Nokea
Which clinical conditions are associated with increased levels of alpha-fetoprotein (AFP)? (Select all that apply.)
- A. Down syndrome
- B. Molar pregnancy
- C. Twin gestation
- D. Incorrect gestational age assessment of a normal fetus—estimation is earlier in the pregnancy
Correct Answer: C
Rationale: Elevated AFP levels are seen in multiple gestations, miscalculated gestational age, and threatened abortion.
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A patient in labor is undergoing an epidural block and develops hypotension. What should the nurse do first?
- A. Increase intravenous fluids
- B. Place the patient in a Trendelenburg position
- C. Administer oxygen via face mask
- D. Notify the physician immediately
Correct Answer: A
Rationale: The correct first action is to increase intravenous fluids (Choice A). This will help improve the patient's blood volume and subsequently increase blood pressure. Trendelenburg position (Choice B) is not recommended due to potential complications. Administering oxygen (Choice C) may be helpful but doesn't directly address the hypotension. Notifying the physician (Choice D) is important but addressing hypotension promptly is the priority. Increasing fluids helps address the underlying cause of hypotension in this scenario.
A pregnant patient is at 32 weeks gestation and reports that she feels short of breath when lying flat. What should the nurse's priority action be?
- A. Assess the patient's respiratory rate and oxygen saturation.
- B. Encourage the patient to sit up and rest in a more upright position.
- C. Ask the patient to perform deep breathing exercises to improve oxygen flow.
- D. Instruct the patient to take shallow breaths and avoid exertion.
Correct Answer: B
Rationale: The correct answer is B: Encourage the patient to sit up and rest in a more upright position. This is the priority action because it helps relieve pressure on the diaphragm and allows for better lung expansion, improving oxygenation for the pregnant patient experiencing shortness of breath. Sitting upright also reduces the risk of supine hypotensive syndrome by improving blood flow to the placenta.
Assessing respiratory rate and oxygen saturation (Choice A) may be important but should come after the patient is in a more comfortable position. Deep breathing exercises (Choice C) may not address the immediate relief needed for the patient. Instructing the patient to take shallow breaths (Choice D) may worsen the situation by limiting oxygen intake and exacerbating respiratory distress.
The nurse is caring for a pregnant patient who is at 25 weeks gestation and is concerned about gestational diabetes. Which of the following symptoms should the nurse educate the patient to watch for?
- A. Increased thirst and frequent urination
- B. Severe leg cramps and dizziness
- C. Constant fatigue and swollen feet
- D. Shortness of breath and dizziness upon standing
Correct Answer: A
Rationale: The correct answer is A: Increased thirst and frequent urination. These symptoms are indicative of gestational diabetes due to elevated blood sugar levels. Increased thirst is a result of the body trying to dilute the excess glucose through increased fluid intake, leading to frequent urination. This occurs because the kidneys work to eliminate the excess glucose from the blood by excreting it in the urine. Therefore, educating the patient to watch for these symptoms is crucial for early detection and management of gestational diabetes.
Choices B, C, and D are incorrect as they do not directly correlate with the symptoms of gestational diabetes. Severe leg cramps and dizziness (Choice B) may be related to other factors such as dehydration or electrolyte imbalance. Constant fatigue and swollen feet (Choice C) could be common symptoms during pregnancy but are not specific to gestational diabetes. Shortness of breath and dizziness upon standing (Choice D) are more likely to be related to issues such as anemia or changes
A pregnant woman informs the nurse that her last normal menstrual period was on September 20, 2012. Using Nagele’s rule, the nurse calculates the client’s estimated date of delivery as:
- A. May 30, 2013.
- B. June 20, 2013.
- C. June 27, 2013.
- D. July 3, 2013.
Correct Answer: C
Rationale: Using Nagele’s rule (adding 7 days to the first day of the last menstrual period, subtracting 3 months, and adding 1 year), the calculated EDD is June 27, 2013.
A patient asks the nurse when her infant’s heart will begin to pump blood. What will the nurse reply?
- A. By the end of week 3
- B. Beginning in week 8
- C. At the end of week 16
- D. Beginning in week 24
Correct Answer: A
Rationale: The fetal heart begins to pump by week 3 of gestation.