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Woman receiving oxytocin stimulation
One side effect of oxytocin stimulation is hypertonic contractions. This can be detrimental to the fetus because
- A. It produces a prolapsed cord.
- B. It increases maternal renal blood flow.
- C. It decreases maternal blood pressure.
- D. There is a reduction of placental blood flow.
Correct Answer: D
Rationale: Hypertonic contractions reduce placental blood flow by limiting the time for the placenta to refill with blood between contractions, risking fetal hypoxia. Note: The document incorrectly lists 'A' as the correct answer, but the explanation supports 'D' as the correct choice based on standard medical understanding.
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Client receiving opioid epidural analgesia during labor
A nurse is caring for a client who is receiving opioid epidural analgesia during labor. Which of the following findings is the nurse's priority?
- A. Blood pressure 80/56 mm Hg.
- B. The client reports profuse itching.
- C. The client reports weakness of the lower extremities.
- D. Temperature 38.2°C (100.8 F).
Correct Answer: A
Rationale: Hypotension (80/56 mm Hg) is the priority as it can reduce placental blood flow, risking fetal distress, and requires immediate intervention.
Newborn 1 hour after birth, axillary temperature 95.8°F, apical pulse 114 bpm, respiratory rate 60 breaths/minute
When assessing a newborn 1 hour after birth, the nurse measures an axillary temperature of 95.8° F (35.4° C), an apical pulse of 114 beats per minute, and a respiratory rate of 60 breaths per minute. The nurse would identify which area as the priority?
- A. Hypothermia.
- B. Deficient fluid volume.
- C. Impaired gas exchange.
- D. Risk for infection.
Correct Answer: A
Rationale: The low temperature (95.8°F) indicates hypothermia, a priority due to risks of hypoglycemia, acidosis, and impaired oxygen delivery.
Client in labor, external fetal monitor, late decelerations
A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?
- A. Uteroplacental insufficiency.
- B. Umbilical cord compression.
- C. Maternal bradycardia.
- D. Fetal head compression.
Correct Answer: A
Rationale: Late decelerations indicate uteroplacental insufficiency, where reduced placental blood flow during contractions causes fetal hypoxia.
Newborns in nursery
A nurse receives handoff report. Which newborn should the nurse assess first?
- A. Glucose reading 58 mg/dL.
- B. Pulse 144 beats/minute.
- C. Respiratory rate 78 breaths/minute.
- D. Temperature 97.7° F (36.5° C).
Correct Answer: C
Rationale: A respiratory rate of 78 breaths/minute indicates tachypnea, suggesting potential respiratory distress, which requires immediate assessment.
Male newborn, genitalia assessment
The nurse is inspecting a male newborn's genitalia. Which action should the nurse avoid when conducting this assessment?
- A. Inspecting if the urethral opening appears circular.
- B. Retracting the foreskin over the glans to assess for secretions.
- C. Palpating if testes are descended into the scrotal sac.
- D. Inspecting the genital area for irritated skin.
Correct Answer: B
Rationale: Retracting the foreskin over the glans should be avoided as it can cause pain, bleeding, and infection in the newborn. The foreskin is usually adhered to the glans and should not be forcibly retracted.