ATI RN
NCLEX Questions on Perinatal Loss Questions
Question 1 of 5
A nurse has administered Methergine (methylergonovine) 0.2 mg po to a grand multipara who delivered vaginally 30 minutes earlier. Which of the following outcomes indicates that the medication is effective?
Correct Answer: C
Rationale: In this scenario, the correct answer is option C: Fundus firm at umbilicus. Methergine is a medication commonly used to prevent or control postpartum hemorrhage by promoting uterine contractions. The firmness of the fundus at the level of the umbilicus indicates effective contraction of the uterus, which helps prevent excessive bleeding after childbirth. Option A: Blood pressure 120/80 is not a direct indicator of the effectiveness of Methergine in preventing postpartum hemorrhage. While stable blood pressure is important, it is not a specific indicator of the medication's effectiveness in this context. Option B: Pulse rate 80 bpm and regular is also not a direct indicator of the medication's effectiveness in preventing postpartum hemorrhage. A normal pulse rate is important but does not directly reflect uterine contraction and prevention of hemorrhage. Option D: Increase in prothrombin time is incorrect because an increase in prothrombin time would actually suggest a disturbance in the blood's ability to clot, which is not the desired effect of Methergine in this situation. Educationally, understanding the rationale behind the correct answer helps nurses recognize the appropriate assessment findings to monitor after administering Methergine in postpartum care. This knowledge is crucial for providing safe and effective care to postpartum patients and preventing complications such as postpartum hemorrhage.
Question 2 of 5
The nurse is circulating on a cesarean delivery of a G5P4004. All of the client's previous children were delivered via cesarean section. The physician declares after delivering the placenta that it appears that the client has a placenta accreta. Which of the following maternal complications would be consistent with this diagnosis?
Correct Answer: A
Rationale: Placenta accreta is a serious obstetric complication where the placenta attaches too deeply into the uterine wall. In this scenario, the correct answer is A) Blood loss of 2000 mL. Placenta accreta can lead to significant blood loss during delivery due to the abnormal attachment of the placenta, which can cause difficulty in separating it from the uterine wall without excessive bleeding. Option B) Blood pressure of 160/110 is incorrect because while hypertension can be a complication of placenta accreta due to blood loss, it is not a direct result of the condition itself. Option C) Jaundice skin color is incorrect as it is not a typical symptom of placenta accreta. Jaundice is usually associated with liver or hemolytic disorders. Option D) Shortened prothrombin time is incorrect because placenta accreta is more likely to cause coagulation abnormalities resulting in prolonged, not shortened, prothrombin time. In an educational context, understanding the complications associated with placenta accreta is crucial for nurses caring for women during childbirth. Recognizing the signs and symptoms of this condition is essential for timely intervention and preventing severe maternal outcomes. By knowing the correct maternal complications, nurses can provide appropriate care and support to ensure the best possible outcomes for both the mother and the baby.
Question 3 of 5
The nurse is providing education to a patient who has given birth to her first child and is being discharged home. The patient expressed concern regarding infant mortality and sudden infant death syndrome (SIDS). The patient had an uncomplicated pregnancy, labor, and vaginal delivery. She has a body mass index of 25 and has no other health conditions. The infant is healthy and was delivered full-term. What will be most helpful thing to explain to the patient?
Correct Answer: D
Rationale: The correct answer is D) The Safe to Sleep campaign. This campaign, formerly known as the Back to Sleep campaign, focuses on educating parents and caregivers on safe sleep practices to reduce the risk of Sudden Infant Death Syndrome (SIDS). It emphasizes placing babies on their backs to sleep, using a firm sleep surface, keeping soft objects and loose bedding out of the sleep area, and avoiding overheating. Option A) Uses of extracorporeal membrane oxygenation therapy (ECMO) and Option B) Uses of exogenous pulmonary surfactant are not relevant to the patient's concern about infant mortality and SIDS, as they are specific medical interventions for respiratory distress syndrome in newborns. Option C) The Baby-Friendly Hospital Initiative promotes breastfeeding support in hospitals and does not directly address the patient's concerns about infant mortality and SIDS. Educating the patient about the Safe to Sleep campaign is crucial as it empowers parents to create a safe sleep environment for their infant, which is a key preventive measure against SIDS. By providing this information, the nurse can help alleviate the patient's concerns and promote a safe sleep environment for the newborn, ultimately contributing to infant safety and well-being.
Question 4 of 5
The nurse is caring for a 16-year-old patient who is 32 weeks pregnant with her first child, who is male. The patient's mother has accompanied her to today's visit. During the nursing assessment, the patient mentions that she is no longer in a relationship with the baby's father but her mother plans to help her. However, the patient's mother asks whether this will have any impact on the child. Which should the nurse indicate the child is at increased risk of during his adolescence?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Alcohol abuse. The nurse should explain to the patient's mother that the child is at increased risk of alcohol abuse during his adolescence due to the presence of certain risk factors such as parental separation, lack of a stable family environment, and potential psychological distress faced by the child. Adolescents who experience perinatal loss or disruption in family structure may turn to alcohol as a coping mechanism or to deal with emotional challenges. Option A) Hypertension and B) Diabetes are not directly related to the situation described in the question. These conditions are more commonly associated with genetic factors, lifestyle choices, and other health-related issues rather than parental relationship status. Option D) Intraventricular bleeding is a medical condition typically seen in premature infants and is not linked to the child's risk of alcohol abuse during adolescence. Educationally, this question highlights the importance of understanding the potential long-term effects of perinatal loss and family dynamics on child development. It emphasizes the need for healthcare providers to be aware of the social determinants of health and how they can impact a child's future well-being. By recognizing these risk factors, nurses can provide appropriate support and interventions to promote the child's healthy development and prevent negative outcomes.
Question 5 of 5
A pregnant woman weighs 90.9 kg. The nurse is educating the patient on complications that the patient may be at risk for during pregnancy. Which response by the patient indicates that she understands?
Correct Answer: A
Rationale: The correct answer is option A) "Due to my weight, there is a possibility that I may develop gestational diabetes." This response indicates that the patient understands the increased risk of gestational diabetes associated with being overweight. Obesity is a well-known risk factor for gestational diabetes as excess weight can lead to insulin resistance, which is a key factor in the development of diabetes during pregnancy. Option B is incorrect because weight is a significant risk factor for gestational diabetes, regardless of whether the patient considers themselves overweight or not. Option C is irrelevant to the question as it talks about the patient's mother's medical history, which does not directly relate to the patient's risk factors. Option D is incorrect because while a glucose tolerance test may be necessary, it does not address the underlying risk factor of weight in relation to gestational diabetes. Educationally, this question highlights the importance of patient education on risk factors for complications during pregnancy. It emphasizes the need for healthcare providers to educate patients on how factors like weight can impact their pregnancy and the importance of managing these risks to ensure a healthy outcome for both the mother and the baby.