Nokea
What is the most common indication for performing an episiotomy?
- A. to prevent severe perineal tears
- B. to allow the birth to occur more quickly
- C. to relieve the risk of shoulder dystocia
- D. to control excessive vaginal bleeding
Correct Answer: D
Rationale: The correct answer is D: to control excessive vaginal bleeding. Episiotomy is primarily performed to manage and control postpartum hemorrhage by facilitating better visualization and access for suturing any bleeding vessels. It is not routinely done for preventing severe tears, expediting birth, or addressing shoulder dystocia, as there are alternative interventions for these situations. Episiotomy should be carefully considered and performed only when necessary to avoid unnecessary complications and promote better outcomes.
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What is true about the morula stage of development?
- A. Fertilized egg has yet to implant
- B. Lung fields are completely formed
- C. Sex of fetus can be identified
- D. Eyelids begin to open and close
Correct Answer: A
Rationale: The morula stage occurs before implantation, representing an early phase of embryonic development.
The nurse is caring for a pregnant patient who has a BMI of 30. Which of the following complications is the patient at increased risk for during pregnancy?
- A. Preeclampsia and gestational diabetes
- B. Hyperemesis gravidarum and miscarriage
- C. Iron-deficiency anemia and urinary tract infections
- D. Gestational hypertension and placenta previa
Correct Answer: A
Rationale: The correct answer is A: Preeclampsia and gestational diabetes. A pregnant patient with a BMI of 30 is considered obese, increasing the risk of developing preeclampsia and gestational diabetes. Obesity is a known risk factor for these complications due to the increased strain on the body's systems. Preeclampsia is characterized by high blood pressure and protein in the urine, which can lead to serious complications for both the mother and the baby. Gestational diabetes is a type of diabetes that develops during pregnancy and can lead to complications for both the mother and the baby if not managed properly. The other choices (B, C, D) are not directly associated with obesity or a BMI of 30 during pregnancy, making them incorrect.
A patient in labor is experiencing vaginal bleeding with no pain. What is the most likely cause?
- A. Placental abruption
- B. Placenta previa
- C. Uterine rupture
- D. Cervical laceration
Correct Answer: B
Rationale: The correct answer is B: Placenta previa. In placenta previa, the placenta partially or completely covers the cervix, leading to painless vaginal bleeding. Placental abruption (choice A) presents with painful bleeding. Uterine rupture (choice C) typically causes severe abdominal pain. Cervical laceration (choice D) usually occurs during delivery and is not typically associated with painless bleeding during labor. Placenta previa is the most likely cause in this scenario due to painless bleeding and the absence of contractions.
Which is an expected characteristic of amniotic fluid?
- A. Deep yellow color
- B. Clear, with small white particles
- C. Nitrazine test: acidic result
- D. Absence of ferning
Correct Answer: B
Rationale: The correct answer is B: Clear, with small white particles. Amniotic fluid is typically clear with small white particles, representing vernix caseosa. Vernix caseosa is a white, cheese-like substance that covers the skin of the fetus. It helps protect the skin and regulate body temperature. The presence of vernix particles in amniotic fluid is a normal and expected characteristic.
Incorrect choices:
A: Deep yellow color - Amniotic fluid is usually clear or slightly straw-colored. A deep yellow color may indicate the presence of meconium, which suggests fetal distress.
C: Nitrazine test: acidic result - Amniotic fluid is normally alkaline, not acidic. An acidic result may indicate infection.
D: Absence of ferning - Ferning is a characteristic pattern seen under a microscope in dried cervical mucus, not amniotic fluid. Absence of ferning in amniotic fluid is not a relevant characteristic.
Which of the following is the most important nursing intervention for a laboring person who is receiving oxytocin for induction of labor?
- A. monitor for signs of uterine hyperstimulation
- B. monitor fetal heart rate continuously
- C. provide emotional support
- D. encourage ambulation
Correct Answer: B
Rationale: The correct answer is B: monitor fetal heart rate continuously. This is crucial because oxytocin can cause uterine hyperstimulation leading to fetal distress. Continuous monitoring allows for early detection of fetal compromise. Monitoring for signs of uterine hyperstimulation (A) is important but secondary to fetal well-being. Emotional support (C) and encouraging ambulation (D) are beneficial but not as critical as ensuring fetal safety during oxytocin administration.