Nokea
What is the purpose of chorionic villus sampling (CVS) in the first trimester?
- A. to measure the amount of amniotic fluid
- B. to confirm pregnancy
- C. to assess the risk of chromosomal abnormalities in the fetus
- D. to assess for potential maternal infection
Correct Answer: C
Rationale: Rationale: CVS is done in the first trimester to assess the risk of chromosomal abnormalities in the fetus by obtaining a sample of cells from the placenta. This allows for genetic testing to detect conditions such as Down syndrome. Other choices are incorrect as CVS is not used to measure amniotic fluid quantity (A), confirm pregnancy (B), or assess maternal infection (D).
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A 27-year-old patient presents with injuries sustained in a motor vehicle accident. She was wearing her seatbelt and has multiple bruises and scrapes along her abdomen. She complains of pain 3/10 in her abdomen. She is G1P0 and is at 14 weeks’ gestation. A bedside ultrasound scan confirms that the fetus is stable and not in any distress. The patient is Rh negative, and her husband is Rh positive. What do you anticipate being the next step?
- A. Obtain a urinalysis.
- B. Administer Rh(D) immune globulin (RhoGAM).
- C. Confirm with the provider that she can be discharged home.
- D. Schedule a follow-up ultrasound.
Correct Answer: B
Rationale: The correct answer is B: Administer Rh(D) immune globulin (RhoGAM). In this scenario, the patient is Rh negative and her husband is Rh positive, which puts her at risk for Rh isoimmunization. Administration of Rh(D) immune globulin (RhoGAM) helps prevent the mother's immune system from developing antibodies against the Rh-positive fetus's blood, thereby protecting future pregnancies. This intervention is crucial in preventing hemolytic disease of the newborn.
Choice A: Obtaining a urinalysis is not indicated in this case as the patient's main concern is her abdominal pain and pregnancy status, not related to her urinalysis.
Choice C: Discharging the patient without administering Rh(D) immune globulin would be inappropriate as it puts future pregnancies at risk of complications due to Rh incompatibility.
Choice D: Scheduling a follow-up ultrasound is not the immediate next step. Administering Rh(D) immune globulin is the priority to
A patient at 13 weeks gestation asks the nurse how her baby is nourished during pregnancy. Which information does the nurse use to explain the process to the mother?
- A. Fetal waste products and CO2 pass through the placenta to the mother.
- B. The placenta is a special organ developed to create nutrients and oxygen.
- C. The mother’s blood and fetus’s blood mix for an exchange of nutrients.
- D. Glucose, amino acids, and oxygen pass through the placenta from mother to baby.
Correct Answer: D
Rationale: Step-by-step rationale for choice D being correct:
1. Glucose, amino acids, and oxygen are essential nutrients for fetal growth.
2. These nutrients pass through the placenta from the mother's blood to the baby's blood.
3. This exchange occurs via diffusion and active transport processes.
4. The placenta acts as a barrier, filtering out harmful substances like waste products and CO2.
5. This process ensures the baby receives necessary nutrients for development.
Summary of why other choices are incorrect:
A: Fetal waste products and CO2 pass from the baby to the mother, not the other way around.
B: The placenta facilitates nutrient and oxygen exchange but does not create them.
C: The mother's and baby's blood do not mix; exchange of nutrients occurs through the placental barrier.
What is an example of a statement by the patient that indicates effective teaching by the nurse about methods to improve fertility?
- A. “Caffeine does not affect my fertility.”
- B. “I should start taking prenatal vitamins to increase my chances of conception.”
- C. “My partner should avoid any exercise while we are trying to conceive to avoid damaging the sperm.”
- D. “Smoking can increase my risk of miscarriage.”
Correct Answer: D
Rationale: The correct answer is D because it accurately reflects the nurse's teaching on fertility. Smoking is known to have negative effects on fertility and can increase the risk of miscarriage. This statement shows that the patient has understood the information provided by the nurse regarding factors that could impact fertility.
A is incorrect because caffeine can actually affect fertility. B is incorrect because while taking prenatal vitamins is beneficial, it does not directly address fertility improvement. C is incorrect as exercise is generally beneficial for fertility and does not necessarily harm sperm.
The nurse is assessing a newborn immediately after birth. After assigning the first Apgar score
of 9, the nurse notes two vessels in the umbilical cord. What is the nurse’s next action?
- A. Assess for other abnormalities of the infant.
- B. Note the assessment finding in the infant’s chart.
- C. Notify the health care provider of the assessment finding.
- D. Call for the neonatal resuscitation team to attend the infant immediately.
Correct Answer: A
Rationale: The correct answer is A. The nurse should assess for other abnormalities of the infant because the presence of two vessels in the umbilical cord (a condition known as a two-vessel cord) may be associated with other congenital anomalies. By assessing for other abnormalities, the nurse can identify any potential issues that may require immediate intervention or further evaluation. This proactive approach ensures the newborn's well-being and allows for timely management of any additional concerns.
Summary of other choices:
B: Noting the finding in the chart is important but does not address the immediate need to assess for other abnormalities.
C: Notifying the health care provider is important, but assessing for other abnormalities should be the nurse's initial priority.
D: Calling for the neonatal resuscitation team is not necessary based solely on the presence of a two-vessel cord; further assessment is needed before determining the need for resuscitation.
In practical terms regarding genetic health care, nurses should be aware that:
- A. Genetic disorders affect people of all socioeconomic backgrounds, races, and ethnic groups equally.
- B. Genetic health care is more concerned with populations than individuals.
- C. The most important of all nursing functions is providing emotional support to the family during counseling.
- D. Taking genetic histories is the province of large universities and medical centers.
Correct Answer: C
Rationale: Nurses should be prepared to help with various stress reactions from a couple facing the possibility of a genetic disorder.