A nurse is reinforcing teaching with a client who is at 23 weeks of gestation and will return to the facility the following week for an amniocentesis. Which of the following instructions should the nurse include?

Empty her bladder immediately prior to the procedure.

Refrain from eating breakfast on the day of the procedure.

Give herself a hypertonic enema the day before the procedure.

Wash her abdomen with soap and water the morning of the procedure.

Answer and Explanation

The Correct Answer is A

Choice A rationale: An amniocentesis involves inserting a needle through the abdominal wall into the amniotic sac to obtain a sample of amniotic fluid. Emptying the bladder before the procedure reduces the risk of bladder puncture during the process.
Choice B rationale: Fasting is not typically necessary for an amniocentesis. It is generally done on an outpatient basis, and fasting is not required.
Choice C rationale: An enema is not necessary before an amniocentesis and is not part of the standard preparation.
Choice D rationale: While cleanliness is important, this instruction is not specific to an amniocentesis and is not a standard pre-procedure requirement.

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Correct Answer is C

Explanation

Choice A rationale: The presence of phosphatidylglycerol (PG) in the amniotic fluid is another indicator of fetal lung maturity. The absence of PG is associated with an increased risk of respiratory distress syndrome (RDS) in the newborn.
Choice B rationale: A nonstress test is a test performed during pregnancy to evaluate the fetal heart rate in response to fetal movement. It is not directly related to assessing fetal lung maturity.
Choice C rationale: The L/S ratio is an important indicator of fetal lung maturity. Lecithin and sphingomyelin are two surfactants present in the lungs, and the ratio of these two substances increases as the fetal lungs mature. An L/S ratio of 2:1 or greater is considered an indication of lung maturity and suggests that the newborn should be able to breathe adequately after birth.
Choice D rationale: The biophysical profile (BPP) is a prenatal ultrasound assessment of the fetus, which includes evaluating fetal movements, breathing, heart rate, and amniotic fluid volume. While a BPP of 8 is a reassuring score, it does not provide direct information about fetal lung maturity.

A. Gestational hypertension B. Small for gestational age newborn C. Precipitous birth D. Two-vessel umbilical cord

Correct Answer is C

Explanation

Choice A rationale: While gestational hypertension can have various implications for the mother and baby, it is not directly associated with an increased risk of postpartum hemorrhage.
Choice B rationale: The birth of a small-for-gestational-age newborn may have certain implications, but it is not directly associated with an increased risk of postpartum hemorrhage.
Choice C rationale: Precipitous birth, which refers to an extremely rapid labor and delivery lasting less than 3 hours, is a risk factor for postpartum hemorrhage. Rapid delivery can lead to incomplete uterine contractions and inadequate uterine tone, increasing the risk of excessive bleeding after birth.
Choice D rationale: A two-vessel umbilical cord, also known as a single umbilical artery, may be associated with certain fetal anomalies but is not directly related to an increased risk of postpartum hemorrhage.

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A nurse is reinforcing teaching with a client who is at 23 weeks of gestation and will return to the facility the following week for an amniocentesis. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

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