As you assess a pregnant patient, you suspect false small-for-dates presentation. You should recognize that a possible cause for this is:
A. Error in date of LMP
B. Fetus in tranverse lie
C. Error in calculation of fundal height
D. All of the above
ANS: D
A fetus may be found to be of a size that is not commensurate with normal growth rates (size not equal to dates) when the uterine size is measured and evaluated during routine prenatal visits. First-trimester uterine sizes are usually determined with bimanual examination, and size-date discrepancies are often not clinically relevant. After 20 weeks of gestation, fundal height measurements begin to correlate (within 2 cm) with gestational age. The fundus should be at the level of the umbilicus at 20 weeks of gestation, and it rises 1 cm per week until 32 weeks of gestation. False small-for-dates presentations may result from inaccurate LMP dates, varying menstrual cycle lengths, improper fundal height measurement, or a fetus in a transverse lie. Differential diagnoses include intrauterine growth restriction (either asymmetric or symmetric), which affects about 5% of the general population and as much as 10% of high-risk populations (Table 19.9); constitutionally small fetus; inaccurate pregnancy dating; improper fundal height measurement; transverse lie of the fetus; and oligohydramnios.
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The nurse is caring for a preschool-aged client who is in pain secondary to a compound fracture resulting from a motor vehicle crash. The nurse recognizes which items as true when providing care to this client?
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A teacher comes to the mental health clinic saying a co-worker recently confronted her about
behaviors that are annoying to other co-workers. Because of the confrontation, the client has experienced moderate to severe levels of anxiety. The co-worker told the client that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team, always demanding that things should be done according to her plans. The co-worker mentioned that the client made everyone feel as though everything they tried was inadequate, and that her co-workers feel frustrated and angry about her need to control. The client states she likes her co-workers and only wanted to help them be successful. The nurse realizes the client's behaviors are most consistent with a. obsessive-compulsive personality disorder. b. narcissistic personality disorder. c. histrionic personality disorder. d. schizoid personality disorder.
Nested sampling is a preferred sampling technique used by many researchers for which of the following reasons?
A) It reduces costs related to recruiting participants. B) It decreases the risk for bias. C) Using overlapping samples can be advantageous. D) Only one group of people has to be recruited for both qualitative and quantitative strands.
Which is the nurse's best response to an older adult client who is hesitant to take the pneumo-coccal vaccination and influenza vaccine in the same year?
a. "You need both injections. A risk factor for getting pneumonia is infection with influenza." b. "Take both injections. They will protect you against respiratory problems for this year." c. "The flu shot may protect you against in-fluenza but not against bacteria that cause pneumonia." d. "You should get the pneumococcal vac-cination so you won't infect other people."