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A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2012. Using Nagele’s rule, the nurse calculates the client’s estimated date of delivery as:
- A. May 30, 2013.
- B. June 20, 2013.
- C. June 27, 2013.
- D. July 3, 2013.
Correct Answer: C
Rationale: Using Nagele’s rule (adding 7 days to the first day of the last menstrual period, subtracting 3 months, and adding 1 year), the calculated EDD is June 27, 2013.
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A nurse is caring for a pregnant patient who is at 16 weeks gestation and is concerned about varicose veins. Which of the following interventions should the nurse recommend?
- A. Wear tight compression stockings to reduce swelling.
- B. Elevate the legs and avoid prolonged periods of standing.
- C. Massage the affected area to improve circulation.
- D. Apply ice packs to the legs for 15 minutes every hour.
Correct Answer: B
Rationale: The correct answer is B: Elevate the legs and avoid prolonged periods of standing. Elevating the legs helps improve circulation and reduces pressure on the veins, which can help alleviate varicose veins. Prolonged standing can worsen varicose veins by increasing pressure on the lower extremities.
A: Wearing tight compression stockings can further constrict blood flow and should be avoided.
C: Massaging the affected area may not be recommended as it can potentially increase the risk of blood clots in pregnant women.
D: Applying ice packs is not recommended for varicose veins as it may not effectively address the underlying issue of poor circulation.
A nurse is preparing a laboring person for a cesarean birth. What is the most important action before the procedure?
- A. administer preoperative medication
- B. administer preoperative antibiotics
- C. assist with perineal care
- D. apply pressure to the abdomen
Correct Answer: A
Rationale: The correct answer is A: administer preoperative medication. Before a cesarean birth, it is crucial to administer preoperative medication to ensure the person's comfort and safety during the procedure. This medication can include pain relief and sedatives to manage anxiety. Administering antibiotics (choice B) is important to prevent infection, but it typically occurs after preoperative medication. Assisting with perineal care (choice C) and applying pressure to the abdomen (choice D) are not necessary steps before a cesarean birth.
A pregnant patient is at 32 weeks gestation and reports that she feels short of breath when lying flat. What should the nurse's priority action be?
- A. Assess the patient's respiratory rate and oxygen saturation.
- B. Encourage the patient to sit up and rest in a more upright position.
- C. Ask the patient to perform deep breathing exercises to improve oxygen flow.
- D. Instruct the patient to take shallow breaths and avoid exertion.
Correct Answer: B
Rationale: The correct answer is B: Encourage the patient to sit up and rest in a more upright position. This is the priority action because it helps relieve pressure on the diaphragm and allows for better lung expansion, improving oxygenation for the pregnant patient experiencing shortness of breath. Sitting upright also reduces the risk of supine hypotensive syndrome by improving blood flow to the placenta.
Assessing respiratory rate and oxygen saturation (Choice A) may be important but should come after the patient is in a more comfortable position. Deep breathing exercises (Choice C) may not address the immediate relief needed for the patient. Instructing the patient to take shallow breaths (Choice D) may worsen the situation by limiting oxygen intake and exacerbating respiratory distress.
What is the primary goal of using a forceps-assisted delivery?
- A. to assist with fetal descent
- B. to provide immediate relief of shoulder dystocia
- C. to help expel the placenta
- D. to avoid unnecessary surgical interventions
Correct Answer: C
Rationale: The primary goal of using forceps in delivery is to help expel the placenta. Forceps are not typically used to assist with fetal descent, provide immediate relief of shoulder dystocia, or avoid unnecessary surgical interventions. Forceps are specifically designed to aid in the safe and efficient removal of the placenta after the baby has been delivered. This minimizes the risk of postpartum hemorrhage and other complications.
Which clinical conditions are associated with increased levels of alpha-fetoprotein (AFP)? (Select all that apply.)
- A. Down syndrome
- B. Molar pregnancy
- C. Twin gestation
- D. Incorrect gestational age assessment of a normal fetus—estimation is earlier in the pregnancy
Correct Answer: C
Rationale: Elevated AFP levels are seen in multiple gestations, miscalculated gestational age, and threatened abortion.