ATI RN
NCLEX Questions on Perinatal Loss Questions
Question 1 of 5
A nursing student is asked to set goals that will decrease the fetal death outcomes during delivery. What guidelines will the nursing student use to assist in setting her goals?
Correct Answer: B
Rationale: In this scenario, the correct answer is option B) Healthy People 2020. The Healthy People 2020 initiative provides science-based, 10-year national objectives for improving the health of all Americans. It specifically addresses perinatal health and sets goals for reducing fetal death outcomes during delivery. By using the guidelines from Healthy People 2020, the nursing student can align her goals with national objectives and evidence-based practices to effectively decrease fetal death rates. Option A) WHO Maternal care guidelines may provide valuable information on a global scale, but for this specific question regarding decreasing fetal death outcomes in the context of the United States, referring to national objectives like Healthy People 2020 would be more appropriate. Option C) AWHONN white papers are resources from the Association of Women's Health, Obstetric and Neonatal Nurses, which are valuable for clinical practice guidelines and recommendations, but may not specifically address national objectives related to decreasing fetal death outcomes during delivery. Option D) State Practice Act outlines the legal scope of nursing practice within a specific state, which is important for ensuring safe and ethical care, but it does not provide guidelines for setting goals to decrease fetal death outcomes during delivery at a national level. For nursing students, understanding and utilizing national health objectives like Healthy People 2020 is crucial for evidence-based practice and aligning care goals with broader public health initiatives. By incorporating these guidelines into their practice, nursing students can contribute to improving perinatal health outcomes and providing quality care to mothers and infants.
Question 2 of 5
A client, 2 days postpartum from a spontaneous vaginal delivery, asks the nurse about postpartum exercises. Which of the following responses by the nurse is appropriate?
Correct Answer: D
Rationale: The correct answer is D: "You can do some Kegel exercises today and then slowly increase your toning exercises over the next few weeks." This response is appropriate because it provides the client with specific guidance on postpartum exercises that are safe and beneficial for her recovery. Kegel exercises help strengthen the pelvic floor muscles, which can be done early postpartum to promote healing. Slowly increasing toning exercises over time is important to prevent injury and allow the body to regain strength gradually. Option A is incorrect because the client does not need to wait until the six-week checkup to start any form of exercise. Option B is incorrect as it limits the client to only Kegel exercises when a gradual return to other exercises is safe. Option C is incorrect because returning to the pre-pregnancy exercise routine immediately postpartum can be too strenuous for the body that is still healing. Educationally, it is important for nurses to provide evidence-based guidance on postpartum exercises to promote the physical well-being and recovery of clients. Understanding the physiological changes that occur during pregnancy and childbirth is crucial in tailoring exercise recommendations to each individual's needs. Encouraging gradual progression in exercise routines can help prevent complications and support the client's overall health and fitness goals postpartum.
Question 3 of 5
Which finding would the nurse view as normal when evaluating the laboratory reports of a 34-week gestation client?
Correct Answer: A
Rationale: In this scenario, the correct answer is option A) Anemia. During pregnancy, the maternal blood volume increases to support the growing fetus. This physiological hemodilution commonly leads to a mild decrease in red blood cells and hemoglobin levels, resulting in a state of relative anemia in pregnant individuals. Therefore, a 34-week gestation client would likely exhibit signs of anemia as a normal finding in their laboratory reports. Option B) Thrombocytopenia, a low platelet count, is not a normal finding in a 34-week gestation client. Thrombocytopenia can lead to an increased risk of bleeding, which is particularly concerning during childbirth. Option C) Polycythemia, an elevated red blood cell count, is also not a typical finding in a 34-week gestation client. Polycythemia can lead to complications such as increased blood viscosity, which may impair circulation and oxygen delivery to the fetus. Option D) Hyperbilirubinemia, an increase in bilirubin levels, is not expected in a 34-week gestation client. Hyperbilirubinemia is commonly associated with conditions like jaundice in newborns rather than pregnant individuals. Educationally, understanding the normal physiological changes that occur during pregnancy is crucial for nurses caring for pregnant clients. Recognizing what is considered normal versus abnormal helps in providing appropriate care and identifying potential complications promptly. This knowledge is especially important when interpreting laboratory reports and assessing the overall health status of pregnant clients.
Question 4 of 5
A 3-month-old baby has been diagnosed with cystic fibrosis. The mother states, 'How could this happen? I had an amniocentesis during my pregnancy and everything was supposed to be normal!' What does the nurse understand about this situation?
Correct Answer: B
Rationale: In this scenario, option B is correct: "The baby may have an uncommon genetic variant of the disease." This answer is correct because cystic fibrosis can result from various genetic mutations, and not all genetic variants associated with the condition may be detectable through standard prenatal testing like amniocentesis. Option A, "Cystic fibrosis cannot be diagnosed by amniocentesis," is incorrect because while amniocentesis can detect certain genetic disorders, it may not identify all possible genetic variations linked to cystic fibrosis. Option C, "The amniocentesis results were likely inaccurate," is incorrect as it assumes a fault in the testing process, which may not necessarily be the case. Amniocentesis results are generally reliable for the conditions they are designed to detect. Option D, "Cystic fibrosis develops after birth and cannot be detected prenatally," is incorrect as cystic fibrosis is a genetic condition that is present from birth, although symptoms may manifest later. Educationally, this question highlights the complexities of genetic testing and the limitations of prenatal screening methods. It underscores the importance of genetic counseling and the need for parents to understand that not all genetic variations may be identified through prenatal testing, emphasizing the value of ongoing medical surveillance and care for infants at risk for genetic conditions like cystic fibrosis.
Question 5 of 5
After a Preparation for Parenting class session, a pregnant client tells the nurse that she has had some yellow-gray frothy vaginal discharge and local itching. The nurse's best action is to advise the client to do which of the following?
Correct Answer: B
Rationale: Rationale: The correct answer is B) Schedule an appointment at the clinic for an examination. The client's symptoms of yellow-gray frothy vaginal discharge and itching could indicate a possible infection, such as bacterial vaginosis or trichomoniasis, rather than a yeast infection. It is essential for the client's health and the health of the fetus to have a healthcare provider evaluate and diagnose the condition accurately. Option A) Using an over-the-counter cream for yeast infections is not appropriate in this case because the symptoms described are not typical of a yeast infection. Misdiagnosis and inappropriate treatment could lead to worsening of the condition. Option C) Administering a vinegar douche under low pressure is not recommended as it can disrupt the natural pH balance of the vagina and worsen the symptoms or even lead to further complications. Option D) Preparing for preterm labor and delivery is premature and not indicated based solely on the client's symptoms of vaginal discharge and itching. It is essential to rule out any infections or other underlying issues first before considering preterm labor. In an educational context, this question highlights the importance of accurate assessment and appropriate intervention in perinatal care. Nurses need to be vigilant in recognizing abnormal symptoms in pregnant clients and guiding them to seek proper medical evaluation and treatment to ensure the well-being of both the mother and the baby.