Nokea
One of the assessments performed in the birth room is checking the umbilical cord for blood vessels. Which finding is considered to be within normal limits?
- A. One artery and one vein
- B. Two veins and one artery
- C. Two arteries and one vein
- D. Two arteries and two veins
Correct Answer: A
Rationale: In a normal umbilical cord, there should be two vessels present - one artery and one vein. The most common finding is having one umbilical vein and two umbilical arteries, but it is also considered within normal limits to have one artery and one vein. This is important as an abnormal number of blood vessels in the umbilical cord can indicate potential issues like congenital abnormalities or genetic conditions.
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A patient who has just received confirmation that she is pregnant is distressed because she has a seizure disorder that she manages with carbamazepine. Which is the nurse’s greatest concern?
- A. The carbamazepine may be discontinued.
- B. The pregnancy is likely to end with fetal demise.
- C. The fetus will experience loss of vision and hearing.
- D. Carbamazepine is teratogenic and causes neural and facial defects.
Correct Answer: D
Rationale: Carbamazepine is a teratogenic drug that poses risks of neural tube defects and craniofacial abnormalities, making this the greatest concern.
When should a woman start having pap smears?
- A. None
- B. At age 21.
- C. None
- D. None
Correct Answer: B
Rationale: Guidelines recommend starting pap smears at age 21.
With regard to the estimation and interpretation of the recurrence of risks for genetic disorders, nurses should be aware that:
- A. With a dominant disorder, the likelihood of the second child also having the condition is 100%.
- B. An autosomal recessive disease carries a one in eight risk of the second child also having the disorder.
- C. Disorders involving maternal ingestion of drugs carry a one in four chance of being repeated in the second child.
- D. The risk factor remains the same no matter how many affected children are already in the family.
Correct Answer: D
Rationale: Each pregnancy is an independent event. The risk factor remains the same for each child.
Identify the physician who is certified to provide the most comprehensive perinatal care.
- A. family practice
- B. obstetrician
- C. surgeon
- D. maternal-fetal medicine
Correct Answer: D
Rationale: Maternal-fetal medicine specialists provide comprehensive perinatal care. Other physicians have more limited scopes.
What is the most vulnerable time for teratogen exposure?
- A. 1-2 weeks after conception.
- B. 3-8 weeks after conception.
- C. 8-12 weeks after conception.
- D. The entire pregnancy.
Correct Answer: B
Rationale: The embryonic period (3-8 weeks) is when organogenesis occurs, making it highly sensitive to teratogens.