ATI RN
Antenatal complications Questions
Question 1 of 5
Which laboratory finding is indicative of DIC?
Correct Answer: A
Rationale: The correct answer is A: Decreased fibrinogen. In DIC, there is widespread activation of the coagulation cascade, leading to consumption of clotting factors like fibrinogen. This results in decreased levels of fibrinogen in the blood. Increased platelets (B) are seen in early stages, but they decrease as consumption continues. Increased hematocrit (C) is a nonspecific finding. Decreased thromboplastin time (D) is not indicative of DIC, as it would typically be prolonged due to consumption of clotting factors.
Question 2 of 5
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 following assessments. The vaginal exam is deferred until the 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 a history of PROM at 28 weeks, which puts her at risk for placental abruption due to the weakened membranes. The sudden onset of decreased fetal movement and absence of fetal heart tones on EFM indicate a potential emergency. The fundal height of 34 cm suggests the baby is at term, ruling out placental previa or preterm labor. Active labor typically presents with contractions, which are not observed in this case. Placental abruption can be concealed, leading to a sudden decrease in fetal well-being. The nurse should suspect hidden placental abruption and notify the physician immediately for further evaluation and intervention.
Question 3 of 5
A blood-soaked peripad weighs 900 g. The nurse would document a blood loss of _____ mL.
Correct Answer: C
Rationale: The correct answer is C (900 mL). To calculate blood loss, divide the weight of the blood-soaked pad (900 g) by the specific gravity of blood (1 g/mL). This gives 900 mL. Choice A (1800 mL) is incorrect as it doubles the correct amount. Choice B (450 mL) is incorrect as it halves the correct amount. Choice D (90 mL) is incorrect as it divides the correct amount by 10. The key is to convert the weight to volume using the specific gravity of blood to determine the correct blood loss measurement.
Question 4 of 5
Fraternal twins are delivered by your Rh-negative patient. Twin A is Rh-positive and twin B is Rh-negative. Prior to administering Rho(D) immune globulin (RhoGAM), the nurse should determine the results of the
Correct Answer: C
Rationale: The correct answer is C, indirect Coombs test of the mother. This test is crucial to determine if the mother has developed antibodies against the Rh-positive blood of twin A. If the test is positive, it indicates sensitization has occurred, making RhoGAM necessary to prevent hemolytic disease in future pregnancies. Direct Coombs tests of the twins (choices A and B) are not relevant in this scenario as they assess for antibodies already attached to the red blood cells. Transcutaneous bilirubin levels (choice D) are used to monitor jaundice, not Rh incompatibility.
Question 5 of 5
Which factor is most important in diminishing maternal, fetal, and neonatal complications in a pregnant patient with diabetes?
Correct Answer: C
Rationale: The correct answer is C, the degree of glycemic control before and during the pregnancy. Proper management of blood sugar levels is crucial in reducing complications in pregnant patients with diabetes. Uncontrolled blood sugar levels can lead to adverse outcomes for both the mother and the baby. Monitoring and maintaining optimal glycemic control before and during pregnancy can help prevent complications such as birth defects, preterm birth, macrosomia, and neonatal hypoglycemia. Choice A, evaluation of retinopathy by an ophthalmologist, is important for diabetic patients but is not the most critical factor in reducing maternal, fetal, and neonatal complications. Choice B, the patient's stable emotional and psychological status, is important for overall well-being but does not directly impact maternal, fetal, and neonatal complications in the same way as glycemic control. Choice D, total protein excretion and creatinine clearance within normal limits, is important for assessing kidney function in diabetic patients but is not as directly related to