A nurse is preparing a client who is at 10 weeks of gestation for an ultrasound procedure.
Which of the following statements should the nurse make?
"With this procedure, we will be able to determine the biological sex of your fetus.”.
"With this procedure, we will be able to detect congenital anomalies.”.
"This procedure will help in determining your expected delivery date.”.
"This procedure will determine if you have enough amniotic fluid.”.
The Correct Answer is C
Choice A rationale
At 10 weeks of gestation, the external genitalia of the fetus are not yet fully differentiated or large enough to be reliably visualized and identified as male or female on an ultrasound. Fetal sex determination is typically more accurate later in pregnancy, usually after 16-20 weeks, when anatomical structures are more developed and distinct.
Choice B rationale
While some major structural congenital anomalies might be detectable at 10 weeks, a comprehensive and detailed assessment for a wide range of congenital anomalies is usually performed during the anomaly scan, which is typically conducted between 18 and 22 weeks of gestation. Fetal development is still ongoing at 10 weeks.
Choice C rationale
An ultrasound performed in the first trimester, particularly around 10 weeks, is highly accurate for estimating gestational age and, consequently, the expected delivery date. This is because fetal growth is very consistent during this period, allowing for precise measurements such as crown-rump length to determine gestational age within a small margin of error.
Choice D rationale
Assessment of amniotic fluid volume, often quantified using the amniotic fluid index (AFI) or deepest vertical pocket, is more commonly performed in the second and third trimesters of pregnancy. At 10 weeks, the amniotic fluid volume is relatively small, and its adequacy is not typically a primary focus of an early ultrasound unless there are specific concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Hydrocodone is an opioid analgesic, but it is typically used for moderate to severe pain and is not commonly administered as a primary agent for severe active labor pain due to its slower onset and potential for more pronounced maternal and neonatal respiratory depression compared to other rapid-acting opioids.
Choice B rationale
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) primarily used for mild to moderate pain and inflammation. It is generally not effective enough for severe labor pain and is contraindicated in late pregnancy due to potential adverse effects on fetal circulation, such as premature closure of the ductus arteriosus.
Choice C rationale
Naloxone hydrochloride is an opioid antagonist used to reverse opioid-induced respiratory depression. Administering naloxone during active labor would reverse the effects of any pain medication given, exacerbating the client's pain and potentially precipitating opioid withdrawal symptoms, thus it is not an appropriate pain management strategy.
Choice D rationale
Fentanyl citrate is a potent, rapid-acting synthetic opioid analgesic commonly used for severe pain during active labor. Its quick onset and short duration of action make it suitable for intermittent administration, allowing for effective pain relief with a lower risk of prolonged neonatal respiratory depression compared to longer-acting opioids.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Vacuum-assisted delivery increases the risk of postpartum hemorrhage due to potential trauma to the birth canal and uterine atony caused by prolonged pressure or rapid extraction. The vacuum device can bruise the cervix, vagina, or perineum, leading to lacerations that bleed excessively. It can also overstretch uterine muscles, impairing their ability to contract effectively after birth.
Choice B rationale
A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal weight range for a full-term infant. This weight does not typically pose an increased risk for postpartum hemorrhage. Larger infants (macrosomia, generally > 4 kg) are associated with higher risks due to increased uterine stretching and potential for prolonged labor or birth trauma.
Choice C rationale
Labor induction with oxytocin significantly increases the risk for postpartum hemorrhage, particularly due to uterine atony. Prolonged oxytocin administration can lead to desensitization of myometrial receptors, reducing the uterus's ability to contract effectively postpartum. This impaired contractility prevents compression of uterine blood vessels, resulting in excessive bleeding.
Choice D rationale
A history of uterine atony is a substantial risk factor for recurrent postpartum hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, accounting for a majority of cases. A prior history indicates a predisposition for the uterine musculature to fail in contracting adequately after birth, leading to uncontrolled blood loss.
Choice E rationale
A history of human papillomavirus (HPV) infection does not directly increase the risk of postpartum hemorrhage. HPV is a viral infection that primarily affects epithelial cells, often leading to genital warts or cervical dysplasia. It does not inherently alter uterine contractility, coagulation factors, or predispose to abnormal placental implantation, which are direct causes of hemorrhage.
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