A patient who had premature rupture of the membranes (PROM) earlier in the pregnancy at 28 weeks returns to the labor unit 1 week later complaining that she is now in labor. The labor and birth nurse performs the NfollRowiIng aGssesBsm.eCntsM. The vaginal exam is deferred until the U S N T O physician is in attendance. The patient is placed on electronic fetal monitoring (EFM) and a baseline FHR of 130 bpm is noted. No contraction pattern is observed. The patient is then transferred to the antepartum unit for continued observation. Several hours later, the patient complains that she does not feel the baby move. Examination of the abdomen reveals a fundal height of 34 cm. Muscle tone is no different from earlier in the hospital admission. The patient is placed on the EFM and no fetal heart tones are observed. What does the nurse suspect is occurring?

Correct Answer: D

Rationale: The correct answer is D: Hidden placental abruption. In this scenario, the patient had PROM and is now presenting with decreased fetal movement and absence of fetal heart tones after a fundal height increase. These signs suggest a hidden placental abruption, where the placenta has partially detached, leading to fetal distress and potential fetal demise. The absence of contractions rules out active labor (B) as the cause. Placental previa (A) would typically present with painless vaginal bleeding, which is not described in the scenario. Placental abruption (C) usually presents with painful vaginal bleeding, which is also not mentioned. Therefore, the most likely explanation for the symptoms described is a hidden placental abruption.

Correct Answer: C

Rationale: The correct answer is C: Degree of glycemic control before and during the pregnancy. Proper glycemic control is crucial in managing complications in a pregnant patient with diabetes. Uncontrolled blood sugar levels can lead to maternal, fetal, and neonatal complications. Monitoring and maintaining stable blood glucose levels before and during pregnancy help reduce the risk of adverse outcomes. A: Evaluation of retinopathy by an ophthalmologist - Although important for overall health, retinopathy does not directly impact maternal, fetal, and neonatal complications in diabetes during pregnancy. B: The patient’s stable emotional and psychological status - While emotional and psychological well-being are important, they do not directly affect complications related to diabetes in pregnancy. D: Total protein excretion and creatinine clearance within normal limits - While these are indicators of kidney function, they are not the most crucial factors in managing complications in a pregnant patient with diabetes.

Correct Answer: B

Rationale: The correct answer is B because pregnant patients with Class II heart disease should avoid strenuous activity to prevent further strain on the heart. Strenuous activity can increase the risk of complications in these patients. Option A is incorrect as excessive weight gain can exacerbate heart disease. Option C is incorrect because limiting fluid intake can lead to dehydration, which is harmful during pregnancy. Option D is incorrect as a diet high in calcium is not specifically indicated for pregnant patients with Class II heart disease.

Correct Answer: A

Rationale: The correct answer is A because the postpartum patient who has had four saturated pads during the last 12 hours should receive further assessment. This indicates excessive postpartum bleeding (postpartum hemorrhage), which is a critical complication that requires immediate intervention to prevent complications like hypovolemic shock. Monitoring vital signs, assessing for signs of shock, evaluating uterine tone, and determining the cause of bleeding are crucial steps in managing postpartum hemorrhage. Choices B, C, and D are not the correct answers because: B: A patient with Class II heart disease complaining of frequent coughing is more likely experiencing cardiac-related issues and requires evaluation and management by a cardiologist. C: A patient with gestational diabetes and a fasting blood sugar level of 100 mg/dL is within the normal range and does not require immediate further assessment. D: A postcesarean patient with active herpes lesions on the labia requires appropriate management of the herpes infection but does not necess

Correct Answer: C

Rationale: The correct term to describe the belief that the nurse-patient relationship is a partnership where both are equal participants is "Mutuality" (C). This term emphasizes the idea of shared responsibility, respect, and collaboration between the nurse and the patient. It signifies a relationship built on equality and mutual understanding, fostering trust and positive outcomes. Choice A (Critical thinking) involves analyzing and evaluating information, which is essential for decision-making but does not directly reflect the equality and partnership aspect of the nurse-patient relationship. Choice B (Authentic) relates to being genuine and true to oneself, which is important in building trust but does not specifically address the equal participation aspect in the relationship. Choice D (Attend) means to be present or pay attention, which is a fundamental aspect of nursing care but does not capture the full essence of a partnership based on equality and mutual involvement.