Intrapartum Complications Nursing

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A gravida 1 para 0 who is 10 weeks pregnant has her first prenatal visit. After performing a history and physical, which test ordered by the physician should the nurse verify with the examiner?

  • A. Serological test for syphilis
  • B. Rubella vaccine
  • C. Clean-catch urinalysis
  • D. Abdominal ultrasound
Correct Answer: D

Rationale: The correct answer is D: Abdominal ultrasound. At 10 weeks gestation, an abdominal ultrasound is typically ordered to confirm the viability of the pregnancy, assess fetal development, and determine gestational age. This test allows the healthcare provider to visualize the fetus, placenta, and amniotic fluid. It is essential in monitoring the progress of the pregnancy and identifying any potential complications.

Rationale for other choices:
A: Serological test for syphilis - While this test is important in prenatal care to screen for syphilis, it is usually done as part of routine prenatal blood work and not typically verified immediately after the first visit.
B: Rubella vaccine - Administering the rubella vaccine during pregnancy is contraindicated as it poses a risk to the developing fetus.
C: Clean-catch urinalysis - While urinalysis is a common test in prenatal care to screen for urinary tract infections and other conditions, it is not typically the first test verified following

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Which clinical finding can be determined only by electronic fetal monitoring?

  • A. Variability
  • B. Tachycardia
  • C. Bradycardia
  • D. Fetal response to contractions
Correct Answer: D

Rationale: The correct answer is D because electronic fetal monitoring is the only method that can directly measure and display the fetal heart rate in response to contractions. Variability, tachycardia, and bradycardia can also be observed through electronic fetal monitoring, but fetal response to contractions specifically requires continuous monitoring of the fetal heart rate during contractions. Therefore, D is the only clinical finding that can be determined exclusively through electronic fetal monitoring. Variability (A), tachycardia (B), and bradycardia (C) can be identified through other means of monitoring and assessment as well.

What is a potential sign of intrauterine fetal demise?

  • A. increased fetal heart rate
  • B. vaginal bleeding
  • C. decreased or absent fetal movement
  • D. macrosomia
Correct Answer: C

Rationale: The correct answer is C: decreased or absent fetal movement. This is a potential sign of intrauterine fetal demise because it indicates a lack of fetal activity, which could suggest fetal distress or death. Reduced or absent fetal movement may be an early warning sign that the fetus is not receiving enough oxygen or nutrients. It is important to monitor fetal movement regularly to ensure the well-being of the fetus.

Other choices are incorrect because:
A: increased fetal heart rate is more commonly associated with fetal distress, not demise.
B: vaginal bleeding can be a sign of various conditions such as placental abruption or placenta previa, but it is not specific to fetal demise.
D: macrosomia refers to a large baby, which is not indicative of fetal demise.

The nurse is educating a primigravida patient about prenatal testing/screening. She inquires why she needs to be tested for HIV. Which of the following is the nurse’s best response?

  • A. It is a recommended screening for all women, regardless of risk factors.
  • B. It is a recommended screening for a woman who is not married.
  • C. It is a recommended screening for a woman who has had gonorrhea.
  • D. It is a recommended screening for a woman who has had more than one sexual partner.
Correct Answer: A

Rationale: The correct answer is A: It is a recommended screening for all women, regardless of risk factors. This is because HIV screening during pregnancy is essential to prevent mother-to-child transmission. HIV can be asymptomatic, so screening all pregnant women is crucial. Options B, C, and D are incorrect because marital status, history of gonorrhea, or number of sexual partners do not determine the need for HIV screening during pregnancy. HIV screening is recommended universally to ensure the health of both the mother and the baby.

How much blood loss must occur to define the loss as a postpartum hemorrhage?

  • A. 250 mL
  • B. 500 mL
  • C. 750 mL
  • D. 1,000 mL
Correct Answer: B

Rationale: The correct answer is B (500 mL) for defining postpartum hemorrhage. This amount is used as the threshold because it represents a significant loss that may lead to maternal complications. Excessive bleeding after childbirth can quickly become life-threatening, so it is crucial to define postpartum hemorrhage accurately. Choices A (250 mL), C (750 mL), and D (1,000 mL) are incorrect as they do not align with the standard definition of postpartum hemorrhage, which is typically considered when blood loss exceeds 500 mL.

What is a potential risk associated with prolonged second stage labor?

  • A. decreased risk of instrumental delivery
  • B. decreased risk of cesarean birth
  • C. increased risk of fetal distress
  • D. increased risk of rapid delivery
Correct Answer: C

Rationale: The correct answer is C: increased risk of fetal distress. Prolonged second stage labor can lead to decreased oxygen supply to the fetus, causing fetal distress. This can result in adverse outcomes for the baby. Other options are incorrect because prolonged second stage labor is actually associated with an increased risk of instrumental delivery (A), an increased risk of cesarean birth (B), and not rapid delivery (D) as it is a prolonged process.

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