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A patient in labor is having difficulty pushing during the second stage of labor. Which of the following interventions would be most helpful?
- A. Increase the epidural dose
- B. Encourage the patient to bear down with each contraction
- C. Perform a cesarean section
- D. Place the patient in a lithotomy position
Correct Answer: B
Rationale: The correct answer is B: Encourage the patient to bear down with each contraction. This is the most helpful intervention as it helps the patient effectively push during the second stage of labor, facilitating the descent of the baby through the birth canal. Increasing the epidural dose (choice A) can further impair the patient's ability to push. Performing a cesarean section (choice C) is not necessary unless there are other complications. Placing the patient in a lithotomy position (choice D) is a common position for delivery but does not address the issue of difficulty pushing.
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The following four changes occur during pregnancy. Which of them usually increases the father’s interest and involvement in the pregnancy?
- A. Learning the results of the pregnancy test.
- B. Attending childbirth education classes.
- C. Hearing the fetal heartbeat.
- D. Meeting the obstetrician or midwife.
Correct Answer: C
Rationale: Hearing the fetal heartbeat is a significant moment that often increases the father’s interest and involvement in the pregnancy. The other options may also increase involvement but are less impactful.
A client, in her third trimester, is concerned that she will not know the difference between labor contractions and normal aches and pains of pregnancy.
- A. Don't worry. You'll know the difference when the contractions start.
- B. The contractions may feel just like a backache
- C. but they will come and go.
- D. Contractions are a lot worse than your pregnancy aches and pains.
Correct Answer: B
Rationale: Labor contractions typically have a pattern, coming and going at regular intervals, whereas normal aches and pains do not follow such a predictable pattern.
A pregnant woman states, “My husband hopes I will give him a boy because we have three girls.” What will the nurse explain to this woman?
- A. The sex chromosome of the fertilized ovum determines the gender of the child.
- B. When the sperm and ovum are united, there is a 75% chance the child will be a girl.
- C. When the pH of the female reproductive tract is acidic, the child will be a girl.
- D. If a sperm carrying a Y chromosome fertilizes an ovum, then a boy is produced.
Correct Answer: D
Rationale: When a Y-bearing sperm fertilizes an ovum, a male child is produced.
What are the functions of amniotic fluid? (Select all that apply.)
- A. Maintaining an even temperature
- B. Impeding excessive fetal movement
- C. Lubricating fetal skin
- D. Acting as a reservoir for nutrients
Correct Answer: A
Rationale: The amniotic fluid provides maintenance of even temperature; prevents amnion from adhering to fetal skin; allows buoyancy, symmetrical growth, and fetal movement; and acts as a cushion for the fetus. Although the fetus does swallow amniotic fluid, it has no nutritional value. Impeding excessive fetal movement and lubricating fetal skin are not primary functions of amniotic fluid.
A pregnant patient at 32 weeks gestation reports severe heartburn. What should the nurse recommend to relieve symptoms?
- A. Take over-the-counter antacids after every meal.
- B. Eat smaller, more frequent meals and avoid lying down after eating.
- C. Drink a large glass of water immediately after meals to dilute stomach acid.
- D. Increase caffeine intake to speed up digestion.
Correct Answer: B
Rationale: The correct answer is B: Eat smaller, more frequent meals and avoid lying down after eating. This recommendation helps prevent acid reflux by reducing the pressure on the stomach and ensuring that the stomach is not overly full. Eating smaller meals more frequently prevents the stomach from becoming too full, which can trigger heartburn. Avoiding lying down after eating helps prevent stomach acid from flowing back into the esophagus. Options A, C, and D are incorrect. Taking antacids after every meal can lead to excessive intake and potential side effects. Drinking water immediately after meals may exacerbate heartburn by diluting stomach acid further. Increasing caffeine intake can worsen heartburn symptoms due to its ability to relax the lower esophageal sphincter.