Nokea
The nurse is caring for a woman who is suspected of having chorioamnionitis. Which of the following are risk factors for chorioamnionitis? Select all that apply.
- A. Changing cat litter
- B. Frequent vaginal examination during labor
- C. Gestational diabetes
- D. Preterm premature rupture of the membranes
Correct Answer: A
Rationale: The correct answer is A: Changing cat litter. Chorioamnionitis is an infection of the amniotic fluid and membranes. Changing cat litter exposes the woman to toxoplasmosis, a risk factor for chorioamnionitis. Choices B, C, and D are incorrect. Vaginal exams during labor can introduce bacteria but are not a direct risk factor. Gestational diabetes is unrelated, and preterm premature rupture of membranes can increase infection risk but is not a direct cause like exposure to toxoplasmosis.
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A nurse is monitoring a client with type 2 diabetes mellitus. Her blood work reveals a glycosylated hemoglobin (HbA1c) of 10%. The nurse knows this blood work indicates which of the following?
- A. A normal value indicating that the client is managing blood glucose control well
- B. A low value indicating that the client is not managing blood glucose control very well
- C. A high value indicating that the client is not managing blood glucose control very well
- D. The value does not offer information regarding client management of her disease
Correct Answer: C
Rationale: Rationale:
1. HbA1c reflects average blood glucose levels over the past 2-3 months.
2. A value of 10% indicates poor blood glucose control.
3. High HbA1c (above 6.5-7%) signifies uncontrolled diabetes.
4. Choice C is correct as it aligns with the interpretation of HbA1c.
Summary:
- Choice A is incorrect as 10% is not a normal HbA1c value.
- Choice B is incorrect as a low value would indicate good control.
- Choice D is incorrect as HbA1c is a key marker for diabetes management.
The nurse is caring for a woman with a history of a previous preterm birth. Based on current knowledge related to cervical incompetency, which should the nurse do?
- A. Prepare the woman for an abdominal ultrasound
- B. Place the patient on her left side to increase perfusion to the fetus
- C. Be prepared to discuss the action and side effects of progesterone
- D. Monitor the patient’s blood pressure closely
Correct Answer: C
Rationale: The correct answer is C because progesterone is a recommended treatment for cervical incompetency to prevent preterm birth. Progesterone helps support the uterine lining and decrease the risk of preterm labor. Therefore, discussing the action and side effects of progesterone with the patient is essential.
A: While an abdominal ultrasound may provide information about the cervix, it is not the immediate priority in this case.
B: Placing the patient on her left side is a common practice for improving blood flow, but it is not directly related to managing cervical incompetency.
D: Monitoring blood pressure is important in prenatal care, but it is not specifically related to the management of cervical incompetency in this context.
Which factor places the client at the highest risk of pre-eclampsia?
- A. White race
- B. Multiparity
- C. Obesity
- D. Infertility
Correct Answer: C
Rationale: The correct answer is C: Obesity. Obesity is a major risk factor for pre-eclampsia due to the increased strain on the cardiovascular system, leading to hypertension and other complications during pregnancy. Multiparity (B) is associated with a lower risk of pre-eclampsia, as previous pregnancies can provide some level of protection. Infertility (D) is not a known risk factor for pre-eclampsia. White race (A) is not a definitive risk factor for pre-eclampsia, as it can affect individuals of all races.
The nurse is providing discharge instructions to a 28-year-old client who received methotrexate for an ectopic pregnancy. Which should the discharge instructions include?
- A. Make sure to take folic acid
- B. Make an appointment to see her provider in 6 weeks
- C. Flush the toilet twice after she urinates for the next 24 hours
- D. Resume all activity in 48 hours
Correct Answer: C
Rationale: The correct answer is C: Flush the toilet twice after she urinates for the next 24 hours. Methotrexate is excreted in urine and can be harmful if it comes into contact with others. Flushing the toilet twice helps to minimize the risk of exposure to others. Choice A is incorrect because although folic acid supplementation may be necessary with methotrexate, it is not the priority in this scenario. Choice B is incorrect as the client should be advised to seek immediate medical attention if any concerning symptoms occur, rather than waiting for 6 weeks. Choice D is incorrect as the client needs to avoid certain activities for a period of time after receiving methotrexate to prevent complications.
A nurse is caring for a client who is 32 weeks gestation who comes to the emergency department for painful bleeding. Which is the priority nursing assessment?
- A. Monitor for contractions
- B. Assess pain level
- C. Assess for hemorrhage
- D. Provide emotional support
Correct Answer: C
Rationale: The correct priority nursing assessment in this scenario is to assess for hemorrhage (Choice C). This is crucial because painful bleeding in a client at 32 weeks gestation could indicate a potential life-threatening situation such as placental abruption or placenta previa. Assessing for hemorrhage involves checking the amount and type of bleeding, vital signs, and signs of shock. It is essential to identify and address hemorrhage promptly to prevent adverse outcomes for both the mother and the baby.
Monitoring for contractions (Choice A) is important but assessing for hemorrhage takes precedence due to the immediate risk it poses. Assessing the pain level (Choice B) is secondary to assessing for hemorrhage in this case. Providing emotional support (Choice D) is important but should come after ensuring the client's physical well-being is addressed.