Nokea
Rh incompatibility can occur if the patient is Rh-negative and the
- A. fetus is Rh-negative.
- B. fetus is Rh-positive.
- C. father is Rh-positive.
- D. father and fetus are both Rh-negative.
Correct Answer: B
Rationale: The correct answer is B because Rh incompatibility occurs when an Rh-negative mother carries an Rh-positive fetus. During pregnancy or birth, some fetal Rh-positive blood may enter the mother's bloodstream, leading to the production of Rh antibodies. These antibodies can then cause complications in future pregnancies if the fetus is Rh-positive again. Choices A, C, and D are incorrect because Rh incompatibility specifically involves the Rh factor of the fetus, not the mother's own Rh status, the father's Rh status, or both being Rh-negative.
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A patient at 10 weeks' gestation informs the nurse they are having vaginal bleeding and cramping. After completing a speculum examination, the health-care provider (HCP) informs the patient their cervix is open. What does the nurse anticipate the HCP will inform the patient they are experiencing?
- A. complete abortion
- B. incomplete abortion
- C. inevitable abortion
- D. spontaneous abortion
Correct Answer: C
Rationale: The correct answer is C: inevitable abortion. At 10 weeks' gestation, an open cervix with vaginal bleeding and cramping indicates an inevitable abortion, where the miscarriage is unavoidable and the process is ongoing. The open cervix suggests that the pregnancy is not viable and will not continue. The other options are incorrect because: A. Complete abortion refers to the expulsion of all products of conception, B. Incomplete abortion involves partial expulsion of products of conception, and D. Spontaneous abortion is a general term for any non-induced abortion.
What should the nurse recognize as evidence that the patient is recovering from preeclampsia?
- A. 1+ protein in urine
- B. 2+ pitting edema in lower extremities
- C. Urine output >100 mL/hour
- D. Deep tendon reflexes +2
Correct Answer: C
Rationale: The correct answer is C: Urine output >100 mL/hour. This signifies improved kidney function, a key indicator of recovery in preeclampsia. Increased urine output indicates better kidney perfusion and reduced risk of complications like renal failure. A: 1+ protein in urine suggests ongoing kidney damage. B: 2+ pitting edema in lower extremities indicates fluid retention, a common symptom of preeclampsia. D: Deep tendon reflexes +2 are not specific to preeclampsia recovery, although hyperreflexia can be seen in severe cases.
What is the difference between a complete abortion and an incomplete abortion?
- A. In a complete abortion, the uterus is empty, while in an incomplete abortion, some products of conception are still present in the uterus.
- B. In a complete abortion, the cervix dilates, while in an incomplete abortion, the cervix remains closed.
- C. In a complete abortion, the patient experiences minimal to no signs or symptoms of miscarriage, while in an incomplete abortion, the patient experiences persistent bleeding, cramping, or abdominal pain.
- D. In a complete abortion, the fetus is delivered through the birth canal, while in an incomplete abortion, the fetus is removed through medical or surgical intervention.
Correct Answer: A
Rationale: The correct answer is A because in a complete abortion, the uterus is empty, indicating that all products of conception have been expelled. In contrast, in an incomplete abortion, some products of conception remain in the uterus, leading to ongoing bleeding and cramping. Choice B is incorrect because cervical dilation is not the defining factor between complete and incomplete abortions. Choice C is incorrect as both complete and incomplete abortions can present with symptoms of miscarriage. Choice D is incorrect because the method of fetal removal does not differentiate between complete and incomplete abortions.
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 pregnant client with a history of preterm labor is at home on bed rest. Which instruction would be included in this client's teaching plan?
- A. Place blocks under the foot of the bed.
- B. Sit upright with several pillows behind the back.
- C. Lie on the side with the head raised on a small pillow.
- D. Assume the knee-chest position at regular intervals throughout the day.
Correct Answer: C
Rationale: The correct answer is C: Lie on the side with the head raised on a small pillow. This position helps improve circulation to the uterus and placenta, reducing the risk of preterm labor. Lying on the left side also promotes optimal blood flow. Option A is incorrect as elevating the foot of the bed can decrease blood flow to the placenta. Option B may cause discomfort and increase pressure on the cervix. Option D is not suitable for bed rest as it involves being on all fours, which is not conducive to rest and relaxation.