Nokea
What is the term for a nonstress test in which there are two or more fetal heart rate accelerations of 15 or more beats per minute (BPM) with fetal movement in a 20-minute period?
- A. Positive
- B. Negative
- C. Reactive
- D. Nonreactive
Correct Answer: C
Rationale: A nonstress test is considered reactive when there are at least two accelerations of 15 BPM or more in a 20-minute period, indicating fetal well-being.
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Can the baby's sex be determined at 8 weeks' gestation?
- A. Doctor knows the sex
- B. Organs are formed but too small
- C. Technician sees a penis
- D. It will take another month
Correct Answer: D
Rationale: At 8 weeks, organs are developing but too small to determine sex; this usually occurs around 18–20 weeks.
What is the most appropriate action when a laboring person's membranes rupture and meconium is present?
- A. notify the healthcare provider
- B. document the amount of meconium
- C. prepare the person for vacuum extraction
- D. apply pressure to the abdomen
Correct Answer: A
Rationale: The correct answer is A: notify the healthcare provider. This is the most appropriate action because the presence of meconium in the amniotic fluid indicates potential fetal distress, requiring immediate medical evaluation. Notifying the healthcare provider allows for prompt assessment and necessary interventions to ensure the well-being of both the laboring person and the baby. Documenting the amount of meconium (choice B) may be important for the medical record but is not the priority in this situation. Choices C and D, preparing for vacuum extraction and applying pressure to the abdomen, are not indicated and could potentially harm the baby or the laboring person.
A client is 35 weeks’ gestation.
- A. Nausea and vomiting.
- B. Maternal ambivalence.
- C. Fundal height 10 cm above the umbilicus.
- D. Use of three pillows for sleep comfort.
Correct Answer: D
Rationale: Using multiple pillows for sleep comfort is common in late pregnancy due to discomfort from the growing uterus. Nausea and vomiting are more common in early pregnancy, and maternal ambivalence is not specific to this stage.
A pregnant patient at 30 weeks gestation reports feeling dizzy when standing. What should the nurse instruct the patient to do?
- A. Lie down flat on your back to restore blood flow.
- B. Rise slowly from a sitting or lying position to avoid dizziness.
- C. Increase fluid intake to prevent dehydration.
- D. Avoid physical activity to prevent further dizziness.
Correct Answer: B
Rationale: The correct answer is B: Rise slowly from a sitting or lying position to avoid dizziness. This recommendation is appropriate because pregnant patients often experience dizziness due to changes in blood pressure and circulation. Rising slowly helps prevent sudden drops in blood pressure, which can lead to dizziness. Lying flat on the back can worsen dizziness by reducing blood flow to the brain. Increasing fluid intake is generally recommended during pregnancy but may not directly address the issue of dizziness. Avoiding physical activity entirely is not necessary and may not address the underlying cause of the dizziness.
A client is 35 weeks’ gestation.
- A. Nausea and vomiting.
- B. Maternal ambivalence.
- C. Fundal height 10 cm above the umbilicus.
- D. Use of three pillows for sleep comfort.
Correct Answer: D
Rationale: Using multiple pillows for sleep comfort is common in late pregnancy due to discomfort from the growing uterus. Nausea and vomiting are more common in early pregnancy, and maternal ambivalence is not specific to this stage.