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A 34-week gestation woman calls the obstetric office stating, 'Since last night I have had three nosebleeds.'
- A. You should see the doctor to make sure you are not becoming severely anemic.
- B. Do you have a temperature?
- C. One of the hormones of pregnancy makes the nasal passages prone to bleeds.
- D. Do you use any inhaled drugs?
Correct Answer: C
Rationale: Pregnancy hormones increase blood supply to mucous membranes, making them more prone to bleeding. Nosebleeds are generally harmless unless associated with other symptoms.
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A pregnant woman states, “My husband hopes I will give him a boy because we have three girls.” What will the nurse explain to this woman?
- A. The sex chromosome of the fertilized ovum determines the gender of the child.
- B. When the sperm and ovum are united, there is a 75% chance the child will be a girl.
- C. When the pH of the female reproductive tract is acidic, the child will be a girl.
- D. If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.
Correct Answer: D
Rationale: When a Y-bearing sperm fertilizes an ovum, a male child is produced.
What is the primary purpose of performing an episiotomy during delivery?
- A. to reduce the risk of perineal trauma
- B. to promote faster delivery
- C. to facilitate fetal descent
- D. to provide immediate fetal oxygenation
Correct Answer: A
Rationale: The primary purpose of performing an episiotomy during delivery is to reduce the risk of perineal trauma. Episiotomy is a surgical incision made in the perineum to widen the vaginal opening during childbirth, which can help prevent severe tearing of the perineal tissue. This procedure is performed to provide controlled and precise incision, reducing the likelihood of extensive tears that may lead to complications such as infection or prolonged healing time. It is not done to promote faster delivery, facilitate fetal descent, or provide immediate fetal oxygenation. These choices do not accurately reflect the main goal of episiotomy, which is to minimize perineal trauma.
A pregnant patient at 28 weeks gestation reports dizziness and faintness when standing. What is the nurse's most appropriate recommendation?
- A. Rise quickly from a seated position to avoid dizziness.
- B. Instruct the patient to increase fluid intake and stand slowly.
- C. Encourage the patient to rest in bed to prevent fainting.
- D. Advise the patient to avoid standing for long periods.
Correct Answer: B
Rationale: The correct answer is B: Instruct the patient to increase fluid intake and stand slowly. This recommendation is appropriate because the patient is likely experiencing orthostatic hypotension due to the expanding uterus compressing blood vessels, leading to decreased blood flow to the brain when standing. Increasing fluid intake helps maintain blood volume, while standing slowly helps prevent sudden drops in blood pressure.
A: Rising quickly can worsen dizziness by further decreasing blood flow to the brain.
C: Resting in bed may not address the underlying issue of orthostatic hypotension and may lead to deconditioning.
D: Avoiding standing for long periods may be impractical and may not address the need to maintain adequate blood volume and prevent sudden drops in blood pressure.
A nurse is assisting with a vaginal birth. What is the most appropriate nursing action when the head crowns during delivery?
- A. apply gentle pressure to the fetal head
- B. prepare for delivery of the placenta
- C. assist with shoulder delivery
- D. apply gentle pressure to the perineum
Correct Answer: A
Rationale: The correct answer is A: apply gentle pressure to the fetal head. This action helps prevent rapid delivery, reducing the risk of perineal tearing and promoting controlled delivery of the baby. Applying pressure also helps prevent the baby from being born too quickly, reducing the risk of umbilical cord compression and potential birth injuries.
Choices B, C, and D are incorrect because at the moment the head crowns, the priority is to assist with the controlled delivery of the baby's head. Delivering the placenta (B) and assisting with shoulder delivery (C) are steps that come after the baby's head is delivered. Applying pressure to the perineum (D) is not recommended as it may increase the risk of perineal tearing.
A pregnant woman who is 28 weeks gestation reports that she feels dizzy and faint when she stands up. What should the nurse instruct the patient to do?
- A. Lie down flat on your back immediately.
- B. Stand up quickly to prevent dizziness from worsening.
- C. Drink a large amount of water to alleviate the dizziness.
- D. Get up slowly and avoid standing for long periods.
Correct Answer: D
Rationale: The correct answer is D, instructing the pregnant woman to get up slowly and avoid standing for long periods. This is because during pregnancy, blood pressure can drop when standing up quickly, leading to dizziness and fainting. Getting up slowly allows the body to adjust gradually, preventing a sudden drop in blood pressure. Standing for long periods can worsen these symptoms, so it is important to avoid prolonged standing.
A: Lying down flat on the back immediately can worsen symptoms in this case by reducing blood flow to the brain.
B: Standing up quickly can exacerbate dizziness and fainting by causing a sudden drop in blood pressure.
C: Drinking a large amount of water may not address the underlying issue of postural hypotension and could potentially worsen symptoms by increasing blood volume without addressing the drop in blood pressure.