Nokea
A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is a
- A. diuretic.
- B. tocolytic.
- C. anticonvulsant.
- D. antihypertensive.
Correct Answer: C
Rationale: The correct answer is C: anticonvulsant. Magnesium sulfate is commonly used in preeclampsia to prevent seizures/eclampsia. It works by reducing neuromuscular transmission and excitability, making it an effective anticonvulsant. Diuretics (A) help remove excess fluid, tocolytics (B) inhibit uterine contractions, and antihypertensives (D) lower blood pressure, but they do not address the primary purpose of using magnesium sulfate in preeclampsia, which is to prevent seizures.
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A pregnant client is admitted with abdominal pain and heavy vaginal bleeding. Which is the immediate nursing action?
- A. Administering oxygen
- B. Elevating the head of the bed
- C. Drawing blood for a hematocrit level
- D. Giving an intramuscular analgesic
Correct Answer: A
Rationale: The correct immediate nursing action is to administer oxygen (Choice A) to ensure adequate oxygenation for both the mother and the fetus. Oxygen is crucial in cases of vaginal bleeding as it helps maintain tissue perfusion and prevent hypoxia. Elevating the head of the bed (Choice B) is not the priority as oxygenation should be addressed first. Drawing blood for a hematocrit level (Choice C) may provide valuable information but does not address the immediate need for oxygen. Giving an intramuscular analgesic (Choice D) is not appropriate without knowing the cause of the pain and bleeding.
Rh incompatibility can occur if the patient is Rh-negative and the
- A. fetus is Rh-negative.
- B. fetus is Rh-positive.
- C. father is Rh-positive.
- D. father and fetus are both Rh-negative.
Correct Answer: B
Rationale: The correct answer is B because Rh incompatibility occurs when an Rh-negative mother carries an Rh-positive fetus. During pregnancy or birth, some fetal Rh-positive blood may enter the mother's bloodstream, leading to the production of Rh antibodies. These antibodies can then cause complications in future pregnancies if the fetus is Rh-positive again. Choices A, C, and D are incorrect because Rh incompatibility specifically involves the Rh factor of the fetus, not the mother's own Rh status, the father's Rh status, or both being Rh-negative.
What is the difference between a complete abortion and an incomplete abortion?
- A. In a complete abortion, the uterus is empty, while in an incomplete abortion, some products of conception are still present in the uterus.
- B. In a complete abortion, the cervix dilates, while in an incomplete abortion, the cervix remains closed.
- C. In a complete abortion, the patient experiences minimal to no signs or symptoms of miscarriage, while in an incomplete abortion, the patient experiences persistent bleeding, cramping, or abdominal pain.
- D. In a complete abortion, the fetus is delivered through the birth canal, while in an incomplete abortion, the fetus is removed through medical or surgical intervention.
Correct Answer: A
Rationale: The correct answer is A because in a complete abortion, the uterus is empty, indicating that all products of conception have been expelled. In contrast, in an incomplete abortion, some products of conception remain in the uterus, leading to ongoing bleeding and cramping. Choice B is incorrect because cervical dilation is not the defining factor between complete and incomplete abortions. Choice C is incorrect as both complete and incomplete abortions can present with symptoms of miscarriage. Choice D is incorrect because the method of fetal removal does not differentiate between complete and incomplete abortions.
Which position increases cardiac output in the obstetrical client with cardiac disease?
- A. Trendelenburg
- B. Low semi-Fowler
- C. Lateral positioning
- D. Supine with legs elevated
Correct Answer: C
Rationale: The correct answer is C: Lateral positioning. This position increases cardiac output in obstetrical clients with cardiac disease by improving venous return to the heart, reducing pressure on the vena cava, and optimizing uteroplacental perfusion. The other choices are incorrect because Trendelenburg can worsen cardiac function by increasing venous return and intracardiac volume, low semi-Fowler does not optimize venous return and may decrease preload, and supine positioning with legs elevated can compress the vena cava, leading to decreased cardiac output and potential hypotension.
A patient at 10 weeks' gestation informs the nurse they are having vaginal bleeding and cramping. After completing a speculum examination, the health-care provider (HCP) informs the patient their cervix is open. What does the nurse anticipate the HCP will inform the patient they are experiencing?
- A. complete abortion
- B. incomplete abortion
- C. inevitable abortion
- D. spontaneous abortion
Correct Answer: C
Rationale: The correct answer is C: inevitable abortion. At 10 weeks' gestation, an open cervix with vaginal bleeding and cramping indicates an inevitable abortion, where the miscarriage is unavoidable and the process is ongoing. The open cervix suggests that the pregnancy is not viable and will not continue. The other options are incorrect because: A. Complete abortion refers to the expulsion of all products of conception, B. Incomplete abortion involves partial expulsion of products of conception, and D. Spontaneous abortion is a general term for any non-induced abortion.