A nurse on an antepartum unit is caring for a 32-year-old female client at 28 weeks gestation.

Exhibits

For each potential intervention, click to specify if the intervention is anticipated or contraindicated for the client. There must be at least one selection in every row. There does not need to be a selection in every column.

Administration of IV fluids

Continuous monitoring of FHR

Abdominal ultrasound

Digital cervical exam to assess dilation and effacement

Laboratory testing: CBC, Blood Type & Rh, Coagulation Studies

Placement of an internal fetal spiral electrode

Administration of betamethasone

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"A"}}

Administration of IV fluids: This is anticipated as it ensures the client remains well-hydrated, which is important for both maternal and fetal health.
Continuous monitoring of FHR: This is anticipated to monitor the fetal well-being and ensure there are no signs of fetal distress.
Abdominal ultrasound: This is anticipated to assess fetal growth, amniotic fluid levels, and placental positioning.
Digital cervical exam to assess dilation and effacement: This is contraindicated because frequent cervical exams can increase the risk of infection and may cause unnecessary discomfort, especially if there are no signs of labor.
Laboratory testing: CBC, Blood Type & Rh, Coagulation Studies: These tests are anticipated to provide important information about the client's blood count, blood type, Rh status, and coagulation parameters, which are crucial for managing potential complications.
Placement of an internal fetal spiral electrode: This is contraindicated as it is an invasive procedure that carries risks, and it is unnecessary given that the FHR is within normal limits with external monitoring.
Administration of betamethasone: This is anticipated as betamethasone is often given to promote fetal lung maturity in cases where there is a risk of preterm birth.

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Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A"}}

Explanation

Preterm Labor

Preterm labor refers to labor that begins before 37 weeks of gestation. The key findings associated with preterm labor are:

Cervical effacement and dilation: The client is 100% effaced and 2 cm dilated.
Regular uterine contractions: The client is experiencing contractions every 3 minutes, lasting 60 seconds.
Bloody show: The presence of bloody mucus discharge is another sign of preterm labor.
Low backache: The client reports cramping and low back pain.

Preterm Prelabor Rupture of Membranes (PPROM)

PPROM refers to the rupture of membranes before labor begins and before 37 weeks of gestation. The key findings associated with PPROM are:

Vaginal discharge: The client reported urinary leakage earlier, which could be misinterpreted as amniotic fluid leakage. Clear mucus discharge can also be a sign of ruptured membranes.

A. A positive finding indicates the inability to metabolize galactose. B. A positive finding indicates the infant will have a slow metabolism. C. A positive finding indicates an inability to metabolize certain amino acids. D. A positive finding indicates an increased risk for neurological anomalies.

Correct Answer is C

Explanation

Choice A rationale

A positive finding for galactosemia, not PKU, indicates the inability to metabolize galactose. Galactosemia is a different metabolic disorder that requires a separate dietary intervention.

Choice B rationale

A positive PKU test does not indicate slow metabolism. Instead, it signifies the inability to metabolize phenylalanine, an amino acid.

Choice C rationale

Phenylketonuria (PKU) is a genetic disorder that leads to the inability to break down the amino acid phenylalanine. Without proper management, it can accumulate in the body and cause brain damage and other health issues.

Choice D rationale

A positive PKU test is not directly linked to an increased risk for neurological anomalies in general. The specific issue in PKU is the inability to metabolize certain amino acids, primarily phenylalanine, which can cause neurological damage if untreated. .

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Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"A"}}

Explanation

A nurse is collecting a blood phenylketonuria (PKU) test for a newborn prior to discharge.The newborn's guardian asks the nurse what a positive PKU test would mean.Which of the following statements should the nurse make?

Correct Answer is C

Explanation

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