Nokea
A laboring person requests an epidural for pain relief. What is the nurse's priority action before the procedure?
- A. administer a test dose of anesthesia
- B. ensure informed consent is obtained
- C. administer IV fluids
- D. ensure continuous fetal monitoring
Correct Answer: A
Rationale: The correct answer is A: administer a test dose of anesthesia. Before administering an epidural, it is crucial to perform a test dose to assess the person's response and ensure correct placement of the catheter. This step helps prevent potential complications such as unintentional intravascular injection.
Summary:
B: Ensuring informed consent is important but not the priority before administering the test dose.
C: Administering IV fluids is important for hydration but not the immediate priority before the test dose.
D: Continuous fetal monitoring is essential during labor, but it is not the priority before administering the test dose of anesthesia.
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A nurse is caring for a laboring person who is experiencing fetal bradycardia. What is the priority intervention?
- A. increase fluid intake
- B. administer oxygen
- C. monitor the fetal heart rate continuously
- D. place the laboring person on their left side
Correct Answer: B
Rationale: The correct answer is B: administer oxygen. Fetal bradycardia indicates reduced oxygen supply to the fetus, so providing oxygen to the laboring person can help increase oxygen levels for the fetus. This intervention is crucial to prevent further complications. Increasing fluid intake (A) may not address the immediate issue of fetal distress. Monitoring fetal heart rate continuously (C) is important but not the priority when immediate intervention is needed. Placing the laboring person on their left side (D) can help optimize fetal oxygenation, but administering oxygen is more direct and effective in this situation.
The nurse takes the history of a client, G2 P1001, at her first prenatal visit. Which of the following statements would indicate that the client should be referred to a genetic counselor?
- A. My first child has cerebral palsy.
- B. My first child has hypertension.
- C. My first child has asthma.
- D. My first child has cystic fibrosis.
Correct Answer: D
Rationale: Cystic fibrosis is a genetic condition, and a history of it in a previous child would warrant a referral to a genetic counselor. Cerebral palsy, hypertension, and asthma are not typically genetic conditions.
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks’ gestation; delivered a daughter, now 5 years old, at 39 weeks’ gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman’s gravidity and parity?
- A. G4 P2121.
- B. G4 P1212.
- C. G5 P1122.
- D. G5 P2211.
Correct Answer: D
Rationale: Gravidity includes all pregnancies (live births, miscarriages, abortions, and current pregnancy). Parity reflects live births. This woman has had 5 pregnancies (2 live births, 1 miscarriage, 1 abortion, and 1 current pregnancy), making her G5 P2211.
A pregnant patient is at 32 weeks gestation and reports swelling of the feet and legs. What is the most appropriate recommendation for the nurse to make?
- A. Limit fluid intake to reduce swelling.
- B. Elevate the legs and avoid prolonged standing.
- C. Apply compression stockings to improve circulation.
- D. Rest in bed with the feet elevated at all times.
Correct Answer: B
Rationale: The correct answer is B. Elevating the legs and avoiding prolonged standing is the most appropriate recommendation for a pregnant patient experiencing swelling at 32 weeks gestation. Elevating the legs helps to reduce swelling by aiding in venous return and reducing fluid accumulation in the lower extremities. Prolonged standing can worsen swelling due to increased pressure on the veins. Limiting fluid intake (choice A) may lead to dehydration and is not recommended during pregnancy. Applying compression stockings (choice C) may help improve circulation but may not address the underlying cause of swelling. Resting in bed with feet elevated at all times (choice D) is excessive and may not be practical for the patient.
What item represents a serving of meat?
- A. Deck of cards
- B. Paperback book
- C. Clenched fist
- D. Large tomato
Correct Answer: A
Rationale: A serving of meat is approximately the size of a deck of cards, which equates to about 3 ounces.