Nokea
Woman in labor, vacuum extraction
A maternal indication for the use of vacuum extraction is
- A. Maternal exhaustion.
- B. Failure to progress past 0 station.
- C. A wide pelvic outlet.
- D. A history of rapid deliveries.
Correct Answer: A
Rationale: Maternal exhaustion indicates vacuum extraction to assist delivery when the mother cannot push effectively, reducing fatigue and distress.
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Woman receiving oxytocin stimulation
One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because
- A. It produces a prolapsed cord.
- B. It increases maternal renal blood flow.
- C. It decreases maternal blood pressure.
- D. There is a reduction of placental blood flow.
Correct Answer: D
Rationale: Hypertonic contractions reduce placental blood flow by limiting the time for the placenta to refill with blood between contractions, risking fetal hypoxia. Note: The document incorrectly lists 'A' as the correct answer, but the explanation supports 'D' as the correct choice based on standard medical understanding.
Woman received epidural or intrathecal opioids
The main nursing observations of the woman who receives epidural or intrathecal opioids are for all except
- A. delayed respiratory depression.
- B. inability to move lower extremities.
- C. pruritus.
- D. nausea and vomiting.
Correct Answer: A
Rationale: Delayed respiratory depression is not a primary concern with epidural or intrathecal opioids, which have limited systemic effects compared to systemic opioids.
Client receiving opioid epidural analgesia during labor
A nurse is caring for a client who is receiving opioid epidural analgesia during labor. Which of the following findings is the nurse's priority?
- A. Blood pressure 80/56 mm Hg.
- B. The client reports profuse itching.
- C. The client reports weakness of the lower extremities.
- D. Temperature 38.2°C (100.8 F).
Correct Answer: A
Rationale: Hypotension (80/56 mm Hg) is the priority as it can reduce placental blood flow, risking fetal distress, and requires immediate intervention.
2-day-old newborn
The nurse explains to the parents of a 2-day-old newborn that decreased life span of neonatal red blood cells has contributed to which complication?
- A. Hyperbilirubinemia.
- B. Respiratory distress syndrome.
- C. Polycythemia.
- D. Transient tachypnea.
Correct Answer: A
Rationale: The increased breakdown of neonatal red blood cells, which have a shorter lifespan, produces bilirubin, leading to hyperbilirubinemia and potential jaundice.
Newborn, signs of diaphoresis, jitteriness, lethargy
A nurse is caring for a newborn and observes signs of diaphoresis, jitteriness, and lethargy. Which of the following actions should the nurse take?
- A. Obtain blood glucose by heel stick.
- B. Initiate phototherapy.
- C. Monitor the newborn's blood pressure.
- D. Place the newborn in a radiant warmer.
Correct Answer: A
Rationale: These symptoms suggest hypoglycemia, and obtaining a blood glucose level via heel stick is the priority to confirm and guide treatment.