Nokea
How soon should delivery of the fetus occur when a Category III FHR tracing is diagnosed?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: B
Rationale: The correct answer is B: 30 minutes. When a Category III FHR tracing is diagnosed, it indicates severe fetal distress. Prompt delivery is crucial to prevent adverse outcomes. 30 minutes allows for timely intervention without risking further harm to the fetus. Option A (15 minutes) may be too rushed, potentially causing unnecessary stress during the delivery process. Options C (45 minutes) and D (60 minutes) delay delivery, increasing the risk of complications due to prolonged fetal distress. Timing is critical in ensuring the best possible outcome for both the mother and the baby.
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Which method of intrapartum fetal monitoring is the most appropriate when a woman has a history of hypertension during pregnancy?
- A. Continuous auscultation with a fetoscope
- B. Continuous electronic fetal monitoring
- C. Intermittent assessment with a Doppler transducer
- D. Intermittent electronic fetal monitoring for 15 minutes each hour
Correct Answer: B
Rationale: The correct answer is B: Continuous electronic fetal monitoring. This method is most appropriate for a woman with a history of hypertension during pregnancy because it allows continuous monitoring of fetal heart rate patterns and uterine contractions, providing real-time data to detect any signs of fetal distress promptly. Continuous monitoring is crucial in high-risk pregnancies to ensure timely intervention if any issues arise.
A: Continuous auscultation with a fetoscope is not ideal for a woman with a history of hypertension as it does not provide continuous monitoring and may miss subtle changes in fetal well-being.
C: Intermittent assessment with a Doppler transducer does not offer continuous monitoring, which is essential in high-risk pregnancies like hypertension.
D: Intermittent electronic fetal monitoring for 15 minutes each hour is not as effective as continuous monitoring in detecting changes in fetal well-being promptly, which is crucial in cases of hypertension during pregnancy.
A nurse is reviewing the record of a woman who has just been told that she is pregnant. The physician has documented the presence of Goodell’s sign. The nurse determines this sign refers to which of the following?
- A. A softening of the tip of the cervix
- B. A soft blowing sound that corresponds to the maternal pulse
- C. Enlargement of the uterus
- D. A softening of the lower uterine segment
Correct Answer: A
Rationale: The correct answer is A: A softening of the tip of the cervix. Goodell's sign is a softening of the tip of the cervix, which is one of the early signs of pregnancy due to increased vascularity and edema. This sign is often used by healthcare providers to confirm pregnancy.
Rationale:
1. Goodell's sign specifically refers to the softening of the cervix, not any other part of the reproductive system.
2. It is an important early sign of pregnancy due to hormonal changes.
3. Enlargement of the uterus (Choice C) typically occurs later in pregnancy, not as an early sign.
4. A blowing sound corresponding to maternal pulse (Choice B) and softening of the lower uterine segment (Choice D) are not associated with Goodell's sign.
What is a potential complication when the fetus is footling breech?
- A. prolapsed cord
- B. oligohydramnios
- C. low biophysical profile score
- D. meconium-stained fluid
Correct Answer: A
Rationale: The correct answer is A: prolapsed cord. In a footling breech presentation, the feet or legs of the fetus are positioned to deliver first, increasing the risk of the umbilical cord slipping down before the fetus during labor, leading to a prolapsed cord. This is a serious emergency as it can compromise fetal blood flow and oxygen supply.
Choice B: Oligohydramnios is a decreased level of amniotic fluid and is not directly related to a footling breech presentation.
Choice C: Low biophysical profile score indicates fetal well-being based on specific parameters and is not a direct complication of a footling breech presentation.
Choice D: Meconium-stained fluid can occur due to fetal distress but is not specific to a footling breech presentation.
What medication is administered to treat uterine atony?
- A. ampicillin
- B. nitroglycerine
- C. magnesium sulfate
- D. methylergonovine
Correct Answer: D
Rationale: The correct answer is D: methylergonovine. Methylergonovine is a uterotonic medication used to treat uterine atony by causing the uterus to contract and prevent postpartum hemorrhage. Ampicillin (A) is an antibiotic, nitroglycerine (B) is a vasodilator, and magnesium sulfate (C) is a medication used for conditions like preeclampsia and eclampsia, but not specifically for uterine atony. Therefore, D is the correct choice for treating uterine atony.
What intervention may be used to manage failure to descend during labor?
- A. administering pain medication
- B. allowing the patient to rest
- C. continuing to push for an extended period of time
- D. using forceps or a vacuum to assist delivery
Correct Answer: D
Rationale: The correct answer is D because using forceps or a vacuum to assist delivery can help manage failure to descend during labor by aiding in the descent of the baby through the birth canal. Forceps or vacuum extraction can provide the necessary assistance to safely deliver the baby when maternal pushing alone is insufficient.
Explanation for why the other choices are incorrect:
A: Administering pain medication does not address the underlying issue of failure to descend during labor.
B: Allowing the patient to rest may not resolve the issue of failure to descend and could potentially delay necessary interventions.
C: Continuing to push for an extended period of time without progress can lead to maternal exhaustion and fetal distress without addressing the root cause of failure to descend.