Nokea
A client at 35 weeks' gestation reports sharp abdominal pain and vaginal bleeding. What condition should the nurse suspect?
- A. Placenta previa.
- B. Abruptio placentae.
- C. Preterm labor.
- D. Chorioamnionitis.
Correct Answer: B
Rationale: The correct answer is B: Abruptio placentae. This condition presents with sharp abdominal pain and vaginal bleeding, typically occurring in the third trimester. It is caused by the premature separation of the placenta from the uterine wall. The pain is often severe due to the bleeding and can lead to fetal distress. Placenta previa (A) presents with painless vaginal bleeding, preterm labor (C) typically involves regular contractions and cervical changes, and chorioamnionitis (D) is characterized by fever and uterine tenderness.
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What is the best position for a laboring mother with a suspected occiput posterior position?
- A. Encourage side-lying position
- B. Place the mother in lithotomy position
- C. Encourage ambulation to facilitate descent
- D. Use a peanut ball to widen the pelvis
Correct Answer: D
Rationale: The correct answer is D. Using a peanut ball widens the pelvis, which can help rotate the baby into an optimal position for birth. This position can aid in reducing the likelihood of prolonged labor and the need for interventions. Encouraging side-lying position (A) may not provide the necessary pelvic widening. Placing the mother in lithotomy position (B) can impede the baby's descent. Encouraging ambulation (C) may not specifically address the occiput posterior position and may not provide enough pelvic opening.
The nurse provides education regarding male sterilization. What important information is provided?
- A. “Many people have vasectomies reversed.â€
- B. “You will need to return to the office to check for sperm in your ejaculate.â€
- C. “You will be sterile after 3 months.â€
- D. “Vasectomy consent forms must have both partners’ consent.â€
Correct Answer: B
Rationale: The correct answer is B: "You will need to return to the office to check for sperm in your ejaculate." This information is crucial as it ensures the success of the sterilization procedure. By checking for sperm in the ejaculate, the effectiveness of the vasectomy can be confirmed. This step is important to ensure that the individual is indeed sterile and can rely on the procedure for contraception.
Choice A is incorrect because vasectomy reversal is not always successful and should not be assumed. Choice C is incorrect as sterility is not immediate and may take several months after the procedure. Choice D is incorrect as consent forms for vasectomy typically require only the individual undergoing the procedure to give consent.
In summary, choice B is correct because it emphasizes the need for follow-up to confirm sterility, while the other choices provide incorrect or irrelevant information regarding male sterilization.
The nurse understands vitamin k is for?
- A. Not initially synthesized because of sterile bowel at birth (so they don't have enough clothing factors)
- B. Necessary for the production of platelets
- C. Important for production red blood cells
- D. Responsible for the breakdown of bilirubin and the prevention of jaundice
Correct Answer: D
Rationale: The correct answer is D because vitamin K is responsible for the breakdown of bilirubin in the liver, which helps prevent jaundice in newborns. Bilirubin is a product of the breakdown of old red blood cells, and vitamin K plays a crucial role in this process. Choice A is incorrect as sterile bowel does not affect vitamin K synthesis. Choice B is incorrect because platelet production is not directly related to vitamin K. Choice C is incorrect as red blood cell production is mainly regulated by other nutrients like iron, vitamin B12, and folate, not vitamin K.
The client delivered a 4200 g fetus. The physician performed a
midline episiotomy which extended into a 3rd degree laceration. The
client asks the nurse where she tore. Which response is best?
- A. Through your rectal sphincter
- B. Through your vaginal mucosa
- C. Through your cervix
- D. Through your bladder
Correct Answer: A
Rationale: The correct answer is A: Through your rectal sphincter. A 3rd degree laceration involves the perineal body and extends through the anal sphincter muscles. This type of laceration can occur with a midline episiotomy during childbirth. The rectal sphincter is a part of the anal canal and can be torn in severe cases. Choices B, C, and D are incorrect because a 3rd degree laceration does not involve the vaginal mucosa, cervix, or bladder. The tear is specifically related to the rectal area due to the extension of the episiotomy.
A nurse is caring for a client who is in active labor and notes late decelerations in the FRH on the external fetal.... Which of the following actions should the nurse take first?
- A. Change the client's position.
- B. Palpate the uterus to assess for tachysystole.
- C. Increase the client's IV infusion rate.
- D. Administer oxygen at 10 L/min via nonrebreather mask.
Correct Answer: A
Rationale: The correct answer is A: Change the client's position. Late decelerations indicate uteroplacental insufficiency, which can be caused by pressure on the vena cava from the uterus. Changing the client's position can alleviate this pressure, improving fetal oxygenation. Palpating the uterus or increasing IV infusion rate may not address the underlying issue. Administering oxygen is important but should come after addressing the positional issue to ensure optimal oxygen delivery to the fetus.