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A patient 11 weeks' gestation comes to the emergency room department with c/o dizziness, abdominal pain, and shoulder pain. Lab tests reveal a beta-hcg lower than expected level for gestational age
- A. Ultrasound confirms no intrauterine
- B. The nurse knows the most likely diagnostic is an ectopic pregnancy. What statement should the nurse use to explain to the patient?
- C. The baby is in the fallopian tube, the tube has ruptured and is causing bleeding
Correct Answer: B
Rationale: Step 1: Recognize Symptoms - Dizziness, abdominal pain, shoulder pain, low beta-hcg.
Step 2: Consider Ectopic Pregnancy - Symptoms align with ectopic pregnancy.
Step 3: Rule Out Miscarriage - Low beta-hcg indicates not viable intrauterine pregnancy (Choice A).
Step 4: Understand Ectopic Pregnancy - Explaining ectopic pregnancy (Choice C) and rupture to patient may cause distress.
Step 5: Communicate - Nurse should use simple, empathetic statement (Choice B) to explain the likely diagnosis.
Summary: Choice B is correct as it addresses the likely diagnosis without causing undue distress to the patient, unlike Choices A and C which may lead to confusion and anxiety.
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The nurse is teaching a client about foods rich in folic acid during pregnancy. Which food should the nurse recommend?
- A. Citrus fruits.
- B. Lean meats.
- C. Dairy products.
- D. Whole grains.
Correct Answer: A
Rationale: The correct answer is A, citrus fruits. Folic acid is important for fetal development and helps prevent birth defects. Citrus fruits like oranges, grapefruits, and lemons are rich sources of folic acid. They provide the necessary nutrients for a healthy pregnancy. Lean meats (B) are good sources of protein but not specifically high in folic acid. Dairy products (C) are important for calcium but do not contain significant amounts of folic acid. Whole grains (D) are beneficial for fiber and nutrients, but they are not the best source of folic acid compared to citrus fruits.
In planning sex education classes for the middle school age group, more emphasis should be placed on
- A. how to set limits for sexual behavior.
- B. the inaccuracy of information from peers.
- C. the use of oral contraceptives to prevent unwanted pregnancy.
- D. the use of condoms to prevent sexually transmitted diseases as well as pregnancy.
Correct Answer: D
Rationale: The correct answer is D because emphasizing the use of condoms is crucial for preventing both sexually transmitted diseases and pregnancy among middle school students who may engage in sexual activity. Condoms are the most effective method for dual protection at this age. Choice A focuses on setting limits but may not address the practical aspect of protection. Choice B is important but not as critical as ensuring proper protection. Choice C is not suitable for this age group due to legal and ethical considerations.
The nurse would classify a newborn delivered at 39 weeks' gestation, weighing 2400 g ( 5.0 lbs) as being:
- A. Preterm and immature
- B. Small-for-gestational age
- C. Average-for-gestational age
- D. Average-for-gestational age but pre-term
Correct Answer: B
Rationale: The correct answer is B: Small-for-gestational age. A newborn delivered at 39 weeks' gestation and weighing 2400g is considered small-for-gestational age because the weight is below the 10th percentile for the gestational age. This indicates intrauterine growth restriction. Preterm and immature (choice A) would not apply as the baby was delivered at term. Average-for-gestational age (choice C) would not be accurate as the baby's weight is below the normal range for that gestational age. Choice D is also incorrect as the baby is not within the average weight range for the gestational age.
The nurse is assessing a client in the third trimester with suspected placental abruption. What finding supports this diagnosis?
- A. Painless bright red bleeding.
- B. Boardlike abdomen and severe pain.
- C. Soft, relaxed uterus.
- D. Increased fetal movement.
Correct Answer: B
Rationale: The correct answer is B: Boardlike abdomen and severe pain. This finding supports the diagnosis of placental abruption because it indicates a significant and sudden separation of the placenta from the uterine wall, leading to intense pain and rigidity of the abdomen due to internal bleeding. Painless bright red bleeding (choice A) is more indicative of placenta previa, not placental abruption. A soft, relaxed uterus (choice C) is not typical in placental abruption, which usually presents with uterine tenderness and rigidity. Increased fetal movement (choice D) is not specific to placental abruption and can occur in various pregnancy conditions.
In addition to the bolus of fluid which medication should she be given to increase blood pressure?
- A. Ephedrine
- B. Terbutaline
- C. Epinephrine
- D. Epifoam
Correct Answer: A
Rationale: The correct answer is A: Ephedrine. Ephedrine is a sympathomimetic amine that acts on alpha and beta adrenergic receptors to increase blood pressure. It is commonly used to treat hypotension. Terbutaline (B) and Epinephrine (C) are bronchodilators that can lower blood pressure. Epifoam (D) is a topical medication for skin conditions and does not affect blood pressure. Therefore, Ephedrine is the most appropriate choice to increase blood pressure in this scenario.