Nokea
A client has a midpelvic contracture from a previous pelvic injury due to a motor vehicle accident as a teenager. The nurse is aware that this could prevent a fetus from passing through or around which structure during childbirth?
- A. Symphysis pubis
- B. Sacral promontory
- C. Ischial spines
- D. Pubic arch
Correct Answer: C
Rationale: A midpelvic contracture could prevent the fetus from passing through or around the ischial spines, which are located in the mid-pelvis and can be narrowed by previous injury. The symphysis pubis, sacral promontory, and pubic arch are not primarily affected in the mid-pelvis.
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A PP client is being treated for DVT. The nurse understands that the client's response to treatment will be evaluated by regularly assessing the client for:
- A. Dysuria, ecchymosis, and vertigo
- B. Epistaxis, hematuria, and dysuria
- C. Hematuria, ecchymosis, and epistaxis
- D. Hematuria, ecchymosis, and vertigo
Correct Answer: C
Rationale: The treatment for DVT is anticoagulant therapy. The nurse assesses for bleeding, which is an adverse effect of anticoagulants. This includes hematuria, ecchymosis, and epistaxis.
Which statement accurately describes the importance of birthing person position changes during the second stage of labor?
- A. Position changes have an impact on fetal descent.
- B. Position changes can lead to support person stress.
- C. Fetal descent is solely determined by uterine contractions.
- D. Maintaining a supine position is the safest option.
Correct Answer: A
Rationale: Position changes during the second stage of labor can facilitate fetal descent by optimizing pelvic alignment and gravity.
When preparing a woman who is 2 days postpartum for discharge, recommendations for which of the following contraceptive methods would be avoided?
- A. Diaphragm
- B. Female condom
- C. Oral contraceptives
- D. Rhythm method
Correct Answer: A
Rationale: A diaphragm should be avoided immediately postpartum because the cervix and vaginal tissues are still healing, and fitting may be inaccurate due to changes in pelvic anatomy. Female condoms, oral contraceptives, and the rhythm method are safer options at this stage.
Fetal presentation refers to which of the following descriptions?
- A. Fetal body part that enters the maternal pelvis first
- B. Relationship of the presenting part to the maternal pelvis
- C. Relationship of the long axis of the fetus to the long axis of the mother
- D. A classification according to the fetal part
Correct Answer: A
Rationale: Presentation is the fetal body part that enters the maternal pelvis first.
A nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period. When the nurse locates the fundus, she notes that the uterus feels soft and boggy. Which of the following nursing interventions would be most appropriate initially?
- A. Massage the fundus until it is firm
- B. Elevate the mothers legs
- C. Push on the uterus to assist in expressing clots
- D. Encourage the mother to void
Correct Answer: A
Rationale: If the uterus is not contracted firmly, the first intervention is to massage the fundus until it is firm and to express clots that may have accumulated in the uterus. Pushing on an uncontracted uterus can invert the uterus and cause massive hemorrhage. Elevating the client's legs and encouraging the client to void will not assist in managing uterine atony.