Nokea
The measurement of lecithin in relation to sphingomyelin (L/S ratio) is used to determine fetal lung maturity. Which ratio reflects maturity of the lungs?
- A. 1.4:1
- B. 1.8:1
- C. 2:01
- D. 1:01
Correct Answer: C
Rationale: A ratio of 2:1 indicates lung maturity.
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The nurse is providing care to a pregnant person at 32 weeks’ gestation. The nurse expects to observe what change in the pregnant person’s spine?
- A. sclerosis
- B. scoliosis
- C. kyphosis
- D. lordosis
Correct Answer: D
Rationale: The correct answer is D: lordosis. At 32 weeks' gestation, the pregnant person's center of gravity shifts forward, causing an increased lumbar lordosis to compensate. This change helps maintain balance and support the growing uterus. Sclerosis (choice A) refers to hardening of tissues, not a typical change in the spine during pregnancy. Scoliosis (choice B) is a lateral curvature of the spine, not typically related to pregnancy. Kyphosis (choice C) is an exaggerated outward curve in the upper spine, not a common change in pregnancy.
What is an example of a statement by the patient that indicates effective teaching by the nurse about methods to improve fertility?
- A. “Caffeine does not affect my fertility.”
- B. “I should start taking prenatal vitamins to increase my chances of conception.”
- C. “My partner should avoid any exercise while we are trying to conceive to avoid damaging the sperm.”
- D. “Smoking can increase my risk of miscarriage.”
Correct Answer: D
Rationale: The correct answer is D because it accurately reflects the nurse's teaching on fertility. Smoking is known to have negative effects on fertility and can increase the risk of miscarriage. This statement shows that the patient has understood the information provided by the nurse regarding factors that could impact fertility.
A is incorrect because caffeine can actually affect fertility. B is incorrect because while taking prenatal vitamins is beneficial, it does not directly address fertility improvement. C is incorrect as exercise is generally beneficial for fertility and does not necessarily harm sperm.
The nurse is reviewing the schedule for the OB/GYN she works for. In reviewing a patient’s chart, the nurse notes the patient is 32 weeks pregnant, has hypertension, and had a previous fetal death. What test does the nurse anticipate the provider will order?
- A. a contraction stress test
- B. amniotic fluid index
- C. nonstress test
- D. fetal movement count
Correct Answer: C
Rationale: The correct answer is C: nonstress test. A nonstress test is used to assess fetal well-being by monitoring the baby's heart rate in response to its own movements. In this case, the patient's history of hypertension and previous fetal death indicate a higher risk pregnancy, making it important to monitor the baby's well-being. A contraction stress test (choice A) is not suitable for a patient with hypertension as it can induce contractions and potentially harm the baby. An amniotic fluid index (choice B) is used to evaluate amniotic fluid levels and is not specific to this patient's situation. Fetal movement count (choice D) assesses the baby's movements but does not provide real-time information on fetal well-being like a nonstress test does.
Why do infants born at 25 weeks' gestation have a poor survival rate?
- A. Cardiac development is incomplete.
- B. Fetal lung alveoli are not present in sufficient numbers.
- C. Gastrointestinal development is incomplete.
- D. Sucking reflex is not present.
Correct Answer: B
Rationale: The correct answer is B because infants born at 25 weeks' gestation have a poor survival rate due to insufficient numbers of fetal lung alveoli. This leads to respiratory distress and difficulty in oxygen exchange, impacting their chances of survival. Choice A is incorrect as cardiac development is not the primary factor affecting survival. Choice C is incorrect as gastrointestinal development does not directly impact survival at this stage. Choice D is incorrect as the sucking reflex is not a critical factor in survival compared to respiratory function.
The nurse is assessing a newborn immediately after birth. After assigning the first Apgar score
of 9, the nurse notes two vessels in the umbilical cord. What is the nurse’s next action?
- A. Assess for other abnormalities of the infant.
- B. Note the assessment finding in the infant’s chart.
- C. Notify the health care provider of the assessment finding.
- D. Call for the neonatal resuscitation team to attend the infant immediately.
Correct Answer: A
Rationale: The correct answer is A. The nurse should assess for other abnormalities of the infant because the presence of two vessels in the umbilical cord (a condition known as a two-vessel cord) may be associated with other congenital anomalies. By assessing for other abnormalities, the nurse can identify any potential issues that may require immediate intervention or further evaluation. This proactive approach ensures the newborn's well-being and allows for timely management of any additional concerns.
Summary of other choices:
B: Noting the finding in the chart is important but does not address the immediate need to assess for other abnormalities.
C: Notifying the health care provider is important, but assessing for other abnormalities should be the nurse's initial priority.
D: Calling for the neonatal resuscitation team is not necessary based solely on the presence of a two-vessel cord; further assessment is needed before determining the need for resuscitation.