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A nurse is teaching a client who is at 15 weeks of gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? (Select all that apply.)

Rh incompatibility

Fetal gender

Cephalopelvic disproportion

Anomalies in fetal chromosomes

Neural tube defects

Answer and Explanation

Correct Answer : B,D,E

Explanation:

A. Rh incompatibility

Amniocentesis is not used to identify Rh incompatibility. Rh incompatibility occurs when the mother is Rh-negative, and the baby is Rh-positive, leading to potential complications if the mother develops antibodies against the baby's Rh-positive blood cells. However, this condition is typically managed through other means such as Rh immunoglobulin (RhIg) administration.

B. Fetal gender

Amniocentesis can determine the fetal gender by analyzing the chromosomes present in the fetal cells obtained from the amniotic fluid. The presence of a Y chromosome indicates a male fetus, while its absence indicates a female fetus. Therefore, fetal gender can be identified through amniocentesis.

C. Cephalopelvic disproportion

Cephalopelvic disproportion refers to a situation where the baby's head is too large to pass through the mother's pelvis during childbirth. This condition is typically diagnosed during labor based on the progress of labor and fetal descent. Amniocentesis is not used to identify cephalopelvic disproportion.

D. Anomalies in fetal chromosomes

Amniocentesis is primarily used to identify anomalies in fetal chromosomes, such as chromosomal abnormalities like Down syndrome (Trisomy 21), Trisomy 18, and Trisomy 13. It can also detect other chromosomal abnormalities and genetic disorders caused by changes in the number or structure of chromosomes.

E. Neural tube defects

Amniocentesis can detect neural tube defects, such as spina bifida and anencephaly, by analyzing levels of alpha-fetoprotein (AFP) and other markers in the amniotic fluid. Elevated levels of AFP may indicate a neural tube defect.

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Correct Answer is D

Explanation

Explanation:

A. Acarbose:

Acarbose is an oral antidiabetic medication that works by slowing down the digestion and absorption of carbohydrates in the intestines. It is typically used in the management of type 2 diabetes but is not commonly prescribed for gestational diabetes mellitus (GDM). Acarbose is not usually recommended during pregnancy, especially since there are other safer options available for managing GDM.

B. Repaglinide:

Repaglinide is another oral antidiabetic medication that stimulates insulin release from the pancreas. While it is effective in lowering blood sugar levels, it is not commonly used as a first-line treatment for gestational diabetes. Repaglinide may have a more rapid onset of action compared to other oral antidiabetic drugs, but its use during pregnancy is not as common as other medications like glyburide or insulin.

C. Glipizide:

Glipizide is an oral sulfonylurea medication used primarily in the management of type 2 diabetes. It stimulates insulin secretion from the pancreas. However, like other sulfonylureas, glipizide is not typically recommended for use during pregnancy due to safety concerns for the developing fetus. It may also have a higher risk of hypoglycemia compared to other options.

D. Glyburide:

Glyburide is an oral sulfonylurea medication that helps lower blood sugar levels by stimulating insulin release from the pancreas. It is one of the commonly used medications for managing gestational diabetes when diet and exercise alone are not sufficient. Glyburide is generally considered safe for use during pregnancy, especially after the first trimester, and it has been found to effectively control blood glucose levels in many pregnant individuals with GDM.

A. A client who is at 38 weeks of gestation and reports a cough and fever B. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding C. A client who is at 14 weeks of gestation and reports nausea and vomiting D. A client who has missed a period and reports vaginal spotting

Correct Answer is A

Explanation

Explanation:

A. A client who is at 38 weeks of gestation and reports a cough and fever.

The client at 38 weeks of gestation with a cough and fever presents with symptoms that could indicate a potential infection, such as respiratory or urinary tract infection, which can be serious during pregnancy. Infections in late pregnancy can also increase the risk of complications for both the mother and the baby. Therefore, assessing this client first is crucial to evaluate and address any potential infection and prevent complications.

B. A client who is at 28 weeks of gestation and reports painless vaginal bleeding.

Painless vaginal bleeding can be a concern, especially in the second or third trimester, as it may indicate conditions such as placenta previa or placental abruption. However, since this client's bleeding is painless, it may not be an immediate emergency compared to the potential infection in option A.

C. A client who is at 14 weeks of gestation and reports nausea and vomiting.

Nausea and vomiting, commonly known as morning sickness, are common during early pregnancy. While these symptoms can be uncomfortable, they are typically not urgent unless they lead to dehydration or other complications, which would require assessment but may not be as urgent as a potential infection in option A.

D. A client who has missed a period and reports vaginal spotting.

Vaginal spotting can occur in early pregnancy and may or may not be concerning depending on the amount and frequency. Since this client has missed a period, it suggests early pregnancy, and spotting can be relatively common in early pregnancy without indicating a significant problem. However, assessment is still needed to rule out any potential complications.

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A nurse is teaching a client who is at 15 weeks of gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? (Select all that apply.)

Nursing Test Bank

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