Nokea
A woman in the first trimester comes to the clinic with vaginal bleeding. The physician determines that the fetus has died and that the placenta, fetus, and tissues still remain in the uterus. How should the findings be documented?
- A. Complete abortion
- B. Stillborn abortion
- C. Missed abortion
- D. Incomplete abortion
Correct Answer: C
Rationale: The correct answer is C: Missed abortion. In a missed abortion, the fetus has died but has not been expelled from the uterus yet. The findings should be documented as a missed abortion because the fetus has not been passed naturally. This is different from a complete abortion (A) where all products of conception have been expelled, a stillborn abortion (B) which is not a recognized medical term, and an incomplete abortion (D) where some products of conception remain in the uterus. Therefore, based on the scenario described, the most appropriate term to document the findings is missed abortion.
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A woman in the transition stage of labor is using paced breathing to relieve pain. She complains of blurred vision, numbness, and tingling of her hands and mouth. Which condition is indicated by these signs and symptoms?
- A. Anoxia
- B. Hyperventilation
- C. Anxiety
- D. Hypertension
Correct Answer: B
Rationale: The correct answer is B: Hyperventilation. The symptoms of blurred vision, numbness, and tingling in the hands and mouth are indicative of hyperventilation. During paced breathing, if the woman breathes too quickly or deeply, it can lead to a decrease in carbon dioxide levels in the blood, causing these symptoms. To address this, the woman should be guided to slow down her breathing and breathe into a paper bag to rebreathe some carbon dioxide. Anoxia (A) is a severe lack of oxygen, which would present with different symptoms. Anxiety (C) may cause similar symptoms but is not the primary issue here. Hypertension (D) does not typically lead to these specific symptoms.
The parents of a 5-month-old infant state that their infant seems to eat very little. Most of the food comes out of the infant's mouth and onto his clothes.
- A. "Give the baby a bottle of formula before solid food to assure adequate caloric intake."'
- B. "Stop the solid foods and try again when the baby is 12 months old."'
- C. "Put the cereal in a bottle and feed the baby through a nipple with a large hole."'
- D. "Place the food in the back of the baby's mouth using a long-handled spoon."'
Correct Answer: D
Rationale: The correct answer is D because at 5 months, infants are typically ready to start experimenting with solid foods. Placing the food in the back of the baby's mouth using a long-handled spoon helps prevent the baby from pushing the food out with their tongue reflex, allowing for more successful feeding. This method also encourages the baby to learn how to swallow solids properly. Choice A is incorrect as giving formula before solid food won't address the feeding issue. Choice B is incorrect as stopping solid foods until 12 months can hinder the baby's developmental milestones. Choice C is incorrect as feeding cereal in a bottle can increase the risk of choking and doesn't address the underlying issue of feeding difficulty.
A nurse is assessing a client who is at 30 wks gestation during a routine prenatal visit. Which of the following findings should the nurse report to the provider?
- A. Swelling of the face
- B. Varicose veins in the calves
- C. Nonpitting 1+ ankle edema
- D. Hyperpigmentation
Correct Answer: A
Rationale: The correct answer is A: Swelling of the face. Facial swelling in a pregnant woman at 30 weeks gestation could be a sign of preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. It is important to report this finding promptly to the provider for further evaluation and management to prevent complications for both the mother and the baby. Varicose veins in the calves (B) and hyperpigmentation (D) are common in pregnancy but are not urgent issues requiring immediate reporting. Nonpitting 1+ ankle edema (C) is a common finding in pregnancy but is not as concerning as facial swelling. Make sure to report any change in the severity of edema.
For a client in the second trimester of pregnancy, which assessment data support a diagnosis of pregnancy-induced hypertension (PIH)?
- A. Hemoglobin 10.2 mg/dL and uterine tenderness
- B. Polyuria and weight loss of 3 pounds in the last month
- C. Blood pressure 168/110 and 3+ proteinuria
- D. Hematuria and blood glucose of 160 mg/dL
Correct Answer: C
Rationale: The correct answer is C: Blood pressure 168/110 and 3+ proteinuria. Pregnancy-induced hypertension (PIH) is characterized by high blood pressure (systolic ≥140 mmHg and/or diastolic ≥90 mmHg) and proteinuria. In this case, the blood pressure reading of 168/110 indicates hypertension, and 3+ proteinuria indicates significant protein in the urine, both of which are key diagnostic criteria for PIH.
A: Hemoglobin 10.2 mg/dL and uterine tenderness - These are not specific indicators of PIH.
B: Polyuria and weight loss of 3 pounds in the last month - These symptoms are not typically associated with PIH.
D: Hematuria and blood glucose of 160 mg/dL - Hematuria suggests blood in the urine, which is not a typical finding in PIH, and elevated blood glucose is more indicative of diabetes rather than PIH.
Therefore,
During the active phase of labor, the membranes rupture and the nurse notes green amniotic fluid. Which nursing action should be initiated immediately?
- A. Call the physician.
- B. Replace the soiled underpad.
- C. Test the fluid with pH (Nitrazine) paper.
- D. Assess fetal heart rate.
Correct Answer: D
Rationale: The correct answer is D: Assess fetal heart rate. This is important because green amniotic fluid indicates meconium staining, which can be a sign of fetal distress. Assessing the fetal heart rate immediately will help determine the baby's well-being. Calling the physician (choice A) may be necessary but assessing the fetal heart rate should be the priority. Replacing the underpad (choice B) can wait until after assessing the fetal heart rate. Testing the fluid with pH paper (choice C) may confirm the presence of meconium but assessing the fetal heart rate is more urgent.