Nokea
A woman presents to labor and delivery at 37 weeks plus 6 days gestation with complaints of constant abdominal pain and dark red bleeding that started 30 minutes ago. Upon examination, the woman’s abdomen is consistently rigid and tender. Fetal heart tones are noted to be in the 70s. Which are these findings are associated with?
- A. Placental abruption
- B. Placental accreta
- C. Placenta previa
- D. Placenta succenturiata
Correct Answer: A
Rationale: Placental abruption is characterized by sudden onset of abdominal pain, dark red bleeding, and a rigid, tender abdomen. This condition can compromise fetal oxygenation and requires immediate medical intervention to prevent further complications.
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A nurse performs a vaginal examination on her patient in early labor and determines that the head is ballotable. What is this defined as?
- A. Floating
- B. Zero station
- C. +1 station
- D. -2 station
Correct Answer: A
Rationale: Ballotable means the fetal head is floating and can be pushed away from the cervix.
Which female pelvis is most suitable for vaginal delivery?
- A. Gynecoid
- B. Android
- C. Platypelloid
- D. Anthropoid
Correct Answer: A
Rationale: A gynecoid pelvis is the most suitable for vaginal delivery.
A 24-year-old G4 T1 A2 L1 presents to obstetric triage with complaints of contractions every 3 minutes, accompanied by bright red vaginal bleeding. The woman is 29 weeks gestation with a twin pregnancy. She has had three urinary tract infections during this pregnancy and is currently taking Microbid daily as prophylaxis. Her last baby was born via cesarean section for breech malpresentation. She denies any other significant medical history. What risk factors for placenta previa does this patient have? Select all that apply.
- A. Maternal age of 24
- B. Twin gestation
- C. Gestational age of 29 weeks
- D. Previous delivery by cesarean section
Correct Answer: D
Rationale: The patient's age, history of cesarean section, and twin gestation all contribute to an increased risk of placenta previa. The most significant risk factor here is the previous cesarean section, which can cause scarring and increase the likelihood of abnormal placental implantation.
An increase in urinary frequency and leg cramps after the 36th week of pregnancy are an indication of
- A. lightening.
- B. breech presentation.
- C. urinary tract infection.
- D. onset of Braxton-Hicks contractions.
Correct Answer: A
Rationale: An increase in urinary frequency and leg cramps after the 36th week of pregnancy are common signs of "lightening." Lightening refers to the descent of the baby into the pelvis in preparation for labor. This shift in position can put pressure on the bladder, leading to increased urinary frequency. Additionally, the pressure on nerves and blood vessels in the pelvis can cause leg cramps. These symptoms are typically experienced in the final weeks of pregnancy and are considered normal signs that the body is preparing for labor.
A laboring patient asks the nurse how she will know that the contraction is at its peak. The nurse explains that the contraction peaks during which stage of measurement?
- A. The acme
- B. The interval
- C. The increment
- D. The decrement
Correct Answer: B
Rationale: The peak of a contraction, also known as its highest point or intensity, is referred to as the acme. This is the stage during which the contraction reaches its maximum strength before gradually subsiding. By identifying the acme of the contraction, healthcare providers can better gauge the progress of labor and assess the intensity of contractions to determine the appropriate course of action for the laboring patient.