Nokea
A couple who has stated that they are LGBTQIA+ during prior visits arrives at the clinic for prenatal care. What can the nurse say in the waiting area to help them feel welcome and safe?
- A. You can take this tablet to an area in the waiting room and check in. Then bring the tablet back to me when you are done.
- B. Are you pregnant? Your paperwork says your name is Tom.
- C. You can have a seat, and a person from the LGBTQIA+ office will come to assist you.
- D. Here is our paperwork. It doesn't have a box for your sex, but you can write it next to the gender box.
Correct Answer: A
Rationale: Providing a neutral and respectful approach helps create a welcoming environment for LGBTQIA+ patients.
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A nurse midwife is examining a client who is a primigravida at 42 weeks of gestation and states that she believes she is in labor. Which of the following findings confirm to the nurse that the client is in labor
- A. Cervical dilation
- B. Report of pain above the umbilicus
- C. Brownish vaginal discharge
- D. Amniotic fluid in the vaginal vault
Correct Answer: A
Rationale: Cervical dilation is a key physiological change that confirms labor has begun. During the late stages of pregnancy, the cervix starts to soften, thin out (efface), and open up (dilate) in preparation for childbirth. Therefore, cervical dilation is a critical finding that indicates the onset of labor. Pain above the umbilicus, brownish vaginal discharge, and amniotic fluid in the vaginal vault are not definitive signs of labor and do not confirm the initiation of the labor process.
A newborn is delivered vaginally in the breech presentation. When examining her baby, the mother asks if the baby has been injured during birth because of the large black and blue areas on the buttocks and legs, The nurse should respond that:
- A. This is not a birth injury probably just a birthmark
- B. These are caused by forceps used to aid in the delivery of the baby
- C. This a temporary complication that will disappear in about a week
- D. These Mongolian spots, common in dark-skinned babies, disappear within a year
Correct Answer: A
Rationale: The large black and blue areas on the buttocks and legs of the newborn are likely Mongolian spots. Mongolian spots are common in infants with dark skin and are not a result of birth trauma. They are benign birthmarks caused by pigment that did not make it to the top layer of the skin before birth. These spots typically fade over time and may disappear completely within a few years. It is important to educate parents about Mongolian spots to alleviate any concerns they may have about their baby's skin markings.
The nurse is assessing a client diagnosed with placenta previa. Which findings should the nurse expect to note?
- A. Uterine rigidity.
- B. Severe abdominal pain.
- C. Bright red vaginal bleeding.
- D. Soft, relaxed, nontender uterus.
Correct Answer: C
Rationale: Placenta previa presents as painless bright red bleeding and a soft, non-tender uterus.
A woman has been having contractions since 4am this morning. At 8am her cervix dilated 5cm. Contractions are frequent, mild to moderate in intensity. CPD has been ruled out. After giving her sedation so she can rest, what would anticipate preparing her for?
- A. oxytocin induction
- B. Amnioinfusion
- C. c/s
- D. increased IV infusion
Correct Answer: C
Rationale: The scenario describes a woman in active labor with frequent, mild to moderate contractions and significant cervical dilation. If cephalopelvic disproportion (CPD) has been ruled out and the progress of labor is slow despite sufficient dilation and descent of the fetus, it may indicate cephalopelvic disproportion, failure to progress, or other complications that could necessitate a cesarean section (c/s). In this case, providing sedation to allow for rest suggests that the medical team is considering the possibility of further intervention, such as a c/s, if the labor does not progress effectively despite sufficient dilation. Therefore, preparing the woman for a c/s would be the anticipated next step in her care.
The nurse is educating a client about managing heartburn during pregnancy. What is the best advice?
- A. Lie down immediately after eating.
- B. Eat small, frequent meals.
- C. Drink a glass of water with meals.
- D. Consume spicy foods to aid digestion.
Correct Answer: B
Rationale: Eating small, frequent meals helps prevent reflux and minimizes heartburn during pregnancy.