Nokea
A placenta previa when the placental edge just reaches the internal os is called
- A. total.
- B. partial.
- C. low-lying.
- D. marginal.
Correct Answer: D
Rationale: The correct answer is D: marginal. In placenta previa, when the placental edge just reaches the internal os, it is classified as marginal. This indicates that the placenta is close to, but not covering, the cervical os. Total previa covers the entire os, partial covers part of it, and low-lying indicates the placental edge is near the os but not reaching it. The key is to understand the specific location of the placental edge in relation to the internal os for each classification.
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As the triage nurse in the emergency room, you are reviewing results for the high-risk obstetric patient who is in labor because of traumatic injury experienced as a result of a motor vehicle accident (MVA). You note that the Kleihauer–Betke test is positive. Based on this information, you anticipate that
- A. immediate birth is required.
- B. the patient should be transferred to the critical care unit for closer observation.
- C. RhoGAM should be administered.
- D. a tetanus shot should be administered.
Correct Answer: A
Rationale: The correct answer is A: immediate birth is required. The positive Kleihauer–Betke test indicates fetal-maternal hemorrhage, where fetal blood enters the maternal circulation. This can lead to fetal-maternal transfusion, causing fetal anemia. Immediate birth is necessary to assess and manage potential fetal distress, such as anemia and hypoxia, due to the trauma from the MVA.
Choices B, C, and D are incorrect:
B: Transferring to critical care unit is not the immediate priority. The focus should be on addressing the fetal distress.
C: RhoGAM is given to Rh-negative mothers to prevent Rh sensitization, but it is not directly related to the positive Kleihauer–Betke test result.
D: Tetanus shot administration is important for tetanus prevention, but it is not the priority in this case where immediate birth is required due to fetal-maternal hemorrhage.
Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?
- A. 10th and 12th weeks of gestation
- B. 18th and 22nd weeks of gestation
- C. 24th and 28th weeks of gestation
- D. 36th and 40th weeks of gestation
Correct Answer: C
Rationale: The correct answer is C (24th and 28th weeks of gestation) because during the second and third trimesters of pregnancy, insulin needs typically increase due to hormonal changes causing insulin resistance. This is when the placenta produces hormones that interfere with insulin, leading to higher blood sugar levels. Choices A, B, and D are incorrect because they do not align with the typical pattern of insulin dosage adjustments during pregnancy for clients with type 1 diabetes.
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.
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.
A labor and birth nurse receives a call from the laboratory regarding a preeclamptic patient receiving an IV infusion of magnesium sulfate. The laboratory technician reports that the patient's magnesium level is 7.6 mg/dL. What is the nurse's priority action?
- A. Stop the infusion of magnesium.
- B. Assess the patient's respiratory rate.
- C. Assess the patient's deep tendon reflexes.
- D. Notify the health care provider of the magnesium level.
Correct Answer: B
Rationale: The correct answer is B: Assess the patient's respiratory rate. A magnesium level of 7.6 mg/dL is above the therapeutic range (4-7 mg/dL) and can lead to magnesium toxicity. Respiratory depression is a common early sign of magnesium toxicity. Assessing the patient's respiratory rate is the priority to monitor for this potentially life-threatening complication. Stopping the infusion of magnesium (Choice A) is not the immediate priority as the patient's respiratory status needs to be assessed first. Assessing deep tendon reflexes (Choice C) is important for magnesium toxicity but not as urgent as assessing respiratory rate. Notifying the health care provider (Choice D) can be done after assessing the patient's respiratory rate.