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How should the nurse intervene to relieve perineal bruising and edema following delivery?
- A. Place an ice pack on the area for 12 hours.
- B. Place a warm pack on the perineal area for 24 hours.
- C. Administer aspirin to relieve inflammation.
- D. Change the perineal pad frequently.
Correct Answer: A
Rationale: An ice pack can be placed on the mother's perineum to reduce bruising and edema for 12 hours followed by a warm pack after the first 12 to 24 hours after delivery.
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Vaginal examination reveals the presenting part is the infant's head, which is well flexed on the chest. What is this presentation?
- A. Vertex
- B. Military
- C. Brow
- D. Face
Correct Answer: A
Rationale: In the vertex presentation, the fetal head is the presenting part. The head is fully flexed on the chest.
After being given an explanation by the nursing instructor, what statement by the student indicates an accurate understanding of station?
- A. Fetal head is above the ischial spines.'
- B. Fetal head is below the ischial spines.'
- C. Fetal head is engaged in the mother's pelvis.'
- D. Fetal head is visible at the perineum.'
Correct Answer: A
Rationale: Station describes the level of the presenting part in the pelvis. Minus stations are above the ischial spines.
What signs and symptoms would lead the nurse to suspect false (prodromal) labor?
- A. Leaking of vaginal fluid
- B. Contractions intensify with ambulation
- C. Pink spotting
- D. Painless tightening of abdominal muscles
- E. Cervix thick and not effaced
Correct Answer: D,E
Rationale: Painless tightening of abdominal muscles (Braxton Hicks contractions) and a cervix that is thick and not effaced indicate false (prodromal) labor.
Why should the nurse encourage the mother to void during the fourth stage of labor?
- A. A full bladder could interfere with cervical dilation.
- B. A full bladder could obstruct progress of the infant through the birth canal.
- C. A full bladder could obstruct the passage of the placenta.
- D. A full bladder could predispose the mother to uterine hemorrhage.
Correct Answer: D
Rationale: A full bladder immediately after birth can cause excessive bleeding because it pushes the uterus upward and interferes with contractions.
What are the advantages of a freestanding birth center?
- A. Homelike setting
- B. Designed for high-risk pregnancies
- C. Lower costs
- D. Attended by certified obstetricians
- E. Immediate emergency access
Correct Answer: A,C
Rationale: Advantages of a freestanding birth center include a homelike setting and lower costs, as they do not require expensive departments like emergency or critical care.