Maternal Newborn Nursing

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A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for an induction of labor with misoprostol?

  • A. A client who has active genital herpes
  • B. A client who has gestational diabetes mellitus
  • C. A client who has a previous uterine incision
  • D. A client who has placenta previa
Correct Answer: C

Rationale: Misoprostol is a prostaglandin E1 analog that is commonly used for labor induction. It is particularly useful in clients with a previous uterine incision, such as a cesarean section scar, because it helps soften the cervix and promote uterine contractions, which can lead to successful vaginal birth after cesarean (VBAC). Misoprostol can be an effective method for inducing labor in these clients while minimizing the risk of uterine rupture. However, it is important to closely monitor clients for signs of uterine hyperstimulation when using misoprostol for labor induction.

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Which comment by a woman shows understanding of diaphragm teaching?

  • A. I should regularly put the diaphragm up to the light and look at it carefully.
  • B. This is one method that can be used during menstruation.
  • C. I can leave the diaphragm in place for a day or two.
  • D. The diaphragm should be well powdered before I put it back in the case.
Correct Answer: B

Rationale: Diaphragms can be used during menstruation.

A nurse is assessing a client following an amniocentesis. Which of the following findings should the nurse recognize as complications? (Select all that apply).

  • A. Amnionitis
  • B. Urinary tract infection
  • C. Polyhydramnios
  • D. Leakage of amniotic fluid
Correct Answer: A

Rationale: A. Amnionitis: This is the inflammation of the amniotic sac or membranes and is a potential complication following an amniocentesis procedure. It can lead to maternal fever, fetal tachycardia, and other signs of infection.

A client at 20 weeks' gestation is undergoing a routine ultrasound. What is the primary focus of this examination?

  • A. Confirm the baby's sex.
  • B. Evaluate fetal anatomy and growth.
  • C. Assess maternal cervical length.
  • D. Check for signs of preterm labor.
Correct Answer: B

Rationale: The 20-week ultrasound focuses on assessing fetal anatomy, growth, and structural development.

What intervention is highest priority for a woman entering the emergency department after a stranger rape?

  • A. Create a safe environment.
  • B. Offer postcoital contraceptive therapy.
  • C. Provide sexually transmitted disease prophylaxis.
  • D. Take a thorough health history.
Correct Answer: A

Rationale: Ensuring safety is paramount immediately after trauma.

A newborn's birth was prolonged because the shoulders were very wide. The nurse performing the assessment would be particularly observant for a problem with the:

  • A. Moro reflex
  • B. Plantar reflex
  • C. Babinski reflex
  • D. Stepping reflex
Correct Answer: B

Rationale: Shoulder dystocia can affect the plantar reflex.

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