Nokea
A nurse is taking a birth history assessment on a client who is 8 weeks gestation and has one child who was born at 38 weeks. Which is consistent with this birth history?
- A. Primipara
- B. Primigravida
- C. Nulligravida
- D. Multipara
Correct Answer: D
Rationale: The correct answer is D: Multipara. This term refers to a woman who has given birth to two or more children. In this case, the client has one child already, making her a multipara.
A: Primipara refers to a woman who has given birth to one child, which does not match the client's birth history.
B: Primigravida refers to a woman who is pregnant for the first time, which also does not match the client's history.
C: Nulligravida refers to a woman who has never been pregnant, which is not the case for the client.
Therefore, the correct term to describe the client's birth history is Multipara, as she has one child and is currently 8 weeks gestation.
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Which statement by the patient indicates to the nurse that the patient understands danger signs during the second trimester?
- A. I should contact the doctor if I experience heartburn.
- B. I should contact the doctor if I experience constipation.
- C. I should contact the doctor if I experience hurting when I urinate.
- D. I should contact the doctor if I experience leg cramps.
Correct Answer: C
Rationale: The correct answer is C because pain while urinating can be a sign of a urinary tract infection, which is common during pregnancy and can lead to complications if not treated promptly. Heartburn, constipation, and leg cramps are common discomforts during pregnancy but are not typically considered emergency danger signs. Therefore, option C is the most critical symptom that requires immediate medical attention to prevent potential harm to the mother and baby.
The fetal heart rate baseline increases 20 bpm after vibroacoustic stimulation. The best interpretation of this is that the fetus is showing
- A. a worsening hypoxi
- B. progressive acidosis.
- C. an expected respons
- D. parasympathetic stimulation.
Correct Answer: C
Rationale: The correct answer is C. After vibroacoustic stimulation, an increase in fetal heart rate baseline indicates an expected response, showing the fetus is healthy and responding appropriately to the stimulus. This increase is a sign of fetal well-being and does not suggest worsening hypoxia (choice A) or progressive acidosis (choice B). Additionally, parasympathetic stimulation (choice D) would typically lead to a decrease in heart rate, not an increase as observed in this scenario. Therefore, choice C is the best interpretation based on the positive response of the fetal heart rate to the stimulation, indicating a healthy and expected reaction.
What pregnant person is at high risk for labor dystocia?
- A. 38-week gestation
- B. 41-year-old
- C. prenatal anemia
- D. no prenatal care
Correct Answer: B
Rationale: The correct answer is B: 41-year-old. Advanced maternal age increases the risk of labor dystocia due to reduced uterine muscle tone and coordination. Older individuals are more likely to experience prolonged labor or difficulty with fetal descent. Choice A (38-week gestation) is not a risk factor for labor dystocia. Prenatal anemia (Choice C) may lead to complications during pregnancy but is not directly linked to labor dystocia. Lack of prenatal care (Choice D) can increase the risk of complications but is not a specific risk factor for labor dystocia.
Decreased capillary refill, delay in milk production, and diminished peripheral pulses are signs of what complication?
- A. alteration in perfusion
- B. alteration in liver function
- C. alteration in kidney function
- D. alteration in uterine function
Correct Answer: C
Rationale: The correct answer is C, alteration in kidney function. Decreased capillary refill indicates poor perfusion due to impaired kidney function leading to reduced blood flow. Delay in milk production is not directly related to kidney or liver function. Diminished peripheral pulses can be a sign of decreased blood flow due to kidney dysfunction affecting circulation. Alteration in liver or uterine function would not typically present with these specific signs. Therefore, the signs listed are most indicative of a complication related to kidney function.
A patient who is expecting her first baby tells the nurse, “I am afraid of the whole birth experience and plan to ask the doctor for a cesarean delivery.” Which response by the nurse is most appropriate?
- A. I will get you some material about how labor pain is managed.
- B. Most women avoid cesarean births unless it is an emergency.
- C. I suggest you talk with the physician and get another opinion.
- D. Cesarean will cause you issues with additional pregnancies.
Correct Answer: B
Rationale: The correct answer is B: Most women avoid cesarean births unless it is an emergency.
Rationale:
1. Cesarean delivery is a major surgery with potential risks and longer recovery time compared to vaginal birth.
2. Most women opt for vaginal birth unless there are medical reasons necessitating a cesarean section.
3. It is important for the nurse to educate the patient on the benefits of vaginal birth and address her fears about the birth experience.
4. Encouraging the patient to consider vaginal birth unless there is a medical emergency aligns with best practices in obstetric care.
Summary:
- Choice A is incorrect because focusing solely on pain management may not address the patient's underlying fear of the birth experience.
- Choice C is incorrect as seeking another opinion may not be necessary if the patient's concerns can be addressed through education and counseling.
- Choice D is incorrect as not all cesarean deliveries lead to complications in subsequent pregnancies.