Nokea
Which finding in the exam of a patient with a diagnosis of threatened abortion would change the diagnosis to inevitable abortion?
- A. Presence of backache
- B. Rise in hCG level
- C. Clear fluid from vagina
- D. Pelvic pressure
Correct Answer: C
Rationale: The correct answer is C: Clear fluid from vagina. In threatened abortion, the pregnancy is at risk but the fetus is still viable. In inevitable abortion, there is no chance of continuation. Clear fluid from the vagina indicates rupture of membranes, leading to inevitable abortion due to the loss of amniotic fluid. Backache, rise in hCG levels, and pelvic pressure are common symptoms in threatened abortion but do not definitively indicate progression to inevitable abortion.
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A patient with preeclampsia is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs indicate
- A. gastrointestinal upset.
- B. effects of magnesium sulfate.
- C. anxiety caused by hospitalization.
- D. worsening disease and impending convulsion.
Correct Answer: D
Rationale: The correct answer is D because the symptoms described (headache, visual changes, epigastric pain) are classic signs of worsening preeclampsia, indicating impending eclampsia with seizures. This requires urgent intervention to prevent serious complications. Option A is incorrect as gastrointestinal upset does not typically present with these specific signs. Option B is incorrect as magnesium sulfate is used to prevent seizures in preeclampsia, not cause the symptoms described. Option C is incorrect as anxiety would not cause the specific symptoms mentioned. In summary, the signs described point towards worsening disease and the likelihood of impending convulsions, necessitating immediate medical attention.
A patient at 32 weeks' gestation is diagnosed with polyhydramnios. The patient asks the nurse if polyhydramnios can affect the baby. What is the nurse's response to the patient's question?
- A. No, polyhydramnios commonly occurs toward the end of pregnancy.
- B. No, polyhydramnios is a sign that the lungs are maturing.
- C. Yes, polyhydramnios increases the risk of a preterm delivery.
- D. Yes, polyhydramnios causes umbilical cord compression.
Correct Answer: C
Rationale: The correct answer is C: Yes, polyhydramnios increases the risk of a preterm delivery. Polyhydramnios, an excess of amniotic fluid, can lead to uterine overdistension, which may trigger premature labor. The increased pressure from the excess fluid can also cause premature rupture of membranes. This complication can potentially result in a preterm delivery, which carries risks for the baby's health and development. Choices A and B are incorrect because polyhydramnios is not a normal occurrence at the end of pregnancy nor a sign of lung maturity. Choice D is incorrect as umbilical cord compression is a potential complication of polyhydramnios but not the primary risk associated with it.
The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
- A. Female fetus, Mexican-American, primigravida
- B. Male fetus, Asian-American, previous preterm birth
- C. Male fetus, African-American, previous cesarean birth
- D. Female fetus, European-American, previous spontaneous abortion
Correct Answer: C
Rationale: The correct answer is C: Male fetus, African-American, previous cesarean birth. Placenta previa occurs when the placenta partially or completely covers the cervix. African-American women have a higher incidence of placenta previa. Previous cesarean birth is a risk factor due to possible scarring on the uterine wall, increasing the likelihood of placenta implantation issues. Male fetuses are associated with a higher risk of placenta previa, possibly due to a larger placental size. The other choices do not align with known risk factors for placenta previa, such as the ethnicity, fetal gender, and obstetric history mentioned.
The nurse applies fetal and uterine monitors to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. Which is the next nursing action?
- A. Calling the primary health care provider
- B. Changing the maternal position
- C. Obtaining the maternal blood pressure
- D. Preparing the environment for an immediate birth
Correct Answer: B
Rationale: The correct answer is B: Changing the maternal position. Deceleration of fetal heart rate during contractions can indicate umbilical cord compression. Changing the maternal position can relieve pressure on the cord, improving blood flow to the fetus. This action is a non-invasive and immediate intervention that can potentially improve fetal oxygenation. Calling the primary health care provider (A) can be done after addressing the immediate concern. Obtaining maternal blood pressure (C) is not the priority in this situation. Preparing for an immediate birth (D) is premature without first attempting non-invasive interventions.
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.