Maternal Monitoring During Labor

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A nurse is educating a postpartum person about newborn care. What is the best way to prevent diaper rash?

  • A. frequent diaper changes
  • B. use of a barrier cream
  • C. apply petroleum jelly to the skin
  • D. change diapers frequently
Correct Answer: C

Rationale: The correct answer is C: apply petroleum jelly to the skin. Petroleum jelly acts as a barrier, protecting the baby's skin from moisture and irritants in the diaper. It helps maintain the skin's natural moisture and prevents diaper rash.

Rationale:
1. Petroleum jelly creates a protective barrier on the skin, preventing direct contact with moisture and irritants.
2. It helps to keep the skin moisturized, reducing the risk of irritation.
3. Petroleum jelly is safe and gentle on the baby's skin.
4. It is particularly effective for preventing diaper rash compared to other options.

Summary:
A: Frequent diaper changes are important but may not provide enough protection against moisture and irritants.
B: Barrier creams can be effective, but petroleum jelly is a more commonly recommended option.
D: Changing diapers frequently is essential, but applying petroleum jelly as an additional protective measure is more effective in preventing diaper rash.

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A nurse is assessing the fetal heart rate of a laboring person. What is the most significant finding that would indicate fetal distress?

  • A. variable decelerations
  • B. late decelerations
  • C. bradycardia
  • D. accelerations
Correct Answer: C

Rationale: The correct answer is C, bradycardia. Bradycardia in the fetal heart rate is a significant finding indicating fetal distress because it signifies a heart rate below normal range, which can lead to inadequate oxygen supply to the fetus. Bradycardia can be a sign of fetal hypoxia, acidosis, or other serious conditions. Variable decelerations (choice A) are often caused by umbilical cord compression, late decelerations (choice B) are associated with uteroplacental insufficiency, and accelerations (choice D) are considered a reassuring sign of fetal well-being. Therefore, in the context of fetal distress, bradycardia is the most concerning finding.

A nurse is caring for a pregnant patient who is at 24 weeks gestation and reports feeling fatigued and weak. What is the most appropriate action for the nurse to take?

  • A. Assess the patient's hemoglobin levels to check for anemia.
  • B. Recommend a high-calorie diet to improve energy levels.
  • C. Encourage the patient to rest and avoid any physical activity.
  • D. Instruct the patient to perform gentle exercises to combat fatigue.
Correct Answer: A

Rationale: The correct answer is A: Assess the patient's hemoglobin levels to check for anemia. Fatigue and weakness are common symptoms of anemia, especially in pregnant women. By assessing the hemoglobin levels, the nurse can determine if the patient is anemic and needs appropriate treatment. This step is crucial for identifying and addressing the underlying cause of the symptoms.

Summary:
B: Recommending a high-calorie diet may not address the root cause of the fatigue and weakness, which could be anemia.
C: While rest is important during pregnancy, simply encouraging rest without investigating the cause of the symptoms may delay appropriate treatment.
D: While gentle exercises can be beneficial during pregnancy, they may not be suitable if the patient is experiencing significant fatigue and weakness due to anemia.

The nurse explains that prior to fertilization each cell is reduced from 46 chromosomes to 23 chromosomes. This is referred to as the __________ number.

  • A. haploid
  • B. DNA
  • C. Chromoses
  • D. Plastoderm
Correct Answer: A

Rationale: Prior to fertilization, each cell undergoes meiosis, reducing its chromosome count from 46 to 23. This reduction ensures genetic diversity and proper development of the embryo. The term 'haploid' refers to cells containing only one set of chromosomes.

For which patient would an L/S ratio of 2:1 potentially be considered abnormal?

  • A. A 38-year-old gravida 2, para 1, who is 38 weeks’ gestation
  • B. A 24-year-old gravida 1, para 0, who has diabetes
  • C. A 44-year-old gravida 6, para 5, who is at term
  • D. An 18-year-old gravida 1, para 0, who is in early labor at term
Correct Answer: B

Rationale: In diabetic pregnancies, an L/S ratio of 2:1 may not reliably indicate lung maturity due to delayed surfactant production.

A 40-year-old primiparous woman who is 38 weeks pregnant has been on the labor unit for an hour when she starts to complain of feeling dizzy, light-headed, and nauseous. Her blood pressure is 90/60. What should be the first response of the nurse?

  • A. Give the patient a bolus of intravenous fluid.
  • B. Turn the patient to her left side.
  • C. Call the obstetrician or nurse midwife.
  • D. Give the patient an antiemetic medication for the nausea.
Correct Answer: B

Rationale: The correct answer is B: Turn the patient to her left side.

Rationale:
1. The patient's symptoms of dizziness, light-headedness, and low blood pressure (90/60) suggest hypotension, which could be due to supine hypotensive syndrome in pregnancy.
2. Turning the patient to her left side can help alleviate pressure on the vena cava, improving blood flow back to the heart and subsequently increasing blood pressure.
3. This immediate action can help prevent further complications such as decreased placental perfusion and fetal distress.

Summary:
- Choice A (Give the patient a bolus of intravenous fluid): While IV fluids may be needed, the priority is to address the underlying cause of hypotension first.
- Choice C (Call the obstetrician or nurse midwife): While it is important to involve the healthcare provider, immediate action to address the hypotension is crucial.
- Choice D (Give the patient an antiemetic medication for

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