Nokea
What point in the pregnancy is the most accurate time to determine gestational age through ultrasound?
- A. First trimester
- B. Second trimester
- C. Third trimester
- D. No difference in accuracy among the trimesters
Correct Answer: A
Rationale: The correct answer is A: First trimester. During the first trimester, gestational age can be accurately determined through ultrasound by measuring the crown-rump length of the fetus. This measurement is most accurate during this time as the fetus is small and growth is consistent. In the second and third trimesters, other factors such as fetal growth variations and positioning can affect the accuracy of gestational age determination. Therefore, the first trimester is the most accurate time for determining gestational age through ultrasound. Other choices are incorrect because the precision of ultrasound measurements decreases as pregnancy progresses, making the first trimester the optimal window for accurate gestational age assessment.
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A nurse should monitor a client who is postpartum from a forceps delivery for which of the following complications?
- A. Placental abruption.
- B. Seizure.
- C. Idiopathic thrombocytopenia.
- D. Infection.
Correct Answer: D
Rationale: Forceps delivery increases the risk of trauma and infection due to potential tissue damage.
The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks' gestation. The nurse determines that the patient understands the teaching when she states that will be collected for the initial screening process?
- A. Urine
- B. Blood
- C. Saliva
- D. Amniotic fluid
Correct Answer: B
Rationale: The correct answer is B: Blood. Alpha-fetoprotein (AFP) screening is a test that measures the level of AFP in the mother's blood to screen for certain fetal abnormalities. AFP is a protein produced by the fetus and can be detected in the mother's blood. Blood is the most appropriate sample for this screening as it directly reflects the fetal AFP levels. Urine (A), saliva (C), and amniotic fluid (D) do not contain AFP in levels that can be accurately measured for this screening, making them incorrect choices. Blood is the standard and most reliable sample for AFP screening due to its direct correlation with fetal AFP levels.
A patient with an IUD in place has a positive pregnancy test. When planning care, the nurse will base decisions on which anticipated action?
- A. A therapeutic abortion will need to be scheduled since fetal damage is inevitable.
- B. Hormonal analyses will be done to determine the underlying cause of the false-positive test result.
- C. The IUD will need to be removed to avoid complications such as miscarriage or infection.
- D. The IUD will need to remain in place to avoid injuring the fetus.
Correct Answer: C
Rationale: Rationale:
C is correct because when a patient with an IUD in place has a positive pregnancy test, the IUD should be removed to avoid complications such as ectopic pregnancy, miscarriage, or infection. Leaving the IUD in place can increase the risk of adverse outcomes for both the mother and the fetus. Removing the IUD allows for safer management of the pregnancy and reduces potential harm.
Summary:
A: Incorrect. Fetal damage is not inevitable, and a therapeutic abortion is not the immediate action required in this situation.
B: Incorrect. Hormonal analyses are not the priority when a positive pregnancy test with an IUD in place is detected.
D: Incorrect. Leaving the IUD in place can lead to complications and is not the recommended course of action.
A woman asks the nurse to recommend the best douche for use after menstruation. Which of the following responses by the nurse is appropriate?
- A. Tap water with white vinegar is most refreshing and least allergenic.'
- B. It is really best for women not to douche.'
- C. Any of the over-the-counter douches is satisfactory.'
- D. It is best to douche during menstruation rather than after it is over.'
Correct Answer: B
Rationale: Douching can disrupt the natural vaginal flora and increase the risk of infections, so it is generally not recommended.
Which of the patient health behaviors in the first trimester would the nurse identify as a risk factor in pregnancy?
- A. Sexual intercourse two or three times weekly
- B. Moderate exercise for 30 minutes daily
- C. Working 40 hours a week as a secretary in a travel agency
- D. Relaxing in a hot tub for 30 minutes a day, several days a week
Correct Answer: D
Rationale: The correct answer is D because relaxing in a hot tub for 30 minutes a day, several days a week can increase the body temperature, which is harmful during the first trimester and can lead to birth defects. Choice A is not a risk factor as it promotes a healthy sexual relationship. Choice B is beneficial as moderate exercise is recommended during pregnancy. Choice C is not necessarily a risk factor unless it involves exposure to harmful substances or excessive stress.