Nokea
Which of the following vital sign changes should the nurse highlight for a pregnant woman’s obstetrician?
- A. Prepregnancy blood pressure (BP) 100/60 and third trimester BP 140/90.
- B. Prepregnancy respiratory rate (RR) 16 rpm and third trimester RR 22 rpm.
- C. Prepregnancy heart rate (HR) 76 bpm and third trimester HR 88 bpm.
- D. Prepregnancy temperature (T) 98.6°F and third trimester T 99.2°F.
Correct Answer: A
Rationale: A significant increase in blood pressure, particularly to 140/90, could indicate preeclampsia and should be highlighted for further evaluation. The other changes are within normal limits for pregnancy.
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Why is pregnancy planning important for women of childbearing age?
- A. Much organogenesis occurs before the missed period
- B. Insurance preapproval is required
- C. No more than 3 pregnancies are recommended
- D. Pregnancies less than 2 years apart stress the cardiovascular system
Correct Answer: A
Rationale: Organogenesis occurs early in pregnancy, often before a missed period, making early intervention critical for fetal health.
A nurse is assessing the fetal heart rate of a laboring person. What is the most significant finding that would indicate fetal distress?
- A. variable decelerations
- B. late decelerations
- C. bradycardia
- D. accelerations
Correct Answer: C
Rationale: The correct answer is C, bradycardia. Bradycardia in the fetal heart rate is a significant finding indicating fetal distress because it signifies a heart rate below normal range, which can lead to inadequate oxygen supply to the fetus. Bradycardia can be a sign of fetal hypoxia, acidosis, or other serious conditions. Variable decelerations (choice A) are often caused by umbilical cord compression, late decelerations (choice B) are associated with uteroplacental insufficiency, and accelerations (choice D) are considered a reassuring sign of fetal well-being. Therefore, in the context of fetal distress, bradycardia is the most concerning finding.
A multigravid client is 22 weeks pregnant. Which of the following symptoms would the nurse expect the client to exhibit?
- A. Nausea.
- B. Dyspnea.
- C. Urinary frequency.
- D. Leg cramping.
Correct Answer: D
Rationale: Leg cramping is a common complaint during the second trimester. Nausea is more common in the first trimester, and dyspnea and urinary frequency are more common in the third trimester.
The clinic nurse is obtaining a health history on a newly pregnant patient. Which is an indication for fetal diagnostic procedures if present in the health history?
- A. Maternal diabetes
- B. Weight gain of 25 lb
- C. Maternal age older than 30 years
- D. Previous infant weighing more than 3000 g at birth
Correct Answer: A
Rationale: Maternal diabetes is a risk factor in pregnancy due to possible impairment of placental perfusion, necessitating fetal diagnostic procedures.
During an ultrasound, two amnions and two placentas are observed. What will be the most likely result of this pregnancy?
- A. Dizygotic twins
- B. Monozygotic twins
- C. Conjoined twins
- D. High birth-weight twins
Correct Answer: A
Rationale: Dizygotic twins always have two amnions and two chorions (placentas).