Nokea
Which of the following are probable signs, strongly indicating pregnancy?
- A. The presence of fetal heart sounds is a positive sign of pregnancy; quickening is a presumptive sign of pregnancy.
- B. These are presumptive signs. They may indicate pregnancy or they may be caused by other conditions, such as disease processes.
- C. Hegar’s sign is a softening of the lower uterine segment, and Chadwick's sign is the bluish or purplish color of the cervix as a result of the increased blood supply and increased estrogen. Ballottement occurs when the cervix is tapped by an examiner's finger and the fetus floats upward in the amniotic fluid and then falls downward.
- D. These are presumptive signs that might indicate pregnancy, but they might be caused by other conditions, such as disease processes.
Correct Answer: C
Rationale: The correct answer is C because Hegar's sign and Chadwick's sign are considered probable signs of pregnancy. Hegar's sign indicates softening of the lower uterine segment, a physiological change that typically occurs in pregnancy. Chadwick's sign refers to the bluish or purplish color of the cervix due to increased blood supply and estrogen levels in pregnancy. These signs are more specific to pregnancy compared to presumptive signs like quickening, which can be caused by other conditions. Ballottement is a technique used to assess fetal movement and position, not a sign indicating pregnancy certainty. Therefore, choices A, B, and D are incorrect as they refer to presumptive signs or signs that could be caused by conditions other than pregnancy.
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An hour after delivery, a 4000 gram infant exhibits pallor, jitteriness, a blood sugar level of 40 gm/dL, irritability and periodic apnea. Which maternal condition could be the cause of the newborn's symptoms?
- A. Drug addiction
- B. Pregnancy-induced hypertension
- C. TORCH infection
- D. Gestational diabetes
Correct Answer: D
Rationale: The correct answer is D: Gestational diabetes. Infants born to mothers with gestational diabetes are at risk for hypoglycemia due to excessive production of insulin in response to maternal hyperglycemia. This causes the infant's blood sugar level to drop, leading to symptoms such as pallor, jitteriness, irritability, and apnea. The maternal condition directly affects the newborn's blood sugar levels, explaining the infant's symptoms.
Choice A: Drug addiction does not directly cause hypoglycemia in the newborn.
Choice B: Pregnancy-induced hypertension would not typically result in hypoglycemia in the newborn.
Choice C: TORCH infections are unlikely to cause the specific symptoms described in the newborn.
In summary, only gestational diabetes directly affects the newborn's blood sugar levels, leading to the observed symptoms.
If a pregnant client diagnosed with gestational diabetes cannot maintain control of her blood sugar by diet alone, which medication will she receive?
- A. Metformin (Glucophage)
- B. Glucagon
- C. Insulin
- D. Glyburide (DiaBeta)
Correct Answer: C
Rationale: The correct answer is C: Insulin. Insulin is the preferred medication for managing gestational diabetes as it is safe for the fetus and provides precise blood sugar control. Metformin (A) and Glyburide (D) are alternatives if insulin is not tolerated, but they may cross the placenta and have potential risks. Glucagon (B) is not used for diabetes management but for treating severe hypoglycemia.
A nurse is reinforcing teaching to a group of parents about preventing accidental poisoning in preschoolers. Which of the following should the nurse include?
- A. Have syrup of ipecac available in the home.
- B. Explain to preschool children that plants can be eaten only after they are cooked.
- C. Keep labels on containers of toxic substances and never remove them.
- D. Place medications in a cabinet above the sink.
Correct Answer: C
Rationale: The correct answer is C: Keep labels on containers of toxic substances and never remove them. This is important to prevent accidental poisoning in preschoolers as it helps parents and caregivers easily identify and differentiate toxic substances from safe ones. Removing labels can lead to confusion and increase the risk of accidental ingestion. Having syrup of ipecac available (choice A) is no longer recommended as a first-aid treatment for poisoning. Teaching children to cook plants before eating them (choice B) is not a practical or safe approach. Placing medications in a cabinet above the sink (choice D) may not be effective as preschoolers can still access them if the cabinet is not securely locked.
A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening. Which of the following statements should the nurse include in the teaching?
- A. Obtain an informed consent prior to obtaining the specimen
- B. Collect at least milliliter of the urine for the test
- C. Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen.
- D. Premature newborns may have false negative tests due to immature development of liver enzymes.
Correct Answer: C
Rationale: The correct answer is C: Ensure that the newborn has been receiving feedings for 24 hours prior to obtaining the specimen. This is important because certain metabolic disorders can only be detected if the baby has been feeding normally. Without proper feeding, the test results may not be accurate.
Choice A is incorrect because informed consent is not required for universal newborn screening; it is a routine procedure. Choice B is incorrect as urine is not typically used for the universal newborn screening. Choice D is incorrect because premature newborns may have false positive tests, not false negative tests, due to immature liver enzyme development.
Which of the following approaches is the most accurate way to measure the heart rate of a 10-month-old infant?
- A. "Apical"'
- B. "Radial"'
- C. "Ulna"'
- D. "Brachial"'
Correct Answer: A
Rationale: The correct answer is A: "Apical." This method involves placing the stethoscope over the apex of the heart to directly listen to the heart sounds. In infants, especially 10-month-olds, the apical pulse is more accurate as it allows for a direct assessment of the heart rate without interference from other factors like peripheral pulses. The apical pulse is easier to locate in infants due to their smaller chest size and thinner chest walls. Choices B, C, and D (Radial, Ulna, and Brachial) are incorrect for measuring heart rate in infants as they involve peripheral pulse sites which may not provide an accurate representation of the heart rate due to various factors like weak pulses or difficulty in palpating them accurately in infants.