Nokea
What adverse fetal effect is associated with undernutrition?
- A. hyperglycemia
- B. impaired bone development
- C. cardiovascular disorders
- D. psychiatric disorders
Correct Answer: B
Rationale: The correct answer is B: impaired bone development. Undernutrition during pregnancy can lead to inadequate nutrient supply for fetal bone development. Calcium and other minerals are essential for bone growth. Hyperglycemia (A) is associated with maternal diabetes, not undernutrition. Cardiovascular disorders (C) are more commonly linked to maternal obesity. Psychiatric disorders (D) are not directly caused by undernutrition in the fetus. In summary, impaired bone development is the most direct adverse fetal effect of undernutrition.
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What term describes a spontaneous abortion with no expulsion of the products of conception and a closed cervix?
- A. incomplete abortion
- B. threatened abortion
- C. missed abortion
- D. recurrent abortion
Correct Answer: C
Rationale: The correct answer is C: missed abortion. In a missed abortion, the fetus has died but has not been expelled. The cervix remains closed, and there are no signs of active miscarriage. This term specifically describes the scenario where the pregnancy is no longer viable, but the body has not recognized it yet.
A: Incomplete abortion involves partial expulsion of the products of conception.
B: Threatened abortion signifies a possible miscarriage with ongoing pregnancy.
D: Recurrent abortion refers to multiple consecutive miscarriages.
A patient who had premature rupture of the membranes (PROM) earlier in the pregnancy at 28 weeks returns to the labor unit 1 week later complaining that she is now in labor. The labor and birth nurse performs the following assessments. The vaginal exam is deferred until the physician is in attendance. The patient is placed on electronic fetal monitoring (EFM) and a baseline FHR of 130 bpm is noted. No contraction pattern is observed. The patient is then transferred to the antepartum unit for continued observation. Several hours later, the patient complains that she does not feel the baby move. Examination of the abdomen reveals a fundal height of 34 cm. Muscle tone is no different from earlier in the hospital admission. The patient is placed on the EFM and no fetal heart tones are observed. What does the nurse suspect is occurring?
- A. Placental previa
- B. Active labor has started
- C. Placental abruption
- D. Hidden placental abruption
Correct Answer: D
Rationale: The correct answer is D: Hidden placental abruption. In this scenario, the patient had a history of PROM at 28 weeks, which puts her at risk for placental abruption due to the weakened membranes. The sudden onset of decreased fetal movement and absence of fetal heart tones on EFM indicate a potential emergency. The fundal height of 34 cm suggests the baby is at term, ruling out placental previa or preterm labor. Active labor typically presents with contractions, which are not observed in this case. Placental abruption can be concealed, leading to a sudden decrease in fetal well-being. The nurse should suspect hidden placental abruption and notify the physician immediately for further evaluation and intervention.
A blood-soaked peripad weighs 900 g. The nurse would document a blood loss of _____ mL.
- A. 1800
- B. 450
- C. 900
- D. 90
Correct Answer: C
Rationale: The correct answer is C (900 mL). To calculate blood loss, divide the weight of the blood-soaked pad (900 g) by the specific gravity of blood (1 g/mL). This gives 900 mL. Choice A (1800 mL) is incorrect as it doubles the correct amount. Choice B (450 mL) is incorrect as it halves the correct amount. Choice D (90 mL) is incorrect as it divides the correct amount by 10. The key is to convert the weight to volume using the specific gravity of blood to determine the correct blood loss measurement.
Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the
- A. direct Coombs test of twin A.
- B. direct Coombs test of twin B.
- C. indirect Coombs test of the mother.
- D. transcutaneous bilirubin level for both twins.
Correct Answer: C
Rationale: The correct answer is C, indirect Coombs test of the mother. This test is crucial to determine if the mother has developed antibodies against the Rh-positive blood of twin A. If the test is positive, it indicates sensitization has occurred, making RhoGAM necessary to prevent hemolytic disease in future pregnancies. Direct Coombs tests of the twins (choices A and B) are not relevant in this scenario as they assess for antibodies already attached to the red blood cells. Transcutaneous bilirubin levels (choice D) are used to monitor jaundice, not Rh incompatibility.
Which condition is most commonly associated with late decelerations of the fetal heart rate?
- A. Head compression
- B. Maternal hypothyroidism
- C. Uteroplacental insufficiency
- D. Umbilical cord compression
Correct Answer: C
Rationale: Late decelerations of the fetal heart rate are most commonly associated with uteroplacental insufficiency. During contractions, there is reduced blood flow to the placenta, leading to hypoxia and acidosis in the fetus, resulting in late decelerations. Head compression (A) typically causes early decelerations. Maternal hypothyroidism (B) does not directly affect fetal heart rate. Umbilical cord compression (D) can cause variable decelerations, not late decelerations. Therefore, the correct answer is C.