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A nurse is preparing a laboring person for an epidural. What is the most important intervention before the procedure?
- A. ensure informed consent
- B. assist with proper positioning
- C. check for allergies to anesthesia
- D. educate on wound care
Correct Answer: C
Rationale: The correct answer is C: check for allergies to anesthesia. Before administering an epidural, it is crucial to check for any allergies to anesthesia to prevent potential allergic reactions. This step ensures the safety and well-being of the laboring person. Informed consent (choice A) is important but not the most critical step before an epidural. Proper positioning (choice B) is essential during the procedure but not the top priority before it. Educating on wound care (choice D) is not directly relevant to preparing for an epidural.
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A nurse is assessing a laboring person's progress. What is the most reliable indicator that the laboring person is in the active phase of labor?
- A. Progressive cervical dilation
- B. Frequent, regular contractions
- C. Fetal descent
- D. Effacement of the cervix
Correct Answer: A
Rationale: The correct answer is A: Progressive cervical dilation. This is the most reliable indicator of the active phase of labor because it directly reflects the opening of the cervix, indicating that labor is advancing. Cervical dilation is a key aspect of labor progress and is used to determine the stage of labor. Frequent, regular contractions (choice B) are important but can occur in early labor as well. Fetal descent (choice C) is an important aspect but may happen in conjunction with cervical dilation. Effacement of the cervix (choice D) is also important but does not solely indicate the active phase of labor.
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks’ gestation; delivered a daughter, now 5 years old, at 39 weeks’ gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman’s gravidity and parity?
- A. G4 P2121.
- B. G4 P1212.
- C. G5 P1122.
- D. G5 P2211.
Correct Answer: D
Rationale: Gravidity includes all pregnancies (live births, miscarriages, abortions, and current pregnancy). Parity reflects live births. This woman has had 5 pregnancies (2 live births, 1 miscarriage, 1 abortion, and 1 current pregnancy), making her G5 P2211.
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.
The nurse is caring for a pregnant patient who is 35 weeks gestation and reports sharp abdominal pain and decreased fetal movement. What is the nurse's priority action?
- A. Encourage the patient to drink water and rest in a comfortable position.
- B. Call the healthcare provider immediately and prepare for further assessment.
- C. Monitor the fetal heart rate and perform a nonstress test.
- D. Ask the patient to lie on her left side and wait for symptoms to resolve.
Correct Answer: B
Rationale: The correct answer is B: Call the healthcare provider immediately and prepare for further assessment. This is the priority action because sharp abdominal pain and decreased fetal movement at 35 weeks gestation could indicate a serious complication such as placental abruption or fetal distress. Calling the healthcare provider promptly allows for timely intervention and assessment to ensure the safety of both the mother and the baby. Encouraging the patient to drink water and rest (choice A) may not address the underlying issue. Monitoring fetal heart rate and performing a nonstress test (choice C) may be important but not as immediate as contacting the healthcare provider. Asking the patient to lie on her left side and wait for symptoms to resolve (choice D) delays necessary medical evaluation and intervention.
A pregnant patient at 24 weeks gestation reports experiencing leg cramps. What is the most appropriate intervention for the nurse to recommend?
- A. Increase calcium intake to prevent leg cramps.
- B. Encourage the patient to exercise more to strengthen leg muscles.
- C. Elevate the legs and perform gentle stretching exercises.
- D. Apply heat packs to the legs to relieve cramping.
Correct Answer: C
Rationale: The correct answer is C: Elevate the legs and perform gentle stretching exercises. Leg cramps during pregnancy are common due to increased weight and pressure on the legs. Elevating the legs helps improve circulation and reduce cramping. Gentle stretching exercises can also help relieve muscle tension. Increasing calcium intake (choice A) may be beneficial for preventing cramps, but it is not the immediate intervention for relief. Exercise (choice B) may worsen cramping if done excessively. Applying heat packs (choice D) may provide temporary relief but does not address the underlying cause of the cramps.