Nokea
The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which condition?
- A. Hemophilia
- B. Sickle cell anemia
- C. A neural tube defect
- D. Abnormal lecithin-to-sphingomyelin ratio
Correct Answer: C
Rationale: The correct answer is C: A neural tube defect. Elevated AFP levels in maternal serum are indicative of neural tube defects in the fetus. AFP is produced by the fetal liver and yolk sac, and high levels may suggest a defect in the development of the neural tube. Hemophilia (A), sickle cell anemia (B), and abnormal lecithin-to-sphingomyelin ratio (D) do not directly correlate with AFP levels. Hemophilia is a genetic blood disorder, sickle cell anemia is a genetic blood disorder affecting hemoglobin, and abnormal lecithin-to-sphingomyelin ratio is related to fetal lung maturity.
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The nurse has identified the following nursing diagnosis for a postpartum (PP) client: Potential for fluid volume deficit. Which of the following goals for the mother is appropriate?
- A. Minimal perineal pain.
- B. Normal lochial flow.
- C. Normal temperature.
- D. Weight reduction.
Correct Answer: B
Rationale: Normal lochial flow indicates that the client is not experiencing excessive bleeding, which is a key concern for fluid volume deficit.
A postpartum client, who delivered her baby vaginally 2 hours earlier, just voided 100 mL in the bathroom. After returning to bed, the nurse makes the following assessment: fundus 4 cm above the umbilicus and deviated to the right with moderate lochia rubra. Which of the following nursing diagnoses is appropriate at this time?
- A. Impaired skin integrity.
- B. Fluid volume deficit.
- C. Impaired urinary elimination.
- D. Toileting self-care deficit.
Correct Answer: C
Rationale: A deviated fundus and moderate lochia rubra suggest urinary retention, which can impede uterine involution.
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.
Which laboratory is important to know when a client is having an amniocentesis?
- A. Blood type
- B. CBC
- C. Rh
- D. PT and PTT
Correct Answer: C
Rationale: Step-by-step rationale:
1. Rh factor is crucial to know to prevent Rh incompatibility issues during pregnancy.
2. Amniocentesis can pose a risk for Rh sensitization in Rh-negative mothers.
3. Knowing the Rh status helps determine if Rhogam (anti-D) is needed after amniocentesis.
4. Blood type (A) and CBC (B) are important but not directly relevant to amniocentesis.
5. PT and PTT (D) are coagulation tests, typically not required for routine amniocentesis.
A pregnant patient has received the results of her triple-screen testing and it is positive. She provides you with a copy of the test results that she obtained from the lab. What would the nurse anticipate as being implemented in the patient's plan of care?
- A. No further testing is indicated at this time because results are normal.
- B. Refer to the physician for additional testing.
- C. Validate the results with the lab facility.
- D. Repeat the test in 2 weeks and have the patient return for her regularly scheduled prenatal visit.
Correct Answer: B
Rationale: The correct answer is B: Refer to the physician for additional testing. When a triple-screen test is positive in a pregnant patient, it indicates an increased risk of certain conditions such as neural tube defects or chromosomal abnormalities. Therefore, the appropriate course of action is to refer the patient to a physician for further diagnostic testing, such as amniocentesis or ultrasound, to confirm or rule out these conditions.
Choice A is incorrect because a positive result on a triple-screen test does not indicate that results are normal; it suggests the need for further investigation. Choice C is incorrect because validating the results with the lab facility does not address the need for additional diagnostic testing. Choice D is incorrect because waiting 2 weeks to repeat the test and returning for a regular prenatal visit may delay necessary interventions or treatment for the patient.