A nurse in a prenatal clinic is caring for a client who is pregnant and asks the nurse for her estimated date of birth (EDB). The client's last menstrual period began on July 27. What is the client's EDB? (State the date in MMDD format. For example, July 27 is 0727.)

Answer and Explanation

The Correct Answer is ["0504"]

To calculate the estimated date of birth (EDB), also known as the due date, we use Naegele's Rule, which involves adding one year, subtracting three months, and adding seven days to the first day of the last menstrual period (LMP). Using this rule, if the LMP was on July 27, the EDB would be:

- Add one year: July 27, 2024
- Subtract three months: April 27, 2024
- Add seven days: May 4, 2024

Therefore, the EDB in MMDD format is 0504.
Reason:
Naegele's Rule is a standard way of calculating the due date for a pregnancy. The rule estimates the expected date of delivery (EDD) by adding one year, subtracting three months, and adding seven days to the date of a woman's last menstrual period (LMP). This calculation assumes a regular menstrual cycle of 28 days and ovulation occurring on the 14th day of the cycle. The EDB is typically set at 40 weeks from the LMP, which is approximately 280 days. While this method provides an estimate, only about 4% of births occur on the exact due date, and most births occur within a range of two weeks before or after the estimated due date.

It's important to note that the EDB is an estimate and can be influenced by factors such as the length of menstrual cycles, the exact day of ovulation, and the date of conception. Ultrasounds and other prenatal tests can provide additional information to refine the due date estimate as the pregnancy progresses.

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Correct Answer is B

Explanation

Choice A reason:
Initiating pushing in a client with suspected placenta previa is contraindicated. Placenta previa is a condition where the placenta covers the cervix, and pushing could lead to severe bleeding and compromise both the mother and the fetus. The normal labor process involves pushing only after full cervical dilation, and in the case of placenta previa, this could exacerbate the condition.

Choice B reason:
Preparation for cesarean birth is the correct action when placenta previa is suspected. With placenta previa, vaginal delivery could cause significant hemorrhage due to the placenta's position over the cervical opening. A cesarean birth bypasses the cervix, thereby avoiding disruption of the placenta and preventing excessive bleeding.

Choice C reason:
Magnesium sulfate is used in obstetrics to prevent seizures in preeclampsia and to delay preterm labor, not for placenta previa. While it is important to manage the client's overall condition, magnesium sulfate would not address the immediate concern of potential hemorrhage due to placenta previa.

Choice D reason:
An examination to determine cervical status in the presence of placenta previa should be avoided unless absolutely necessary and performed under controlled conditions, such as in an operating room where a cesarean delivery can be performed if needed. Digital cervical examinations can dislodge the placenta and cause bleeding.

A. Placental insufficiency B. Fetal hyperinsulinemia C. Preterm delivery D. Perinatal asphyxia

Correct Answer is A

Explanation

Choice A reason:
Placental insufficiency is a significant cause of a newborn being small for gestational age. It occurs when the placenta cannot deliver an adequate supply of nutrients and oxygen to the fetus. This condition can result from several factors, including maternal hypertension, diabetes, and certain infections. Placental insufficiency leads to intrauterine growth restriction (IUGR), which is often diagnosed when a fetus's estimated weight is below the 10th percentile for its gestational age¹². The normal range for fetal growth varies, but a key indicator is the consistent growth along a certain percentile line on growth charts.

Choice B reason:
Fetal hyperinsulinemia is typically associated with mothers who have diabetes. Insulin acts as a growth hormone; thus, excessive insulin can lead to macrosomia, where the newborn is larger than normal for the gestational age, not smaller². Therefore, fetal hyperinsulinemia is not a likely cause of SGA.

Choice C reason:
Preterm delivery can result in a newborn being small for gestational age simply due to the fact that the baby is born before reaching full term and having the opportunity to achieve the expected in-utero growth. However, being born preterm does not necessarily mean the infant is SGA; it means the infant is smaller than full-term babies because they have had less time to grow in utero¹.

Choice D reason:
Perinatal asphyxia refers to a lack of oxygen to the fetus during the time immediately before, during, or after birth. While it can lead to various complications and is a serious condition, it is not a direct cause of a newborn being small for gestational age. Perinatal asphyxia can occur in infants of any gestational age or size².

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A nurse in a prenatal clinic is caring for a client who is pregnant and asks the nurse for her estimated date of birth (EDB). The client's last menstrual period began on July 27. What is the client's EDB? (State the date in MMDD format. For example, July 27 is 0727.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads in the past 30 minutes. The nurse suspects placenta previa. Which of the following is an appropriate nursing action?

Correct Answer is B

Explanation

A nurse is providing teaching to the mother of a newborn born small for gestational age (SGA). Which of the following should the nurse include as a possible cause of this condition?

Correct Answer is A

Explanation

A nurse is caring for a client who has preeclampsia and is being treated with magnesium sulfate. The client's respiratory rate is 10/min, and deep-tendon reflexes are absent. Which of the following actions should the nurse take?

A nurse is preparing to administer methylergonovine IM to a client who has experienced a vaginal delivery. The nurse should explain to the client that the purpose of this medication is to prevent which of the following conditions?

A nurse is teaching a client who is at 23 weeks of gestation and will return to the facility in 2 days for an amniocentesis. Which of the following instructions should the nurse give the client?

A nurse is assessing a client who is pregnant for preeclampsia. Which of the following findings should indicate to the nurse that the client requires further evaluation for this disorder?

A nurse is caring for a client who is at 36 weeks of gestation and has a suspected placenta previa. Which of the following findings support this diagnosis?

A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make?