Nokea
An older adult patient has extensive wound care needs after discharge from the hospital. Which facility should the nurse discuss with the patient?
- A. Hospice
- B. Respite care
- C. Assisted living
- D. Skilled nursing
Correct Answer: D
Rationale: An intermediate care or skilled nursing facility offers skilled care from a licensed nursing staff.
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A patient at 36 weeks gestation is undergoing a nonstress (NST) test. The nurse observes the fetal heart rate baseline at 135 beats per minute (bpm) and four nonepisodic patterns of the fetal heart rate reaching 160 bpm for periods of 20 to 25 seconds each. How will the nurse record these findings?
- A. NST positive, nonreassuring
- B. NST negative, reassuring
- C. NST reactive, reassuring
- D. NST nonreactive, nonreassuring
Correct Answer: C
Rationale: Step 1: The baseline fetal heart rate is 135 bpm, which is within the normal range of 110-160 bpm.
Step 2: The four nonepisodic patterns of fetal heart rate reaching 160 bpm for 20-25 seconds each indicate accelerations, a positive sign.
Step 3: A reactive NST requires at least two accelerations of the fetal heart rate within a 20-minute window, which this scenario meets.
Step 4: Therefore, the nurse will record these findings as NST reactive, reassuring because the fetal heart rate responded appropriately to stimuli.
Summary of Other Choices:
A: NST positive, nonreassuring - Inaccurate, as the findings indicate a reassuring response.
B: NST negative, reassuring - Incorrect, as the test results are actually reactive, not negative.
D: NST nonreactive, nonreassuring - Wrong, as the test is reactive and reassuring, not nonreactive and nonreassuring.
A woman who states that she smokes 2 packs of cigarettes each day is admitted to the labor and delivery suite in labor. The nurse should monitor this labor for which of the following?
- A. Delayed placental separation.
- B. Late decelerations.
- C. Shoulder dystocia.
- D. Precipitous fetal descent.
Correct Answer: B
Rationale: Smoking during pregnancy is associated with placental insufficiency, which can lead to late decelerations in the fetal heart rate.
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.
A certified nursing assistant (CNA) is working with a registered nurse (RN) in the neonatal nursery. It would be appropriate for the nurse to delegate which of the following actions to the assistant?
- A. Admission assessment on a newly delivered baby.
- B. Patient teaching of a neonatal sponge bath.
- C. Placement of a bag on a baby for urine collection.
- D. Hourly neonatal blood glucose assessments.
Correct Answer: C
Rationale: CNAs can perform tasks such as placing a urine collection bag, which does not require advanced assessment or teaching skills. Admission assessments and blood glucose monitoring require the expertise of an RN.
Use Naegele's rule to determine the EDD (estimated day of birth) for a patient whose last menstrual period started on April 12.
- A. 19-Feb
- B. 19-Jan
- C. 21-Jan
- D. 7-Feb
Correct Answer: B
Rationale: To calculate EDD using Naegele's rule, add 7 days to the first day of the last menstrual period, then count back 3 months and add 1 year. For this question, starting with April 12, adding 7 days gives April 19. Counting back 3 months gives January 19 of the following year. Therefore, the estimated day of birth (EDD) is January 19. Choice B (19-Jan) is correct.
Choice A (19-Feb): Incorrect as it does not follow the correct calculation method for Naegele's rule.
Choice C (21-Jan): Incorrect as the calculation does not match the steps of Naegele's rule.
Choice D (7-Feb): Incorrect as it does not align with the correct application of Naegele's rule.