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Which condition is most commonly associated with late decelerations of the fetal heart rate?
- A. Head compression
- B. Maternal hypothyroidism
- C. Uteroplacental insufficiency
- D. Umbilical cord compression
Correct Answer: C
Rationale: Late decelerations of the fetal heart rate are most commonly associated with uteroplacental insufficiency. During contractions, there is reduced blood flow to the placenta, leading to hypoxia and acidosis in the fetus, resulting in late decelerations. Head compression (A) typically causes early decelerations. Maternal hypothyroidism (B) does not directly affect fetal heart rate. Umbilical cord compression (D) can cause variable decelerations, not late decelerations. Therefore, the correct answer is C.
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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.
Which factor will increase the risk for hypotonic uterine dystocia in a postpartum client?
- A. Twin gestation
- B. Gestational anemia
- C. Hypertonic contractions
- D. Gestational hypertension
Correct Answer: A
Rationale: The correct answer is A: Twin gestation. In twin gestation, there is an increased risk of hypotonic uterine dystocia due to the higher likelihood of uterine overdistention. This can lead to decreased uterine muscle tone and ineffective contractions, resulting in difficulty in the progress of labor.
Summary:
B: Gestational anemia does not directly increase the risk for hypotonic uterine dystocia.
C: Hypertonic contractions are associated with hyperactivity of the uterus, not hypotonic uterine dystocia.
D: Gestational hypertension may lead to other complications but is not directly related to hypotonic uterine dystocia in a postpartum client.
A blood-soaked peripad weighs 900 g. The nurse would document a blood loss of _____ mL.
- A. 1800
- B. 450
- C. 900
- D. 90
Correct Answer: C
Rationale: The correct answer is C (900 mL). To calculate blood loss, divide the weight of the blood-soaked pad (900 g) by the specific gravity of blood (1 g/mL). This gives 900 mL. Choice A (1800 mL) is incorrect as it doubles the correct amount. Choice B (450 mL) is incorrect as it halves the correct amount. Choice D (90 mL) is incorrect as it divides the correct amount by 10. The key is to convert the weight to volume using the specific gravity of blood to determine the correct blood loss measurement.
Which laboratory finding is indicative of DIC?
- A. Decreased fibrinogen
- B. Increased platelets
- C. Increased hematocrit
- D. Decreased thromboplastin time
Correct Answer: A
Rationale: The correct answer is A: Decreased fibrinogen. In DIC, there is widespread activation of the coagulation cascade, leading to consumption of clotting factors like fibrinogen. This results in decreased levels of fibrinogen in the blood. Increased platelets (B) are seen in early stages, but they decrease as consumption continues. Increased hematocrit (C) is a nonspecific finding. Decreased thromboplastin time (D) is not indicative of DIC, as it would typically be prolonged due to consumption of clotting factors.
Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the
- A. direct Coombs test of twin A.
- B. direct Coombs test of twin B.
- C. indirect Coombs test of the mother.
- D. transcutaneous bilirubin level for both twins.
Correct Answer: C
Rationale: The correct answer is C, indirect Coombs test of the mother. This test is crucial to determine if the mother has developed antibodies against the Rh-positive blood of twin A. If the test is positive, it indicates sensitization has occurred, making RhoGAM necessary to prevent hemolytic disease in future pregnancies. Direct Coombs tests of the twins (choices A and B) are not relevant in this scenario as they assess for antibodies already attached to the red blood cells. Transcutaneous bilirubin levels (choice D) are used to monitor jaundice, not Rh incompatibility.