Nokea
A patient with a history of rheumatic heart disease is being admitted to the labor and delivery unit. To prevent further stress on the heart what should the nurse anticipate to be ordered?
- A. Oxygen administration
- B. Administering large amount of IV fluids
- C. Positioning the patient on her back
- D. Encouraging activity between contractions
Correct Answer: A
Rationale: Oxygen is administered to increase blood oxygen saturation and decrease the stress on the heart. IV fluid administration is kept to a minimum to prevent fluid overload. The patient would be positioned in a semi-Fowler's position to improve circulation. The patient should be encouraged to rest between contractions to conserve energy.
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A pregnant woman visits a clinic visit during her 21st week of pregnancy. The nurse identifies edema hypertension and proteinuria. What condition does the nurse suspect?
- A. Allergy
- B. Protein deficiency
- C. Circulatory problem
- D. Gestational hypertension
Correct Answer: D
Rationale: Gestational hypertension (GH), formerly referred to as pregnancy-induced hypertension (PIH), is a disease encountered during pregnancy or early in the puerperium, characterized by increasing hypertension, proteinuria, and generalized edema. These signs generally appear after the 20th week of pregnancy.
The patient who has taken the ovulation stimulant clomiphene (Clomid) and who has been determined to be pregnant calls the clinic nurse to report that she is bleeding and has passed a small grapelike object. From this information the nurse suspects a ___.
Correct Answer: mole
Rationale: Hydatidiform moles occur frequently in people who have taken Clomid. The physical changes are similar to a real pregnancy until bleeding occurs and some grapelike clusters are passed.
The nurse is assessing a "kick count" for a patient with gestational hypertension. What result should be a cause for concern?
- A. Less than three kicks per hour
- B. Less than five kicks per hour
- C. Less than seven kicks per hour
- D. Less than nine kicks per hour
Correct Answer: A
Rationale: A kick count of fewer than three per hour is considered serious and a cause for concern.
Cognitive impairment facial abnormalities and growth retardation are characteristics of which abnormality in a fetus?
- A. Fetal dependency
- B. Fetal immaturity
- C. Malnutrition dependency
- D. Fetal alcohol syndrome
Correct Answer: D
Rationale: Use of alcohol may result in multiple anomalies called fetal alcohol syndrome. The fetus may also be born with alcohol dependency and immaturity, but the characteristics noted are specific for fetal alcohol syndrome.
What percent of first-trimester pregnancies spontaneously abort?
- A. 5% to 10%
- B. 10% to 15%
- C. 20% to 25%
- D. 40% to 50%
Correct Answer: B
Rationale: It is estimated that 10% to 15% of first-trimester pregnancies end in spontaneous abortion.