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A woman who has had multiple cesarean sections is in labor. What is the most important complication to monitor for?
- A. Uterine rupture
- B. Precipitous labor
- C. Maternal hypotension
- D. Fetal malpresentation
Correct Answer: A
Rationale: Correct Answer: A: Uterine rupture
Rationale:
1. History of multiple cesarean sections increases the risk of uterine rupture.
2. Uterine rupture is a life-threatening complication for both mother and baby.
3. Signs include sudden severe abdominal pain, fetal distress, and hemodynamic instability.
4. Immediate intervention is crucial to prevent adverse outcomes.
Summary:
B: Precipitous labor - Quick labor is not specifically associated with multiple cesarean sections.
C: Maternal hypotension - Important but not the most critical complication in this scenario.
D: Fetal malpresentation - While important, it is not the most immediate concern compared to uterine rupture.
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A nurse is caring for a postpartum person who is at risk for infection. What is the most important nursing intervention to reduce the risk of infection?
- A. Monitor vital signs
- B. Educate on proper hygiene
- C. Educate on wound care
- D. Encourage ambulation
Correct Answer: A
Rationale: The correct answer is A: Monitor vital signs. This is the most important intervention because changes in vital signs can indicate the presence of infection early on. By closely monitoring the postpartum person's vital signs, the nurse can promptly identify any signs of infection and initiate appropriate interventions. Educating on proper hygiene (B) and wound care (C) are essential but monitoring vital signs takes precedence in immediate infection detection. Encouraging ambulation (D) is beneficial for preventing complications like blood clots, but it is not the most crucial intervention for infection prevention in this scenario.
How long should clamping of the cord be delayed in an uncomplicated delivery to increase the newborn's hemoglobin levels and improve circulation?
- A. 30–60 seconds
- B. 15–30 seconds
- C. 30 seconds
- D. Delayed cord clamping is not recommended.
Correct Answer: A
Rationale: The correct answer is A (30-60 seconds) for delayed cord clamping in an uncomplicated delivery. Delaying cord clamping for 30-60 seconds allows more blood to flow from the placenta to the baby, increasing the baby's hemoglobin levels and improving circulation. This extra blood transfer can provide the baby with essential nutrients and oxygen, reducing the risk of anemia and improving overall health outcomes.
Choice B (15-30 seconds) may not provide enough time for sufficient blood transfer compared to the optimal window of 30-60 seconds.
Choice C (30 seconds) is within the recommended range, but 30-60 seconds is considered more beneficial for maximizing blood flow to the newborn.
Choice D (Delayed cord clamping is not recommended) is incorrect as delayed cord clamping has been shown to have various benefits for newborns when done in uncomplicated deliveries.
What is the recommended frequency for assessing maternal vital signs during the first hour after delivery?
- A. every 15 minutes
- B. every 30 minutes
- C. once, then hourly
- D. once, then every 4 hours
Correct Answer: A
Rationale: The correct answer is A (every 15 minutes) because immediate postpartum assessment is crucial for early detection of complications. Monitoring vital signs every 15 minutes allows for prompt identification of issues like hemorrhage or infection. Choice B (every 30 minutes) may lead to a delayed response to critical changes. Choice C (once, then hourly) may miss rapid changes in the first hour. Choice D (once, then every 4 hours) is too infrequent for the critical postpartum period. Regular monitoring is essential for ensuring maternal safety.
The nurse is teaching a pregnant patient about the importance of folic acid. Which statement by the patient indicates that the teaching has been effective?
- A. Folic acid will help prevent spinal cord defects in my baby.
- B. Folic acid is important for healthy skin development.
- C. Folic acid will help reduce my risk of high blood pressure during pregnancy.
- D. Folic acid helps prevent excessive weight gain during pregnancy.
Correct Answer: A
Rationale: Step 1: Folic acid is crucial for neural tube development in the fetus.
Step 2: Spinal cord defects are a type of neural tube defect.
Step 3: Statement A directly links folic acid to preventing spinal cord defects.
Therefore, choice A is correct as it demonstrates an understanding of the specific benefit of folic acid during pregnancy. Choices B, C, and D are incorrect as they do not accurately reflect the primary role of folic acid in pregnancy.
A nurse is caring for a laboring person who has been pushing for several hours without progress. What is the most appropriate intervention?
- A. perform a cesarean section
- B. assist with vacuum extraction
- C. perform an emergency cesarean
- D. assist with forceps delivery
Correct Answer: B
Rationale: The correct answer is B: assist with vacuum extraction. This intervention is appropriate when prolonged pushing has not resulted in progress during labor. Vacuum extraction helps facilitate the delivery of the baby by applying suction to the baby's head to assist with pulling them out. It is less invasive than a cesarean section and forceps delivery, making it a safer option in this scenario. Performing a cesarean section (choices A and C) would be considered if vacuum extraction is unsuccessful or contraindicated due to specific factors. Forceps delivery (choice D) is another option but is generally considered more invasive and carries higher risks compared to vacuum extraction.