A nurse is teaching routine prenatal care to a group of clients who are pregnant.
Which of the following statements by a client indicates an understanding of the teaching?
I will be able to hear my baby's heartbeat when I am 6 weeks pregnant.
I will have monthly prenatal visits for the first 28 weeks of pregnancy.
I will have a complete blood count performed at each prenatal visit.
I will have a blood test to check for neural tube defects when I am 32 weeks pregnant.
The Correct Answer is B
Choice A rationale
Fetal cardiac activity is typically detectable via transvaginal ultrasound as early as 5.5 to 6 weeks gestational age, when the embryo is approximately 2-4 mm in crown-rump length. However, hearing the heartbeat with a Doppler stethoscope usually occurs later, around 10 to 12 weeks, as the fetal heart is still very small and sound transmission is limited.
Choice B rationale
The standard schedule for prenatal visits involves monthly appointments from the first prenatal visit until 28 weeks of gestation. This frequency allows for consistent monitoring of maternal and fetal well-being, early detection of potential complications, and timely interventions. After 28 weeks, visits typically become more frequent.
Choice C rationale
While a complete blood count (CBC) is a crucial laboratory test performed during pregnancy, it is not typically done at every prenatal visit. Initial CBCs are obtained at the first prenatal visit to establish baseline values, and then repeated later in pregnancy, often around 28 weeks, to screen for anemia and other hematologic changes.
Choice D rationale
Screening for neural tube defects, often through maternal serum alpha-fetoprotein (MSAFP) testing, is typically performed between 15 and 20 weeks of gestation. This timing is crucial for accurate interpretation of results and allows for further diagnostic evaluation if abnormalities are detected, well before 32 weeks.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Magnesium sulfate toxicity causes central nervous system depression, including respiratory depression. A respiratory rate of 12 breaths/min indicates that the respiratory depression has resolved, suggesting the calcium gluconate, a magnesium antagonist, has effectively reversed the neuromuscular blockade caused by magnesium. A normal respiratory rate is 12-20 breaths/min.
Choice B rationale
Absent deep tendon reflexes (DTRs) are a sign of magnesium sulfate toxicity due to its depressant effect on neuromuscular transmission. If calcium gluconate were effective, DTRs would return to normal or become less diminished, indicating resolution of magnesium's inhibitory effects on the nervous system.
Choice C rationale
Slurred speech is a neurological symptom associated with magnesium sulfate toxicity, reflecting central nervous system depression. If calcium gluconate were effective in reversing the toxicity, slurred speech would improve or resolve as the central nervous system depression diminishes.
Choice D rationale
Urine output of 22 mL/hr indicates oliguria, which can be a sign of worsening preeclampsia or kidney dysfunction, and is not an indicator of effective calcium gluconate administration for magnesium toxicity. Adequate urine output (typically >30 mL/hr) is essential for magnesium excretion and overall renal function.
Correct Answer is ["B","C"]
Explanation
Choice A rationale
Meconium stools are a normal physiological finding in a newborn during the first 24-48 hours of life. This thick, tarry, dark-green stool is composed of intestinal epithelial cells, amniotic fluid, bile, and water, reflecting fetal gastrointestinal tract development and function. Its presence indicates typical bowel activity.
Choice B rationale
Depressed fontanels indicate dehydration in a newborn. The fontanels are soft spots on a baby's head where the skull bones have not yet fused. When a baby is dehydrated, the fluid volume in the brain decreases, causing the fontanel to appear sunken below the normal contour of the skull, which necessitates immediate medical attention due to potential complications.
Choice C rationale
Rust-stained urine, also known as "brick dust" urine, in a newborn can indicate dehydration. This discoloration is caused by the excretion of urate crystals, which are a normal metabolic byproduct. However, in concentrated urine, these crystals become more visible, suggesting insufficient fluid intake and requiring further assessment to prevent significant dehydration.
Choice D rationale
Overlapping suture lines, also known as molding, are a common and expected finding in newborns, especially after vaginal delivery. This temporary reshaping of the fetal skull allows it to pass more easily through the birth canal and typically resolves spontaneously within a few days as the brain grows and fills the cranial cavity.
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