Nokea
A primigravida patient asks the nurse to explain the term quickening. Which statement by the nurse is correct?
- A. It is intermittent uterine contractions caused by the increase in hormones, especially estrogen.
- B. It is the absence of menses and is one of the earliest symptoms a woman reports when she is pregnant.
- C. It is when the mother can first feel the movements of the fetus.
- D. It is an increase in vaginal discharge caused by the increase in estrogen.
Correct Answer: C
Rationale: The correct answer is C because quickening refers to the first time a mother feels fetal movements, usually around 18-20 weeks gestation. This marks the beginning of fetal movements that the mother can perceive.
A is incorrect because intermittent uterine contractions are not referred to as quickening.
B is incorrect as it describes amenorrhea, not quickening.
D is incorrect as an increase in vaginal discharge is not the definition of quickening.
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When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern?
- A. Early decelerations
- B. Variable decelerations
- C. Nonperiodic accelerations
- D. Increase in baseline variability
Correct Answer: B
Rationale: The correct answer is B: Variable decelerations. When the mother's membranes rupture during active labor, variable decelerations should be observed in the fetal heart rate. This is because the rupture of membranes can lead to umbilical cord compression, causing variable decelerations in the fetal heart rate pattern. Variable decelerations are characterized by abrupt and visually apparent decreases in heart rate variability.
A: Early decelerations are usually associated with head compression during contractions and are benign.
C: Nonperiodic accelerations are not a typical pattern seen in response to ruptured membranes during labor.
D: An increase in baseline variability is a positive sign and does not specifically indicate the occurrence of variable decelerations related to umbilical cord compression.
Gestational diabetes increases what complication of labor?
- A. breech
- B. macrosomia
- C. macrosomia
- D. precipitous birth
Correct Answer: B
Rationale: The correct answer is B: macrosomia. Gestational diabetes can lead to fetal macrosomia, where the baby is larger than average, increasing the risk of complications during labor such as shoulder dystocia. This is due to the excess glucose crossing the placenta and stimulating the baby's pancreas to produce more insulin, resulting in increased growth. Choice A, breech presentation, is not directly associated with gestational diabetes. Choice C is a duplicate of the correct answer. Choice D, precipitous birth, is not a common complication of gestational diabetes but rather refers to an extremely rapid labor process.
What is one potential fetal complication of using obstetric forceps?
- A. flexion of the head
- B. abdominal complications
- C. skull fracture
- D. femur fracture
Correct Answer: C
Rationale: The correct answer is C: skull fracture. When obstetric forceps are used during delivery, there is a risk of excessive pressure on the fetal skull, leading to a potential complication such as a skull fracture. This occurs due to the force exerted by the instrument during the delivery process, which can cause trauma to the baby's delicate skull bones. Flexion of the head (choice A) is a normal part of the birthing process and not a complication of forceps use. Abdominal complications (choice B) and femur fracture (choice D) are not typically associated with obstetric forceps use.
Which maternal condition should be considered a contraindication for the application of internal monitoring devices?
- A. Unruptured membranes
- B. intravenous (IV) fluid.
- C. Fetus has known heart defect
- D. must act quickly to improve placental blood flow and fetal oxygen supply
Correct Answer: A
Rationale: The correct answer is A: Unruptured membranes. Internal monitoring devices are inserted through the cervix and into the uterus, which can introduce bacteria and increase the risk of infection if the membranes are not ruptured. This can lead to serious complications for both the mother and the baby.
Choice B (intravenous fluid) is incorrect because IV fluids are commonly used during labor to maintain hydration and provide necessary nutrients.
Choice C (Fetus has known heart defect) is incorrect because internal monitoring devices are used to assess fetal heart rate and detect any abnormalities, making this condition a reason for monitoring rather than a contraindication.
Choice D (must act quickly to improve placental blood flow and fetal oxygen supply) is incorrect because internal monitoring devices are usually used for continuous monitoring and do not require immediate intervention to be placed.
The nurse in the post-delivery unit is encouraging skin-to-skin contact for a mother and neonate after cesarean delivery. Which action, if noticed by the nurse, requires immediate intervention by the nurse?
- A. Mother is sitting up with the neonate prone on her chest.
- B. Mother is supine with the neonate prone on her chest.
- C. The neonate is prone on mother’s chest and facing to the side.
- D. Neonate is prone with mother resting in semi-Fowler’s position.
Correct Answer: B
Rationale: B is the correct answer because having the mother in a supine position with the neonate prone on her chest can potentially increase the risk of neonatal suffocation or accidental injury due to the baby slipping off. This position restricts the baby's ability to breathe properly and may lead to adverse outcomes.
A: Sitting up with the neonate prone on her chest allows for better supervision and support for the baby's breathing.
C: The neonate facing to the side is a safe position for skin-to-skin contact and breastfeeding.
D: Neonate resting in semi-Fowler's position is a safe and comfortable position that allows for proper breathing and bonding between mother and baby.