Assessment of High Risk Pregnancy NCLEX Questions

Assessment of High Risk Pregnancy NCLEX Questions Related

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A patient, gravida 2, para 1, comes for a prenatal visit at 20 weeks of gestation. Her fundus is palpated 3 cm below the umbilicus. This finding is

  • A. appropriate for gestational age.
  • B. a sign of impending complications.
  • C. lower than normal for gestational age.
  • D. higher than normal for gestational age.
Correct Answer: C

Rationale: The fundal height at 20 weeks gestation should be at the level of the umbilicus. When it is palpated 3 cm below the umbilicus, it is considered lower than normal for gestational age. This finding suggests possible fetal growth restriction or incorrect dating of the pregnancy. It is crucial to monitor closely for fetal well-being and growth.

Choice A is incorrect because being 3 cm below the umbilicus is not appropriate for gestational age. Choice B is incorrect as it does not necessarily indicate impending complications, but rather a need for further evaluation. Choice D is incorrect as a fundus higher than normal for gestational age would suggest a larger-than-expected fetus or multiple gestation.

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Determine the obstetric history of a patient in her fifth pregnancy who has had two spontaneous abortions in the first trimester, one infant at 32 weeks' gestation, and one infant at 38 weeks' gestation.

  • A. G5 T1 P2 A2 L 2
  • B. G5 T1 P1 A1 L2
  • C. G5 T0 P2 A2 L2
  • D. G5 T1 P1 A2 L2
Correct Answer: D

Rationale: Rationale for Answer D (G5 T1 P1 A2 L2):
- G (Gravida): The patient is in her fifth pregnancy
- T (Term births): She has had one infant at 38 weeks' gestation
- P (Preterm births): She has had one infant at 32 weeks' gestation
- A (Abortions): She has had two spontaneous abortions in the first trimester
- L (Living children): She has 2 living children

Summary of other choices:
- A: Incorrect as it states 2 living children, which is not accurate
- B: Incorrect as it only accounts for one abortion and one living child
- C: Incorrect as it indicates no living children, which is not true based on the given information

Therefore, Answer D is the correct option based on the patient's obstetric history.

Which is the method of childbirth that helps prevent the fear-tension-pain cycle by using slow abdominal breathing in early labor and rapid chest breathing in advanced labor?

  • A. Bradley
  • B. Lamaze
  • C. Leboyer
  • D. Dick-Read
Correct Answer: D

Rationale: The correct answer is D: Dick-Read method. This method emphasizes relaxation and controlled breathing to reduce fear and pain during childbirth. Slow abdominal breathing in early labor helps maintain calmness, while rapid chest breathing in advanced labor assists in coping with intense contractions. The Dick-Read method's focus on the mind-body connection and natural childbirth aligns with preventing the fear-tension-pain cycle.

Summary:
A: Bradley method emphasizes partner-coached childbirth.
B: Lamaze method focuses on breathing techniques and relaxation.
C: Leboyer method emphasizes gentle birthing practices.

These choices do not specifically address the fear-tension-pain cycle with the same breathing techniques as the Dick-Read method.

A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session?

  • A. Managed care insures full coverage of health care costs.
  • B. Managed care only assumes the financial risk involved.
  • C. Managed care allows providers to focus on illness care.
  • D. Managed care causes providers to focus on prevention.
Correct Answer: D

Rationale: Managed care describes health care systems in which the provider or the health care system receives a predetermined capitated (fixed amount) payment for each patient enrolled in the program. Therefore, the focus of care shifts from individual illness care to prevention, early intervention, and outpatient care.

A woman, contracting every 3 min 60 seconds, suddenly develops an amniotic fluid embolism. Which of the following signs/symptoms would the nurse observe?

  • A. Sudden gush of fluid from the vagina.
  • B. Intense and unrelenting uterine pain.
  • C. Precipitous dilation and expulsion of the fetus.
  • D. Chest pain with dyspnea and cyanosis.
Correct Answer: D

Rationale: Amniotic fluid embolism can cause sudden cardiovascular collapse, including chest pain, dyspnea, and cyanosis.

A woman has been diagnosed with chlamydia. The nurse would expect the client to complain of which of the following signs/symptoms?

  • A. No signs or symptoms.
  • B. Painful lesions on the labia.
  • C. Foul-smelling discharge.
  • D. Severe lower abdominal pain.
Correct Answer: A

Rationale: Chlamydia is often asymptomatic, but if symptoms occur, they may include discharge or pain.

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