Nokea
Client at 38 weeks of gestation, heavy red vaginal bleeding without contractions, no distress, can feel baby moving
The client should undergo an ultrasound to determine which of the following findings?
- A. Fetal lung maturity
- B. Frequency and duration of contractions
- C. Location of the placenta
- D. Rh incompatibility
Correct Answer: C
Rationale: The correct answer is C: Location of the placenta. An ultrasound can determine the exact position of the placenta in relation to the cervix, which is crucial for assessing the risk of placenta previa or other complications during pregnancy. This information guides healthcare providers in making appropriate decisions regarding delivery methods.
Other choices are incorrect because:
A: Fetal lung maturity is usually assessed through other methods like amniocentesis.
B: Frequency and duration of contractions are usually monitored through external monitoring devices.
D: Rh incompatibility is typically detected through blood tests, not ultrasound.
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Adult patient, physician orders Magnesium 4 gms loading dose to infuse over 30 minutes at 0500, then infuse a maintenance dose of 1 gram/hr, pharmacy sends 80 Gms in 1000 mL of LR
What would the nurse set the pump for the loading dose at 5 Am? Be sure to enter the number AND the unit of measurement (mL).
Correct Answer: 200 mL/hr
Rationale: The correct answer is 200 mL/hr. At 5 AM, the nurse would set the pump for the loading dose based on the prescribed rate per hour. By setting the pump at 200 mL/hr, the patient will receive the intended dose over the specified time. Choices A-G are incorrect as they do not align with the standard dosing calculations for the loading dose at 5 AM.
Client in second trimester, new diagnosis of gestational diabetes
Which statement by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will take my glyburide daily with breakfast.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I know I am at increased risk to develop type 2 diabetes.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week contradicts the goal of managing type 2 diabetes through regular physical activity. Exercise helps control blood sugar levels and improves insulin sensitivity. Limiting exercise can lead to poor diabetes management. Choice A shows understanding of carbohydrate control. Choice B indicates adherence to medication regimen. Choice D demonstrates awareness of diabetes risk.
Client at 34 weeks of gestation, at risk for placental abruption
Which of the following is the most common risk factor for a placental abruption?
- A. Maternal battering
- B. Maternal cigarette smoking
- C. Maternal hypertension
- D. Maternal cocaine use
Correct Answer: C
Rationale: The correct answer is C: Maternal hypertension. Placental abruption is the premature separation of the placenta from the uterus before delivery. Hypertension can lead to reduced blood flow to the placenta, increasing the risk of abruption. Maternal battering (A) can cause trauma but is not the most common risk factor. Maternal cigarette smoking (B) and cocaine use (D) can also increase the risk but are not as prevalent as hypertension. Other factors may include advanced maternal age, multiple pregnancies, and previous history of placental abruption.
Client immediate postoperative period, removal of ectopic pregnancy via salpingostomy
The nurse should prepare to administer Rho(D) immune globulin (RhoGAM or RhiG) as prescribed if the record indicates that the client
- A. has previously given birth to an Rh-negative infant.
- B. has had significant blood loss during the procedure.
- C. has expressed a desire to conceive again.
- D. is Rh-negative.
Correct Answer: D
Rationale: The correct answer is D because Rho(D) immune globulin is administered to Rh-negative mothers to prevent hemolytic disease of the newborn in future pregnancies with Rh-positive infants. Choice A is incorrect because having an Rh-negative infant does not warrant the administration of RhoGAM. Choice B is incorrect because significant blood loss does not relate to the need for RhoGAM. Choice C is incorrect as the desire to conceive again does not indicate the necessity for RhoGAM administration.
Client in second trimester, new diagnosis of gestational diabetes
Which statement by the client indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will take my glyburide daily with breakfast.
- C. I will reduce my exercise schedule to 3 days a week.
- D. I know I am at increased risk to develop type 2 diabetes.
Correct Answer: C
Rationale: The correct answer is C because reducing the exercise schedule to 3 days a week contradicts the importance of regular physical activity in managing diabetes. Regular exercise helps improve insulin sensitivity and control blood sugar levels. Limiting carbohydrates to 50% of caloric intake (choice A) is a recommended dietary guideline for diabetes management. Taking glyburide daily with breakfast (choice B) indicates adherence to medication therapy. Knowing about the increased risk of developing type 2 diabetes (choice D) shows awareness of the condition.