Nokea
A pregnant client with a history of preterm labor is at home on bed rest. Which instruction would be included in this client's teaching plan?
- A. Place blocks under the foot of the bed.
- B. Sit upright with several pillows behind the back.
- C. Lie on the side with the head raised on a small pillow.
- D. Assume the knee-chest position at regular intervals throughout the day.
Correct Answer: C
Rationale: The correct answer is C: Lie on the side with the head raised on a small pillow. This position helps improve circulation to the uterus and placenta, reducing the risk of preterm labor. Lying on the left side also promotes optimal blood flow. Option A is incorrect as elevating the foot of the bed can decrease blood flow to the placenta. Option B may cause discomfort and increase pressure on the cervix. Option D is not suitable for bed rest as it involves being on all fours, which is not conducive to rest and relaxation.
You may also like to solve these questions
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 medication is not recommended for hypertension during pregnancy due to teratogenic effects?
- A. lisinopril
- B. nifedipine
- C. labetalol
- D. hydralazine
Correct Answer: A
Rationale: The correct answer is A: lisinopril. Lisinopril is contraindicated in pregnancy due to its teratogenic effects, particularly in the first trimester. It can cause fetal harm, including renal dysfunction and skull hypoplasia. Nifedipine, labetalol, and hydralazine are considered safe options for hypertension during pregnancy with no known teratogenic effects.
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.
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 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.