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A nurse is reviewing the medical record of a newly admitted client who is at 32 weeks of gestation. Which of the following conditions is an indication for fetal assessment using electronic fetal monitoring?
- A. Oligohydramnios.
- B. Hyperemesis gravidarum.
- C. Leukorrhea.
- D. Periodic tingling of the fingers.
Correct Answer: A
Rationale: The correct answer is A: Oligohydramnios. Electronic fetal monitoring is used to assess the well-being of the fetus during pregnancy, labor, and delivery. Oligohydramnios refers to a low level of amniotic fluid, which can indicate fetal distress or compromise. Monitoring the fetal heart rate patterns using electronic fetal monitoring in this case can help detect any abnormalities and guide appropriate interventions to optimize fetal outcomes.
Incorrect choices:
B: Hyperemesis gravidarum - This is severe nausea and vomiting in pregnancy, not a direct indication for fetal monitoring.
C: Leukorrhea - This is a common vaginal discharge in pregnancy, not a direct indication for fetal monitoring.
D: Periodic tingling of the fingers - This is not related to fetal assessment and is more likely a symptom of a different issue, such as nerve compression.
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A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives. Which of the following findings should the nurse include as an adverse effect of this medication?
- A. Depression.
- B. Polyuria.
- C. Hypotension.
- D. Urticaria.
Correct Answer: A
Rationale: The correct answer is A: Depression. Combined oral contraceptives can potentially cause mood changes, including depression, as they can affect hormone levels. Other choices are incorrect as polyuria is excessive urination (not a common adverse effect of oral contraceptives), hypotension is low blood pressure (not typically associated with oral contraceptives), and urticaria is hives (not a common side effect of oral contraceptives).
A nurse is caring for a client who is to receive oxytocin to augment their labor. Which of the following findings contraindicates the initiation of the oxytocin infusion and should be reported to the provider?
- A. Late decelerations.
- B. Moderate variability of the FHR.
- C. Cessation of uterine dilation.
- D. Prolonged active phase of labor.
Correct Answer: A
Rationale: The correct answer is A: Late decelerations. Late decelerations indicate uteroplacental insufficiency, potentially leading to fetal distress. Oxytocin can further stress the fetus by increasing uterine contractions, exacerbating the late decelerations. Late decelerations are a sign of decreased oxygen supply to the fetus, making it unsafe to augment labor with oxytocin. Therefore, this finding should be reported to the provider to ensure the safety of both the client and the fetus.
Incorrect choices:
B: Moderate variability of the FHR is a reassuring sign of fetal well-being, not a contraindication for oxytocin infusion.
C: Cessation of uterine dilation may indicate a stalled labor progress but is not a contraindication for initiating oxytocin.
D: Prolonged active phase of labor may warrant augmentation with oxytocin rather than being a contraindication.
A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Frequent vomiting with weight loss of 3 lb in 1 week
- B. Reports of mood swings
- C. Nosebleeds occurring approximately 3 times per week
- D. Increased vaginal discharge
Correct Answer: A
Rationale: The correct answer is A. Frequent vomiting with weight loss of 3 lb in 1 week is concerning as it could indicate hyperemesis gravidarum, a severe form of morning sickness that can lead to dehydration and malnutrition, posing risks to both the mother and fetus. It requires medical intervention to prevent complications.
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for immediate concern.
C: Nosebleeds occurring approximately 3 times per week are common in pregnancy due to increased blood volume and hormonal changes. They are usually not a significant concern unless they are severe or accompanied by other symptoms.
D: Increased vaginal discharge is a normal occurrence in pregnancy due to hormonal changes and increased blood flow to the pelvic area. It is not typically a cause for immediate concern unless it is accompanied by other symptoms like itching, burning, or foul odor.
A nurse is caring for a client who is in labor and requires augmentation of labor. Which of the following conditions should the nurse recognize as a contraindication to the use of oxytocin?
- A. Post-term with oligohydramnios.
- B. Chorioamnionitis
- C. Shoulder presentation
- D. Diabetes mellitus
Correct Answer: C
Rationale: The correct answer is C: Shoulder presentation. This condition is a contraindication to the use of oxytocin because it can lead to complications such as umbilical cord prolapse, which can be dangerous for both the mother and the baby. Oxytocin can increase the strength and frequency of contractions, potentially worsening the situation.
Choice A: Post-term with oligohydramnios is not a contraindication to the use of oxytocin. It may actually be a reason to consider augmentation of labor.
Choice B: Chorioamnionitis is an infection of the fetal membranes and amniotic fluid, and while it may require treatment, it is not a contraindication to the use of oxytocin.
Choice D: Diabetes mellitus is not a contraindication to the use of oxytocin unless there are specific complications related to diabetes that would make its use risky.
In summary, the correct answer, shoulder presentation,
A nurse is assessing a newborn who was born at 26 weeks of gestation using the New Ballard Score. Which of the following findings should the nurse expect?
- A. Minimal arm recoil
- B. Popliteal angle of 90°
- C. Creases over the entire foot sole
- D. Raised areolas with 3 to 4 mm buds
Correct Answer: A
Rationale: The correct answer is A: Minimal arm recoil. In premature newborns born at 26 weeks of gestation, they typically exhibit minimal arm recoil due to their immature neuromuscular development. This is a key characteristic assessed in the New Ballard Score to determine the gestational age of the newborn. Choices B, C, and D are incorrect as they do not align with the expected findings in a premature newborn at 26 weeks of gestation. Popliteal angle of 90° (Choice B) is more typical in a term newborn. Creases over the entire foot sole (Choice C) are also more common in term newborns. Raised areolas with 3 to 4 mm buds (Choice D) are indicative of a more mature newborn and not typically seen in a premature newborn at 26 weeks of gestation.