A nurse is caring for a laboring person who is experiencing fetal bradycardia. What is the priority nursing intervention?
- A. administer oxygen
- B. administer IV fluids
- C. increase maternal hydration
- D. increase maternal oxygen
Correct Answer: A
Rationale: The correct answer is A: administer oxygen. Fetal bradycardia indicates decreased oxygen supply to the fetus, which can lead to fetal distress. Administering oxygen helps improve oxygen levels in the mother's blood, increasing oxygen delivery to the fetus. This intervention is crucial in preventing further complications and ensuring the well-being of the baby. Administering IV fluids (B) and increasing maternal hydration (C) may be beneficial but do not directly address the immediate need for oxygen. Increasing maternal oxygen (D) is redundant since the primary focus should be on fetal oxygenation.
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During open glottis pushing, what is the laboring person instructed to do?
- A. hold their breath and push for 10 seconds during each contraction
- B. push spontaneously while exhaling during contractions
- C. exhale slowly during contractions without pushing
- D. perform deep breathing exercises between contractions
Correct Answer: B
Rationale: During open glottis pushing, the correct instruction is for the laboring person to push spontaneously while exhaling during contractions (Choice B). This technique helps prevent breath-holding, which can increase intra-abdominal pressure and reduce blood flow to the heart and baby. Exhaling while pushing allows for better oxygenation and reduces the risk of Valsalva maneuver-related complications. Holding their breath (Choice A) can increase the risk of fetal distress. Exhaling slowly without pushing (Choice C) is not effective in assisting with the pushing stage of labor. Deep breathing exercises between contractions (Choice D) are beneficial for relaxation but not the main focus during pushing.
A pregnant patient at 12 weeks gestation is asking about safe activities during pregnancy. Which of the following responses is most appropriate?
- A. You should avoid all physical activity to protect your baby.
- B. Moderate exercise, such as walking and swimming, is safe during pregnancy.
- C. You can engage in vigorous exercise, as long as you don't feel any discomfort.
- D. Only yoga and stretching exercises are safe during pregnancy.
Correct Answer: B
Rationale: The correct answer is B because moderate exercise like walking and swimming is generally safe during pregnancy and can provide health benefits for both the mother and the baby. Walking and swimming are low-impact activities that can help improve cardiovascular health, reduce stress, and enhance overall well-being without posing significant risks.
Option A is incorrect as physical activity is important during pregnancy, and avoiding all activity can be detrimental to both the mother and the baby. Option C is incorrect as engaging in vigorous exercise may increase the risk of injury or complications during pregnancy. Option D is incorrect as a variety of moderate exercises beyond just yoga and stretching can be safe and beneficial during pregnancy.
A pregnant patient at 28 weeks gestation is experiencing severe swelling in her hands and feet. Which of the following actions should the nurse take first?
- A. Assess the patient's blood pressure and check for signs of preeclampsia.
- B. Encourage the patient to elevate her legs and rest.
- C. Monitor the patient's urine output and report any changes.
- D. Schedule an ultrasound to assess fetal growth and amniotic fluid levels.
Correct Answer: A
Rationale: The correct action to take first is to assess the patient's blood pressure and check for signs of preeclampsia (Answer A). Preeclampsia is a serious condition characterized by high blood pressure and signs of organ dysfunction. In this scenario, the patient's severe swelling could be indicative of preeclampsia, which poses a risk to both the mother and the fetus. By assessing blood pressure and looking for other signs of preeclampsia, the nurse can determine the urgency of the situation and take appropriate actions to manage the condition.
Encouraging leg elevation and rest (Answer B) may help alleviate some symptoms but does not address the underlying cause of the swelling. Monitoring urine output (Answer C) is important for overall assessment but does not address the immediate concern of potential preeclampsia. Scheduling an ultrasound (Answer D) is not the priority in this situation as it does not provide information about the patient's current condition and does not address the
A nurse is preparing a laboring person for an epidural. What is the priority nursing intervention before the procedure?
- A. ensure informed consent
- B. check for allergies to anesthesia
- C. assess for fetal movement
- D. administer pain relief
Correct Answer: C
Rationale: The correct answer is C: assess for fetal movement. This is the priority intervention before an epidural to ensure the safety and well-being of the fetus. Assessing for fetal movement helps determine the fetal well-being and any potential distress that may require immediate intervention. Ensuring informed consent (A) is important but assessing fetal well-being takes precedence. Checking for allergies to anesthesia (B) is important but not the priority before assessing fetal movement. Administering pain relief (D) can be done after assessing fetal movement to ensure the safety of both the laboring person and the fetus.
A pregnant patient is asking about the risks of smoking during pregnancy. Which of the following is the most appropriate response by the nurse?
- A. Smoking during pregnancy is safe if you don't have other complications.
- B. Smoking increases the risk of premature birth, low birth weight, and developmental delays.
- C. It's okay to smoke in moderation during pregnancy as long as you quit before delivery.
- D. Smoking only affects the mother, not the baby.
Correct Answer: B
Rationale: The correct answer is B because smoking during pregnancy significantly increases the risk of adverse outcomes such as premature birth, low birth weight, and developmental delays. Nicotine and other harmful chemicals in cigarettes can restrict oxygen and nutrients to the baby, leading to these complications. Choice A is incorrect as smoking is never safe during pregnancy. Choice C is incorrect as any amount of smoking during pregnancy is harmful. Choice D is incorrect as smoking affects both the mother and the baby due to the harmful substances passing through the placenta.