Nokea
Narcotic analgesia is administered to a laboring patient at 10am. The infant is delivered at 12:30pm. The nurse would anticipate what?
- A. Neonatal respiratory depression
- B. Increased infant alertness
- C. Decreased fetal heart rate variability
- D. No effects on the neonate
Correct Answer: A
Rationale: Narcotic analgesia, when administered to a laboring patient, can cross the placenta and affect the infant. It can cause neonatal respiratory depression in the newborn after delivery. This is because the medication can depress the respiratory drive of the infant, leading to potentially serious breathing problems. It is important for the healthcare provider to closely monitor and assess the newborn for signs of respiratory distress in such cases.
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During a trauma-informed gynecologic examination, what principle emphasizes the importance of involving the patient in decision making about their health care?
- A. respecting autonomy and empowerment
- B. trauma-sensitive language and communication
- C. providing information and explanation
- D. avoiding triggering situations
Correct Answer: A
Rationale:
Which circumstance is most likely to cause uterine partum assessment with a woman who is 4 days atony and lead to excessive blood loss?
- A. Orthostatic hypotension
- B. Involution of the uterus
- C. Urine retention
- D. Afterpains
Correct Answer: A
Rationale: Orthostatic hypotension, which is a sudden drop in blood pressure upon standing, can result in decreased perfusion to the uterus, leading to poor contraction of the uterine muscles. This can result in uterine atony, where the uterus fails to contract properly after delivery. Uterine atony is a common cause of excessive postpartum bleeding (postpartum hemorrhage). Without proper contraction of the uterus, the blood vessels that supplied the placenta during pregnancy remain open and bleeding can continue unchecked.
The nurse is caring for a postpartum client with a perineal laceration. What comfort measure is most appropriate?
- A. Encourage warm sitz baths.
- B. Apply warm compresses to the perineum.
- C. Provide a heating pad for the lower abdomen.
- D. Offer an ice pack for the perineum.
Correct Answer: D
Rationale: Ice packs help reduce swelling and discomfort in the perineal area during the initial postpartum period.
The nurse is caring for a client in labor who reports intense pressure and the urge to push. What is the priority nursing action?
- A. Perform a sterile vaginal examination.
- B. Instruct the client to breathe through the urge to push.
- C. Notify the healthcare provider.
- D. Increase the oxytocin infusion rate.
Correct Answer: A
Rationale: A vaginal examination is needed to confirm full cervical dilation and readiness for delivery.
The nurse is planning to admit a pregnant client who is obese. Which potential client needs should the nurse anticipate?
- A. Routine administration of subcutaneous heparin may be prescribed.
- B. Bed rest as a necessary preventive measure may be prescribed.
- C. An overbed lift may be necessary if the client requires a cesarean section.
- D. Thromboembolism stockings or sequential compression devices may be prescribed.
Correct Answer: D
Rationale: Obese clients may need thromboembolism prevention and specialized equipment for safe cesarean handling.