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A pregnant patient's biophysical profile score is 8. The patient asks the nurse to explain the results. What is the nurse's most appropriate response?
- A. The test results are within normal limits.'
- B. Immediate birth by cesarean birth is being considered.'
- C. Further testing will be performed to determine the meaning of this score.'
- D. An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth.'
Correct Answer: A
Rationale: The correct answer is A: "The test results are within normal limits." A biophysical profile score of 8 is considered normal. A score of 8 out of 10 indicates that the fetus is likely healthy and does not require immediate delivery. The other choices are incorrect because immediate birth by cesarean section is not warranted for a score of 8, further testing is not necessary as the score is normal, and there is no need for an obstetric specialist to evaluate the results urgently. The most appropriate response reassures the patient that the results are normal, providing comfort and clarity.
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A nurse hears a co-worker state that anybody could be a nurse since it is so automated with infusion devices and electronic monitoring; technology is doing the work. What is the nurse’s best response?
- A. Technology use has to be combined with nursing judgment.
- B. The focus of effective nursing care is technology.
- C. If it’s so easy, why don’t you do it?
- D. That is true in the 20th century.
Correct Answer: A
Rationale: In many ways, technology makes work easier, but it does not replace nursing judgment. Technology does not replace your critical eye and clinical judgment. Most importantly, it is essential to remember that the focus of nursing care is not the machine or the technology; it is the patient.
The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning care for this patient?
- A. Capitation provides the hospital with a means of recovering variable charges.
- B. The hospital will be paid for the full cost of the patient’s hospitalization.
- C. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost.
- D. Medicare will pay the national average for the patient’s condition.
Correct Answer: C
Rationale: In 1983, Congress established the prospective payment system (PPS), which grouped inpatient hospital services for Medicare patients into diagnosis-related groups (DRGs), each of which provides a fixed reimbursement amount based on assigned DRG, regardless of a patient’s length of stay or use of services.
Which of the following complications of labor and delivery may develop when a baby enters the pelvis in the LMP position?
- A. Cephalopelvic disproportion.
- B. Placental abruption.
- C. Breech presentation.
- D. Acute fetal distress.
Correct Answer: A
Rationale: LMP (left mentum posterior) position can lead to cephalopelvic disproportion, making delivery difficult.
A woman is in the 'taking-hold phase' of the postpartum period. Which of the following behaviors would the nurse expect to see?
- A. The woman is on the telephone relating her experiences to family and friends.
- B. The woman asks for a meal tray and eats a variety of foods brought from home.
- C. The woman is interested in learning baby-care skills from the nurse.
- D. The woman takes a nap after each breastfeeding and each meal.
Correct Answer: C
Rationale: During the 'taking-hold phase,' the mother is typically eager to learn how to care for her newborn and may seek guidance from the nurse.
You are performing assessments for an obstetric patient who is 5 months pregnant with her third child. Which finding would cause you to suspect that the patient was at risk?
- A. Patient states that she doesn't feel any Braxton Hicks contractions like she had in her prior pregnancies.
- B. Fundal height is below the umbilicus.
- C. Cervical changes, such as Goodell's sign and Chadwick's sign, are present.
- D. She has increased vaginal secretions.
Correct Answer: B
Rationale: The correct answer is B: Fundal height is below the umbilicus. At 5 months pregnant with her third child, fundal height should be at or above the level of the umbilicus. A fundal height below the umbilicus may indicate intrauterine growth restriction or other fetal growth issues. This finding suggests a potential risk to the pregnancy's progress.
Incorrect Choices:
A: Patient not feeling Braxton Hicks contractions is common and not necessarily indicative of risk.
C: Presence of cervical changes like Goodell's and Chadwick's signs are expected physiological changes in pregnancy and do not necessarily indicate risk.
D: Increased vaginal secretions can be normal during pregnancy and do not necessarily signify a risk.