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A nurse is assisting with a vaginal birth and is monitoring for the risk of umbilical cord prolapse. Which is the most appropriate intervention if the cord is prolapsed?
- A. place the person in the knee-chest position
- B. reposition the laboring person
- C. administer oxygen via mask
- D. apply pressure to the cord
Correct Answer: A
Rationale: The correct answer is A: place the person in the knee-chest position. Placing the person in this position helps alleviate pressure on the umbilical cord, reducing the risk of compression and improving fetal oxygenation. Other choices like repositioning the laboring person or administering oxygen via mask do not directly address the issue of cord prolapse. Applying pressure to the cord can further compromise blood flow to the fetus. The knee-chest position is the most appropriate intervention as it helps relieve pressure on the cord and is crucial in managing umbilical cord prolapse effectively.
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When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent?
- A. Congenital heart defects
- B. Neural tube defects
- C. Mental retardation
- D. Premature birth
Correct Answer: B
Rationale: It is now known that folic acid supplements can prevent neural tube defects such as spina bifida.
A client enters the prenatal clinic. She states that she missed her period yesterday and used a home pregnancy test this morning. She states that the results were negative, but 'I still think I am pregnant.' Which of the following statements would be appropriate for the nurse to make at this time?
- A. Your period is probably just irregular.
- B. We could do a blood test to check.
- C. Home pregnancy test results are very accurate.
- D. My recommendation would be to repeat the test in one week.
Correct Answer: B
Rationale: A blood test is more accurate than a home pregnancy test, especially early in pregnancy. Repeating the test in a week is also an option, but a blood test provides more immediate and reliable results.
The midwife has just palpated the fundal height at the location noted on the picture below. It is likely that the client is how many weeks pregnant?
- A. 12
- B. 20
- C. 28
- D. 36
Correct Answer: B
Rationale: At 20 weeks, the fundal height is typically at the level of the umbilicus, which is consistent with the description provided.
The nurse is caring for a pregnant patient who is at 30 weeks gestation and has been diagnosed with gestational diabetes. Which of the following is the most important aspect of the patient's care plan?
- A. Maintaining a healthy weight gain during pregnancy.
- B. Monitoring blood glucose levels and maintaining a balanced diet.
- C. Increasing fluid intake to reduce the risk of dehydration.
- D. Administering insulin to control blood sugar levels.
Correct Answer: B
Rationale: The correct answer is B: Monitoring blood glucose levels and maintaining a balanced diet. This is the most important aspect of care for a pregnant patient with gestational diabetes because it helps control blood sugar levels, reducing the risk of complications for both the mother and the baby. Monitoring blood glucose levels ensures that the patient's blood sugar remains within the target range, while maintaining a balanced diet helps provide essential nutrients without causing spikes in blood sugar levels.
A: Maintaining a healthy weight gain during pregnancy is important but not as crucial as monitoring blood glucose levels for a patient with gestational diabetes.
C: Increasing fluid intake is important for overall health during pregnancy, but it is not the most critical aspect of care for a patient with gestational diabetes.
D: Administering insulin may be necessary in some cases, but it is not the most important aspect of care compared to monitoring blood glucose levels and maintaining a balanced diet.
A pregnant woman must have a glucose challenge test (GCT). Which of the following should be included in the preprocedure teaching?
- A. Fast for 12 hours before the test.
- B. Bring a urine specimen to the laboratory on the day of the test.
- C. Be prepared to have 4 blood specimens taken on the day of the test.
- D. The test should take one hour to complete.
Correct Answer: D
Rationale: The glucose challenge test typically takes one hour to complete and does not require fasting or multiple blood specimens. A urine specimen is not required for this test.