Nokea
Which analysis of maternal serum is the best predictor of chromosomal abnormalities in the fetus?
- A. Biophysical profile
- B. Multiple-marker screening
- C. Lecithin-to-sphingomyelin ratio
- D. Blood type and crossmatch of maternal and fetal serum
Correct Answer: B
Rationale: The correct answer is B: Multiple-marker screening. This analysis measures levels of certain proteins and hormones in maternal serum to assess the risk of chromosomal abnormalities in the fetus. It is considered the best predictor because abnormal levels of these markers can indicate conditions like Down syndrome. Biophysical profile (A) assesses fetal well-being but does not directly predict chromosomal abnormalities. Lecithin-to-sphingomyelin ratio (C) is used to assess fetal lung maturity, not chromosomal abnormalities. Blood type and crossmatch (D) are important for identifying Rh incompatibility but do not predict chromosomal abnormalities.
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The nurse is discussing pregnancy concerns with a patient in the third trimester of pregnancy. What warning sign should the nurse teach the patient to report immediately to the health-care provider?
- A. chronic constipation
- B. decreased fetal movement
- C. early evening fatigue
- D. loss of appetite
Correct Answer: B
Rationale: The correct answer is B: decreased fetal movement. This warning sign is crucial in the third trimester as it could indicate fetal distress or other complications requiring prompt medical attention. Decreased fetal movement can be a sign of potential problems with the baby's health and should not be ignored. Chronic constipation (A), early evening fatigue (C), and loss of appetite (D) are common pregnancy symptoms but are not typically considered urgent warning signs that require immediate reporting to the healthcare provider. It is important for the nurse to emphasize the significance of monitoring fetal movements and seeking medical advice promptly if there is a noticeable decrease.
A nurse has provided a young woman with preconception counseling. Which of the statements by the woman indicates that the teaching was successful? Select all that apply.
- A. “As soon as I think I may be pregnant, I should stop drinking alcohol.”
- B. “It is important for me to see my medical doctor for a complete physical.”
- C. “I should make sure that my daily multivitamin contains folic acid.”
- D. “When I go to my dentist for a checkup I should state that I may be pregnant.”
Correct Answer: A
Rationale: All the statements indicate successful preconception counseling, covering topics such as alcohol cessation, medical checkups, folic acid intake, dental care, and dietary precautions.
A nurse is teaching the staff about the Institute of Medicine competencies. Which examples indicate the staff has a correct understanding of the teaching? (Select all that apply.)
- A. Use informatics.
- B. Use transparency.
- C. Apply globalization.
- D. Apply quality improvement.
Correct Answer: D
Rationale: The Institute of Medicine competencies include: Provide patient-centered care; work in interdisciplinary teams; use evidence-based practice; apply quality improvement; and use informatics. Transparency is included in the 10 rules of performance in a redesigned health care system, not a competency. While globalization is important in health care, it is not a competency.
A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session?
- A. Managed care insures full coverage of health care costs.
- B. Managed care only assumes the financial risk involved.
- C. Managed care allows providers to focus on illness care.
- D. Managed care causes providers to focus on prevention.
Correct Answer: D
Rationale: Managed care describes health care systems in which the provider or the health care system receives a predetermined capitated (fixed amount) payment for each patient enrolled in the program. Therefore, the focus of care shifts from individual illness care to prevention, early intervention, and outpatient care.
The triage nurse is interviewing a client, 19 years old, unmarried, who states, 'I felt a hard thing on the lip of my vagina this morning. It doesn’t hurt.' Which of the following questions is most important for the nurse to ask at this time?
- A. Have any of your partners ever hurt you?'
- B. Do you ever have unprotected intercourse?'
- C. Have you ever had a baby?'
- D. Do you think you may be pregnant?'
Correct Answer: B
Rationale: Unprotected intercourse increases the risk of sexually transmitted infections (STIs), which could explain the hard lump.