Nokea
Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?
- A. Marijuana
- B. Cocaine
- C. Nicotine
- D. Caffeine
Correct Answer: B
Rationale: Cocaine causes tachycardia, hypertension, and vasoconstriction, risking placental abruption and fetal distress. Marijuana causes relaxation, nicotine raises heart rate but vasodilates, and caffeine mildly stimulates but doesn't constrict vessels.
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A nurse is preparing to infuse 1 liter of 0.9% sodium chloride IV over 8 hr with a tubing set that delivers 15 gtts/mL. The nurse should set the manual IV infusion to deliver how many drops/min?
- A. 31 gtts/min
- B. 30 gtts/min
- C. 32 gtts/min
- D. 29 gtts/min
Correct Answer: A
Rationale: Formula: gtts/min = (volume x drop factor) / time. (1000 mL x 15 gtts/mL) / (8 x 60 min) = 15000 / 480 = 31.25, rounded to 31 gtts/min. Other options miscalculate the rate.
A client's last menstrual period was April 11. Using Nägele's rule, her estimated date of birth (EDB) would be:
- A. 18-Feb
- B. 18-Jan
- C. 8-Jan
- D. 28-Dec
Correct Answer: B
Rationale: Nägele's rule: add 1 year, subtract 3 months, add 7 days. April 11, 2023 + 1 year = April 11, 2024; minus 3 months = January 11, 2024; plus 7 days = January 18, 2024. Other options misapply the rule.
A nurse suspects that a pregnant client may be experiencing placenta abruption based on which finding? Select all that apply.
- A. Absence of pain
- B. Insidious onset
- C. Dark red vaginal bleeding
- D. Rigid uterus
- E. Absent fetal heart tones
Correct Answer: C,D,E
Rationale: Placental abruption involves sudden separation of the placenta, causing severe pain, a rigid uterus from bleeding, dark red vaginal bleeding due to clotted blood, and absent fetal heart tones if the fetus is compromised. Absence of pain and insidious onset are not typical, as abruption is acute and painful.
A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomforts as common during the first trimester? Select all that apply.
- A. Breast tenderness
- B. Urinary frequency
- C. Backache
- D. Cravings
- E. Leg cramps
Correct Answer: A,B,D
Rationale: First trimester discomforts include breast tenderness (hormonal growth), urinary frequency (bladder pressure), and cravings (taste changes). Backache and leg cramps typically occur later due to weight and nerve pressure.
A nurse is providing prenatal care to a pregnant client. At which time would the nurse expect to screen the client for group B streptococcus infection?
- A. 28 weeks' gestation
- B. 32 weeks' gestation
- C. 16 weeks' gestation
- D. 36 weeks' gestation
Correct Answer: D
Rationale: Screening for group B streptococcus (GBS) is done at 35-37 weeks (36 weeks is closest) to assess colonization status near delivery, guiding intrapartum antibiotic use to prevent neonatal infection. Earlier screening (16, 28, or 32 weeks) may not reflect status at birth, as GBS colonization can change.