Nokea
As relates to the structure and function of the placenta, the maternity nurse should be aware that:
- A. As the placenta widens, it gradually thins to allow easier passage of air and nutrients.
- B. As one of its early functions, the placenta acts as an endocrine gland.
- C. The placenta is able to keep out most potentially toxic substances such as cigarette smoke to which the mother is exposed.
- D. Optimal blood circulation is achieved through the placenta when the woman is lying on her back or standing.
Correct Answer: B
Rationale: The placenta produces hormones necessary to maintain the pregnancy.
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A 27-year-old patient presents with injuries sustained in a motor vehicle accident. She was wearing her seatbelt and has multiple bruises and scrapes along her abdomen. She complains of pain 3/10 in her abdomen. She is G1P0 and is at 14 weeks’ gestation. A bedside ultrasound scan confirms that the fetus is stable and not in any distress. The patient is Rh negative, and her husband is Rh positive. What do you anticipate being the next step?
- A. Obtain a urinalysis.
- B. Administer Rh(D) immune globulin (RhoGAM).
- C. Confirm with the provider that she can be discharged home.
- D. Schedule a follow-up ultrasound.
Correct Answer: B
Rationale: The correct answer is B: Administer Rh(D) immune globulin (RhoGAM). In this scenario, the patient is Rh negative and her husband is Rh positive, which puts her at risk for Rh isoimmunization. Administration of Rh(D) immune globulin (RhoGAM) helps prevent the mother's immune system from developing antibodies against the Rh-positive fetus's blood, thereby protecting future pregnancies. This intervention is crucial in preventing hemolytic disease of the newborn.
Choice A: Obtaining a urinalysis is not indicated in this case as the patient's main concern is her abdominal pain and pregnancy status, not related to her urinalysis.
Choice C: Discharging the patient without administering Rh(D) immune globulin would be inappropriate as it puts future pregnancies at risk of complications due to Rh incompatibility.
Choice D: Scheduling a follow-up ultrasound is not the immediate next step. Administering Rh(D) immune globulin is the priority to
The nurse is reviewing the schedule for the OB/GYN she works for. In reviewing a patient’s chart, the nurse notes the patient is 32 weeks pregnant, has hypertension, and had a previous fetal death. What test does the nurse anticipate the provider will order?
- A. a contraction stress test
- B. amniotic fluid index
- C. nonstress test
- D. fetal movement count
Correct Answer: C
Rationale: The correct answer is C: nonstress test. A nonstress test is used to assess fetal well-being by monitoring the baby's heart rate in response to its own movements. In this case, the patient's history of hypertension and previous fetal death indicate a higher risk pregnancy, making it important to monitor the baby's well-being. A contraction stress test (choice A) is not suitable for a patient with hypertension as it can induce contractions and potentially harm the baby. An amniotic fluid index (choice B) is used to evaluate amniotic fluid levels and is not specific to this patient's situation. Fetal movement count (choice D) assesses the baby's movements but does not provide real-time information on fetal well-being like a nonstress test does.
A woman is 15 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is:
- A. You should have felt the baby move by now.
- B. Within the next month, you should start to feel fluttering sensations.
- C. The baby is moving; however, you can't feel it yet.
- D. Some babies are quiet, and you don't feel them move.
Correct Answer: B
Rationale: Maternal perception of fetal movement usually begins 16 to 20 weeks after conception.
The nurse is providing care to a pregnant person at 32 weeks’ gestation. The nurse expects to observe what change in the pregnant person’s spine?
- A. sclerosis
- B. scoliosis
- C. kyphosis
- D. lordosis
Correct Answer: D
Rationale: The correct answer is D: lordosis. At 32 weeks' gestation, the pregnant person's center of gravity shifts forward, causing an increased lumbar lordosis to compensate. This change helps maintain balance and support the growing uterus. Sclerosis (choice A) refers to hardening of tissues, not a typical change in the spine during pregnancy. Scoliosis (choice B) is a lateral curvature of the spine, not typically related to pregnancy. Kyphosis (choice C) is an exaggerated outward curve in the upper spine, not a common change in pregnancy.
At 16 weeks of gestation a pregnant person states, 'The most dangerous time is the first 3 months, so I shouldn’t have to worry from now on about any dangers to the baby.' What is the nurse's most appropriate response?
- A. There are teratogens with the potential to harm your baby at any time during the pregnancy.
- B. We really won’t be able to say for sure before you have an ultrasound.
- C. You are correct. You are past the critical point.
- D. You don’t seem very concerned about your baby’s welfare.
Correct Answer: A
Rationale: The correct answer is A because teratogens, substances that can harm the developing fetus, can have negative effects on the baby at any point during pregnancy, not just in the first trimester. The nurse's response should educate the pregnant person about the ongoing risks and the importance of avoiding harmful substances throughout pregnancy.
Option B is incorrect because an ultrasound is not used to assess the risk of teratogens. Option C is incorrect as it provides incorrect information that the risk is past, which is not true. Option D is incorrect as it is judgmental and does not address the pregnant person's misconception about the risks throughout pregnancy.