Nokea
The nurse is screening prenatal clients who may be carriers for potential genetic abnormalities. Which ethnic group should the nurse identify as having the lowest risk for hemoglobinopathies, such as sickle cell disease and thalassemia?
- A. African descent
- B. Southeast Asian descent
- C. Scandinavian descent
- D. Mediterranean descent
Correct Answer: C
Rationale: Individuals of Scandinavian descent are not an identified risk group for hemoglobinopathies. Individuals of African descent are at risk for hemoglobinopathies and should be offered carrier screening. Individuals of Southeast Asian descent are at risk for hemoglobinopathies and should be offered carrier screening. Individuals of Mediterranean descent are at risk for hemoglobinopathies and should be offered carrier screening.
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The nurse identifies which factor as increasing the risk of gestational hypertension?
- A. Low body mass index
- B. Family history of hypertension
- C. First pregnancy at age 20
- D. Vegetarian diet
Correct Answer: B
Rationale: A family history of hypertension increases the risk of gestational hypertension, as genetics play a significant role.
The nurse is caring for the client admitted to the antepartum unit at 32 weeks’ gestation with possible preterm labor. The nurse is performing a fetal fibronectin (fFN) test. Which event, if it occurred, would require the nurse to recollect the specimen?
- A. The specimen is collected before a vaginal examination.
- B. A lubricant was used to facilitate insertion of the swab.
- C. The client reports that she has not had intercourse for 3 days.
- D. The specimen is collected before other specimens are collected.
Correct Answer: B
Rationale: When collecting a fetal fibronectin test swab, the nurse must not use lubricant, as it will interfere with the collection of the specimen and contaminate the specimen. If this occurs, the test will need to be repeated. The specimen needs to be collected before a vaginal examination in order to ensure that the fluids are not contaminated. The client must not have had sexual intercourse within 24 hours of the specimen collection, as semen will contaminate the specimen. The specimen must be collected before other specimens are collected to maintain the integrity of the specimen.
The nurse correctly sends a requisition and specimen for which laboratory test?
- A. Alpha-fetoprotein (AFP)
- B. Corticotropin-releasing hormone (CRH)
- C. Human chorionic gonadotropin (hCG)
- D. Follicle-stimulating hormone (FSH)
Correct Answer: C
Rationale: Human chorionic gonadotropin (hCG) is the hormone tested to confirm pregnancy, as it is produced by the placenta shortly after implantation.
When the nurse discusses the tasks to be accomplished during the client's visit at 24 weeks' gestation, which routine test will be performed?
- A. Coombs' test
- B. Glucose tolerance test
- C. Urinalysis
- D. Rubella titer
Correct Answer: B
Rationale: The glucose tolerance test is routinely performed around 24-28 weeks to screen for gestational diabetes.
The nurse is caring for the antepartum client with a velamentous cord insertion. The client asks what symptom she would most likely experience first if one of the vessels should tear. The nurse should respond that she would most likely experience which symptom first?
- A. Vaginal bleeding
- B. Abdominal cramping
- C. Uterine contractions
- D. Placental abruption
Correct Answer: A
Rationale: In a velamentous cord insertion, vessels of the cord divide some distance from the placenta in the placental membrane. Thus, the most likely first symptom would be vaginal bleeding. Abdominal cramping is unlikely to occur; velamentous cord insertion is not related to uterine activity. Contractions are unlikely to occur; velamentous cord insertion is not related to uterine activity. An abruption, when the placenta comes off the uterine wall, results in severe abdominal pain.