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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Which action by the nurse best ensures that an accurate fetal heart rate is obtained?
- A. Assess the fetal heart rate when the client is lying on her right side.
- B. Assess the fetal heart rate when the client reports fetal movement.
- C. Assess the fetal heart rate between Braxton Hicks contractions.
- D. Assess the maternal pulse and fetal heart rate, and compare the two.
Correct Answer: D
Rationale: Comparing maternal pulse with fetal heart rate ensures the nurse is not mistaking the maternal pulse for the fetal heartbeat.
The nurse is reviewing the medication history of the client during preconception counseling. The client reports taking isotretinoin for acne. Which is the nurse’s best response?
- A. “Stop taking isotretinoin now! It can cause serious birth defects if you become pregnant.”
- B. “You need to be on some type of birth control right now. Getting pregnant is not an option.”
- C. “Talk with your HCP about changing isotretinoin before you consider becoming pregnant.”
- D. “Once you are off of isotretinoin for treating acne, you can then safely become pregnant.”
Correct Answer: C
Rationale: The best response is to have the client consult her HCP so another medication can be prescribed. This response indicates that isotretinoin (Accutane) is not safe but that alternative medications can be prescribed. Responding to the client emphatically can create anxiety and fear. Telling the client that getting pregnant is not an option is a paternal response and does not facilitate open communication. Clients must wait one month after cessation of isotretinoin before becoming pregnant.
How many factors in this scenario place the client at risk for nutritional deficiencies and the need for dietary guidance and counseling?
- A. Three
- B. Four
- C. Five
- D. Six
Correct Answer: C
Rationale: Five risk factors: adolescence, skipping meals, fast food diet, alcohol consumption, and weight gain concerns increase nutritional deficiency risk.
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 explains to the group that the most important condition related to frequent urination during pregnancy is related to what factor?
- A. Loss of bladder tone in the mother
- B. The presence of a urinary tract infection
- C. The enlarging uterus exerting pressure on the bladder
- D. The growing fetus excreting increased amounts of waste
Correct Answer: C
Rationale: The enlarging uterus presses on the bladder, causing frequent urination, especially in early and late pregnancy.