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Anti-infective prophylaxis is indicated for a pregnant patient with a history of mitral valve stenosis related to rheumatic heart disease because the patient is at risk of developing
- A. hypertension.
- B. postpartum infection.
- C. bacterial endocarditis.
- D. upper respiratory infections.
Correct Answer: C
Rationale: The correct answer is C: bacterial endocarditis. Pregnant patients with mitral valve stenosis are at increased risk for developing bacterial endocarditis due to the presence of abnormal valve structures. This condition can lead to serious complications including septic emboli and heart failure. Hypertension (choice A) is not directly related to mitral valve stenosis. Postpartum infection (choice B) is not a primary concern in this scenario. Upper respiratory infections (choice D) are not specifically associated with mitral valve stenosis. In summary, anti-infective prophylaxis is indicated to prevent bacterial endocarditis in pregnant patients with a history of mitral valve stenosis.
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A patient at 10 weeks' gestation informs the nurse they are having vaginal bleeding and cramping. After completing a speculum examination, the health-care provider (HCP) informs the patient their cervix is open. What does the nurse anticipate the HCP will inform the patient they are experiencing?
- A. complete abortion
- B. incomplete abortion
- C. inevitable abortion
- D. spontaneous abortion
Correct Answer: C
Rationale: The correct answer is C: inevitable abortion. At 10 weeks' gestation, an open cervix with vaginal bleeding and cramping indicates an inevitable abortion, where the miscarriage is unavoidable and the process is ongoing. The open cervix suggests that the pregnancy is not viable and will not continue. The other options are incorrect because: A. Complete abortion refers to the expulsion of all products of conception, B. Incomplete abortion involves partial expulsion of products of conception, and D. Spontaneous abortion is a general term for any non-induced abortion.
The nurse receives a phone call from a patient at 36 weeks' gestation who states they are having right upper quadrant pain that penetrates to the upper back. What priority information does the nurse need to obtain from the patient? Select 3 that apply.
- A. onset and characteristics of the pain
- B. any nausea or vomiting
- C. any vaginal discharge
- D. content of last meal
Correct Answer: A,B,C
Rationale: The correct answers are A, B, and C. A is important to determine the onset and characteristics of the pain to assess for possible causes like pre-eclampsia. B is crucial to assess for signs of liver or gallbladder issues. C is important to rule out any potential infection like chorioamnionitis. D is not relevant to the presenting symptoms and does not provide information related to the patient's condition.
Which assessment by the nurse would differentiate a placenta previa from an abruptio placentae?
- A. Saturated perineal pad in 1 hour
- B. Pain level 0 on a scale of 0 to 10
- C. Cervical dilation at 2 cm
- D. Fetal heart rate at 160 bpm
Correct Answer: B
Rationale: The correct answer is B because in placenta previa, pain is usually minimal or absent, while in abruptio placentae, there is severe abdominal pain. Saturated perineal pad (choice A) is common in both conditions. Cervical dilation (choice C) is not specific to differentiate between the two conditions. Fetal heart rate (choice D) may be normal in both conditions.
Rh incompatibility can occur if the patient is Rh-negative and the
- A. fetus is Rh-negative.
- B. fetus is Rh-positive.
- C. father is Rh-positive.
- D. father and fetus are both Rh-negative.
Correct Answer: B
Rationale: The correct answer is B because Rh incompatibility occurs when an Rh-negative mother carries an Rh-positive fetus. During pregnancy or birth, some fetal Rh-positive blood may enter the mother's bloodstream, leading to the production of Rh antibodies. These antibodies can then cause complications in future pregnancies if the fetus is Rh-positive again. Choices A, C, and D are incorrect because Rh incompatibility specifically involves the Rh factor of the fetus, not the mother's own Rh status, the father's Rh status, or both being Rh-negative.
A pregnant client is admitted with abdominal pain and heavy vaginal bleeding. Which is the immediate nursing action?
- A. Administering oxygen
- B. Elevating the head of the bed
- C. Drawing blood for a hematocrit level
- D. Giving an intramuscular analgesic
Correct Answer: A
Rationale: The correct immediate nursing action is to administer oxygen (Choice A) to ensure adequate oxygenation for both the mother and the fetus. Oxygen is crucial in cases of vaginal bleeding as it helps maintain tissue perfusion and prevent hypoxia. Elevating the head of the bed (Choice B) is not the priority as oxygenation should be addressed first. Drawing blood for a hematocrit level (Choice C) may provide valuable information but does not address the immediate need for oxygen. Giving an intramuscular analgesic (Choice D) is not appropriate without knowing the cause of the pain and bleeding.