage symptoms but do not cure the underlying condition. Magnesium sulfate is used to prevent seizures in severe cases, antihypertensive medications control high blood pressure, and aspirin may be used for prevention but not as a cure. Delivery is the definitive treatment to resolve preeclampsia and prevent further complications for both the mother and the baby.
Why is a multiple-gestation pregnancy considered a high risk?
- A. Postpartum hemorrhage is an expected complication.
- B. Perinatal mortality is two to three times more likely in multiple than in single births.
- C. Optimal psychological adjustment after a multiple birth requires 6 months to 1 year.
- D. Maternal mortality is higher during the prenatal period in the setting of multiple gestation.
Correct Answer: B
Rationale: The correct answer is B because perinatal mortality is two to three times more likely in multiple gestation pregnancies compared to single births. This is due to the increased risk of complications such as preterm birth, low birth weight, and other neonatal issues. Postpartum hemorrhage (A) is a potential complication but not specific to multiple gestation pregnancies. Optimal psychological adjustment (C) and maternal mortality during the prenatal period (D) are not directly related to the increased risks associated with multiple gestation pregnancies.
The nurse admits a client with preeclampsia to the high-risk prenatal unit. Which is the next nursing action after the vital signs have been obtained?
- A. Calling the primary health care provider
- B. Checking the client's reflexes
- C. Determining the client's blood type
- D. Establishing an intravenous (IV) line
Correct Answer: B
Rationale: The correct answer is B: Checking the client's reflexes. This is important in assessing for signs of worsening preeclampsia, such as hyperreflexia. It helps determine the severity of the condition and guides further interventions. Calling the primary health care provider (A) may be necessary but not the immediate next step. Determining the client's blood type (C) is important but not urgent in this situation. Establishing an IV line (D) is important for treatment but assessing reflexes takes priority in preeclampsia management.
Which condition is most commonly associated with late decelerations of the fetal heart rate?
- A. Head compression
- B. Maternal hypothyroidism
- C. Uteroplacental insufficiency
- D. Umbilical cord compression
Correct Answer: C
Rationale: Late decelerations of the fetal heart rate are most commonly associated with uteroplacental insufficiency. During contractions, there is reduced blood flow to the placenta, leading to hypoxia and acidosis in the fetus, resulting in late decelerations. Head compression (A) typically causes early decelerations. Maternal hypothyroidism (B) does not directly affect fetal heart rate. Umbilical cord compression (D) can cause variable decelerations, not late decelerations. Therefore, the correct answer is C.
In which situation would a dilation and curettage (D&C) be indicated?
- A. Complete abortion at 8 weeks
- B. Incomplete abortion at 16 weeks
- C. Threatened abortion at 6 weeks
- D. Incomplete abortion at 10 weeks
Correct Answer: D
Rationale: A dilation and curettage (D&C) is indicated for an incomplete abortion at 10 weeks because it involves dilating the cervix and removing remaining products of conception from the uterus to prevent infection or excessive bleeding. Incomplete abortion at 16 weeks (Choice B) would be too advanced for a D&C and may require a different procedure. A complete abortion at 8 weeks (Choice A) does not require a D&C as all products of conception have already been expelled. Threatened abortion at 6 weeks (Choice C) indicates a possible miscarriage, but a D&C is not necessary unless the miscarriage is confirmed and incomplete.