Nokea
A woman is planning to become pregnant. Which of the following actions should she be counseled to take before stopping birth control? Select all that apply.
- A. Take a daily multivitamin.
- B. See a medical doctor.
- C. Drink beer instead of vodka.
- D. Stop all over-the-counter medications.
Correct Answer: B
Rationale: Taking a multivitamin, consulting a doctor, and stopping potentially harmful medications are important preconception steps. Alcohol consumption should generally be minimized, but switching from vodka to beer is not a significant improvement.
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A nurse is caring for a postpartum person who is at risk for uterine atony. What is the most important intervention to prevent uterine atony?
- A. administer uterotonic medications
- B. perform fundal massage
- C. perform a vaginal exam
- D. monitor vital signs
Correct Answer: B
Rationale: The correct answer is B: perform fundal massage. Fundal massage helps stimulate uterine contractions and prevents uterine atony by promoting uterine firmness and reducing the risk of excessive bleeding. It is a non-invasive intervention that can be done immediately after delivery to prevent postpartum hemorrhage. Administering uterotonic medications (Choice A) may be necessary in severe cases but fundal massage is the initial intervention. Performing a vaginal exam (Choice C) is not indicated unless there are specific concerns or indications. Monitoring vital signs (Choice D) is important but addressing uterine atony requires more direct intervention like fundal massage.
The vessels comprising the umbilical cord are cushioned and protected by a substance called _____________ _____________.
- A. Wharton’s jelly
- B. Endoderm
- C. jelly
- D. haploid
Correct Answer: A
Rationale: Wharton’s jelly is a gelatinous substance surrounding the blood vessels in the umbilical cord. It cushions and protects the vessels from compression and damage during pregnancy.
What is the primary purpose of performing a vaginal examination during labor?
- A. to assess cervical dilation and effacement
- B. to assess fetal well-being and progress of labor
- C. to identify fetal distress
- D. to assess fetal descent and station
Correct Answer: B
Rationale: The correct answer is B because the primary purpose of performing a vaginal examination during labor is to assess fetal well-being and progress of labor. By conducting a vaginal exam, healthcare providers can monitor the fetal heart rate, position, and stage of labor. This information helps determine if the labor is progressing normally and if any interventions are needed. Choice A is incorrect because cervical dilation and effacement can be assessed but are not the primary purpose. Choice C is incorrect as fetal distress is typically identified through other methods such as continuous fetal monitoring. Choice D is incorrect as assessing fetal descent and station can be done through vaginal examination but is not the primary purpose.
A 40-week pregnant woman is admitted to the labor and delivery unit and is in active labor. Her cervix is 8 cm dilated, and she is experiencing strong contractions. What is the next priority action?
- A. Administer an epidural block
- B. Perform a vaginal examination to assess fetal descent
- C. Assess the fetal heart rate
- D. Prepare for delivery
Correct Answer: C
Rationale: The correct answer is C: Assess the fetal heart rate. This is the next priority action because monitoring the fetal heart rate is crucial to ensure the well-being of the baby during labor. It helps in identifying any signs of fetal distress and guides the healthcare provider in making timely interventions to prevent complications. Administering an epidural block (choice A) can be considered later once the fetal well-being is ensured. Performing a vaginal examination (choice B) may not be necessary at this moment as the woman is already in active labor and has progressed to 8 cm dilation. Preparing for delivery (choice D) should only be done after assessing the fetal well-being to ensure a safe delivery.
A patient in labor begins to experience significant vaginal bleeding. What is the first step the nurse should take?
- A. Administer oxygen to the patient
- B. Check for a cord prolapse
- C. Perform a vaginal examination
- D. Perform a vaginal examination
Correct Answer: B
Rationale: The correct answer is B: Check for a cord prolapse. This is the first step because cord prolapse is a critical emergency that can lead to fetal compromise. By checking for cord prolapse, the nurse can quickly assess the situation and take appropriate actions to relieve pressure on the cord. Administering oxygen (choice A) may be necessary later but not the first step. Performing a vaginal examination (choices C and D) can exacerbate the situation by pushing the cord further into the birth canal.