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What is the most common cause of shoulder dystocia during delivery?
- A. fetal macrosomia
- B. maternal obesity
- C. maternal diabetes
- D. advanced maternal age
Correct Answer: A
Rationale: The correct answer is A: fetal macrosomia. Fetal macrosomia, defined as a birth weight above 4 kg, is the most common cause of shoulder dystocia during delivery. This occurs when the baby's shoulders get stuck behind the mother's pelvic bone, leading to complications. Macrosomia is more likely in pregnancies with gestational diabetes, maternal obesity, and advanced maternal age, but the primary risk factor for shoulder dystocia is fetal macrosomia due to the large size of the baby. Maternal obesity, diabetes, and advanced age are secondary risk factors that can contribute to the likelihood of shoulder dystocia but are not the primary cause.
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A nurse is preparing a laboring person for an emergency cesarean birth. What is the most important nursing intervention prior to the procedure?
- A. administer a preoperative medication
- B. administer pain relief
- C. administer an epidural block
- D. administer IV fluids
Correct Answer: A
Rationale: The correct answer is A: administer a preoperative medication. This is crucial prior to an emergency cesarean birth to ensure the person is adequately prepared for the procedure. Preoperative medications can help reduce anxiety, prevent complications such as aspiration during anesthesia induction, and promote smooth recovery post-surgery. Administering pain relief (B) and epidural block (C) may be important for comfort but are not the priority in this urgent situation. Administering IV fluids (D) is generally important in preparation for surgery, but administering preoperative medication takes precedence in this scenario to ensure the person's safety and well-being during the emergency cesarean birth.
A nurse is caring for a laboring person who is in the second stage of labor. What is the most important action to promote fetal descent?
- A. coach the person through controlled pushing
- B. increase maternal hydration
- C. provide comfort measures
- D. apply gentle pressure to the abdomen
Correct Answer: A
Rationale: The correct answer is A: coach the person through controlled pushing. This is the most important action to promote fetal descent during the second stage of labor because pushing helps the baby move through the birth canal. Controlled pushing helps prevent exhaustion and reduces the risk of maternal injury. Increasing maternal hydration (choice B) is important for overall well-being but does not directly promote fetal descent. Comfort measures (choice C) are important for pain management but do not directly aid in fetal descent. Applying gentle pressure to the abdomen (choice D) is not recommended as it can interfere with the natural process of labor.
A pregnant woman in her second trimester asks the nurse about taking herbal supplements to alleviate nausea. Which of the following is the nurse's best response?
- A. It is safe to take any herbal supplement during pregnancy.
- B. Some herbal supplements may cause harm to your pregnancy, and it's best to consult your doctor.
- C. Only certain over-the-counter medications are safe, not herbal supplements.
- D. Herbal supplements are more effective than prescription medications for nausea.
Correct Answer: B
Rationale: The correct answer is B because herbal supplements can vary in safety during pregnancy. It is always recommended to consult a healthcare provider before taking any supplements, as some herbs may potentially harm the pregnancy or interact with other medications. Answer A is incorrect as not all herbal supplements are safe during pregnancy. Answer C is incorrect as some herbal supplements may be safe if recommended by a healthcare provider. Answer D is incorrect as prescription medications are often more rigorously tested and regulated for safety during pregnancy compared to herbal supplements.
A nurse is monitoring a postpartum person for signs of infection. Which finding would be most concerning in the first 24 hours after delivery?
- A. fever
- B. foul-smelling lochia
- C. increased blood pressure
- D. increased heart rate
Correct Answer: A
Rationale: The correct answer is A: fever. A fever in the first 24 hours after delivery is most concerning as it may indicate an infection, such as endometritis, which can lead to serious complications if not promptly treated. Postpartum fever is often the earliest sign of infection due to retained products of conception or ascending genital tract infection. Monitoring for fever is crucial as it can help prevent sepsis. Foul-smelling lochia (choice B) may suggest infection but is not as immediate a concern as fever. Increased blood pressure (choice C) and heart rate (choice D) may be normal physiological responses to delivery and are not specific indicators of infection in the immediate postpartum period.
A pregnant patient at 12 weeks gestation is asking about safe activities during pregnancy. Which of the following responses is most appropriate?
- A. You should avoid all physical activity to protect your baby.
- B. Moderate exercise, such as walking and swimming, is safe during pregnancy.
- C. You can engage in vigorous exercise, as long as you don't feel any discomfort.
- D. Only yoga and stretching exercises are safe during pregnancy.
Correct Answer: B
Rationale: The correct answer is B because moderate exercise like walking and swimming is generally safe during pregnancy and can provide health benefits for both the mother and the baby. Walking and swimming are low-impact activities that can help improve cardiovascular health, reduce stress, and enhance overall well-being without posing significant risks.
Option A is incorrect as physical activity is important during pregnancy, and avoiding all activity can be detrimental to both the mother and the baby. Option C is incorrect as engaging in vigorous exercise may increase the risk of injury or complications during pregnancy. Option D is incorrect as a variety of moderate exercises beyond just yoga and stretching can be safe and beneficial during pregnancy.