Nokea
Which cardiac disease has the lowest risk for maternal mortality?
- A. Endocarditis
- B. Aortic stenosis
- C. Patent ductus arteriosus
- D. Pulmonary hypertension
Correct Answer: C
Rationale: The correct answer is C: Patent ductus arteriosus. This condition typically does not pose a significant risk for maternal mortality because it is a relatively benign cardiac defect that does not significantly impact maternal health during pregnancy. Other choices, such as endocarditis, aortic stenosis, and pulmonary hypertension, have higher risks for maternal mortality due to complications like heart failure, arrhythmias, and increased risk of thromboembolic events. Therefore, patent ductus arteriosus is the lowest risk for maternal mortality among the given options.
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A patient taking magnesium sulfate has a respiratory rate of 10 breaths per minute. In addition to discontinuing the medication, which action should the nurse take?
- A. Increase the patient's IV fluids.
- B. Administer calcium gluconate.
- C. Vigorously stimulate the patient.
- D. Instruct the patient to take deep breaths.
Correct Answer: B
Rationale: The correct answer is B: Administer calcium gluconate. This is because magnesium sulfate can lead to respiratory depression by inhibiting neuromuscular transmission. Calcium gluconate is the antidote as it competes with magnesium for binding sites, reversing its effects. Increasing IV fluids (A) is not directly related to addressing respiratory depression. Vigorously stimulating the patient (C) can exacerbate respiratory depression. Instructing the patient to take deep breaths (D) may not be effective in addressing respiratory depression caused by magnesium sulfate.
A high-risk labor patient progresses from preeclampsia to eclampsia. Aggressive management is instituted, and the fetus is delivered via cesarean birth. Which finding in the immediate postoperative period indicates that the patient is at risk of developing HELLP syndrome?
- A. Platelet count of 50,000/mcL
- B. Liver enzyme levels within normal range
- C. Negative for edema
- D. No evidence of nausea or vomiting
Correct Answer: A
Rationale: The correct answer is A: Platelet count of 50,000/mcL. In HELLP syndrome, there is hemolysis, elevated liver enzymes, and low platelet count. A platelet count of 50,000/mcL indicates thrombocytopenia, a key feature of HELLP syndrome. It signifies ongoing coagulation abnormalities and liver dysfunction.
B: Liver enzyme levels within normal range is incorrect as HELLP syndrome typically presents with elevated liver enzymes.
C: Negative for edema is incorrect as edema is not a defining characteristic of HELLP syndrome.
D: No evidence of nausea or vomiting is incorrect as these symptoms are not specific to HELLP syndrome.
Which instructions should the nurse include when teaching a pregnant patient with Class II heart disease?
- A. Advise her to gain at least 30 lb.
- B. Instruct her to avoid strenuous activity.
- C. Inform her of the need to limit fluid intake.
- D. Explain the importance of a diet high in calcium.
Correct Answer: B
Rationale: The correct answer is B: Instruct her to avoid strenuous activity. For a pregnant patient with Class II heart disease, avoiding strenuous activity is crucial to prevent excessive strain on the heart. Strenuous activities can lead to increased heart rate and blood pressure, which can worsen the heart condition. Advising her to gain at least 30 lb (choice A) may put additional strain on the heart. Limiting fluid intake (choice C) can lead to dehydration, affecting blood volume and circulation. A diet high in calcium (choice D) is beneficial for overall health but is not specifically related to managing Class II heart disease during pregnancy.
What virus is highly contagious, spread through airborne particles, and can cause intrauterine fetal demise, skin scarring, eye, limb or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus?
- A. toxoplasmosis
- B. syphilis
- C. rubella
- D. Varicella (chickenpox)
Correct Answer: D
Rationale: The correct answer is D: Varicella (chickenpox). Varicella virus is highly contagious and spreads through airborne particles. It can cause intrauterine fetal demise, skin scarring, eye, limb, or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus. Varicella infection during pregnancy can lead to severe complications for both the mother and the fetus. Toxoplasmosis (A), syphilis (B), and rubella (C) can also cause complications during pregnancy, but they do not match all the characteristics mentioned in the question.
Several hours after delivery, a new mother expresses ambivalence regarding her infant. How will the nurse promote bonding?
- A. Having the mother feed the infant
- B. Removing the infant from the mother's arms if it cries
- C. Positioning the infant so its head rests on the mother's shoulder
- D. Encouraging the mother to sleep for 4 to 6 hours before interacting with the infant
Correct Answer: A
Rationale: The correct answer is A, having the mother feed the infant. This helps promote bonding through physical closeness, eye contact, and the release of oxytocin. Feeding also fosters a sense of responsibility and nurturing. Choice B may disrupt bonding by creating separation anxiety. Choice C is a comforting position but not as interactive as feeding. Choice D delays bonding and can impact the establishment of a strong maternal-infant relationship.