Nokea
Which factors should be considered a contraindication for transcervical chorionic villus sampling?
- A. Rh-negative mother
- B. Gestation less than 15 weeks
- C. Maternal age younger than 35 years
- D. Positive for group B Streptococcus
Correct Answer: D
Rationale: The correct answer is D because being positive for group B Streptococcus can increase the risk of infection during transcervical chorionic villus sampling, making it a contraindication. Rh-negative mother (A) and maternal age younger than 35 years (C) are not contraindications. Gestation less than 15 weeks (B) is not a strict contraindication but may affect the accuracy of the procedure.
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The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning care for this patient?
- A. Capitation provides the hospital with a means of recovering variable charges.
- B. The hospital will be paid for the full cost of the patient’s hospitalization.
- C. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost.
- D. Medicare will pay the national average for the patient’s condition.
Correct Answer: C
Rationale: In 1983, Congress established the prospective payment system (PPS), which grouped inpatient hospital services for Medicare patients into diagnosis-related groups (DRGs), each of which provides a fixed reimbursement amount based on assigned DRG, regardless of a patient’s length of stay or use of services.
What is the gravida and para for a patient who delivered triplets 2 years ago and is now pregnant again?
- A. 2, 3
- B. 1, 2
- C. 2, 1
- D. 1, 3
Correct Answer: C
Rationale: The correct answer is C: 2, 1. Gravida refers to the total number of pregnancies, including the current one. The patient delivered triplets 2 years ago, so she is currently pregnant again, making her total pregnancies 2. Para refers to the number of deliveries after 20 weeks of gestation, regardless of the number of fetuses. Since she delivered triplets 2 years ago, she had 1 delivery after 20 weeks of gestation, making her para 1. Choices A, B, and D are incorrect as they do not accurately reflect the patient's obstetric history based on the information provided.
The nurse is caring for a client who is scheduled to have an amniocentesis. Which intervention is most important for the nurse to perform after the procedure?
- A. Evaluate need for Rh0D immunoglobulin
- B. Clean site
- C. Administer pain medication
- D. Perform vital signs
Correct Answer: A
Rationale: The correct answer is A: Evaluate need for Rh0D immunoglobulin. After an amniocentesis, it is crucial to assess if the client is Rh-negative and the fetus is Rh-positive. If this is the case, Rh0D immunoglobulin should be administered to prevent Rh incompatibility issues in future pregnancies. This intervention is critical to prevent hemolytic disease in the newborn.
Cleaning the site (B) is important for infection prevention but not the most critical post-procedure intervention. Administering pain medication (C) can be done based on client's discomfort level but not the top priority. Performing vital signs (D) is important but assessing Rh status and administering Rh0D immunoglobulin take precedence.
A pregnant patient's biophysical profile score is 8. The patient asks the nurse to explain the results. What is the nurse's most appropriate response?
- A. The test results are within normal limits.'
- B. Immediate birth by cesarean birth is being considered.'
- C. Further testing will be performed to determine the meaning of this score.'
- D. An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding birth.'
Correct Answer: A
Rationale: The correct answer is A: "The test results are within normal limits." A biophysical profile score of 8 is considered normal. A score of 8 out of 10 indicates that the fetus is likely healthy and does not require immediate delivery. The other choices are incorrect because immediate birth by cesarean section is not warranted for a score of 8, further testing is not necessary as the score is normal, and there is no need for an obstetric specialist to evaluate the results urgently. The most appropriate response reassures the patient that the results are normal, providing comfort and clarity.
A doula is working with a laboring woman who is 6 cm dilated and is contracting every 3 min × 60 sec on an oxytocin drip. Which of the following interventions should the nurse suggest the doula perform?
- A. Regulate the oxytocin drip rate.
- B. Check the vaginal dilation of the client.
- C. Encourage the woman to use breathing techniques.
- D. Monitor the client for uterine hyperstimulation.
Correct Answer: C
Rationale: The doula's role is to provide emotional and physical support, such as encouraging breathing techniques. Regulating medications and monitoring for complications are the nurse's responsibilities.