Nokea
The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks’ gestation. What sample will be collected for the initial screening process?
- A. Urine
- B. Blood
- C. Saliva
- D. Amniotic fluid
Correct Answer: B
Rationale: AFP screening is done using a blood sample, which is less invasive than an amniocentesis.
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A nurse is preparing a laboring person for an epidural. What is the most important nursing action prior to the procedure?
- A. ensure the birthing person is in a sitting position
- B. check for allergies to anesthesia
- C. ensure informed consent is obtained
- D. administer IV fluids
Correct Answer: C
Rationale: The correct answer is C: ensure informed consent is obtained. Prior to any medical procedure, including epidural administration, it is crucial to obtain informed consent from the patient. This involves explaining the procedure, risks, benefits, and alternatives to the patient, ensuring they understand and voluntarily agree to the procedure. Without informed consent, the procedure cannot proceed ethically.
Choice A (ensure the birthing person is in a sitting position) is not the most important action as the position can be adjusted during the procedure. Choice B (check for allergies to anesthesia) is important but obtaining informed consent takes precedence. Choice D (administer IV fluids) is not a priority before obtaining informed consent.
What alternative could the nurse suggest to someone practicing pica?
- A. Replace laundry starch with salt
- B. Replace ice with frozen fruit juice
- C. Replace soap with cream cheese
- D. Replace soil with uncooked pie crust
Correct Answer: B
Rationale: Replacing ice with frozen fruit juice provides a safer alternative while satisfying the craving for cold substances.
A couple is preparing to interview obstetric primary care providers to determine who they will go to for care during their pregnancy and delivery.
- A. Take a tour of hospital delivery areas.
- B. Develop a preliminary birth plan.
- C. Make appointments with three or four obstetric care providers.
- D. Search the Internet for the malpractice histories of the providers.
Correct Answer: B
Rationale: Developing a preliminary birth plan helps couples clarify their preferences and priorities, facilitating better communication with potential providers.
A nurse is assisting with a vaginal delivery. What is the most important action to take when the fetal head crowns?
- A. apply gentle downward pressure
- B. assist with shoulder delivery
- C. assist with perineal massage
- D. administer pain relief
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This action helps prevent rapid delivery, reducing the risk of perineal tearing and ensuring a controlled birth. Applying too much pressure can cause trauma to the mother and baby. Incorrect choices: B is premature, as shoulder delivery should only be done after the head and shoulders are delivered. C is not the most important action at crowning. D is not necessary at this specific stage of delivery.
The nurse is caring for a pregnant patient who has been diagnosed with gestational diabetes. Which of the following interventions should be implemented first?
- A. Administer insulin to control blood glucose levels.
- B. Instruct the patient to follow a diabetic diet and monitor blood glucose levels.
- C. Schedule a cesarean delivery due to the risk of macrosomia.
- D. Start the patient on antihypertensive medications to control blood pressure.
Correct Answer: B
Rationale: The correct answer is B because instructing the patient to follow a diabetic diet and monitor blood glucose levels is the initial intervention for managing gestational diabetes. This step is crucial in controlling blood glucose levels and preventing complications for both the mother and the baby. Administering insulin (option A) may be necessary but is not the first step. Scheduling a cesarean delivery (option C) is not indicated unless there are specific obstetric indications. Starting the patient on antihypertensive medications (option D) is not relevant for managing gestational diabetes unless the patient also has hypertension.