Nokea
A pregnant woman undergoes a triple/quadruple screen at 16 to 18 weeks' gestation. What would the nurse suspect if the woman's alpha-fetoprotein (AFP) level is decreased?
- A. Sickle-cell anemia
- B. Cardiac defects
- C. Down syndrome
- D. Respiratory disorders
Correct Answer: C
Rationale: Low AFP suggests Down syndrome, often with altered hCG and estriol. Sickle-cell anemia uses other tests, cardiac defects may raise AFP, and respiratory issues don't typically affect AFP levels.
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Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which finding?
- A. striae gravidarum
- B. linea nigra
- C. vascular spiders
- D. melasma
Correct Answer: B
Rationale: Linea nigra is a dark line from umbilicus to pubis caused by increased melanin from hormonal changes. Striae gravidarum are stretch marks, vascular spiders are dilated vessels on face or chest, and melasma is facial pigmentation, none matching the abdominal line description.
When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes which goal as the primary one?
- A. Eliminate anxiety so that they can have an uncomplicated birth
- B. Empower the couple to take control over their pregnancy and birth
- C. Equip a couple with the knowledge to experience a positive birth
- D. Provide knowledge and skills that will help them cope with labor
Correct Answer: C
Rationale: Perinatal education aims to prepare couples for a positive birth by providing knowledge for informed decisions and coping strategies, enhancing satisfaction and well-being. Eliminating anxiety is unrealistic, control is partial, and labor skills are only one aspect.
A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure. Which finding would lead the nurse to suspect that the client is having an adverse effect associated with this drug?
- A. Gastrointestinal bleeding
- B. Sweating
- C. Tachycardia
- D. Blurred vision
Correct Answer: C
Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia as blood pressure drops, increasing cardiac strain. Gastrointestinal bleeding, sweating, and blurred vision (a preeclampsia symptom) are not typical adverse effects.
A provider prescribes quetiapine 50 mg PO divided equally every 12 hours for 3 days. Available is quetiapine 25 mg tablets. How many tablets should the nurse administer per dose on day 3?
- A. 2 tablets
- B. 1 tablet
- C. 3 tablets
- D. 4 tablets
Correct Answer: B
Rationale: Daily dose (50 mg) ÷ 2 (every 12 hours) = 25 mg per dose. At 25 mg/tablet, 25 mg ÷ 25 mg = 1 tablet per dose, consistent on day 3 as dosing doesn't change.
Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy?
- A. Recurrent pelvic infections
- B. Ovarian cyst 2 years ago
- C. Use of oral contraceptives for 8 years
- D. Heavy, irregular periods
Correct Answer: A
Rationale: Recurrent pelvic infections (e.g., PID) scar fallopian tubes, increasing ectopic pregnancy risk by hindering egg transport. Ovarian cysts, oral contraceptives (which reduce risk), and irregular periods don't directly contribute.