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Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?
- A. 10th and 12th weeks of gestation
- B. 18th and 22nd weeks of gestation
- C. 24th and 28th weeks of gestation
- D. 36th and 40th weeks of gestation
Correct Answer: C
Rationale: The correct answer is C (24th and 28th weeks of gestation) because during the second and third trimesters of pregnancy, insulin needs typically increase due to hormonal changes causing insulin resistance. This is when the placenta produces hormones that interfere with insulin, leading to higher blood sugar levels. Choices A, B, and D are incorrect because they do not align with the typical pattern of insulin dosage adjustments during pregnancy for clients with type 1 diabetes.
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A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is a
- A. diuretic.
- B. tocolytic.
- C. anticonvulsant.
- D. antihypertensive.
Correct Answer: C
Rationale: The correct answer is C: anticonvulsant. Magnesium sulfate is commonly used in preeclampsia to prevent seizures/eclampsia. It works by reducing neuromuscular transmission and excitability, making it an effective anticonvulsant. Diuretics (A) help remove excess fluid, tocolytics (B) inhibit uterine contractions, and antihypertensives (D) lower blood pressure, but they do not address the primary purpose of using magnesium sulfate in preeclampsia, which is to prevent seizures.
Which routine nursing assessment is contraindicated for a patient admitted with suspected placenta previa?
- A. Determining cervical dilation and effacement
- B. Monitoring FHR and maternal vital signs
- C. Observing vaginal bleeding or leakage of amniotic fluid
- D. Determining frequency, duration, and intensity of contractions
Correct Answer: A
Rationale: The correct answer is A: Determining cervical dilation and effacement. This assessment is contraindicated for a patient with suspected placenta previa because it can lead to further disruption of the placenta and potentially cause severe bleeding. Monitoring FHR and vital signs (B) is important for assessing fetal well-being and maternal status. Observing vaginal bleeding or amniotic fluid leakage (C) is crucial in identifying complications. Determining the frequency, duration, and intensity of contractions (D) is essential for monitoring labor progression but is not appropriate for a patient with suspected placenta previa due to the risk of placental disruption.
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on which of the following?
- A. Hemorrhage is the primary concern.
- B. She will be unable to conceive in the future.
- C. Bed rest and analgesics are the recommended treatment.
- D. A D&C will be performed to remove the products of conception.
Correct Answer: A
Rationale: The correct answer is A: Hemorrhage is the primary concern. In an ectopic pregnancy, the fertilized egg implants outside the uterus, typically in the fallopian tube, which can lead to life-threatening internal bleeding. Nursing care focuses on monitoring for signs of hemorrhage, such as abdominal pain, vaginal bleeding, and signs of shock. Prompt intervention is crucial to prevent serious complications.
Explanation of why the other choices are incorrect:
B: She will be unable to conceive in the future - This statement is not true as having an ectopic pregnancy does not necessarily impact future fertility.
C: Bed rest and analgesics are the recommended treatment - Bed rest and analgesics are not the primary treatments for ectopic pregnancy, as surgical intervention is often necessary.
D: A D&C will be performed to remove the products of conception - A D&C is not typically performed for ectopic pregnancy management, as it involves the removal of tissue from inside the uterus, not the fallopian
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.
Examination of a newborn in the birth room reveals bilateral cataracts. Which disease process in the maternal history would likely cause this abnormality?
- A. Rubella
- B. Cytomegalovirus (CMV)
- C. Syphilis
- D. HIV
Correct Answer: A
Rationale: The correct answer is A: Rubella. Rubella infection during pregnancy can lead to congenital rubella syndrome, which includes bilateral cataracts in newborns. Rubella virus can cross the placenta and affect the developing fetus, leading to various congenital abnormalities. The other choices, B: CMV, C: Syphilis, and D: HIV, can also cause congenital abnormalities but are not specifically associated with bilateral cataracts in newborns. Rubella is the most likely cause in this scenario based on the clinical presentation.