Nokea
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.
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Why is a multiple-gestation pregnancy considered a high risk?
- A. Postpartum hemorrhage is an expected complication.
- B. Perinatal mortality is two to three times more likely in multiple than in single births.
- C. Optimal psychological adjustment after a multiple birth requires 6 months to 1 year.
- D. Maternal mortality is higher during the prenatal period in the setting of multiple gestation.
Correct Answer: B
Rationale: The correct answer is B because perinatal mortality is two to three times more likely in multiple gestation pregnancies compared to single births. This is due to the increased risk of complications such as preterm birth, low birth weight, and other neonatal issues. Postpartum hemorrhage (A) is a potential complication but not specific to multiple gestation pregnancies. Optimal psychological adjustment (C) and maternal mortality during the prenatal period (D) are not directly related to the increased risks associated with multiple gestation pregnancies.
Which postpartum patient requires further assessment?
- A. G4 P4 who has had four saturated pads during the last 12 hours
- B. G1 P1 with Class II heart disease who complains of frequent coughing
- C. G2 P2 with gestational diabetes whose fasting blood sugar level is 100 mg/dL
- D. G3 P2 postcesarean patient who has active herpes lesions on the labia
Correct Answer: B
Rationale: The correct answer is B because a postpartum patient with Class II heart disease complaining of frequent coughing requires further assessment due to the risk of exacerbating heart failure. Coughing can increase cardiac workload, leading to potential complications. Choice A may indicate excessive postpartum bleeding, which would require immediate intervention. Choice C has a slightly elevated blood sugar level but is not immediately concerning. Choice D may require monitoring and possibly treatment for active herpes lesions, but it is not as urgent as assessing a patient with heart disease and coughing.
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.
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.
Nursing intervention for pregnant patients with diabetes is based on the knowledge that the need for insulin is
- A. varied depending on the stage of gestation.
- B. increased throughout pregnancy and the postpartum period.
- C. decreased throughout pregnancy and the postpartum period.
- D. should not change because the fetus produces its own insulin.
Correct Answer: A
Rationale: The correct answer is A because insulin needs vary during pregnancy due to hormonal changes affecting insulin sensitivity. In early pregnancy, insulin needs may decrease due to increased insulin sensitivity, but in late pregnancy, insulin needs may increase due to insulin resistance. Choice B is incorrect as insulin needs do not consistently increase throughout pregnancy and postpartum. Choice C is incorrect as insulin needs typically increase rather than decrease during pregnancy. Choice D is incorrect as the fetus does not produce its own insulin to regulate the mother's blood sugar levels.