Nokea
A nurse is educating a postpartum person about newborn care. Which of the following should be included in the teaching about umbilical cord care?
- A. keep the cord dry and clean
- B. apply a sterile dressing to the cord
- C. use alcohol or iodine to clean the cord
- D. apply a sterile dressing to the umbilicus
Correct Answer: A
Rationale: The correct answer is A: keep the cord dry and clean. This is because keeping the umbilical cord dry and clean helps prevent infection and promotes healing. Applying a sterile dressing (B) is unnecessary and may trap moisture, leading to infection. Using alcohol or iodine (C) is outdated and can delay cord separation. Applying a sterile dressing to the umbilicus (D) is not recommended as it can interfere with air circulation and healing. In summary, choice A is correct as it aligns with current best practices for umbilical cord care.
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A patient who is about to undergo a cesarean section for breech presentation without fetal distress asks her nurse what kind of anesthesia would be best for her. The nurse explains that which of the following is the preferred method of anesthesia in this nonemergent case?
- A. Spinal block
- B. Epidural block
- C. General anesthesia
- D. Intravenous sedation
Correct Answer: A
Rationale: The correct answer is A: Spinal block. In a non-emergent cesarean section for breech presentation without fetal distress, a spinal block is preferred due to its rapid onset, reliable anesthesia for surgical procedures, and minimal risk to the fetus. Spinal block provides adequate pain relief and muscle relaxation without affecting the mother's ability to breathe and interact with the newborn immediately after delivery.
Summary of other choices:
B: Epidural block - Epidural block may not provide a dense enough block for a cesarean section and might require more time to administer.
C: General anesthesia - General anesthesia poses more risks to both the mother and the fetus compared to regional anesthesia methods.
D: Intravenous sedation - Intravenous sedation may not provide sufficient anesthesia for a cesarean section and is not the preferred method for this type of surgery.
A woman in labor is receiving magnesium sulfate for preterm labor. What should the nurse monitor closely during this treatment?
- A. Deep tendon reflexes
- B. Respiratory rate
- C. Maternal blood pressure
- D. Fetal heart rate
Correct Answer: A
Rationale: The correct answer is A: Deep tendon reflexes. Magnesium sulfate can cause muscle weakness and respiratory depression due to its effect on the central nervous system. Monitoring deep tendon reflexes helps assess for magnesium toxicity. Respiratory rate (B) should also be monitored, but it is not the most critical parameter for magnesium sulfate. Maternal blood pressure (C) is important, but changes are usually gradual and not directly related to magnesium sulfate. Fetal heart rate (D) is crucial, but in this case, the focus should be on the mother's response to the medication.
Which of the following skin changes should the nurse highlight for a pregnant woman’s health care practitioner?
- A. Linea nigra.
- B. Melasma.
- C. Petechiae.
- D. Spider nevi.
Correct Answer: C
Rationale: Petechiae (small hemorrhages under the skin) could indicate underlying medical conditions such as thrombocytopenia or coagulopathy, warranting further investigation. Linea nigra and melasma are common benign changes, while spider nevi are usually harmless but less urgent.
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.
A pregnant patient is at 30 weeks gestation and is experiencing difficulty breathing, especially when lying flat. What is the nurse's priority action?
- A. Encourage the patient to rest in an upright position.
- B. Administer oxygen and prepare the patient for delivery.
- C. Monitor the fetal heart rate for signs of distress.
- D. Instruct the patient to take deep breaths and stay in bed.
Correct Answer: A
Rationale: The correct answer is A - Encourage the patient to rest in an upright position. This is the priority action because the patient is likely experiencing supine hypotensive syndrome due to pressure on the vena cava when lying flat. This can compromise blood flow to the fetus. By having the patient rest in an upright position, the pressure on the vena cava is reduced, improving blood flow and oxygenation for both the patient and the fetus. Administering oxygen and preparing for delivery (option B) is not the immediate priority. Monitoring fetal heart rate (option C) is important but not the initial action. Instructing the patient to take deep breaths and stay in bed (option D) does not address the underlying issue of supine hypotensive syndrome.