Nokea
Which effect is a common response to both smoking and cocaine use in the pregnant patient?
- A. Vasoconstriction
- B. Increased appetite
- C. Increased metabolism
- D. Changes in insulin metabolism
Correct Answer: A
Rationale: The correct answer is A: Vasoconstriction. Both smoking and cocaine use can lead to vasoconstriction, which is the narrowing of blood vessels. In pregnant patients, this can reduce blood flow to the fetus, leading to potential complications. Increased appetite (B) and increased metabolism (C) are not common responses to both smoking and cocaine use. Changes in insulin metabolism (D) are more commonly associated with conditions like gestational diabetes rather than as a common response to smoking and cocaine use during pregnancy.
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A pregnant patient asks the nurse if she can double her prenatal vitamin dose because she does not like to eat vegetables. What is the nurse's response regarding the danger of taking excessive vitamins?
- A. Increases caloric intake
- B. Has toxic effects on the fetus
- C. Increases absorption of all vitamins
- D. Promotes development of pregnancy-induced hypertension (PIH)
Correct Answer: B
Rationale: The correct answer is B: Has toxic effects on the fetus. Doubling prenatal vitamin dose can lead to excessive intake of certain vitamins like Vitamin A, which can be harmful to the fetus. Excessive vitamins can cause toxicity and harm the developing baby. Other choices are incorrect: A is irrelevant, C is misleading, and D is not related to excessive vitamin intake.
Following the vaginal delivery of a 10-pound infant, the nurse assesses a new mothers vaginal bleeding and finds that she has saturated two pads in 30 minutes and has a boggy uterus. What action should the nurse implement first?
- A. Have the client empty her bladder
- B. Inspect the perineum for lacerations
- C. Increase oxytocin IV infusion
- D. Perform fundal massage until firm
Correct Answer: D
Rationale: Fundal massage (D) helps control bleeding by stimulating uterine contractions.
The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14 ounces, has a head circumference of 13 inches, and a chest circumference of 10 inches. Based on these physical findings, assessment for which condition has the highest priority?
- A. Hyperthermia
- B. Hyperbilirubinemia
- C. Polycythemia
- D. Hypoglycemia
Correct Answer: D
Rationale: Small-for-gestational-age infants are at high risk for hypoglycemia (D).
At the present time, which agency governs surrogate parenting?
- A. State law
- B. Federal law
- C. Individual court decision
- D. Protective child services
Correct Answer: C
Rationale: Surrogacy cases are decided individually in court, as there is no overarching state or federal law governing surrogacy.
A client at 39-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 5 cm, 90% effaced, and the fetus is at 0 station. The client's membranes rupture spontaneously, and the fluid is greenish-brown. What action should the nurse take first?
- A. Assess the fetal heart rate pattern.
- B. Perform a vaginal examination.
- C. Prepare for an emergency cesarean section.
- D. Administer oxygen via face mask.
Correct Answer: A
Rationale: Greenish-brown amniotic fluid indicates meconium-stained fluid, and assessing the fetal heart rate pattern is critical to determine fetal well-being.