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Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand?
- A. Stress on the heart is greatest in the first trimester and the last 2 weeks before labor.
- B. Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms.
- C. Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise.
- D. Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term.
Correct Answer: B
Rationale: Class II cardiac disease is symptomatic with ordinary activity. Women in this category need to avoid heavy exertion and limit regular activities as symptoms dictate. Stress is greatest between weeks 28 and 32 of gestation, when hemodynamic changes reach their maximum. Class III cardiac disease is symptomatic with less-than-ordinary activity. These women need bed rest most of the day and face the possibility of hospitalization near term. Class I cardiac disease is asymptomatic at normal levels of activity. These women can perform limited normal activities with discretion, although they still need a good amount of sleep.
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Chromosomes contain thousands of segments called:
- A. nuclei.
- B. nodes.
- C. capillaries.
- D. genes.
Correct Answer: D
Rationale: Chromosomes are structures composed of DNA and genes. Genes are the functional segments within chromosomes that encode specific traits and characteristics. The other choices ('nuclei,' 'nodes,' 'capillaries') do not accurately describe the segments found within chromosomes and are unrelated to their structure or function.
Which synthetic hormone is used to prevent miscarriages and can cause masculinization of the fetus?
- A. Testosterone
- B. Estrogen
- C. Progestin
- D. Oxytocin
Correct Answer: C
Rationale: Progestin is the synthetic hormone used to prevent miscarriages. While it is beneficial in maintaining pregnancy, in some cases, it can lead to masculinization of the fetus. Testosterone (Choice A) and estrogen (Choice B) are not typically used to prevent miscarriages and do not cause masculinization of the fetus in this context. Oxytocin (Choice D) is a hormone involved in labor and breastfeeding, but it is not used to prevent miscarriages nor does it cause masculinization of the fetus.
Which statement by the client will assist the healthcare provider in determining whether she is in true labor as opposed to false labor?
- A. I passed some thick, pink mucus when I urinated this morning.
- B. My bag of waters just broke.
- C. The contractions in my uterus are getting stronger and closer together.
- D. My baby dropped, and I have to urinate more frequently now.
Correct Answer: C
Rationale: The correct answer is C. Regular, strong contractions with the presence of cervical change indicate that the woman is experiencing true labor. Choice A indicates the passing of the mucus plug, which is a sign of early labor but not definitive for true labor. Choice B, the breaking of the bag of waters, is a sign of labor but does not confirm whether it is true or false labor. Choice D, the baby dropping and increased urination frequency, suggests lightening, a sign that labor may be approaching, but it does not confirm true labor.
A multiparous client at 36 hours postpartum reports increased bleeding and cramping. On examination, the nurse finds the uterine fundus 2 centimeters above the umbilicus. Which action should the nurse take first?
- A. Increase the intravenous fluid to 150 ml/hr.
- B. Call the healthcare provider.
- C. Encourage the client to void.
- D. Administer ibuprofen 800 milligrams by mouth.
Correct Answer: C
Rationale: Encouraging the client to void is the priority action in this scenario. A distended bladder can prevent the uterus from contracting properly, leading to increased bleeding and a high uterine fundus. By encouraging the client to void, the nurse can help the uterus contract effectively, reducing bleeding. Increasing intravenous fluids or administering ibuprofen would not address the immediate concern of a distended bladder affecting uterine contraction. While it may be necessary to involve the healthcare provider, addressing the bladder distention promptly is crucial to prevent further complications.
A newborn is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan?
- A. Apply a thin layer of lotion to the newborn's skin every 8 hours.
- B. Give the newborn 1 oz of glucose water every 4 hours.
- C. Ensure the newborn's eyes are closed beneath the shield.
- D. Dress the newborn in a thin layer of clothing during therapy.
Correct Answer: C
Rationale: During phototherapy using a lamp, it is crucial to protect the newborn's eyes from the light to prevent damage. Closing the newborn's eyes beneath the shield is essential for this purpose. Applying lotion to the skin (Choice A) is not recommended as it can intensify the effects of the phototherapy. Giving glucose water (Choice B) is unrelated to the phototherapy process and is not indicated. Dressing the newborn in clothing (Choice D) may hinder the effectiveness of the phototherapy by blocking the light exposure to the skin.