Nokea
A nurse is providing teaching to a client who is at 35 weeks of gestation and has a prescription for an amniocentesis. Which of the following client statements indicates an understanding of the teaching?
- A. I should empty my bladder before the procedure.
- B. I will be lying on my side during the procedure.
- C. I will be asleep during the procedure.
- D. I should start fasting 24 hours before the procedure.
Correct Answer: A
Rationale: The correct answer is A: "I should empty my bladder before the procedure." This statement indicates understanding because a full bladder can obstruct visualization during amniocentesis. Choice B is incorrect because the client should lie flat on their back during the procedure. Choice C is incorrect as the client is awake for an amniocentesis. Choice D is incorrect because fasting is not required before the procedure.
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What is the recommended method of pain relief during labor for a woman with a high-risk pregnancy?
- A. Epidural anesthesia
- B. Spinal anesthesia
- C. Intravenous opioids
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: Epidural anesthesia. Epidural anesthesia is the recommended method for pain relief during labor for women with high-risk pregnancies as it provides effective pain relief while allowing the mother to remain conscious and able to actively participate in the birthing process. Epidurals can be adjusted to provide varying levels of pain relief and are considered safe for both the mother and the baby. Spinal anesthesia (B) is typically used for cesarean sections and may not be suitable for the entire labor process. Intravenous opioids (C) are less commonly used due to potential side effects on the baby. Choice D is incorrect as not all methods are recommended for high-risk pregnancies.
Which of the following is a potential complication of a vacuum-assisted delivery?
- A. Fetal distress
- B. Maternal hemorrhage
- C. Intra-abdominal injury
- D. All of the above
Correct Answer: C
Rationale: The correct answer is C: Intra-abdominal injury. During a vacuum-assisted delivery, the vacuum extractor can potentially apply excessive force leading to intra-abdominal injury to the mother. This can include injuries to the uterus, bladder, or other abdominal organs. Fetal distress (choice A) and maternal hemorrhage (choice B) are potential complications of vacuum-assisted delivery as well, but they are not directly related to the mechanical trauma that can cause intra-abdominal injury. Therefore, the correct answer is C as it specifically addresses a unique complication associated with vacuum-assisted delivery.
What is the function of the placenta during pregnancy?
- A. To protect the fetus from infection
- B. To remove waste products from the fetus
- C. To facilitate nutrient and gas exchange between the mother and fetus
- D. All of the above
Correct Answer: D
Rationale: The placenta protects the fetus, removes waste, and facilitates nutrient and gas exchange.
Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is indicated or contraindicated for the newborn.
- A. Educate the parents to begin range of motion exercises on the affected arm after 1 week.
- B. Assess for grasp reflex in the affected extremity.
- C. Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt.
- D. Instruct parents to limit physical handling for 2 weeks.
Correct Answer:
Rationale: Educate the parents to begin range of motion exercises on the affected arm after 1 week is indicated. Passive ROM exercises of the arm are indicated to restore function of the extremity. The initiation of these exercises is delayed for approximately 1 week to prevent additional injury to the brachial plexus. Assess for grasp reflex in the affected extremity is indicated. With Erb-Duchenne paralysis, only the upper arm is affected. The function of the wrists and fingers should be unaffected; the nurse should assess for a palmar grasp reflex.Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt is indicated. Intermittent immobilization of the affected arm across the newborn's abdomen can be achieved by pinning the sleeve to the shirt.Instruct parents to limit physical handling for 2 weeks is contraindicated. Parents and guardians should participate in the physical care of their newborn to increase parental-infant attachment. Providing education and practice opportunities for the parents will decrease their fears of injuring the newborn and increase confidence and bonding.
Which of the following is a potential complication of a retained placenta?
- A. Preeclampsia
- B. Postpartum hemorrhage
- C. Gestational diabetes
- D. All of the above
Correct Answer: B
Rationale: The correct answer is B: Postpartum hemorrhage. A retained placenta can lead to postpartum hemorrhage due to incomplete delivery of the placenta, causing excessive bleeding. Preeclampsia and gestational diabetes are not directly related to a retained placenta. Therefore, the correct answer is B.