Nokea
A client at 32 weeks' gestation is diagnosed with oligohydramnios. What complication is associated with this condition?
- A. Fetal macrosomia.
- B. Cord prolapse.
- C. Pulmonary hypoplasia.
- D. Placenta previa.
Correct Answer: C
Rationale: Oligohydramnios can lead to pulmonary hypoplasia due to insufficient amniotic fluid for lung development.
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If the physician indicates shoulder dystocia during the delivery of a macrosomic fetus, how would the nurse assist?
- A. Assisting the woman into McRoberts maneuver
- B. Calling a second physician to assist
- C. Preparing for immediate c/s delivery
- D. Utilizing fundal pressure to push the fetus out
Correct Answer: A
Rationale: In the scenario of shoulder dystocia during the delivery of a macrosomic fetus, the appropriate action for the nurse to assist would be to help the woman into the McRoberts maneuver. The McRoberts maneuver involves flexing the mother's thighs tightly against her abdomen to flatten the pelvis, allowing for more space to maneuver the baby's shoulder out from behind the pubic bone. This maneuver is often effective at resolving shoulder dystocia without the need for additional interventions such as a cesarean section or fundal pressure. It is a recommended initial step in managing shoulder dystocia and has been shown to be successful in many cases.
A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statement should the nurse make?
- A. "You can bathe and dress your baby if you'd like to."
- B. "If you don't hold the baby, it will make letting go much harder."
- C. "You should name the baby so she can have an identity."
- D. "I'm sure you will be able to have another baby when you're ready."
Correct Answer: A
Rationale: In this situation, it is important for the nurse to provide the client with options for how they would like to proceed. By offering the option to bathe and dress the baby, the nurse is allowing the client to make decisions about their care and how they would like to cope with the loss. This empowers the client and respects their individual grieving process. It is crucial to encourage the client to make choices that align with their feelings and provide them with support and sensitivity during this difficult time.
How can a nurse support a mother planning to formula-feed her newborn?
- A. Discourage frequent feeding to avoid overfeeding
- B. Recommend holding the baby during feeding
- C. Provide information about formula preparation
- D. Advise limiting formula feeding to once daily
Correct Answer: C
Rationale: Providing accurate information about formula preparation ensures safe and adequate feeding.
A nurse is caring for a client who is in active labor with 7 cm of cervical dilation and 100% effacement. The fetus is at 1+ station, and the client's amniotic membranes are intact. The client suddenly states that she needs to push. Which of the following actions should the nurse
- A. Assist the client into a comfortable position.
- B. Observe the perineum for signs of crowning.
- C. Have the client pant during the next contractions.
- D. Help the client to the bathroom to void.
Correct Answer: B
Rationale: The sudden urge to push along with the advanced cervical dilation, effacement, and station indicates that the client is likely in the second stage of labor, which is the stage of active pushing. When a woman feels the urge to push, it is essential to assess for the crowning of the fetal head at the perineum as this indicates that the baby is descending and will soon be born. This assessment helps the nurse determine the appropriate actions to take next in assisting the delivery process. Waiting for signs of crowning before guiding the client to push can prevent potential complications related to a rapid birth and help facilitate a more controlled delivery process.
A 17-year-old patient receives emergency contraception in a clinic. What is the priority nursing education for this patient at this time?
- A. The need for further contraception because the emergency contraception is only temporary
- B. The need to protect herself from STIs
- C. The need to come back in for a pelvic examination 1 week after taking the medication
- D. The need to drink plenty of fluids while on this medication
Correct Answer: A
Rationale: The patient should be informed that emergency contraception is a temporary measure and they need a long-term contraceptive plan. Choice B, while important for overall sexual health, is not the priority immediately after administering emergency contraception. Choice C is not necessary unless there are complications or a follow-up consultation is needed. Choice D about drinking fluids is unnecessary and not specific to the effectiveness of emergency contraception.