Nokea
A maternal indication for the use of vacuum extraction is
- A. a wide pelvic outlet.
- B. maternal exhaustion.
- C. a history of rapid deliveries.
- D. failure to progress past 0 station.
Correct Answer: B
Rationale: The correct answer is B: maternal exhaustion. Vacuum extraction may be indicated when the mother is too exhausted to continue pushing, as it can assist in the delivery process. A wide pelvic outlet (choice A) may facilitate delivery but is not a specific indication for vacuum extraction. A history of rapid deliveries (choice C) does not necessarily require vacuum extraction. Failure to progress past 0 station (choice D) may indicate other interventions like cesarean section rather than vacuum extraction. Therefore, the most appropriate indication for vacuum extraction in this scenario is maternal exhaustion.
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The nurse is preparing to initiate intravenous (IV) access on a patient in the active phase of labor. Which size IV cannula is best for this patient?
- A. 18-gauge
- B. 20-gauge
- C. 22-gauge
- D. 24-gauge
Correct Answer: B
Rationale: The correct answer is B: 20-gauge. During active labor, a larger IV cannula is recommended to accommodate rapid fluid administration and potential blood loss. A 20-gauge cannula provides a good balance between flow rate and patient comfort. An 18-gauge cannula (choice A) may be too large and cause discomfort, while 22-gauge (choice C) and 24-gauge (choice D) may not allow for adequate fluid administration in a timely manner.
The nurse is preparing to administer a vaginal prostaglandin preparation to ripen the cervix of her patient. With which patient should the nurse question the use of vaginal prostaglandin as a cervical ripening agent?
- A. The patient who has a Bishop's score of 5
- B. The patient who is at 42 weeks of gestation
- C. The patient who had a previous low transverse cesarean birth
- D. The patient who had previous surgery in the upper uterus
Correct Answer: D
Rationale: The correct answer is D because a patient with previous surgery in the upper uterus is at risk for uterine rupture with prostaglandin use. Previous surgery in the upper uterus may weaken the uterine wall, increasing the risk of complications such as uterine rupture during cervical ripening.
A: Bishop's score of 5 indicates a moderate readiness for induction, making vaginal prostaglandin appropriate.
B: 42 weeks of gestation is considered post-term, where cervical ripening is often needed.
C: Previous low transverse cesarean birth is not a contraindication for prostaglandin use for cervical ripening.
The nurse thoroughly dries the infant immediately after birth primarily to
- A. reduce heat loss from evaporation.
- B. stimulate crying and lung expansion.
- C. increase blood supply to the hands and feet.
- D. remove maternal blood from the skin surfac
Correct Answer: A
Rationale: The correct answer is A because drying the infant helps reduce heat loss through evaporation, preventing hypothermia. Wet skin can lead to rapid heat loss. This is critical for newborns who are at risk of temperature instability.
Choice B is incorrect because drying the infant is not primarily done to stimulate crying and lung expansion. Choice C is incorrect because drying does not increase blood supply to the hands and feet. Choice D is incorrect because maternal blood is typically cleared from the infant's skin through other means, not primarily by drying.
What are the side effects of spinal anesthesia? Select one that doesn't apply.
- A. hypotension
- B. respiratory depression
- C. renal damage
- D. infection
Correct Answer: C
Rationale: The correct answer is C: renal damage. Spinal anesthesia affects the nervous system, not the kidneys. Hypotension and respiratory depression are common side effects due to vasodilation and decreased respiratory drive. Infection can occur due to the invasive nature of the procedure. Renal damage is not a known side effect of spinal anesthesia as it does not directly affect kidney function.
What is a side effect of general anesthesia that usually limits its use to cases of emergency?
- A. hyperactive newborns
- B. newborn respiratory depression
- C. increase in uterine contractions
- D. decrease in cervical dilation
Correct Answer: B
Rationale: The correct answer is B: newborn respiratory depression. General anesthesia can cross the placental barrier and affect the newborn's respiratory system, leading to potential complications such as respiratory depression. This side effect is a major concern, especially in non-emergency situations, as it can pose risks to the newborn's health. Hyperactive newborns (A), increase in uterine contractions (C), and decrease in cervical dilation (D) are not typical side effects of general anesthesia that limit its use in emergency cases. These options are unrelated to the primary concern of newborn respiratory depression in the context of administering general anesthesia during childbirth.