Nokea
A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make?
- A. Be sure that your lupus is stable or in remission for 6 months before getting pregnant.
- B. It's probably not a good idea for you to get pregnant since you have lupus.
- C. Your lupus will not have any effect on your pregnancy whatsoever.
- D. When you get pregnant we'll have to add quite a few medications to your normal treatment plan.
Correct Answer: A
Rationale: Stable lupus for 6 months before pregnancy reduces risks like flares or miscarriage. Discouraging pregnancy is insensitive, claiming no effect is false, and adding many medications is inaccurate without specifics.
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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 nurse is caring for a client who has an NG tube set to low intermittent suction. The nurse irrigates the NG tube twice with 30 mL of normal saline solution during his shift. At the end of the shift, the NG canister contains 475 mL. What amount of NG drainage should the nurse record?
- A. 415 mL
- B. 475 mL
- C. 445 mL
- D. 430 mL
Correct Answer: A
Rationale: NG drainage = canister fluid (475 mL) minus irrigation (2 x 30 mL = 60 mL) = 415 mL. Recording irrigation fluid as drainage would inflate the output inaccurately.
A client comes to the prenatal clinic for her first visit. When determining the client's estimated due date, the nurse understands which method is the most accurate.
- A. Nagele's rule
- B. Ultrasound
- C. Gestation wheel
- D. Birth calculator
Correct Answer: B
Rationale: Ultrasound in the first trimester measures fetal size accurately for due date estimation, unlike Nagele's rule, gestation wheel, or calculators, which rely on less precise menstrual data or assumptions.
Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which condition?
- A. Maternal diabetes
- B. Fetal anencephaly
- C. Placental abruption
- D. Neural tube defects
Correct Answer: B
Rationale: Oligohydramnios (low amniotic fluid) is linked to fetal anencephaly, where absent brain development reduces fetal urine, a fluid source. Maternal diabetes causes polyhydramnios, abruption affects bleeding, and neural tube defects don't directly reduce fluid.
While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of:
- A. Trisomy numeric abnormality
- B. Multifactorial inheritance
- C. X-linked recessive inheritance
- D. Chromosomal deletion
Correct Answer: A
Rationale: Down syndrome is caused by trisomy 21, an extra chromosome 21, a numeric abnormality. Multifactorial inheritance involves genes and environment, X-linked affects males primarily, and deletions miss chromosome parts, none fitting Down syndrome.