Nokea
The nurse is explaining fetal circulation to a group of nursing students. Which information should be included in the teaching session? (Select all that apply.)
- A. After birth the ductus venosus remains open, but the other shunts close
- B. The foramen ovale shunts blood from the right atrium to the left atrium.
- C. The ductus venosus shunts blood from the liver to the inferior vena cava
- D. The ductus venosus shunts blood from the liver to the inferior vena cav
Correct Answer: C
Rationale: The correct answer is C: The ductus venosus shunts blood from the liver to the inferior vena cava. During fetal circulation, the ductus venosus allows oxygenated blood from the placenta to bypass the liver and flow directly into the inferior vena cava. This is important for fetal circulation as the liver is not fully functional in the fetus. After birth, the ductus venosus closes as the liver becomes fully operational.
Rationale for incorrect choices:
A: After birth, the ductus venosus closes, not remains open.
B: The foramen ovale shunts blood from the right atrium to the left atrium, not related to the ductus venosus.
D: This choice is a repetition of the correct information but incorrectly states the destination of the shunted blood.
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A female patient is concerned about an inability to become pregnant after trying for 1 year. Which information collected during a health history causes the nurse the greatest amount of concern about possible infertility?
- A. The patient works as a ballroom dance instructor.
- B. The patient is turning 37 years old this year.
- C. The patient has hot flashes and mood swings.
- D. The patient was treated for a pelvic inflammatory disease while in college.
Correct Answer: C
Rationale: The correct answer is C because hot flashes and mood swings can indicate hormonal imbalances, which are common causes of infertility. This symptom suggests potential issues with ovulation or other reproductive system functions. Choice A is irrelevant to infertility. Choice B, age alone does not indicate infertility. Choice D, a history of pelvic inflammatory disease can cause infertility, but symptoms indicating current hormonal imbalances are of more immediate concern.
Identify the health care provided during a home birth. Select all that apply.
- A. labor support
- B. trained birth attendant
- C. neonatal intensive care
- D. breast-feeding assistance
Correct Answer: C
Rationale: The correct answer is C: neonatal intensive care. This is because during a home birth, neonatal intensive care is not provided as it requires specialized medical equipment and expertise typically only available in hospitals. Labor support (A) and trained birth attendant (B) are essential for home births. Breastfeeding assistance (D) may be provided post-birth but is not a defining feature of care during a home birth.
Why do infants born at 25 weeks' gestation have a poor survival rate?
- A. Cardiac development is incomplete.
- B. Fetal lung alveoli are not present in sufficient numbers.
- C. Gastrointestinal development is incomplete.
- D. Sucking reflex is not present.
Correct Answer: B
Rationale: The correct answer is B because infants born at 25 weeks' gestation have a poor survival rate due to insufficient numbers of fetal lung alveoli. This leads to respiratory distress and difficulty in oxygen exchange, impacting their chances of survival. Choice A is incorrect as cardiac development is not the primary factor affecting survival. Choice C is incorrect as gastrointestinal development does not directly impact survival at this stage. Choice D is incorrect as the sucking reflex is not a critical factor in survival compared to respiratory function.
A 27-year-old patient presents with injuries sustained in a motor vehicle accident. She was wearing her seatbelt and has multiple bruises and scrapes along her abdomen. She complains of pain 3/10 in her abdomen. She is G1P0 and is at 14 weeks’ gestation. A bedside ultrasound scan confirms that the fetus is stable and not in any distress. The patient is Rh negative, and her husband is Rh positive. What do you anticipate being the next step?
- A. Obtain a urinalysis.
- B. Administer Rh(D) immune globulin (RhoGAM).
- C. Confirm with the provider that she can be discharged home.
- D. Schedule a follow-up ultrasound.
Correct Answer: B
Rationale: The correct answer is B: Administer Rh(D) immune globulin (RhoGAM). In this scenario, the patient is Rh negative and her husband is Rh positive, which puts her at risk for Rh isoimmunization. Administration of Rh(D) immune globulin (RhoGAM) helps prevent the mother's immune system from developing antibodies against the Rh-positive fetus's blood, thereby protecting future pregnancies. This intervention is crucial in preventing hemolytic disease of the newborn.
Choice A: Obtaining a urinalysis is not indicated in this case as the patient's main concern is her abdominal pain and pregnancy status, not related to her urinalysis.
Choice C: Discharging the patient without administering Rh(D) immune globulin would be inappropriate as it puts future pregnancies at risk of complications due to Rh incompatibility.
Choice D: Scheduling a follow-up ultrasound is not the immediate next step. Administering Rh(D) immune globulin is the priority to
The nurse caring for the laboring woman should know that meconium is produced by:
- A. Fetal intestines.
- B. Fetal kidneys.
- C. Amniotic fluid.
- D. The placenta.
Correct Answer: A
Rationale: As the fetus nears term, fetal waste products accumulate in the intestines as dark green-to-black, tarry meconium.