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A patient in labor is undergoing an epidural block and develops hypotension. What should the nurse do first?
- A. Increase intravenous fluids
- B. Place the patient in a Trendelenburg position
- C. Administer oxygen via face mask
- D. Notify the physician immediately
Correct Answer: A
Rationale: The correct first action is to increase intravenous fluids (Choice A). This will help improve the patient's blood volume and subsequently increase blood pressure. Trendelenburg position (Choice B) is not recommended due to potential complications. Administering oxygen (Choice C) may be helpful but doesn't directly address the hypotension. Notifying the physician (Choice D) is important but addressing hypotension promptly is the priority. Increasing fluids helps address the underlying cause of hypotension in this scenario.
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When assessing the psychological adjustment of an 8-week gravida, which of the following would the nurse expect to see signs of?
- A. Ambivalence.
- B. Depression.
- C. Anxiety.
- D. Ecstasy.
Correct Answer: A
Rationale: Ambivalence is a common psychological response in early pregnancy as the client adjusts to the idea of being pregnant. Depression, anxiety, and ecstasy are less common at this stage.
A nurse is educating a pregnant patient about preeclampsia. Which of the following statements by the patient indicates the need for further teaching?
- A. I should report sudden swelling in my hands, face, or feet.
- B. I should monitor my blood pressure and avoid excessive salt in my diet.
- C. I should expect occasional headaches and dizziness as normal symptoms of pregnancy.
- D. I should contact my healthcare provider if I experience sudden vision changes or severe headaches.
Correct Answer: C
Rationale: Rationale: Choice C is incorrect because headaches and dizziness are not considered normal symptoms of pregnancy, especially when accompanied by other signs of preeclampsia. Preeclampsia can cause headaches and dizziness due to high blood pressure. Choices A, B, and D are correct as they highlight important signs and symptoms of preeclampsia that the patient should report to their healthcare provider promptly.
A laboring person is requesting an epidural for pain relief. What is the most important nursing action before the procedure?
- A. administer an epidural bolus
- B. check for any contraindications
- C. perform a vaginal exam
- D. ensure continuous fetal monitoring
Correct Answer: B
Rationale: The correct answer is B: check for any contraindications. Before administering an epidural, it is crucial to assess for contraindications such as low platelet count, infection at the insertion site, or severe hypotension as these may increase the risk of complications. Administering an epidural bolus (A) without checking for contraindications can be dangerous. Performing a vaginal exam (C) is not necessary before an epidural and could increase the risk of infection. Ensuring continuous fetal monitoring (D) is important during labor but is not the most critical action before administering an epidural.
The nurse is reading an article that states that the maternal mortality rate in the United States in the year 2000 was 17. Which of the following statements would be an accurate interpretation of the statement?
- A. There were 17 maternal deaths in the United States in 2,000 per 100,000 live births.
- B. There were 17 maternal deaths in the United States in 2,000 per 100,000 women of childbearing age.
- C. There were 17 maternal deaths in the United States in 2,000 per 100,000 pregnancies.
- D. There were 17 maternal deaths in the United States in 2,000 per 100,000 women in the country
Correct Answer: A
Rationale: Maternal mortality rates are typically expressed as the number of maternal deaths per 100,000 live births. This metric focuses specifically on deaths related to pregnancy or childbirth complications among women who have given birth, making option A the correct choice. Options B, C, and D refer to broader populations or less relevant denominators, which do not align with standard definitions of maternal mortality rates.
Which statement accurately describes the importance of birthing person position changes during the second stage of labor?
- A. Position changes have an impact on fetal descent.
- B. Position changes can lead to support person stress.
- C. Fetal descent is solely determined by uterine contractions.
- D. Maintaining a supine position is the safest option.
Correct Answer: A
Rationale: The correct answer is A because position changes during the second stage of labor can indeed impact fetal descent. Different positions such as upright, squatting, or on hands and knees can help utilize gravity to aid in the descent of the baby through the birth canal. This can potentially speed up labor and reduce the risk of complications.
Explanation of why the other choices are incorrect:
B: Position changes are not intended to lead to support person stress, but rather to optimize the birthing process.
C: Fetal descent is influenced by a combination of factors, including uterine contractions and maternal positioning.
D: Maintaining a supine position is not always the safest option as it can compress blood vessels, potentially reducing blood flow to the baby.