Nokea
Which laboratory is important to know when a client is having an amniocentesis?
- A. Blood type
- B. CBC
- C. Rh
- D. PT and PTT
Correct Answer: C
Rationale: Step-by-step rationale:
1. Rh factor is crucial to know to prevent Rh incompatibility issues during pregnancy.
2. Amniocentesis can pose a risk for Rh sensitization in Rh-negative mothers.
3. Knowing the Rh status helps determine if Rhogam (anti-D) is needed after amniocentesis.
4. Blood type (A) and CBC (B) are important but not directly relevant to amniocentesis.
5. PT and PTT (D) are coagulation tests, typically not required for routine amniocentesis.
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The health care provider reports that the primigravida's fundus can be palpated at the umbilicus. Which priority question will the nurse include in the patient's assessment?
- A. Have you noticed that it is easier for you to breathe now?'
- B. Would you like to hear the baby's heartbeat for the first time?'
- C. Have you felt a fluttering sensation in your lower pelvic area yet?'
- D. Have you recently developed any unusual cravings, such as for chalk or dirt?'
Correct Answer: C
Rationale: The correct answer is C: "Have you felt a fluttering sensation in your lower pelvic area yet?" This is the correct question to ask because feeling a fluttering sensation in the lower pelvic area is indicative of quickening, which typically occurs around 18-20 weeks of pregnancy. Quickening is an important milestone in pregnancy that signifies fetal movement. Palpating the fundus at the umbilicus suggests the pregnancy is around 20 weeks, so asking about quickening confirms fetal viability and normal development.
Choice A is incorrect because fundal height does not correlate with ease of breathing. Choice B is incorrect as hearing the baby's heartbeat for the first time is not directly related to fundal height. Choice D is incorrect as unusual cravings are not typically associated with fundal height assessment.
In which type of health care facility does the nurse want to work if applying for a position with a home care organization that specializes in spinal cord injury?
- A. Secondary acute
- B. Continuing
- C. Restorative
- D. Tertiary
Correct Answer: C
Rationale: Patients recovering from an acute or chronic illness or disability often require additional services (restorative care) to return to their previous level of function or reach a new level of function limited by their illness or disability.
A breastfeeding mother and her baby are being discharged home after delivery. The nurse is providing anticipatory guidance about what signs to expect the baby to exhibit every 24 hours by the end of the first week. Which of the following should the nurse include in his/her instructions?
- A. The baby will have at least 6 wet diapers.
- B. The baby will have at least 6 pasty stools.
- C. The baby will breastfeed at least 6 times.
- D. The baby will gain at least 6 ounces.
Correct Answer: A
Rationale: Adequate wet diapers indicate proper hydration and milk intake.
The nurse in the obstetrician’s office is caring for four 25-week-gestation prenatal clients who are carrying singleton pregnancies. With which of the following clients should the nurse carefully review the signs and symptoms of preterm labor?
- A. African American, 15 years old, with newly diagnosed gestational diabetes.
- B. Asian American, 23 years old, with five-year-old twins who were born at term.
- C. Jewish, 25 years old, working as a certified public accountant.
- D. Mormon, 33 years old, who recently moved into a new apartment.
Correct Answer: A
Rationale: Young age and gestational diabetes are risk factors for preterm labor, making it important to educate this client.
A patient who smokes one pack of cigarettes daily has a positive pregnancy test. The nurse will explain that smoking during pregnancy increases the risk of which condition?
- A. Congenital anomalies
- B. Death before or after birth
- C. Neonatal hypoglycemia
- D. Neonatal withdrawal syndrome
Correct Answer: B
Rationale: The correct answer is B: Death before or after birth. Smoking during pregnancy increases the risk of fetal death, both before and after birth, due to the harmful effects of nicotine and other toxins on the developing fetus. Smoking can lead to complications such as placental abruption, preterm birth, low birth weight, and stillbirth.
A: Congenital anomalies - While smoking during pregnancy can increase the risk of certain birth defects, the primary concern related to smoking is not congenital anomalies.
C: Neonatal hypoglycemia - Smoking during pregnancy is not directly linked to neonatal hypoglycemia, which is usually related to maternal diabetes or other factors.
D: Neonatal withdrawal syndrome - Although smoking during pregnancy can lead to nicotine exposure in the fetus, resulting in withdrawal symptoms after birth, the immediate risk of death is a more critical concern associated with smoking during pregnancy.