Nokea
How much blood loss must occur to define the loss as a postpartum hemorrhage?
- A. 250 mL
- B. 500 mL
- C. 750 mL
- D. 1,000 mL
Correct Answer: B
Rationale: The correct answer is B (500 mL) for defining postpartum hemorrhage. This amount is used as the threshold because it represents a significant loss that may lead to maternal complications. Excessive bleeding after childbirth can quickly become life-threatening, so it is crucial to define postpartum hemorrhage accurately. Choices A (250 mL), C (750 mL), and D (1,000 mL) are incorrect as they do not align with the standard definition of postpartum hemorrhage, which is typically considered when blood loss exceeds 500 mL.
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In a research study performed by Schneuder, L., Crenshaw, J., and Gilder, R. (2017), which action by the nurse will be implemented following a cesarean delivery?
- A. Allow the birth partner to hand the neonate to the mother.
- B. Assist the mother and partner to cut the umbilical cord.
- C. Move the neonate into the visual field of the mother.
- D. Encourage skin-to-skin contact between the mother and neonate.
Correct Answer: D
Rationale: The correct answer is D: Encourage skin-to-skin contact between the mother and neonate. This action is crucial following a cesarean delivery to promote bonding, regulate the baby's temperature, and facilitate breastfeeding. Skin-to-skin contact also helps stabilize the baby's heart rate, breathing, and blood sugar levels.
A: Allowing the birth partner to hand the neonate to the mother may be a good practice but is not as essential as skin-to-skin contact for immediate benefits.
B: Assisting the mother and partner to cut the umbilical cord is not typically the nurse's responsibility immediately after a cesarean delivery and does not provide the same benefits as skin-to-skin contact.
C: Moving the neonate into the visual field of the mother is important for bonding but does not offer the same physiological benefits as direct skin-to-skin contact.
Which clinical finding can be determined only by electronic fetal monitoring?
- A. Variability
- B. Tachycardia
- C. Bradycardia
- D. Fetal response to contractions
Correct Answer: D
Rationale: The correct answer is D because electronic fetal monitoring is the only method that can directly measure and display the fetal heart rate in response to contractions. Variability, tachycardia, and bradycardia can also be observed through electronic fetal monitoring, but fetal response to contractions specifically requires continuous monitoring of the fetal heart rate during contractions. Therefore, D is the only clinical finding that can be determined exclusively through electronic fetal monitoring. Variability (A), tachycardia (B), and bradycardia (C) can be identified through other means of monitoring and assessment as well.
The nurses in a labor and delivery unit are concerned about the high incidence of cesarean deliveries at their facility and initiate an internal study. Which is the most likely condition the nurses will recognize as a contributor to the rate of cesarean births?
- A. The facility has a high rating for managing high-risk pregnancies.
- B. Policies and parameters for cesarean need to be reviewed and refined.
- C. Community education about the advantages of vaginal birth is deficient.
- D. The incidence of maternal requests for cesarean delivery is increasing.
Correct Answer: D
Rationale: Step 1: Maternal requests for cesarean delivery are a significant contributor to the high incidence of cesarean births.
Step 2: Maternal requests may stem from various factors such as fear of labor pain, convenience, or personal preferences.
Step 3: Nurses can address this issue by educating women on the risks and benefits of cesarean versus vaginal delivery.
Step 4: By understanding and addressing maternal requests, the facility can potentially lower the cesarean delivery rate.
Summary:
- Choice A is incorrect as high-risk pregnancies do not directly contribute to the rate of cesarean births.
- Choice B is incorrect as reviewing cesarean policies alone may not address the underlying issue of maternal requests.
- Choice C is incorrect as community education, while important, may not directly impact the rate of cesarean deliveries as compared to addressing maternal requests.
What condition do restlessness, cyanosis, nasal flaring, orthopnea, and use of accessory muscles indicate?
- A. liver failure
- B. alteration in oxygenation
- C. preterm delivery
- D. gestational diabetes
Correct Answer: A
Rationale: The correct answer is B: alteration in oxygenation. Restlessness, cyanosis, nasal flaring, orthopnea, and the use of accessory muscles are all classic signs of respiratory distress, indicating a problem with oxygenation. Liver failure (A) would typically present with jaundice, ascites, and coagulopathy, not respiratory symptoms. Preterm delivery (C) is related to early labor signs, such as contractions and cervical changes. Gestational diabetes (D) would manifest with symptoms like increased thirst, frequent urination, and fatigue, not respiratory distress.
In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding?
- A. The fetus is at 30 weeks of gestation.
- B. The mother has a history of fast labors.
- C. The mother has been given an epidural block.
- D. The mother has mild preeclampsia but is not in labor.
Correct Answer: A
Rationale: The correct answer is A because at 30 weeks of gestation, a fetal heart rate of 160 to 170 bpm is considered normal due to the fetus's stage of development. Fetal heart rates gradually decrease as gestation progresses. Choices B, C, and D are incorrect because they do not directly impact the fetal heart rate based on gestational age. Choice B, fast labors, does not affect the baseline fetal heart rate. Choice C, epidural block, may cause maternal hypotension but typically doesn't affect the fetal heart rate. Choice D, mild preeclampsia, may lead to fetal distress but does not directly influence the baseline fetal heart rate.