Nokea
An abortion when the fetus dies but is retained in the uterus is called
- A. inevitable.
- B. missed.
- C. incomplete.
- D. threatened.
Correct Answer: B
Rationale: The correct answer is B: missed. In a missed abortion, the fetus dies but is not expelled from the uterus. This can be diagnosed during an ultrasound when no fetal heartbeat is detected. The term "inevitable" (choice A) refers to an abortion that is in progress and cannot be stopped. "Incomplete" (choice C) refers to an abortion where some fetal or placental tissue remains in the uterus. "Threatened" (choice D) refers to vaginal bleeding in early pregnancy, with a viable pregnancy.
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The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
- A. Female fetus, Mexican-American, primigravida
- B. Male fetus, Asian-American, previous preterm birth
- C. Male fetus, African-American, previous cesarean birth
- D. Female fetus, European-American, previous spontaneous abortion
Correct Answer: C
Rationale: The correct answer is C: Male fetus, African-American, previous cesarean birth. Placenta previa occurs when the placenta partially or completely covers the cervix. African-American women have a higher incidence of placenta previa. Previous cesarean birth is a risk factor due to possible scarring on the uterine wall, increasing the likelihood of placenta implantation issues. Male fetuses are associated with a higher risk of placenta previa, possibly due to a larger placental size. The other choices do not align with known risk factors for placenta previa, such as the ethnicity, fetal gender, and obstetric history mentioned.
Which finding in the exam of a patient with a diagnosis of threatened abortion would change the diagnosis to inevitable abortion?
- A. Presence of backache
- B. Rise in hCG level
- C. Clear fluid from vagina
- D. Pelvic pressure
Correct Answer: C
Rationale: The correct answer is C: Clear fluid from vagina. In threatened abortion, the pregnancy is at risk but the fetus is still viable. In inevitable abortion, there is no chance of continuation. Clear fluid from the vagina indicates rupture of membranes, leading to inevitable abortion due to the loss of amniotic fluid. Backache, rise in hCG levels, and pelvic pressure are common symptoms in threatened abortion but do not definitively indicate progression to inevitable abortion.
Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?
- A. Blood pressure of 120/80 mm Hg
- B. Complaint of frequent mild nausea
- C. Fundal height measurement of 18 cm
- D. History of bright red spotting for 1 day weeks ago
Correct Answer: C
Rationale: The correct answer is C: Fundal height measurement of 18 cm. At 10 weeks of gestation, the fundal height should typically measure around 10-12 cm. A fundal height measurement of 18 cm would suggest excessive growth, which is a characteristic finding in a hydatidiform mole due to abnormal proliferation of placental tissue.
Incorrect choices:
A: Blood pressure of 120/80 mm Hg is within normal range and not specific to hydatidiform mole.
B: Complaint of frequent mild nausea is a common symptom in early pregnancy and not specific to a mole.
D: History of bright red spotting for 1 day weeks ago is more indicative of a potential previous miscarriage, not necessarily a mole.
The nurse applies fetal and uterine monitors to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. Which is the next nursing action?
- A. Calling the primary health care provider
- B. Changing the maternal position
- C. Obtaining the maternal blood pressure
- D. Preparing the environment for an immediate birth
Correct Answer: B
Rationale: The correct answer is B: Changing the maternal position. Deceleration of fetal heart rate during contractions can indicate umbilical cord compression. Changing the maternal position can relieve pressure on the cord, improving blood flow to the fetus. This action is a non-invasive and immediate intervention that can potentially improve fetal oxygenation. Calling the primary health care provider (A) can be done after addressing the immediate concern. Obtaining maternal blood pressure (C) is not the priority in this situation. Preparing for an immediate birth (D) is premature without first attempting non-invasive interventions.
A patient at 32 weeks' gestation is diagnosed with polyhydramnios. The patient asks the nurse if polyhydramnios can affect the baby. What is the nurse's response to the patient's question?
- A. No, polyhydramnios commonly occurs toward the end of pregnancy.
- B. No, polyhydramnios is a sign that the lungs are maturing.
- C. Yes, polyhydramnios increases the risk of a preterm delivery.
- D. Yes, polyhydramnios causes umbilical cord compression.
Correct Answer: C
Rationale: The correct answer is C: Yes, polyhydramnios increases the risk of a preterm delivery. Polyhydramnios, an excess of amniotic fluid, can lead to uterine overdistension, which may trigger premature labor. The increased pressure from the excess fluid can also cause premature rupture of membranes. This complication can potentially result in a preterm delivery, which carries risks for the baby's health and development. Choices A and B are incorrect because polyhydramnios is not a normal occurrence at the end of pregnancy nor a sign of lung maturity. Choice D is incorrect as umbilical cord compression is a potential complication of polyhydramnios but not the primary risk associated with it.