Nokea
A nurse is caring for an infant with hypospadias. Which of the following is an expected finding?
- A. The meatal opening is on the dorsal surface of the penis.
- B. The urethral opening is on the underside of the penis.
- C. Fluid is present in the scrotal sac containing the testes.
- D. The testes are not palpable within the scrotal sac.
Correct Answer: B
Rationale: Hypospadias involves the urethral opening being located on the underside of the penis.
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Which of the following are probable signs, strongly indicating pregnancy?
- A. The presence of fetal heart sounds is a positive sign of pregnancy; quickening is a presumptive sign of pregnancy.
- B. These are presumptive signs. They may indicate pregnancy or they may be caused by other conditions, such as disease processes.
- C. Hegar’s sign is a softening of the lower uterine segment, and Chadwick's sign is the bluish or purplish color of the cervix as a result of the increased blood supply and increased estrogen. Ballottement occurs when the cervix is tapped by an examiner's finger and the fetus floats upward in the amniotic fluid and then falls downward.
- D. These are presumptive signs that might indicate pregnancy, but they might be caused by other conditions, such as disease processes.
Correct Answer: C
Rationale: The correct answer is C because Hegar's sign and Chadwick's sign are considered probable signs of pregnancy. Hegar's sign indicates softening of the lower uterine segment, a physiological change that typically occurs in pregnancy. Chadwick's sign refers to the bluish or purplish color of the cervix due to increased blood supply and estrogen levels in pregnancy. These signs are more specific to pregnancy compared to presumptive signs like quickening, which can be caused by other conditions. Ballottement is a technique used to assess fetal movement and position, not a sign indicating pregnancy certainty. Therefore, choices A, B, and D are incorrect as they refer to presumptive signs or signs that could be caused by conditions other than pregnancy.
Which fetal structure is responsible for carrying oxygenated blood from the placenta to the fetus?
- A. Ductus arteriosus
- B. Umbilical artery
- C. Portal vein
- D. Umbilical vein
Correct Answer: D
Rationale: The correct answer is D: Umbilical vein. The umbilical vein carries oxygenated blood from the placenta to the fetus. This is because the placenta acts as the organ of gas exchange during fetal development. Oxygenated blood from the mother is transferred to the fetus through the umbilical vein. The other choices are incorrect because: A) Ductus arteriosus is a fetal blood vessel that connects the pulmonary artery to the aorta, bypassing the lungs. B) Umbilical artery carries deoxygenated blood from the fetus to the placenta. C) Portal vein carries nutrient-rich blood from the intestines to the liver, not from the placenta to the fetus.
A nurse monitors fetal well-being by means of an external monitor. At the peak of the contractions, the fetal heart rate has repeatedly dropped 30 beats/min below the baseline. Late decelerations are suspected and the nurse notifies the physician. Which is the rationale for this action?
- A. A nuchal cord (cord around the neck) is associated with variable decelerations, not late decelerations.
- B. Variable decelerations (not late decelerations) are associated with cord compression.
- C. Late decelerations are a result of hypoxia. They are not reflective of the strength of maternal contractions.
- D. Late decelerations are associated with uteroplacental insufficiency and are a sign of fetal hypoxia. Repeated late decelerations indicate fetal distress.
Correct Answer: D
Rationale: The correct answer is D because late decelerations are associated with uteroplacental insufficiency, indicating fetal hypoxia. During contractions, the placenta may not be receiving enough oxygen and nutrients, leading to decreased oxygen supply to the fetus, resulting in late decelerations. Repeated late decelerations indicate ongoing fetal distress and the need for immediate intervention to prevent further complications. Choices A, B, and C are incorrect because they do not accurately reflect the characteristics and causes of late decelerations. A nuchal cord is associated with variable decelerations, not late decelerations. Variable decelerations are due to cord compression, not late decelerations. Late decelerations are indeed a result of hypoxia, but they are specifically related to uteroplacental insufficiency, not reflective of the strength of maternal contractions.
A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives. Which of the following findings should the nurse include as an adverse effect of this medication?
- A. Depression
- B. Polyuria
- C. Hypotension
- D. Urticaria
Correct Answer: A
Rationale: The correct answer is A: Depression. Combined oral contraceptives are known to potentially cause mood changes, including depression, in some individuals due to hormonal fluctuations. This adverse effect is important for the nurse to include in teaching to monitor the client's mental health. Polyuria (B) is excessive urination, which is not typically associated with oral contraceptives. Hypotension (C) is low blood pressure, which is not a common side effect of this medication. Urticaria (D) is hives or skin rash, which is not a typical adverse effect of combined oral contraceptives.
A postterm infant is delivered by cesarean section because of fetal distress and meconium-stained amniotic fluid. The nursery nurse frequently monitors the baby's respiratory rate, observing for tachypnea. Which is the reason for the nurse's actions? The infant may:
- A. experience respiratory depression from the medications used during delivery
- B. develop meconium aspiration pneumonia
- C. have an elevated temperature
- D. have a pneumothorax related to delivery
Correct Answer: B
Rationale: The correct answer is B: develop meconium aspiration pneumonia. Meconium-stained amniotic fluid can lead to the infant inhaling meconium, which can cause blockage and inflammation in the airways, leading to meconium aspiration pneumonia. This can result in respiratory distress, tachypnea, and potential complications like respiratory failure. The nurse monitors the respiratory rate to detect any signs of respiratory distress early on.
Incorrect choices:
A: Respiratory depression from medications used during delivery is less likely to be the cause of tachypnea in this scenario.
C: Elevated temperature is not directly related to meconium aspiration pneumonia or respiratory distress in this case.
D: A pneumothorax related to delivery is possible but less likely than meconium aspiration pneumonia as the cause of tachypnea in this case.