Nokea
How would the nurse position the woman to prevent compression of a prolapsed cord?
- A. On her right side with knees flexed
- B. On her left side with a pillow placed between her legs
- C. On her back with her head lower than the rest of her body
- D. Supine with her legs elevated and bent at the knee
Correct Answer: C
Rationale: The Trendelenburg's (head down) position displaces the fetus upward to stop compression of the prolapsed cord.
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What is the best response?
- A. The fundus is not assessed until the second postoperative day.
- B. The fundus is assessed by 'walking' fingers from the side of the uterus to the midline.
- C. The fundus is assessed only if large clots appear in lochia.
- D. The fundus is assessed only once every shift.
Correct Answer: B
Rationale: Assessment of the fundus following a cesarean section is done as usual, but using especially gentle fundal massage.
What nursing assessment should be reported immediately after an amniotomy?
- A. Fetal heart rate is regular at 154 beats/minute.
- B. Amniotic fluid is clear with flecks of vernix.
- C. Amniotic fluid is watery and pale green.
- D. Maternal temperature is 37.8?°C.
Correct Answer: C
Rationale: Amniotic fluid should be clear. Green fluid indicates the fetus has passed meconium, which is associated with fetal compromise.
What is the lowest Bishop score the patient should have prior to induction?
- A. 6
- B. 8
- C. 10
- D. 12
Correct Answer: A
Rationale: The Bishop score evaluates the suitability of the patient for a vaginal delivery. A minimum score of 6 is recommended by the American College of Obstetricians and Gynecologists (ACOG).
What does the nurse explain is used to soften the cervix with a 'cervical ripening' agent?
- A. Prostaglandin gel insertion
- B. Intravenous oxytocin
- C. Warm saline douches
- D. Nipple stimulation
Correct Answer: A
Rationale: Prostaglandin gel is inserted in the cervix and the woman remains in bed for 1 to 2 hours, being monitored for uterine contractions.
What complications of overstimulation of uterine contractions may occur?
- A. Water intoxication
- B. Impaired placental exchange of oxygen and nutrients
- C. Increased blood pressure
- D. Convulsions
- E. Uterine rupture
Correct Answer: A,B,E
Rationale: The most common complications are impaired placental exchange, uterine rupture, and water intoxication due to fluid retention.