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Which laboratory result would be a cause for concern if exhibited by a patient at her first prenatal visit during the second month of her pregnancy?
- A. Rubella titer, 1:6
- B. Platelets, 300,000/mm3
- C. White blood cell count, 6000/mm3
- D. Hematocrit 38%, hemoglobin 13 g/dL
Correct Answer: A
Rationale: The correct answer is A: Rubella titer, 1:6. A low rubella titer indicates susceptibility to rubella infection, which can be harmful during pregnancy. Rubella can lead to birth defects or miscarriage. Platelets, WBC count, and hematocrit/hemoglobin levels are within normal range and not typically concerning during the early stages of pregnancy.
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A client who had a vaginal delivery 2 hours earlier has just been transferred to the postpartum unit from labor and delivery. Which of the following nursing care goals is of highest priority?
- A. The client will breastfeed her baby every 2 hours.
- B. The client will consume a nutritious diet.
- C. The client will have a moderate lochial flow.
- D. The client will ambulate in the hallways every shift.
Correct Answer: C
Rationale: Ensuring the client has a moderate lochial flow is a priority to monitor for postpartum hemorrhage.
A client is receiving terbutaline (Brethine) IV for preterm labor. Which of the following maternal findings would warrant stopping the infusion?
- A. Cardiac arrhythmias.
- B. Respiratory rate 24 rpm.
- C. Blood pressure 90/60.
- D. Hypocalcemia.
Correct Answer: A
Rationale: Cardiac arrhythmias are a serious side effect of terbutaline and would warrant stopping the infusion to prevent further complications.
An older adult patient has extensive wound care needs after discharge from the hospital. Which facility should the nurse discuss with the patient?
- A. Hospice
- B. Respite care
- C. Assisted living
- D. Skilled nursing
Correct Answer: D
Rationale: An intermediate care or skilled nursing facility offers skilled care from a licensed nursing staff.
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.
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.