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For which patient would an L/S ratio of 2:1 potentially be considered abnormal?
- A. A 38-year-old gravida 2, para 1, who is 38 weeks' gestation
- B. A 24-year-old gravida 1, para 0, who has diabetes
- C. A 44-year-old gravida 6, para 5, who is at term
- D. An 18-year-old gravida 1, para 0, who is in early labor at term
Correct Answer: B
Rationale: The correct answer is B. An L/S ratio of 2:1 is indicative of fetal lung maturity. This means that the lungs of the fetus are likely mature enough to function outside the womb. In choice B, the patient is 24 years old with diabetes, a condition that can affect fetal lung development, making it crucial to assess lung maturity.
Choice A is less likely to have abnormal lung maturity at 38 weeks' gestation. Choice C, a 44-year-old gravida 6, para 5, is more likely to have mature fetal lungs due to multiple pregnancies. Choice D, an 18-year-old in early labor at term, may not necessarily have abnormal lung maturity as she is at term and in labor.
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A patient at 36 weeks gestation is undergoing a nonstress (NST) test. The nurse observes the fetal heart rate baseline at 135 beats per minute (bpm) and four nonepisodic patterns of the fetal heart rate reaching 160 bpm for periods of 20 to 25 seconds each. How will the nurse record these findings?
- A. NST positive, nonreassuring
- B. NST negative, reassuring
- C. NST reactive, reassuring
- D. NST nonreactive, nonreassuring
Correct Answer: C
Rationale: Step 1: The baseline fetal heart rate is 135 bpm, which is within the normal range of 110-160 bpm.
Step 2: The four nonepisodic patterns of fetal heart rate reaching 160 bpm for 20-25 seconds each indicate accelerations, a positive sign.
Step 3: A reactive NST requires at least two accelerations of the fetal heart rate within a 20-minute window, which this scenario meets.
Step 4: Therefore, the nurse will record these findings as NST reactive, reassuring because the fetal heart rate responded appropriately to stimuli.
Summary of Other Choices:
A: NST positive, nonreassuring - Inaccurate, as the findings indicate a reassuring response.
B: NST negative, reassuring - Incorrect, as the test results are actually reactive, not negative.
D: NST nonreactive, nonreassuring - Wrong, as the test is reactive and reassuring, not nonreactive and nonreassuring.
Which of the following complications of labor and delivery may develop when a baby enters the pelvis in the LMP position?
- A. Cephalopelvic disproportion.
- B. Placental abruption.
- C. Breech presentation.
- D. Acute fetal distress.
Correct Answer: A
Rationale: LMP (left mentum posterior) position can lead to cephalopelvic disproportion, making delivery difficult.
The mother of a neonate with Down syndrome wishes to breastfeed. Which of the following considerations should the nurse make in relation to the mother’s wishes?
- A. The mother should be encouraged to feed expressed breast milk via a bottle.
- B. Down syndrome babies consume more calories than unaffected neonates.
- C. Because of the weight of the neonatal head, the side-lying position must be used.
- D. The baby will likely have a weak suck due to congenitally poor muscle tone.
Correct Answer: D
Rationale: Babies with Down syndrome often have hypotonia, which can affect their ability to suck effectively during breastfeeding.
A pregnant patient asks the prenatal nurse how much physical activity is safe during pregnancy. What is an acceptable response by the nurse?
- A. Decreasing physical activity decreases emotional and physical symptoms.
- B. Increasing physical activity increases emotional and physical symptoms.
- C. Physical activity during pregnancy should be limited to hygiene and household tasks.
- D. The level of activity prior to pregnancy is used to determine a safe activity level during pregnancy.
Correct Answer: D
Rationale: The correct answer is D because the level of activity prior to pregnancy is a good indicator of the safe activity level during pregnancy. This is because pregnant women are generally encouraged to continue their pre-pregnancy level of exercise, adjusting as needed based on individual circumstances.
A is incorrect because decreasing physical activity may lead to more physical discomfort and emotional symptoms. B is incorrect as increasing physical activity can be beneficial if done safely. C is incorrect because hygiene and household tasks alone may not provide sufficient physical activity during pregnancy.
Which type of cutaneous stimulation involves massage of the abdomen?
- A. Imagery
- B. Effleurage
- C. Mental stimulation
- D. Thermal stimulation
Correct Answer: B
Rationale: The correct answer is B: Effleurage. Effleurage is a type of massage technique involving long, gentle strokes on the skin. Massaging the abdomen with effleurage can help improve circulation, relax muscles, and promote digestion. Imagery (A) is a technique involving mental visualization, not physical touch. Mental stimulation (C) refers to cognitive activities, not physical touch. Thermal stimulation (D) involves the application of temperature changes, not massage. Therefore, effleurage is the most suitable choice for massage of the abdomen.