Nokea
The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine whether the fetus has which condition?
- A. Hemophilia
- B. Sickle cell anemia
- C. A neural tube defect
- D. Abnormal lecithin-to-sphingomyelin ratio
Correct Answer: C
Rationale: The correct answer is C: A neural tube defect. Elevated AFP levels in maternal serum are indicative of neural tube defects in the fetus. AFP is produced by the fetal liver and yolk sac, and high levels may suggest a defect in the development of the neural tube. Hemophilia (A), sickle cell anemia (B), and abnormal lecithin-to-sphingomyelin ratio (D) do not directly correlate with AFP levels. Hemophilia is a genetic blood disorder, sickle cell anemia is a genetic blood disorder affecting hemoglobin, and abnormal lecithin-to-sphingomyelin ratio is related to fetal lung maturity.
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The nurse is performing Leopold's maneuvers on a pregnant patient at 36 weeks of gestation and determines the fetal lie is longitudinal, palpates the fetal legs in the top of the uterus, and palpates the fetal head above the symphysis pubis. Which fetal presentation does the nurse document in the EHR?
- A. cephalic
- B. compound
- C. transverse
- D. breech
Correct Answer: D
Rationale: The correct answer is D: breech. At 36 weeks of gestation, if the nurse palpates the fetal head above the symphysis pubis and the fetal legs are at the top of the uterus, it indicates a breech presentation where the baby's buttocks or feet are positioned to be delivered first. In a breech presentation, the fetal head is not engaged in the pelvis and is palpable above the symphysis pubis. The longitudinal lie with the fetal legs on top further supports the breech presentation.
Summary:
A: Cephalic presentation would have the fetal head engaged in the pelvis.
B: Compound presentation involves an additional body part alongside the presenting part.
C: Transverse lie would have the baby positioned horizontally across the uterus.
D: Breech presentation aligns with the given scenario of palpating fetal legs on top and head above the symphysis pubis.
The mother of a neonate with Down syndrome wishes to breastfeed. Which of the following considerations should the nurse make in relation to the mother’s wishes?
- A. The mother should be encouraged to feed expressed breast milk via a bottle.
- B. Down syndrome babies consume more calories than unaffected neonates.
- C. Because of the weight of the neonatal head, the side-lying position must be used.
- D. The baby will likely have a weak suck due to congenitally poor muscle tone.
Correct Answer: D
Rationale: Babies with Down syndrome often have hypotonia, which can affect their ability to suck effectively during breastfeeding.
Use Naegele's rule to determine the EDD (estimated day of birth) for a patient whose last menstrual period started on April 12.
- A. 19-Feb
- B. 19-Jan
- C. 21-Jan
- D. 7-Feb
Correct Answer: B
Rationale: To calculate EDD using Naegele's rule, add 7 days to the first day of the last menstrual period, then count back 3 months and add 1 year. For this question, starting with April 12, adding 7 days gives April 19. Counting back 3 months gives January 19 of the following year. Therefore, the estimated day of birth (EDD) is January 19. Choice B (19-Jan) is correct.
Choice A (19-Feb): Incorrect as it does not follow the correct calculation method for Naegele's rule.
Choice C (21-Jan): Incorrect as the calculation does not match the steps of Naegele's rule.
Choice D (7-Feb): Incorrect as it does not align with the correct application of Naegele's rule.
For which patient would an L/S ratio of 2:1 potentially be considered abnormal?
- A. A 38-year-old gravida 2, para 1, who is 38 weeks' gestation
- B. A 24-year-old gravida 1, para 0, who has diabetes
- C. A 44-year-old gravida 6, para 5, who is at term
- D. An 18-year-old gravida 1, para 0, who is in early labor at term
Correct Answer: B
Rationale: The correct answer is B. An L/S ratio of 2:1 is indicative of fetal lung maturity. This means that the lungs of the fetus are likely mature enough to function outside the womb. In choice B, the patient is 24 years old with diabetes, a condition that can affect fetal lung development, making it crucial to assess lung maturity.
Choice A is less likely to have abnormal lung maturity at 38 weeks' gestation. Choice C, a 44-year-old gravida 6, para 5, is more likely to have mature fetal lungs due to multiple pregnancies. Choice D, an 18-year-old in early labor at term, may not necessarily have abnormal lung maturity as she is at term and in labor.
The nurse is obtaining the first postpartum meal for a client who has stated that she practices Mormonism (the Church of Jesus Christ of Latter-Day Saints). Which of the following items should the nurse remove from the clients’ food tray?
- A. Caffeinated coffee.
- B. Cheeseburger.
- C. Fried fish.
- D. Pork sausage.
Correct Answer: A
Rationale: Mormons typically avoid caffeinated beverages as part of their religious practices.