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A nurse is calculating the estimated date of delivery for a client who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, which of the following is the client’s estimated date of delivery?
- A. May 13
- B. May 17
- C. May 3
- D. May 20
Correct Answer: B
Rationale: The correct answer is B: May 17. Nägele's Rule calculates the estimated date of delivery by adding 7 days to the first day of the last menstrual period, then subtracting 3 months, and finally adding 1 year. In this case, August 10 + 7 days = August 17. Subtracting 3 months gives us May 17, which is the estimated date of delivery. Choice A (May 13) is too early as it doesn't account for the full gestational period. Choice C (May 3) is also too early, and choice D (May 20) is too late based on the calculation.
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A nurse is assessing a newborn following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of this birth method?
- A. Polycythemia
- B. Hypoglycemia
- C. Bronchopulmonary dysplasia
- D. Facial palsy
Correct Answer: D
Rationale: The correct answer is D: Facial palsy. Forceps-assisted birth can lead to facial nerve injury, resulting in facial palsy. This occurs due to pressure exerted by the forceps on the baby's face during delivery. The other choices are incorrect because: A) Polycythemia is not directly related to forceps-assisted birth. B) Hypoglycemia is more commonly associated with maternal diabetes or prematurity. C) Bronchopulmonary dysplasia is a lung condition seen in premature infants requiring prolonged mechanical ventilation. In summary, facial palsy is the most likely complication of forceps-assisted birth due to potential nerve injury, while the other choices are less directly linked to this birthing method.
What is the function of the cervix during pregnancy?
- A. To secrete mucus that prevents infection
- B. To protect the fetus from trauma
- C. To regulate fetal temperature
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: To secrete mucus that prevents infection. The cervix acts as a barrier to protect the fetus from potential infections entering the uterus. The mucus produced by the cervix forms a plug that blocks the entry of harmful bacteria, reducing the risk of infection reaching the developing fetus. Choices B, C, and D are incorrect because the cervix primarily functions to provide a protective barrier against infections during pregnancy, rather than solely protecting the fetus from trauma, regulating fetal temperature, or encompassing all functions mentioned in the other options.
What is the role of the fallopian tubes in fertilization?
- A. Production of ova
- B. Production of sperm
- C. Transport of ova to the uterus
- D. Transport of sperm to the uterus
Correct Answer: C
Rationale: The correct answer is C: Transport of ova to the uterus. The fallopian tubes are responsible for capturing the released egg after ovulation and providing a site for fertilization to occur. They transport the egg from the ovary to the uterus for potential implantation. This process is essential for successful fertilization and pregnancy. Choices A and B are incorrect as the fallopian tubes do not produce ova or sperm. Choice D is incorrect as the fallopian tubes do not transport sperm to the uterus.
The nurse is assessing the client 30 min later. How should the nurse interpret the findings? For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication of potential improvement, or an indication of potential worsening condition.
- A. Fundus at level of umbilicus
- B. Cloudy urine
- C. Blood pressure 80/50 mm Hg
- D. Moderate lochia rubra
- E. Thready pulse
- F. Fundus firm to palpation
Correct Answer:
Rationale: Findings indicating improvement: Fundus at umbilicus, Moderate lochia rubra, Fundus firm to palpation Findings indicating worsening: Blood pressure 80/50 mm Hg, Thready pulse Unrelated finding: Cloudy urine Clinical Implication: The nurse should urgently address the low blood pressure and thready pulse, as they indicate ongoing hemodynamic instability due to postpartum hemorrhage. Immediate interventions such as IV fluids, blood transfusion, and further uterotonic medications may be necessary.
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)
- A. Labor induction with oxytocin
- B. Newborn weight 2.948 kg (6 lb 8 oz)
- C. Vacuum-assisted delivery
- D. History of uterine atony
- E. History of human papillomavirus
Correct Answer: A,C,D
Rationale: The correct answers are A, C, and D.
A: Labor induction with oxytocin can lead to uterine hyperstimulation, increasing the risk of postpartum hemorrhage.
C: Vacuum-assisted delivery can cause trauma to the birth canal, leading to increased bleeding.
D: History of uterine atony indicates a weak uterine muscle tone, which can result in excessive bleeding after delivery.
B: Newborn weight is not directly related to postpartum hemorrhage risk.
E: History of human papillomavirus does not increase the risk of postpartum hemorrhage.