Nokea
The nurse working in an outpatient obstetric office assesses four primigravid clients. Which of the client findings should the nurse highlight for the physician? Select all that apply.
- A. 17 weeks’ gestation; denies feeling fetal movement.
- B. 24 weeks’ gestation; fundal height at the umbilicus.
- C. 27 weeks’ gestation; salivates excessively.
- D. 34 weeks’ gestation; experiences uterine cramping.
Correct Answer: A
Rationale: Denial of fetal movement at 17 weeks and uterine cramping at 34 weeks are concerning findings that should be highlighted for further evaluation. Fundal height at the umbilicus at 24 weeks and excessive salivation at 27 weeks are within normal limits.
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The patient who has received a dose of preservative- free morphine (Duramorph) is beginning to experience pruritus. Which medication is used to treat this?
- A. Low-dose naloxone infusion
- B. Diphenhydramine
- C. Dilaudid
- D. Sublimaze
Correct Answer: B
Rationale: The correct answer is B: Diphenhydramine. Pruritus is a common side effect of opioid medications like morphine. Diphenhydramine, an antihistamine, can help relieve itching. Low-dose naloxone infusion (A) is used for opioid overdose, not pruritus. Dilaudid (C) and Sublimaze (D) are other opioid medications similar to morphine, and using them would not address the pruritus. Diphenhydramine is the most appropriate choice to alleviate the itching without interfering with the pain relief provided by the morphine.
A nurse is teaching a lesson on fetal development to a class of high school students and explains the primary germ layers. What are the germ layers? (Select all that apply.)
- A. Ectoderm
- B. Endoderm
- C. Mesoderm
- D. Plastoderm
Correct Answer: A
Rationale: The zygote transforms its embryonic disc into three layers: the ectoderm, the mesoderm, and the endoderm. These layers are responsible for the development of various tissues and organs in the body. Plastoderm and Blastoderm are not part of the primary germ layers.
A nurse is educating a pregnant patient about the importance of iron supplementation during pregnancy. Which statement by the patient indicates effective teaching?
- A. I will take iron supplements daily, even if I feel fine.
- B. I will only take iron supplements if my hemoglobin levels drop.
- C. I will stop taking iron supplements after the second trimester.
- D. I will take iron supplements only when I experience symptoms of anemia.
Correct Answer: A
Rationale: Rationale: Choice A is correct because taking iron supplements daily, even if feeling fine, ensures the patient maintains adequate iron levels throughout pregnancy. Iron is crucial for the mother and baby's health, preventing anemia and complications. Choice B is incorrect as waiting for hemoglobin levels to drop may lead to deficiency. Choice C is incorrect as iron needs remain high throughout pregnancy. Choice D is incorrect as symptoms of anemia indicate an existing deficiency rather than prevention.
A nurse is caring for a postpartum person who is at risk for uterine atony. What is the priority intervention to prevent uterine atony?
- A. administer uterotonic medication
- B. administer an analgesic
- C. perform uterine massage
- D. administer IV fluids
Correct Answer: B
Rationale: The correct answer is B: administer an analgesic. This is the priority intervention because pain management helps the person relax, which reduces stress on the uterus and promotes effective contraction to prevent uterine atony. Administering uterotonic medication (choice A) may help contract the uterus but addressing pain first is crucial. Performing uterine massage (choice C) can assist in contracting the uterus but is not the priority intervention. Administering IV fluids (choice D) is important for hydration but does not directly address preventing uterine atony.
A pregnant patient is at 30 weeks gestation and is concerned about gestational diabetes. Which of the following is a key sign that the nurse should monitor for?
- A. Frequent urination and excessive thirst
- B. Nausea and vomiting after meals
- C. Increased appetite and weight gain
- D. Fatigue and dizziness during physical activity
Correct Answer: A
Rationale: The correct answer is A: Frequent urination and excessive thirst. In gestational diabetes, the body may not be able to produce enough insulin, leading to high blood sugar levels. The excess sugar in the blood can cause increased thirst and frequent urination as the body tries to eliminate the sugar through urine. This is a key sign that the nurse should monitor for in a pregnant patient at 30 weeks gestation. Nausea and vomiting after meals (B) are more commonly associated with morning sickness in early pregnancy. Increased appetite and weight gain (C) can occur during pregnancy but are not specific signs of gestational diabetes. Fatigue and dizziness during physical activity (D) can be common in pregnancy due to hormonal changes and increased demands on the body but are not specific to gestational diabetes.