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A laboring person is requesting an epidural for pain relief. What is the most important nursing action before the procedure?
- A. administer an epidural bolus
- B. check for any contraindications
- C. perform a vaginal exam
- D. ensure continuous fetal monitoring
Correct Answer: B
Rationale: The correct answer is B: check for any contraindications. Before administering an epidural, it is crucial to assess for contraindications such as low platelet count, infection at the insertion site, or severe hypotension as these may increase the risk of complications. Administering an epidural bolus (A) without checking for contraindications can be dangerous. Performing a vaginal exam (C) is not necessary before an epidural and could increase the risk of infection. Ensuring continuous fetal monitoring (D) is important during labor but is not the most critical action before administering an epidural.
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The nurse is reading an article that states that the maternal mortality rate in the United States in the year 2000 was 17. Which of the following statements would be an accurate interpretation of the statement?
- A. There were 17 maternal deaths in the United States in 2,000 per 100,000 live births.
- B. There were 17 maternal deaths in the United States in 2,000 per 100,000 women of childbearing age.
- C. There were 17 maternal deaths in the United States in 2,000 per 100,000 pregnancies.
- D. There were 17 maternal deaths in the United States in 2,000 per 100,000 women in the country
Correct Answer: A
Rationale: Maternal mortality rates are typically expressed as the number of maternal deaths per 100,000 live births. This metric focuses specifically on deaths related to pregnancy or childbirth complications among women who have given birth, making option A the correct choice. Options B, C, and D refer to broader populations or less relevant denominators, which do not align with standard definitions of maternal mortality rates.
A 24-year-old patient is in labor and requests pain relief. What is the most appropriate intervention for a patient who is in the active phase of labor?
- A. Administer an epidural block
- B. Provide non-pharmacological pain relief methods
- C. Administer narcotic analgesics
- D. Encourage the patient to push with each contraction
Correct Answer: A
Rationale: The correct answer is A: Administer an epidural block. In the active phase of labor, the pain is typically intense and continuous. Administering an epidural block can provide effective pain relief by blocking nerve signals, allowing the patient to rest and conserve energy for the pushing phase. It does not affect the ability to push and can improve maternal satisfaction. Non-pharmacological methods (B) may not provide sufficient relief at this stage. Narcotic analgesics (C) can cross the placenta and affect the baby's respiratory system. Encouraging the patient to push (D) is appropriate during the second stage of labor, not the active phase.
Which B vitamin should a vegan supplement?
- A. B1 (thiamine)
- B. B2 (niacin)
- C. B6 (pyridoxine)
- D. B12 (cobalamin)
Correct Answer: D
Rationale: Vitamin B12 is primarily found in animal products, so vegans are at risk of deficiency and should supplement with B12.
The nurse is caring for a pregnant patient who is at 28 weeks gestation and has been diagnosed with gestational diabetes. Which of the following interventions should the nurse prioritize?
- A. Monitor the patient's blood glucose levels and administer insulin as needed.
- B. Educate the patient about safe exercise and nutrition practices to manage blood glucose.
- C. Recommend that the patient avoid all carbohydrates to control blood sugar.
- D. Schedule regular ultrasounds to assess fetal growth and development.
Correct Answer: B
Rationale: The correct answer is B because educating the patient about safe exercise and nutrition practices is crucial in managing gestational diabetes. Exercise and proper nutrition help control blood glucose levels and reduce the risk of complications for both the mother and the baby. Monitoring blood glucose levels and administering insulin (choice A) are important but not the priority at this stage. Avoiding all carbohydrates (choice C) is not recommended as balanced carbohydrate intake is essential. Regular ultrasounds (choice D) are important but do not directly address managing gestational diabetes.
A gravida, G1 P0000, is having her first prenatal physical examination. Which of the following assessments should the nurse inform the client that she will have that day? Select all that apply.
- A. Pap smear.
- B. Mammogram.
- C. Glucose challenge test.
- D. Biophysical profile.
Correct Answer: A
Rationale: A Pap smear and complete blood count are standard assessments during the first prenatal visit. A mammogram, glucose challenge test, and biophysical profile are not typically performed at this stage.