Nokea
In preparation for a cesarean birth, the nurse expects which medical-based preoperative interventions? Select all that apply.
- A. Administration of narrow-spectrum prophylactic antibiotics
- B. Verification that the woman has been NPO for 6 to 8 hours before surgery
- C. Assessment of the woman’s knowledge and educational needs
- D. Assessment for risk of venous thromboembolism (VTE)
Correct Answer: B
Rationale: The correct answer is B because being NPO (nothing by mouth) for 6 to 8 hours before surgery helps prevent aspiration during anesthesia. Option A is incorrect because broad-spectrum antibiotics are typically used to cover a wider range of potential pathogens. Option C is not a medical-based preoperative intervention. Option D, while important, is more related to postoperative care rather than preoperative interventions.
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The physician has ordered an amnioinfusion for the laboring patient. Which data supports the use of this therapeutic procedure?
- A. Presenting part not engaged
- B. +4 meconium-stained amniotic fluid on artificial rupture of membranes (AROM)
- C. Breech position of fetus
- D. Twin gestation
Correct Answer: B
Rationale: The correct answer is B because +4 meconium-stained amniotic fluid on AROM indicates meconium passage by the fetus, which can lead to meconium aspiration syndrome. Amnioinfusion can help dilute the meconium, reducing the risk of respiratory complications for the newborn.
A: Presenting part not engaged is not a direct indication for amnioinfusion.
C: Breech position of the fetus does not specifically warrant amnioinfusion.
D: Twin gestation alone is not a direct indication for amnioinfusion.
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.
Which clinical finding would be considered normal for a preterm fetus during the labor period?
- A. Baseline tachycardia
- B. Baseline bradycardia
- C. Fetal anemia
- D. Acidosis
Correct Answer: A
Rationale: The correct answer is A: Baseline tachycardia. During labor, it is normal for a preterm fetus to have a higher heart rate due to the stress of the labor process. This is a physiological response to the stress and is considered normal. Baseline bradycardia (choice B) would not be normal as it indicates fetal distress. Fetal anemia (choice C) can affect the oxygen-carrying capacity of the blood and lead to fetal distress. Acidosis (choice D) results from inadequate oxygen supply and accumulation of acid in the blood, indicating fetal distress.
A woman comes to the prenatal clinic because she thinks she is pregnant. Which of the following are probable signs of pregnancy? Select all that apply.
- A. Amenorrhea
- B. Uterine enlargement
- C. Positive pregnancy test
- D. Breast tenderness
Correct Answer: C
Rationale: The correct answer is C, positive pregnancy test. This is a probable sign of pregnancy because it directly indicates the presence of the pregnancy hormone hCG in the woman's body. Amenorrhea (choice A) and uterine enlargement (choice B) are actually presumptive signs of pregnancy, as they can be caused by factors other than pregnancy. Breast tenderness (choice D) is a possible sign of pregnancy but is not as specific or conclusive as a positive pregnancy test.