Nokea
The nurse correctly sends a requisition and specimen for which laboratory test?
- A. Alpha-fetoprotein (AFP)
- B. Corticotropin-releasing hormone (CRH)
- C. Human chorionic gonadotropin (hCG)
- D. Follicle-stimulating hormone (FSH)
Correct Answer: C
Rationale: Human chorionic gonadotropin (hCG) is the hormone tested to confirm pregnancy, as it is produced by the placenta shortly after implantation.
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The first-trimester pregnant client asks the nurse if the activities in which she participates are safe in the first trimester. Which activity should the nurse verify as a safe activity during the client’s first trimester?
- A. Hair coloring
- B. Hot tub use
- C. Pesticide use
- D. Sexual activity
Correct Answer: D
Rationale: Sexual activity is not contraindicated in pregnancy unless a specific risk factor is identified. Hair coloring should be avoided in the first trimester because the chemicals can be absorbed and pose a risk to the developing fetus. Hot tub use should be avoided because it increases the client’s body temperature. Maternal hyperthermia during the first trimester raises concerns about possible spontaneous abortion, CNS defects, and failure of neural tube closure. Exposure to pesticides during pregnancy increases the risk for preterm birth, intrauterine growth restriction, childhood developmental delays, and infertility later in adulthood.
According to the TPAL method, which of the following reflects the client's obstetric history?
- A. T-III, P-0, A-0, L-III
- B. T-III, P-II, A-0, L-0
- C. T-III, P-II, A-0, L-II
- D. T-III, P-0, A-0, L-III
Correct Answer: A
Rationale: TPAL: Term (3, one son and twin daughters), Preterm (0), Abortions (0), Living (3). The client has three term deliveries and three living children.
In the process of preparing the client for discharge after cesarean section, the nurse addresses all of the following areas during discharge education. Which should be the priority advice for the client?
- A. How to manage her incision
- B. Planning for assistance at home
- C. Infant care procedures
- D. Increased need for rest
Correct Answer: B
Rationale: Although the client needs information about incision care, the priority need is for assistance at home so that she can get the rest needed for multiple demands. Because the client has had a surgical procedure, the priority consideration is for the mother to plan for additional assistance at home. Without this assistance, it is difficult for the mother to get the rest she needs for healing, pain control, and appropriate infant care. Infant care is important, but having assistance at home after a surgical procedure is more important. The need for increased rest is important, but she would not be able to obtain adequate rest without assistance at home.
When looking in the mirror at her abdomen, the postpartum client says to the nurse, “My stomach still looks like I’m pregnant!” The nurse explains that the abdominal muscles, which separate during pregnancy, will undergo which change?
- A. Regain tone Within the first week after birth
- B. Regain prepregnancy tone with exercise
- C. Remain separated, giving the abdomen a slight bulge
- D. Regain tone as the weight gained during pregnancy is lost
Correct Answer: B
Rationale: For most women, it takes about 6 weeks (not one week) to regain abdominal wall muscle tone to the prepregnancy state, and usually only with exercise. The “still-pregnant” appearance is caused by relaxation of the abdominal wall muscles. With exercise, most women can regain prepregnancy abdominal muscle tone within about 6 weeks. If the client delivers a very large infant, the abdominal muscles may separate, but the separation will become less apparent over time. Weight loss alone will not strengthen the abdominal muscles.
The nurse caring for the postpartum client who is 15 years old is concerned about this client’s ability to parent a newborn. Which behavior is characteristic of the developmental level of the 15-year-old that justifies the nurse’s concern?
- A. Developing autonomy
- B. Follows rules established by others
- C. Career oriented
- D. Egocentric
Correct Answer: D
Rationale: The development of autonomy is a developmental task of toddlerhood. School-age children are motivated to follow rules established by others. Adult women are concerned about the effect of childbearing on careers. Although it is biologically possible for the adolescent female to become a parent, her egocentricity and concrete thinking interfere with her ability to parent effectively. Because of this normal development, the adolescent may inadvertently neglect her child.