Nokea
Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?
- A. Abdominal palpation
- B. Venous sample of blood
- C. Checking deep tendon reflexes
- D. Auscultation of the heart and lungs
Correct Answer: A
Rationale: Correct Answer: A - Abdominal palpation
Rationale: Abdominal palpation can lead to increased risk of placental abruption in patients with HELLP syndrome. This can cause severe hemorrhage and compromise fetal and maternal well-being. Therefore, it should be avoided.
Summary of other choices:
- B: Venous sample of blood: Necessary for assessing blood parameters in patients with HELLP syndrome.
- C: Checking deep tendon reflexes: Important for evaluating neurological status in patients with HELLP syndrome.
- D: Auscultation of the heart and lungs: Essential for monitoring cardiovascular and respiratory function in patients with HELLP syndrome.
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An abortion when the fetus dies but is retained in the uterus is called
- A. inevitable.
- B. missed.
- C. incomplete.
- D. threatened.
Correct Answer: B
Rationale: The correct answer is B: missed. In a missed abortion, the fetus dies but is not expelled from the uterus. This can be diagnosed during an ultrasound when no fetal heartbeat is detected. The term "inevitable" (choice A) refers to an abortion that is in progress and cannot be stopped. "Incomplete" (choice C) refers to an abortion where some fetal or placental tissue remains in the uterus. "Threatened" (choice D) refers to vaginal bleeding in early pregnancy, with a viable pregnancy.
What virus is highly contagious, spread through airborne particles, and can cause intrauterine fetal demise, skin scarring, eye, limb or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus?
- A. toxoplasmosis
- B. syphilis
- C. rubella
- D. Varicella (chickenpox)
Correct Answer: D
Rationale: The correct answer is D: Varicella (chickenpox). Varicella virus is highly contagious and spreads through airborne particles. It can cause intrauterine fetal demise, skin scarring, eye, limb, or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus. Varicella infection during pregnancy can lead to severe complications for both the mother and the fetus. Toxoplasmosis (A), syphilis (B), and rubella (C) can also cause complications during pregnancy, but they do not match all the characteristics mentioned in the question.
A patient has tested HIV-positive and has now discovered that she is pregnant. Which statement indicates that she understands the risks of this diagnosis?
- A. “I know I will need to have an abortion as soon as possible.”
- B. “Even though my test is positive, my baby might not be affected.”
- C. “My baby is certain to have AIDS and die within the first year of life.”
- D. “This pregnancy will probably decrease the chance that I will develop AIDS.”
Correct Answer: B
Rationale: The correct answer is B because it shows understanding that a positive HIV test in the mother doesn't guarantee transmission to the baby. This reflects knowledge of the possibility of preventing mother-to-child transmission with proper medical care. Option A is incorrect as abortion is not the standard recommendation for HIV-positive pregnant women. Option C is incorrect as not all babies born to HIV-positive mothers will have AIDS or die within the first year. Option D is incorrect as pregnancy does not decrease the mother's chance of developing AIDS.
Which factor is known to increase the risk of gestational diabetes mellitus?
- A. Previous birth of large infant
- B. Maternal age younger than 25 years
- C. Underweight prior to pregnancy
- D. Previous diagnosis of type 2 diabetes mellitus
Correct Answer: A
Rationale: The correct answer is A: Previous birth of large infant. This factor increases the risk of gestational diabetes mellitus due to the association with maternal insulin resistance. Large infants may have been exposed to higher glucose levels in utero, leading to increased risk in subsequent pregnancies. Maternal age younger than 25 years (B) is not a known risk factor. Being underweight prior to pregnancy (C) is actually associated with a lower risk of gestational diabetes. Previous diagnosis of type 2 diabetes mellitus (D) is a separate condition and not a risk factor for gestational diabetes.
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.