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A nurse is assisting with a vaginal delivery. What is the most important action when the fetal head begins to crown?
- A. apply gentle downward pressure
- B. perform perineal massage
- C. perform a vaginal exam
- D. assist with breathing exercises
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This action helps prevent rapid delivery, reducing the risk of tearing and allowing the perineum to stretch gradually. It also helps control the delivery, ensuring a safe and controlled birth process. Performing perineal massage (B) is beneficial during the pushing stage but is not the most important action when the head crowns. Performing a vaginal exam (C) is unnecessary and may increase the risk of infection. Assisting with breathing exercises (D) is important during labor but not specifically when the head crowns.
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How should the nurse respond to a concern about alcohol exposure during conception?
- A. Inform the doctor
- B. Reassure it's unlikely the baby was affected
- C. Suggest abortion
- D. Recommend ultrasound
Correct Answer: B
Rationale: Occasional alcohol exposure around conception is unlikely to cause significant harm, though ongoing abstinence is advised.
The nurse is caring for a 23-year-old patient who arrives at the clinic for a pregnancy test. The test confirms the patient is pregnant. The patient states, 'I do not need to stop smoking my electronic cigarette because it will not harm my baby.' Which is the best response by the nurse?
- A. You are correct. Electronic cigarettes are not harmful during pregnancy.
- B. Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.
- C. According to the FDA, although electronic cigarettes are safe for you, they can cause harm to the fetus during pregnancy.
- D. Electronic cigarettes are considered harmful only in the first trimester.
Correct Answer: B
Rationale: The correct answer is B: Tobacco products, including electronic cigarettes, should not be used during pregnancy due to risking nicotine toxicity.
Rationale:
1. Nicotine from electronic cigarettes can cross the placenta, affecting fetal development.
2. Nicotine exposure during pregnancy is associated with adverse outcomes like low birth weight and preterm birth.
3. The best practice during pregnancy is to avoid all tobacco products, including electronic cigarettes.
Summary:
A: Incorrect. Electronic cigarettes can harm the fetus due to nicotine exposure.
C: Incorrect. FDA does not consider electronic cigarettes safe during pregnancy.
D: Incorrect. Harm from electronic cigarettes is not limited to the first trimester.
The nurse is teaching a pregnant patient about the importance of folic acid. Which statement by the patient indicates that the teaching has been effective?
- A. Folic acid will help prevent spinal cord defects in my baby.
- B. Folic acid is important for healthy skin development.
- C. Folic acid will help reduce my risk of high blood pressure during pregnancy.
- D. Folic acid helps prevent excessive weight gain during pregnancy.
Correct Answer: A
Rationale: Step 1: Folic acid is crucial for neural tube development in the fetus.
Step 2: Spinal cord defects are a type of neural tube defect.
Step 3: Statement A directly links folic acid to preventing spinal cord defects.
Therefore, choice A is correct as it demonstrates an understanding of the specific benefit of folic acid during pregnancy. Choices B, C, and D are incorrect as they do not accurately reflect the primary role of folic acid in pregnancy.
A patient with gestational hypertension is being monitored during labor. What is the most important factor to assess?
- A. Fetal heart rate
- B. Blood pressure
- C. Uterine contractions
- D. Fetal malpresentation
Correct Answer: B
Rationale: The correct answer is B: Blood pressure. In a patient with gestational hypertension, monitoring blood pressure is crucial to assess for worsening hypertension, which can lead to complications such as preeclampsia and eclampsia. Elevated blood pressure can affect both maternal and fetal well-being. Assessing fetal heart rate (A) is important but not the most critical factor in this scenario. Uterine contractions (C) are important but secondary to monitoring blood pressure. Fetal malpresentation (D) can impact delivery but is not the most vital factor to assess in a patient with gestational hypertension.
Which dairy product should the client avoid during pregnancy?
- A. Vanilla yogurt
- B. Parmesan cheese
- C. Gorgonzola cheese
- D. Chocolate milk
Correct Answer: C
Rationale: Gorgonzola cheese is a soft, mold-ripened cheese that may contain Listeria, posing a risk during pregnancy.