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If the physician indicates shoulder dystocia during the delivery of a macrosomic fetus, how would the nurse assist?
- A. Assisting the woman into McRoberts maneuver
- B. Calling a second physician to assist
- C. Preparing for immediate c/s delivery
- D. Utilizing fundal pressure to push the fetus out
Correct Answer: A
Rationale: In the scenario of shoulder dystocia during the delivery of a macrosomic fetus, the appropriate action for the nurse to assist would be to help the woman into the McRoberts maneuver. The McRoberts maneuver involves flexing the mother's thighs tightly against her abdomen to flatten the pelvis, allowing for more space to maneuver the baby's shoulder out from behind the pubic bone. This maneuver is often effective at resolving shoulder dystocia without the need for additional interventions such as a cesarean section or fundal pressure. It is a recommended initial step in managing shoulder dystocia and has been shown to be successful in many cases.
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A nurse is doing genetic counseling with a couple. give to a client undergoing a mastectomy? The mother has Down syndrome and the father
- A. Tylenol should be avoided after surgery. has no chromosomal abnormalities. What is the
- B. The affected arm should remain in a sling for chance of their offspring being affected by this 4 weeks. disorder?
- C. The client should expect the affected arm to be
- D. 25%
Correct Answer: D
Rationale: When a woman with Down syndrome (trisomy 21) has a child with a man who does not have any chromosomal abnormalities, the chance of their offspring having Down syndrome is 25%. This is because the mother can only pass on one copy of the extra chromosome 21 to her child, resulting in a 50% chance of passing it on. However, since the father does not have an extra chromosome 21 to contribute, the overall chance of the child having Down syndrome is reduced to 25%.
A nurse is caring for a client who is receiving oxytocin for induction of labor and notes late decelerations of the fetal heart rate on the monitor Tracing. Which of the following action should the nurse take?
- A. Decrease maintenance IV solution infusion rate.
- B. Place the client in lateral position.
- C. Administer misoprostol 25 mcg vaginally D
- D. Administer oxygen via face mask at 2 L/min
Correct Answer: B
Rationale: Late decelerations of the fetal heart rate can indicate uteroplacental insufficiency, which may be a result of decreased oxygen supply to the fetus. Placing the client in a lateral position can help enhance uteroplacental perfusion by relieving pressure on the vena cava and improving maternal blood flow to the placenta. This position change can help improve fetal oxygenation and decrease the occurrence of late decelerations. Other actions such as administering oxygen and assessing for other contributing factors should also be done, but placing the client in a lateral position is the most appropriate immediate intervention in this scenario.
The nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis. What instruction should the nurse provide?
- A. Strict bed rest is required after the procedure.
- B. Hospitalization is necessary for 24 hours after the procedure.
- C. An informed consent needs to be signed before the procedure.
- D. A fever is expected after the procedure because of the trauma to the abdomen.
Correct Answer: C
Rationale: Informed consent is essential before an invasive procedure like amniocentesis. Monitoring post-procedure symptoms is also crucial.
A nurse is assessing a newborn who is 48 hours old and is experiencing opioid withdrawals. Which of the following findings should the nurse expect?
- A. Hypotonicity
- B. Moderate tremors of the extremities
- C. Axillary temperature 36.1°C (96.9 F)
- D. Excessive sleeping
Correct Answer: B
Rationale: Neonatal opioid withdrawal syndrome, also known as neonatal abstinence syndrome (NAS), can occur in newborns who were exposed to opioids in utero. Symptoms of NAS can include tremors, irritability, high-pitched crying, poor feeding, vomiting, diarrhea, sweating, and sneezing. The severity of symptoms can vary depending on the type of opioid exposure, dosage, and duration of exposure. In this case, the nurse should expect to see moderate tremors of the extremities in the newborn experiencing opioid withdrawals at 48 hours old. It is important for the nurse to monitor and manage the newborn's withdrawal symptoms closely to ensure their safety and well-being.
The nurse is preparing a client for cesarean delivery. What is the priority nursing action?
- A. Obtain baseline vital signs.
- B. Insert an indwelling urinary catheter.
- C. Verify signed informed consent.
- D. Administer prophylactic antibiotics.
Correct Answer: C
Rationale: Ensuring informed consent is signed is a priority before any surgical procedure.