Nokea
A nurse is caring for a postpartum person who is experiencing a boggy uterus. What is the most appropriate action to take?
- A. perform uterine massage
- B. administer uterotonic medications
- C. perform perineal massage
- D. administer oral pain relief
Correct Answer: A
Rationale: The correct action is to perform uterine massage. This helps to prevent postpartum hemorrhage by promoting uterine contraction and reducing uterine atony. It stimulates the release of endogenous oxytocin, aiding in the expulsion of clots and reducing bleeding. Administering uterotonic medications (choice B) would be the next step if uterine massage alone is ineffective. Perineal massage (choice C) is unrelated to managing a boggy uterus. Administering oral pain relief (choice D) does not address the root cause of the issue.
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A client asks the nurse, “Could you explain how the baby’s blood and my blood separate at delivery?” Which of the following responses is appropriate for the nurse to make?
- A. When the placenta is born, the circulatory systems separate.
- B. When the doctor clamps the cord, the blood stops mixing.
- C. The separation happens after the baby takes the first breath. The baby’s oxygen no longer has to come from you.
- D. The blood actually never mixes. Your blood supply and the baby’s blood supply are completely separate.
Correct Answer: D
Rationale: During pregnancy, the mother's and baby's blood supplies do not mix. The placenta acts as a barrier and facilitates the exchange of nutrients, gases, and waste products between the maternal and fetal bloodstreams without direct mixing. This ensures that each individual maintains their own circulatory system.
Which vitamin should be avoided in excess during pregnancy?
- A. Vitamin C
- B. Vitamin D
- C. Vitamin B2 (niacin)
- D. Vitamin B12 (cobalamin)
Correct Answer: B
Rationale: Vitamin D in excess can lead to hypercalcemia, which may harm the fetus. Other vitamins listed are generally safe when consumed in recommended amounts.
What is the primary goal of fetal heart rate monitoring during the second stage of labor?
- A. to predict when to bear down during contractions
- B. to determine the strength of the uterine contractions
- C. to evaluate fetal well-being
- D. to monitor vital signs of the birthing person
Correct Answer: C
Rationale: The primary goal of fetal heart rate monitoring during the second stage of labor is to evaluate fetal well-being. This is crucial to ensure that the baby is tolerating labor and delivery well. Monitoring fetal heart rate helps identify any signs of distress or compromise in oxygen supply to the baby. It guides healthcare providers in making timely interventions if needed to prevent adverse outcomes. Choices A and B are incorrect because the primary goal is not about timing contractions or assessing uterine contractions strength. Choice D is incorrect as the focus is not on monitoring the vital signs of the birthing person but on assessing the well-being of the fetus.
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.
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.