Nokea
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.
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Which clinical finding should the nurse expect to assess in the third stage of labor that indicates the placenta has separated from the uterine wall? (Select all that apply.)
- A. A gush of blood appears.
- B. The uterus rises upward in the abdomen.
- C. The fundus descends below the umbilicus.
- D. The cord descends further from the vagin
Correct Answer: C
Rationale: A. A gush of blood appears: This clinical finding is indicative of the placenta detaching from the uterine wall and the subsequent expulsion. The sudden release of a significant amount of blood is expected as the placenta separates.
On admission to the labor unit, a primigravid woman at 38 weeks gestation states, “I need to urinate more now but at least I can breathe easier.” The nurse is aware that this is likely due to which physiological process?
- A. Onset of labor
- B. Effacement
- C. Lightening
- D. Rupture of membranes
Correct Answer: C
Rationale: Increased urination and easier breathing are signs of lightening, where the fetal head drops lower into the pelvis.
A woman has chosen a trial of labor after cesarean. Which findings indicate the best understanding of the nurse’s teaching by the patient?
- A. "It is safer for me to be induced at 39 weeks so that my labor can be controlled and monitored carefully.”
- B. "I will need to arrive to the hospital the night before my induction so that my cervix can be ripened with prostaglandins.”
- C. "If I do not go into labor on my own, I will have to have a cesarean section since Pitocin is contraindicated for me.”
- D. "A balloon catheter may be used to manually ripen my cervix, if necessary”
Correct Answer: D
Rationale: The correct understanding is that cervical ripening may be necessary before induction, and a balloon catheter can be used for this purpose. This is part of the education provided to patients who opt for a trial of labor after cesarean.
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.
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.