Nokea
The nurse is discussing the methods of confirming the pregnancy with a patient at the first prenatal visit. What method is used to confirm cardiac activity of the fetus?
- A. bimanual exam
- B. pelvic ultrasound
- C. serum pregnancy test
- D. urine pregnancy test
Correct Answer: B
Rationale: The correct answer is B: pelvic ultrasound. Pelvic ultrasound is used to confirm the presence of cardiac activity in the fetus by visualizing the fetal heartbeat. This method is the most accurate and reliable way to confirm the viability of the pregnancy. A bimanual exam (choice A) is a physical examination technique that assesses the size and shape of the uterus but does not confirm fetal cardiac activity. Serum pregnancy test (choice C) and urine pregnancy test (choice D) detect the presence of human chorionic gonadotropin (hCG) hormone in the blood or urine, indicating pregnancy, but do not confirm fetal cardiac activity.
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For which patient would an L/S ratio of 2:1 potentially be considered abnormal?
- A. A 38-year-old gravida 2, para 1, who is 38 weeks' gestation
- B. A 24-year-old gravida 1, para 0, who has diabetes
- C. A 44-year-old gravida 6, para 5, who is at term
- D. An 18-year-old gravida 1, para 0, who is in early labor at term
Correct Answer: B
Rationale: The correct answer is B. An L/S ratio of 2:1 is indicative of fetal lung maturity. This means that the lungs of the fetus are likely mature enough to function outside the womb. In choice B, the patient is 24 years old with diabetes, a condition that can affect fetal lung development, making it crucial to assess lung maturity.
Choice A is less likely to have abnormal lung maturity at 38 weeks' gestation. Choice C, a 44-year-old gravida 6, para 5, is more likely to have mature fetal lungs due to multiple pregnancies. Choice D, an 18-year-old in early labor at term, may not necessarily have abnormal lung maturity as she is at term and in labor.
The nurse is performing the interval history on a patient at 30 weeks of gestation. What data would the prenatal nurse bring to the attention of the health-care provider?
- A. Hgb change from 12 g/dL (at first prenatal visit) to 11 g at 28 weeks
- B. negative ketones in the urine
- C. dysuria for 3 days
- D. weight gain of 3 pounds in the last 2 weeks
Correct Answer: C
Rationale: Rationale: Choice C (dysuria for 3 days) is the correct answer as it could indicate a urinary tract infection (UTI) which can lead to complications during pregnancy. Dysuria may be a sign of UTI, which can progress quickly in pregnant women. Bringing this to the health-care provider's attention is essential for prompt treatment to prevent potential harm to both the mother and baby.
Summary of other choices:
A: Hgb change is within normal range for pregnancy, not necessarily alarming.
B: Negative ketones in the urine are expected and indicate adequate glucose utilization.
D: Weight gain of 3 pounds in 2 weeks is considered normal in the third trimester and not typically a cause for concern unless sudden or excessive.
A postpartum client, who delivered her baby vaginally 2 hours earlier, just voided 100 mL in the bathroom. After returning to bed, the nurse makes the following assessment: fundus 4 cm above the umbilicus and deviated to the right with moderate lochia rubra. Which of the following nursing diagnoses is appropriate at this time?
- A. Impaired skin integrity.
- B. Fluid volume deficit.
- C. Impaired urinary elimination.
- D. Toileting self-care deficit.
Correct Answer: C
Rationale: A deviated fundus and moderate lochia rubra suggest urinary retention, which can impede uterine involution.
A nurse is reading a research study that states, 'There is a strong negative correlation between the independent and dependent variables (r = --0.85).' The nurse interprets the statement as which of the following?
- A. The dependent variable caused a change in the independent variable.
- B. The independent and dependent variables are significantly different.
- C. As values of the independent variable go up, values of the dependent variable go down.
- D. When the confidence interval is computed, the negative value will change to positive.
Correct Answer: C
Rationale: A negative correlation means that as one variable increases, the other decreases. The strength of the correlation is indicated by the absolute value of r.
What does optimal nursing care after an amniocentesis include?
- A. Pushing fluids by mouth
- B. Monitoring uterine activity
- C. Placing the patient in a supine position for 2 hours
- D. Applying a pressure dressing to the puncture site
Correct Answer: B
Rationale: The correct answer is B: Monitoring uterine activity. After an amniocentesis, it is crucial to monitor uterine activity to detect any signs of preterm labor or uterine contractions. This helps in identifying any potential complications early on and ensures prompt intervention if needed.
A: Pushing fluids by mouth is important for hydration but not directly related to optimal nursing care after an amniocentesis.
C: Placing the patient in a supine position for 2 hours is not recommended as it may increase the risk of hypotension and discomfort for the patient.
D: Applying a pressure dressing to the puncture site is not necessary after an amniocentesis as the risk of bleeding is minimal and pressure dressings may increase the risk of infection.