Nokea
When planning for this test, which one of the following items should the nurse have available?
- A. The emergency crash cart
- B. A cardiac monitor
- C. An ultrasound machine
- D. A fetal monitor
Correct Answer: D
Rationale: A nonstress test requires a fetal monitor to assess fetal heart rate and movement, ensuring fetal well-being.
You may also like to solve these questions
Which statement by the client indicates a need for additional teaching regarding chlamydial infection?
- A. My sex partner(s) will require treatment as well.
- B. I will have to have a cesarean birth to protect my baby.
- C. The physician will treat the infection with an antibiotic.
- D. My Pap smear results may show abnormal cells.
Correct Answer: B
Rationale: Chlamydia does not typically require a cesarean birth; antibiotics treat the infection, and partners need treatment to prevent reinfection.
Which response by the nurse is correct concerning the legal threshold of viability?
- A. It is usually estimated to be 36 to 40 weeks.
- B. It is usually estimated to be 30 to 35 weeks.
- C. It is usually estimated to be 20 to 24 weeks.
- D. It is usually estimated to be 10 to 15 weeks.
Correct Answer: C
Rationale: The legal threshold of viability is typically 20-24 weeks, when a fetus may survive outside the womb with medical support.
The client, who is 12 days postpartum, telephones the clinic and tells the nurse that she is concerned that she may have an infection because her vaginal discharge has been creamy white for two days now. Which response by the nurse is correct?
- A. “You need to come to the clinic as soon as possible.”
- B. “You’ll need an antibiotic; which pharmacy do you use?”
- C. “Take your temperature and let me know if it is elevated.”
- D. “A creamy white discharge 10 days postpartum is normal.”
Correct Answer: D
Rationale: There is no need to be seen in the clinic; vaginal discharge that turns creamy white 10 days postpartum is normal. The client does not have an infection, and no antibiotic is necessary. There is no reason to take her temperature when the discharge is normal. Creamy white discharge 10 to 21 days postpartum is normal. Her lochia changed color on her 10th postpartum day.
The 38-year-old pregnant client at 22 weeks’ gestation has just been told she has hydramnios after undergoing a sonogram for size greater than dates. The nurse should further assess for which conditions associated with hydramnios? Select all that apply.
- A. A congenital anomaly
- B. Gestational diabetes
- C. Chronic hypertension
- D. TORCH infections
- E. Preeclampsia
Correct Answer: A,B,D
Rationale: In cases of anencephaly, the fetus is thought to urinate excessively because of overstimulation of the cerebrospinal centers, resulting in hydramnios. The nurse should further assess for gestational diabetes. Hydramnios is thought to occur from excessive fetal urination due to fetal hyperglycemia. Infants with mothers infected with toxoplasmosis, rubella, CMV, or herpes simplex virus infections (TORCH) are more likely to have hydramnios due to the inflammatory response and fluid accumulation. Chronic hypertension is not associated with excess amniotic fluid. Preeclampsia is not associated with excess amniotic fluid.
The nurse assesses the fundal height for multiple pregnant clients. For which client should the nurse conclude that a fundal height measurement is most accurate?
- A. The pregnant client with uterine fibroids
- B. The pregnant client who is obese
- C. The pregnant client with polyhydramnios
- D. The pregnant client experiencing fetal movement
Correct Answer: D
Rationale: Excessive fetal movement may make it difficult to measure the client’s fundal height; however, it should not cause an inaccuracy in the measurement. Fibroids can increase fundal height and give a false measurement. Obesity can increase fundal height and give a false measurement. Polyhydramnios can increase fundal height and give a false measurement.