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A pregnant woman comes to the hospital 3 weeks before her estimated date of birth (EDB) complaining of severe pain and a rigid abdomen. What should the nurse immediately suspect as the cause of the pain?
- A. Placenta previa
- B. Appendicitis
- C. Ectopic pregnancy
- D. Abruptio placentae
Correct Answer: D
Rationale: The major symptoms of abruptio placentae are severe pain and a rigid abdomen. Placenta previa consists of painless bleeding. Appendicitis is not usually accompanied by a rigid abdomen. Symptoms of an ectopic pregnancy would usually occur in the first trimester.
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A pregnant patient with tuberculosis asks the nurse how the disease will affect her pregnancy and her newborn. What statements by the nurse are most appropriate?
- A. You have nothing to worry about. You will be disease free before you deliver.
- B. The tuberculosis can be transmitted to the fetus in rare occurrences.
- C. Your newborn will be tested for tuberculosis after delivery.
- D. There is no approved treatment for the infant if she tests positive for the disease.
- E. You will not be able to hold your newborn until you have been cleared according to the health department guidelines.
Correct Answer: B,C,E
Rationale: TB can be transmitted to a fetus in the womb. Newborns of infected mothers are skin tested for TB after birth and treated if the skin test is positive. Mothers who have TB are not allowed to have exposure to their newborn until they have been cleared according to the health department standards.
A nursery nurse is implementing phototherapy for a jaundiced infant. What is the purpose of the phototherapy?
- A. It is initiated when the bilirubin level reaches 5 mg/dL.
- B. It converts bilirubin to a water-soluble form to be excreted in the urine.
- C. It changes bilirubin to a bile salt to be excreted through the bowel.
- D. It requires eye patches to remain in place 24 hours a day.
Correct Answer: B
Rationale: Phototherapy converts the bilirubin into a water-soluble form to be excreted by the kidneys. It is initiated when the bilirubin level reaches 12 to 15 mg/dL. The eye patches are worn during therapy, but removed for feeding, bathing, and socialization.
A patient presents with symptoms of abruptio placentae. To facilitate uterine-placental perfusion in what position would the nurse place the patient?
- A. Prone position
- B. Trendelenburg's position
- C. Supine position
- D. Modified side-lying position
Correct Answer: D
Rationale: A modified side-lying position facilitates uterine-placental perfusion.
The newborn infant has oxygenation problems and a lack of subcutaneous fat. What should the nurse determine as the gestational age of this infant?
- A. 20 to 37 completed weeks of pregnancy
- B. 38 to 41 completed weeks of pregnancy
- C. 14 to 36 completed weeks of pregnancy
- D. 42 or more completed weeks of pregnancy
Correct Answer: A
Rationale: The lungs of preterm infants have not fully developed; therefore, they have problems with oxygenation. Preterm infants also lack subcutaneous fat. The gestational age of the preterm is classified as 20 to 37 complete weeks of pregnancy.
How should twins who share a placenta and come from one fertilized ovum be identified?
- A. Dizygotic
- B. Trizygotic
- C. Genetically different
- D. Monozygotic
Correct Answer: D
Rationale: Monozygotic twins, also known as identical twins, originate from one fertilized ovum and share a placenta. Monozygotic twins carry the same genetic code. Dizygotic twins are the result of two separate ova being fertilized at the same time.