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: An open neural tube allows a high level of AFP to seep into the amniotic fluid and enter maternal serum, indicating a neural tube defect.
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Which of the following findings in an 8-week gestation client, G2 P1001, should the nurse highlight for the nurse midwife? Select all that apply.
- A. Body mass index of 17 kg/m².
- B. Rubella titer of 1:8.
- C. Blood pressure of 100/60 mm Hg.
- D. Hematocrit of 30%.
Correct Answer: A
Rationale: A low BMI, low rubella titer, and low hematocrit are all concerning findings that should be highlighted for further evaluation. A blood pressure of 100/60 mm Hg is within normal limits.
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 opioids like morphine. Diphenhydramine, an antihistamine, can help alleviate itching by blocking histamine receptors. Low-dose naloxone infusion (A) is used to reverse opioid overdose, not treat pruritus. Dilaudid (C) and Sublimaze (D) are also opioids and would not be effective in treating pruritus caused by morphine. Diphenhydramine is the most appropriate choice for addressing this specific symptom.
A postpartum person is breastfeeding her newborn. What is the most important factor for successful breastfeeding in the early postpartum period?
- A. encourage frequent feeding
- B. encourage skin-to-skin contact
- C. support the baby's latch
- D. support early initiation of breastfeeding
Correct Answer: B
Rationale: The correct answer is B: encourage skin-to-skin contact. Skin-to-skin contact in the early postpartum period promotes bonding, regulates the baby's body temperature, and encourages successful breastfeeding by stimulating the baby's natural feeding instincts. It also helps in establishing a strong emotional connection between the parent and the newborn. Encouraging frequent feeding (choice A) is important, but skin-to-skin contact is crucial for successful breastfeeding initiation. Supporting the baby's latch (choice C) is essential, but skin-to-skin contact precedes and aids in achieving a proper latch. While supporting early initiation of breastfeeding (choice D) is beneficial, skin-to-skin contact enhances the initiation process and overall breastfeeding success.
A nurse is caring for a postpartum person who is at risk for hemorrhage. What is the most appropriate action to prevent postpartum hemorrhage?
- A. monitor vital signs
- B. administer uterotonic medications
- C. assess uterine tone
- D. perform fundal massage
Correct Answer: B
Rationale: The correct answer is B: administer uterotonic medications. Administering uterotonic medications helps prevent postpartum hemorrhage by promoting uterine contractions, which helps to control bleeding. The step-by-step rationale for this answer is as follows: 1. Uterotonic medications, such as oxytocin or misoprostol, are recommended as a prophylactic measure to prevent postpartum hemorrhage. 2. These medications help the uterus to contract, which compresses blood vessels and reduces the risk of excessive bleeding. 3. Administering uterotonic medications is a proactive approach to managing postpartum hemorrhage in high-risk individuals. Summary: Monitoring vital signs (choice A) is important but does not directly prevent hemorrhage. Assessing uterine tone (choice C) is helpful but may not be sufficient in preventing hemorrhage. Performing fundal massage (choice D) can help manage hemorrhage but is not as effective as administering ut
The nurse is caring for a pregnant patient who is 36 weeks gestation and is concerned about preterm labor. Which of the following is a key sign of preterm labor?
- A. Regular contractions every 10 minutes or less
- B. Decreased fetal movement
- C. Mild cramping and back pain
- D. Increased energy levels and appetite
Correct Answer: A
Rationale: The correct answer is A: Regular contractions every 10 minutes or less. This is a key sign of preterm labor because regular contractions at this frequency could indicate the onset of labor before the full term. Contractions help to thin and dilate the cervix, leading to the birth of the baby. Decreased fetal movement (B) is a concerning sign but not a definitive indicator of preterm labor. Mild cramping and back pain (C) can be common in pregnancy and may not necessarily indicate preterm labor. Increased energy levels and appetite (D) are not typical signs of preterm labor, as the body usually shows signs of preparing for labor rather than increased energy levels.