Nokea
A primigravida has a pelvis of the android type which usually means the delivery will be a ___.
Correct Answer: cesarean
Rationale: The narrow outlet of the android-type pelvis usually requires a cesarean delivery.
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Which assessment findings suggest probable fetal distress?
- A. Fetal heart rate (FHR) of 120
- B. Meconium-stained amniotic fluid
- C. Decreased FHR during contractions
- D. Strong contractions 10 seconds apart
- E. Slow return of FHR to baseline
Correct Answer: B,E
Rationale: Meconium-stained amniotic fluid and the slow return of the FHR to the baseline are indicative of fetal distress. All other options are normal.
Which type of monitor will assess the intensity of contractions?
- A. External monitor
- B. Fetal monitor
- C. Maternal monitor
- D. Internal monitor
Correct Answer: D
Rationale: Internal monitoring is used to monitor the intensity of contractions, the frequency and duration of contractions, and the resting tone of uterine contractions. An external monitor is used to monitor the fetal heart rate and uterine activity.
What area of the uterus provides the force during a contraction?
- A. Lower portion
- B. Middle portion
- C. Upper portion
- D. Cervical portion
Correct Answer: C
Rationale: The upper portion of the uterus provides the force during contractions.
Using Leopold maneuvers to assess fetal position the nurse finds a soft rounded prominence at the level of the fundus a hard round prominence just above the symphysis pubis and nodulations on the left side of the uterus. How should the nurse document the fetal position?
- A. Right occiput anterior (ROA) vertex
- B. Left occiput anterior (LOA) vertex
- C. Right occiput transverse (ROT) breech
- D. Left occiput anterior (LOA) breech
Correct Answer: A
Rationale: Fetal position can be determined by the Leopold maneuver, which defines the relationship of the presenting part to the maternal pelvis quadrant. A soft rounded prominence at the level of the fundus, a hard round prominence just above the symphysis pubis, and nodulations on the left side of the uterus indicate a right occiput anterior (ROA), vertex positioning.
The nurse is alarmed as she assesses a protruding umbilical cord from the vagina. What immediate action should the nurse take?
- A. Monitor intensity of contractions.
- B. Place the patient in the knee-chest position.
- C. Notify the charge nurse.
- D. Ask the patient to perform a Valsalva's maneuver.
Correct Answer: B
Rationale: The knee-chest position reduces the pressure on the prolapsed cord. The charge nurse will need to be notified, and the contractions will need to be monitored. However, the priority is reducing the pressure on the prolapsed cord.