Maternal NCLEX
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Question 1 of 5.
The 42-year-old client who had a partial hydatidiform molar pregnancy 3 months ago asks the nurse whether she and her husband can try conceiving again. Which response by the nurse is incorrect and warrants follow-up action by the observing nurse manager?
A. “You will need serial levels of beta human chorionic gonadotropin (BHCG) drawn.â€
B. “You cannot conceive ever again because of your risk of choriocarcinoma.â€
C. “You should not become pregnant yet for 6 to 12 months.â€
D. “Your risk of another hydatidiform molar pregnancy is low.â€
Explanation: Women who have had a molar pregnancy can conceive again once their BHCG levels are normal and remain normal for a certain time period, usually 6 to 12 months. This response by the nurse is incorrect and should be followed up by the observing nurse manager. Because of the risk of choriocarcinoma, serial serum BHCG testing is completed after a hydatidiform molar pregnancy. Because the client will undergo serial serum BHCG testing after a hydatidiform molar pregnancy, she should not get pregnant for 6 to 12 months until testing is completed and it is confirmed that she does not have a malignancy. Couples with a past history of molar pregnancy have the same statistical chance of conceiving again and having a normal pregnancy as those without.
Question 2 of 5.
The nurse correctly explains that the bleeding is the result of sloughing of which structure?
A. Endometrium
B. Myometrium
C. Epimetrium
D. None of the above
Explanation: Menstrual bleeding occurs due to the sloughing of the endometrium, the inner lining of the uterus, when pregnancy does not occur.
Question 3 of 5.
On the basis of this finding, the nurse can assume that the client is at least how many months' pregnant?
A. 5 months
B. 6 months
C. 7 months
D. 8 months
Explanation: Ballottement, the rebound of the fetus when the cervix is tapped, is typically detectable around 4-5 months, indicating at least 5 months' gestation.
Question 4 of 5.
The nurse correctly assists the client into which position?
A. Lithotomy
B. Prone
C. Sims'
D. Trendelenburg's
Explanation: The lithotomy position, with legs elevated and apart, is standard for pelvic examinations to provide access to the pelvic area.
Question 5 of 5.
Which response by the nurse is most accurate?
A. Fluorescent treponemal antibody absorption (FTA-ABS) test can detect this defect.
B. Hepatitis B surface antigen (HBsAg) test can detect this defect.
C. Maternal serum alpha-fetoprotein (AFP) test can detect this defect.
D. Venereal Disease Research Laboratory (VDRL) test can detect this defect.
Explanation: The maternal serum alpha-fetoprotein (AFP) test screens for neural tube defects like spina bifida by measuring AFP levels.
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