Nokea
Which of the following is most indicative of the presence of hydatidiform mole?
- A. A blotchy brown discoloration on the face
- B. A positive Chadwick's sign
- C. The presence of ballottement
- D. A uterus that is larger than expected
Correct Answer: D
Rationale: A uterus larger than expected for gestational age is characteristic of hydatidiform mole, a gestational trophoblastic disease.
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The nurse is caring for the pregnant client. The nurse identifies that the use of which street drug places the client at risk for placental abruption?
- A. Heroin
- B. Marijuana
- C. Oxycodone
- D. Cocaine
Correct Answer: D
Rationale: The most commonly used drug that places the pregnant client at risk for placental abruption is cocaine. Stillbirth, preterm labor and birth, and small for gestational age are also associated with cocaine use during pregnancy. Heroin use during pregnancy is associated with intrauterine growth restriction, spontaneous abortion, preterm labor and birth, and stillbirth. Marijuana use during pregnancy is primarily associated with intrauterine growth restriction. Oxycodone (OxyContin) is synthetic morphine, and its use during pregnancy is associated with intrauterine growth restriction, spontaneous abortion, preterm labor and birth, and stillbirth.
The client in labor received an epidural anesthesia 20 minutes ago. The nurse assesses that the client’s BP is 98/62 mm Hg and that the client is lying supine. What should the nurse do next?
- A. Increase the lactated Ringer’s infusion rate.
- B. Elevate the client’s legs for 2 to 3 minutes.
- C. Place the bed in 10- to 20-degree Trendelenburg.
- D. Position the client in a left side-lying position.
Correct Answer: D
Rationale: The first action is to place the client in a left side-lying position. This displaces the uterus and alleviates aortocaval compression. Increasing the infusion rate may be implemented if repositioning the client does not correct the hypotension. Elevating the client’s legs for 2 to 3 minutes is done with severe or prolonged hypertension to increase blood return from the extremities. It may be implemented after repositioning to left side, increasing the IV rate, and placing in Trendelenburg position. Placing in 10- to 20-degree Trendelenburg position is usually implemented if the BP does not increase within 1 to 2 minutes after repositioning to left side and increasing the IV flow rate.
How early in a pregnancy can the nurse expect to hear the fetal heartbeat using a Doppler device?
- A. 4 to 6 weeks
- B. 8 to 10 weeks
- C. 12 to 14 weeks
- D. 16 to 18 weeks
Correct Answer: C
Rationale: A fetal heartbeat can typically be detected by Doppler around 12-14 weeks, when the fetus is sufficiently developed.
The nurse recommends which supplement for a vegetarian pregnant client?
- A. Vitamin B12
- B. Vitamin C
- C. Calcium
- D. Magnesium
Correct Answer: A
Rationale: Vitamin B12 supplementation is crucial for vegetarian pregnant clients, as it is primarily found in animal products and supports fetal neurological development.
The pregnant client presents to a clinic with ongoing nausea, vomiting, and anorexia at 29 weeks’ gestation. Her Hgb level is 5 g/dL, and a blood smear reveals that newly formed RBCs are macrocytic. Which condition should the nurse further explore?
- A. Sickle cell anemia
- B. Folic acid deficiency anemia
- C. Beta-thalassemia minor
- D. Beta-thalassemia major
Correct Answer: B
Rationale: With the client’s symptoms and laboratory findings, the nurse should further explore folic acid deficiency. It is usually seen in the third trimester and coexists with iron-deficiency anemia. Sickle cell anemia is an inherited disorder in which the Hgb is abnormally formed. The chief symptom among individuals with sickle cell anemia is pain. Beta-thalassemia minor is an inherited hematological disorder. There is a defect in the synthesis of the beta chain within the Hgb molecule. Beta-thalassemia minor typically results in mild anemia. Beta-thalassemia major is an inherited hematological disorder. There is a defect in the synthesis of the beta chain within the Hgb molecule, but it is more severe than beta-thalassemia minor. Pregnancy in individuals with beta-thalassemia major is rare. Symptoms are usually severe anemia that warrants transfusion therapy.