Nokea
A nurse is assessing a newborn who was born Post term. Which of the following findings should the nurse expect?
- A. A Rh-negative mother who has an Rh- positive infant
- B. A Rh "“positive mother who has an Rh- negative infant
- C. A Rh-positive mother who has an Rh- positive infant
- D. A Rh- negative mother who has an Rh- negative infant
Correct Answer: A
Rationale: The correct answer is A: A Rh-negative mother who has an Rh-positive infant. Post-term infants are at higher risk for conditions such as Rh incompatibility. Since the mother is Rh-negative and the infant is Rh-positive, there is a potential for Rh incompatibility, leading to hemolytic disease of the newborn. This occurs when the mother's antibodies attack the infant's red blood cells.
Choice B is incorrect because Rh incompatibility occurs when the mother is Rh-negative and the infant is Rh-positive. Choice C is incorrect as both mother and infant being Rh-positive do not lead to Rh incompatibility. Choice D is incorrect because Rh incompatibility does not occur when both mother and infant are Rh-negative.
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A patient has just acknowledged that she is 20 weeks pregnant and confides to the nurse that she has a daily heroin habit. The nurse discusses treatment options for the patient. Which patient statement requires follow-up?
- A. "My plan is to visit the outpatient clinic daily for treatment."
- B. "will see my health care provider at least every 2 weeks."
- C. "My baby will not have to go through withdrawal when I take methadone."
- D. "With oral methadone, my baby and I are at decreased risk of infection."
Correct Answer: B
Rationale: The correct answer is B because seeing the healthcare provider every 2 weeks may not be frequent enough for monitoring a pregnant patient with a heroin habit. Regular monitoring is crucial for the well-being of both the mother and the baby. Option A shows a proactive approach for daily treatment, Option C is incorrect as methadone does not eliminate the risk of withdrawal in newborns, and Option D is incorrect as methadone does not reduce the risk of infection. Regular and close monitoring is essential in such cases to ensure the safety and health of both the mother and the baby.
A client at 28 weeks' gestation is undergoing a glucose tolerance test. What is the purpose of this test?
- A. To detect anemia.
- B. To screen for gestational diabetes.
- C. To assess fetal growth.
- D. To evaluate placental function.
Correct Answer: B
Rationale: The correct answer is B: To screen for gestational diabetes. The glucose tolerance test during pregnancy helps to identify women at risk for developing gestational diabetes, a condition that can lead to complications for both the mother and baby. By measuring blood sugar levels after consuming a glucose solution, healthcare providers can assess how the body processes sugar during pregnancy. This test is specifically designed to detect abnormalities in glucose metabolism during pregnancy.
Choice A: To detect anemia - Anemia is not typically identified through a glucose tolerance test. Anemia is usually diagnosed through a blood test that measures hemoglobin levels.
Choice C: To assess fetal growth - Fetal growth is usually monitored through ultrasound scans and measurements, not through a glucose tolerance test.
Choice D: To evaluate placental function - Placental function is evaluated through other tests like Doppler ultrasound, not through a glucose tolerance test.
A nurse is reviewing laboratory results for client who is pregnant. The Nurse should expect which of the following laboratory values to increase?
- A. RBC count
- B. Bilirubin
- C. Fasting blood glucose
- D. Bun
Correct Answer: A
Rationale: The correct answer is A: RBC count. During pregnancy, an increase in RBC count is expected due to physiological changes in the body to support the increased oxygen demand for the developing fetus. This is known as physiologic anemia of pregnancy. Bilirubin levels may remain stable or decrease during pregnancy. Fasting blood glucose levels may increase due to gestational diabetes, but this is not a universal finding. BUN levels can remain stable or slightly decrease during pregnancy due to increased renal blood flow and glomerular filtration rate.
A client at 37 weeks' gestation reports severe itching without a rash. What condition should the nurse suspect?
- A. Preeclampsia.
- B. Cholestasis of pregnancy.
- C. Gestational diabetes.
- D. Fungal infection.
Correct Answer: B
Rationale: The correct answer is B: Cholestasis of pregnancy. Severe itching without a rash in a pregnant client at 37 weeks' gestation is concerning for cholestasis of pregnancy, a condition characterized by impaired bile flow. This can lead to elevated bile acids, causing itching. Preeclampsia (choice A) presents with hypertension and proteinuria. Gestational diabetes (choice C) manifests with high blood sugar levels. Fungal infection (choice D) typically presents with visible skin changes like a rash, which is absent in this case. In summary, cholestasis of pregnancy is the most likely explanation for severe itching in this scenario.
16wks gestation reports for a triple screen test. What statements determines understanding?
- A. "This test can be used as a screening for spina bifida."
- B. "This test is a screen test, and I will need other testing if I have abn results."
- C. "this test can indicate if I may be at an increased risk for having a child with down syndrome."
- D. A triple screen test is a screening tool. Maternal blood is drawn and alpha-fetoprotein, hcg, and estriol values are assessed to determine if the mother is at an increased risk for neural tube defects or chromosomal trisomy's. Spina bifida and downs syndrome are the two most common risks.
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct:
1. A triple screen test includes assessing alpha-fetoprotein, hCG, and estriol levels.
2. These values help determine the risk for neural tube defects and chromosomal trisomies.
3. The test does not directly diagnose spina bifida but assesses neural tube defects.
4. Down syndrome risk is also evaluated, not diagnosed directly.
5. Answer D provides a comprehensive explanation of the test components and its purpose, aligning with the test's actual function.
Summary of why other choices are incorrect:
A. Incorrect because the test screens for neural tube defects and chromosomal trisomies, not just spina bifida.
B. Incorrect because the test is a screening tool for specific conditions, not a definitive diagnostic test.
C. Incorrect because the test assesses multiple conditions, not just Down syndrome specifically.