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The nurse is educating a primigravida patient about prenatal testing/screening. She inquires why she needs to be tested for HIV. Which of the following is the nurse’s best response?
- A. It is a recommended screening for all women, regardless of risk factors.
- B. It is a recommended screening for a woman who is not married.
- C. It is a recommended screening for a woman who has had gonorrhea.
- D. It is a recommended screening for a woman who has had more than one sexual partner.
Correct Answer: A
Rationale: The correct answer is A: It is a recommended screening for all women, regardless of risk factors. This is because HIV screening during pregnancy is essential to prevent mother-to-child transmission. HIV can be asymptomatic, so screening all pregnant women is crucial. Options B, C, and D are incorrect because marital status, history of gonorrhea, or number of sexual partners do not determine the need for HIV screening during pregnancy. HIV screening is recommended universally to ensure the health of both the mother and the baby.
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The nurse admits a laboring patient at term. On review of the prenatal record, the patient's pregnancy has been unremarkable and she is considered low risk. In planning the patient's
- A. the fetal heart rate during the first stage of labor?
- B. Every 10 minutes
- C. Every 15 minutes
- D. Every 30 minutes
Correct Answer: C
Rationale: The correct answer is C: Every 15 minutes. This is the appropriate frequency for monitoring the fetal heart rate during the first stage of labor for a low-risk patient. Monitoring every 15 minutes allows for regular assessment of the baby's well-being without being overly invasive. Monitoring every 10 minutes (choice A) would be too frequent and may lead to unnecessary interventions. Monitoring every 30 minutes (choice D) would be too infrequent and could potentially miss important changes in the fetal heart rate. Choice B is not the correct answer because monitoring every 10 minutes is too frequent for a low-risk patient and could lead to unnecessary interventions and increased stress for the laboring patient.
Shoulder dystocia is difficult to predict. What are thought to be predictors for shoulder dystocia?
- A. estimated birth weight of 4,000 g
- B. gestational diabetes
- C. previous shoulder dystocia
- D. hypertension
Correct Answer: B
Rationale: The correct answer is B: gestational diabetes. Gestational diabetes can lead to larger fetal size, increasing the risk of shoulder dystocia. It is a known risk factor that healthcare providers consider when assessing the likelihood of shoulder dystocia. Estimated birth weight alone (A) may not accurately predict shoulder dystocia. While previous shoulder dystocia (C) is a risk factor, it is not a predictor as it is based on past occurrences. Hypertension (D) is not directly associated with an increased risk of shoulder dystocia.
The nurse is educating a gravida 1 para 0 who is 28 weeks pregnant. Which educational topics are appropriate for the nurse to discuss with the patient at this prenatal visit? Select all that apply.
- A. Discussion of prenatal classes
- B. Discussion of alcohol use
- C. Discussion of family history for pregnancy-induced hypertension
- D. Discussion of signs and symptoms of preterm labor
Correct Answer: B
Rationale: The correct answer is B, Discussion of alcohol use. This topic is important for prenatal education to ensure the well-being of the mother and baby. Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. The other choices are incorrect because:
A: Discussion of prenatal classes is relevant, but not a priority at 28 weeks.
C: Discussion of family history for pregnancy-induced hypertension is important but not usually discussed at every prenatal visit.
D: Discussion of signs and symptoms of preterm labor is crucial, but typically discussed later in pregnancy.
Which nursing action is correct when initiating electronic fetal monitoring?
- A. Lubricate the tocotransducer with an ultrasound gel.
- B. Securely apply the tocotransducer with a strap or belt.
- C. Inform the patient that she should remain in the semi-Fowler position.
- D. Determine the position of the fetus before attaching the electrode to the maternal abdomen.
Correct Answer: D
Rationale: The correct answer is D because determining the position of the fetus before attaching the electrode is crucial for accurate monitoring. This step ensures proper placement, reducing the risk of misinterpretation of data. Lubricating the tocotransducer with gel (A) is unnecessary and may interfere with the signal. Securing the tocotransducer with a strap (B) is important but should come after determining fetal position. Informing the patient to remain in semi-Fowler position (C) is not directly related to the correct initiation of electronic fetal monitoring.
What condition is related to an increased risk for fetal demise?
- A. diabetes
- B. migraine headache
- C. spina bifida
- D. thyroid disorder
Correct Answer: A
Rationale: The correct answer is A: diabetes. Diabetes is associated with an increased risk of fetal demise due to complications such as congenital anomalies, macrosomia, and placental insufficiency. High blood sugar levels can lead to adverse effects on the fetus, including stillbirth. Migraine headache (B) and spina bifida (C) are not directly linked to fetal demise. Thyroid disorders (D) can impact pregnancy outcomes but are not specifically associated with an increased risk of fetal demise.