Nokea
A woman provides the nurse with the following obstetrical history: Delivered a son, now 7 years old, at 28 weeks’ gestation; delivered a daughter, now 5 years old, at 39 weeks’ gestation; had a miscarriage 3 years ago, and had a first-trimester abortion 2 years ago. She is currently pregnant. Which of the following portrays an accurate picture of this woman’s gravidity and parity?
- A. G4 P2121.
- B. G4 P1212.
- C. G5 P1122.
- D. G5 P2211.
Correct Answer: D
Rationale: Gravidity includes all pregnancies (live births, miscarriages, abortions, and current pregnancy). Parity reflects live births. This woman has had 5 pregnancies (2 live births, 1 miscarriage, 1 abortion, and 1 current pregnancy), making her G5 P2211.
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What is the purpose of administering magnesium sulfate during preterm labor?
- A. to relax the uterus and prevent contractions
- B. to improve fetal oxygenation and reduce uterine activity
- C. to reduce the risk of seizures and cerebral hemorrhage
- D. to decrease blood pressure and reduce fetal stress
Correct Answer: C
Rationale: The correct answer is C: to reduce the risk of seizures and cerebral hemorrhage. Magnesium sulfate is used during preterm labor to prevent and treat seizures in women with preeclampsia and eclampsia. It acts as a neuroprotective agent by preventing cerebral vasoconstriction and reducing the risk of cerebral hemorrhage. The other choices are incorrect because magnesium sulfate does not primarily relax the uterus to prevent contractions (A), improve fetal oxygenation (B), or decrease blood pressure (D) during preterm labor.
A patient is in active labor and is experiencing back labor. Which position would be most helpful to relieve the back pain?
- A. Supine position
- B. Hands and knees position
- C. Lithotomy position
- D. Squatting position
Correct Answer: B
Rationale: The correct answer is B: Hands and knees position. This position helps relieve back pain during labor by promoting optimal fetal positioning, reducing pressure on the back, and allowing gravity to assist in the descent of the baby. It also opens up the pelvic outlet, making it easier for the baby to navigate through the birth canal.
Incorrect choices:
A: Supine position can worsen back pain as it puts pressure on the lower back and restricts blood flow to the uterus.
C: Lithotomy position can exacerbate back pain as it involves lying on the back with legs in stirrups, which can increase pressure on the back.
D: Squatting position may not be ideal for relieving back pain in this scenario as it can put additional strain on the back muscles and may not provide optimal support for the laboring individual.
A gravid woman and her husband inform the nurse that they have just moved into a three-story home that was built in the 1930s. Which of the following is critical for the nurse to advise the woman to protect the unborn child?
- A. Stay out of any rooms that are being renovated.
- B. Drink water only from the hot water tap.
- C. Refrain from entering the basement.
- D. Climb the stairs only once per day.
Correct Answer: A
Rationale: Renovations in older homes may release lead dust or asbestos, which are harmful to the developing fetus. Drinking water from the hot tap, limiting stair climbing, or avoiding basements are less critical concerns compared to exposure to renovation hazards.
What response is appropriate regarding sushi consumption during pregnancy?
- A. Fish is healthy
- B. Sushi is too salty
- C. Raw fish is high in mercury
- D. Fish should be cooked
Correct Answer: D
Rationale: Cooking fish destroys harmful bacteria and parasites, reducing the risk of foodborne illnesses during pregnancy.
A laboring person requests an epidural for pain relief. What is the nurse's priority action before the procedure?
- A. administer a test dose of anesthesia
- B. ensure informed consent is obtained
- C. administer IV fluids
- D. ensure continuous fetal monitoring
Correct Answer: A
Rationale: The correct answer is A: administer a test dose of anesthesia. Before administering an epidural, it is crucial to perform a test dose to assess the person's response and ensure correct placement of the catheter. This step helps prevent potential complications such as unintentional intravascular injection.
Summary:
B: Ensuring informed consent is important but not the priority before administering the test dose.
C: Administering IV fluids is important for hydration but not the immediate priority before the test dose.
D: Continuous fetal monitoring is essential during labor, but it is not the priority before administering the test dose of anesthesia.