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What is the difference between a complete abortion and an incomplete abortion?
- A. In a complete abortion, the uterus is empty, while in an incomplete abortion, some products of conception are still present in the uterus.
- B. In a complete abortion, the cervix dilates, while in an incomplete abortion, the cervix remains closed.
- C. In a complete abortion, the patient experiences minimal to no signs or symptoms of miscarriage, while in an incomplete abortion, the patient experiences persistent bleeding, cramping, or abdominal pain.
- D. In a complete abortion, the fetus is delivered through the birth canal, while in an incomplete abortion, the fetus is removed through medical or surgical intervention.
Correct Answer: A
Rationale: The correct answer is A because in a complete abortion, the uterus is empty, indicating that all products of conception have been expelled. In contrast, in an incomplete abortion, some products of conception remain in the uterus, leading to ongoing bleeding and cramping. Choice B is incorrect because cervical dilation is not the defining factor between complete and incomplete abortions. Choice C is incorrect as both complete and incomplete abortions can present with symptoms of miscarriage. Choice D is incorrect because the method of fetal removal does not differentiate between complete and incomplete abortions.
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Examination of a newborn in the birth room reveals bilateral cataracts. Which disease process in the maternal history would likely cause this abnormality?
- A. Rubella
- B. Cytomegalovirus (CMV)
- C. Syphilis
- D. HIV
Correct Answer: A
Rationale: The correct answer is A: Rubella. Rubella infection during pregnancy can lead to congenital rubella syndrome, which includes bilateral cataracts in newborns. Rubella virus can cross the placenta and affect the developing fetus, leading to various congenital abnormalities. The other choices, B: CMV, C: Syphilis, and D: HIV, can also cause congenital abnormalities but are not specifically associated with bilateral cataracts in newborns. Rubella is the most likely cause in this scenario based on the clinical presentation.
Anti-infective prophylaxis is indicated for a pregnant patient with a history of mitral valve stenosis related to rheumatic heart disease because the patient is at risk of developing
- A. hypertension.
- B. postpartum infection.
- C. bacterial endocarditis.
- D. upper respiratory infections.
Correct Answer: C
Rationale: The correct answer is C: bacterial endocarditis. Pregnant patients with mitral valve stenosis are at increased risk for developing bacterial endocarditis due to the presence of abnormal valve structures. This condition can lead to serious complications including septic emboli and heart failure. Hypertension (choice A) is not directly related to mitral valve stenosis. Postpartum infection (choice B) is not a primary concern in this scenario. Upper respiratory infections (choice D) are not specifically associated with mitral valve stenosis. In summary, anti-infective prophylaxis is indicated to prevent bacterial endocarditis in pregnant patients with a history of mitral valve stenosis.
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on which of the following?
- A. Hemorrhage is the primary concern.
- B. She will be unable to conceive in the future.
- C. Bed rest and analgesics are the recommended treatment.
- D. A D&C will be performed to remove the products of conception.
Correct Answer: A
Rationale: The correct answer is A: Hemorrhage is the primary concern. In an ectopic pregnancy, the fertilized egg implants outside the uterus, typically in the fallopian tube, which can lead to life-threatening internal bleeding. Nursing care focuses on monitoring for signs of hemorrhage, such as abdominal pain, vaginal bleeding, and signs of shock. Prompt intervention is crucial to prevent serious complications.
Explanation of why the other choices are incorrect:
B: She will be unable to conceive in the future - This statement is not true as having an ectopic pregnancy does not necessarily impact future fertility.
C: Bed rest and analgesics are the recommended treatment - Bed rest and analgesics are not the primary treatments for ectopic pregnancy, as surgical intervention is often necessary.
D: A D&C will be performed to remove the products of conception - A D&C is not typically performed for ectopic pregnancy management, as it involves the removal of tissue from inside the uterus, not the fallopian
As the triage nurse in the emergency room, you are reviewing results for the high-risk obstetric patient who is in labor because of traumatic injury experienced as a result of a motor vehicle accident (MVA). You note that the Kleihauer–Betke test is positive. Based on this information, you anticipate that
- A. immediate birth is required.
- B. the patient should be transferred to the critical care unit for closer observation.
- C. RhoGAM should be administered.
- D. a tetanus shot should be administered.
Correct Answer: A
Rationale: The correct answer is A: immediate birth is required. The positive Kleihauer–Betke test indicates fetal-maternal hemorrhage, where fetal blood enters the maternal circulation. This can lead to fetal-maternal transfusion, causing fetal anemia. Immediate birth is necessary to assess and manage potential fetal distress, such as anemia and hypoxia, due to the trauma from the MVA.
Choices B, C, and D are incorrect:
B: Transferring to critical care unit is not the immediate priority. The focus should be on addressing the fetal distress.
C: RhoGAM is given to Rh-negative mothers to prevent Rh sensitization, but it is not directly related to the positive Kleihauer–Betke test result.
D: Tetanus shot administration is important for tetanus prevention, but it is not the priority in this case where immediate birth is required due to fetal-maternal hemorrhage.
A pregnant client with a history of preterm labor is at home on bed rest. Which instruction would be included in this client's teaching plan?
- A. Place blocks under the foot of the bed.
- B. Sit upright with several pillows behind the back.
- C. Lie on the side with the head raised on a small pillow.
- D. Assume the knee-chest position at regular intervals throughout the day.
Correct Answer: C
Rationale: The correct answer is C: Lie on the side with the head raised on a small pillow. This position helps improve circulation to the uterus and placenta, reducing the risk of preterm labor. Lying on the left side also promotes optimal blood flow. Option A is incorrect as elevating the foot of the bed can decrease blood flow to the placenta. Option B may cause discomfort and increase pressure on the cervix. Option D is not suitable for bed rest as it involves being on all fours, which is not conducive to rest and relaxation.