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Shoulder dystocia is difficult to predict. What are thought to be predictors for shoulder dystocia?
- A. estimated birth weight of 4,000 g
- B. gestational diabetes
- C. previous shoulder dystocia
- D. hypertension
Correct Answer: B
Rationale: The correct answer is B: gestational diabetes. Gestational diabetes can lead to larger fetal size, increasing the risk of shoulder dystocia. It is a known risk factor that healthcare providers consider when assessing the likelihood of shoulder dystocia. Estimated birth weight alone (A) may not accurately predict shoulder dystocia. While previous shoulder dystocia (C) is a risk factor, it is not a predictor as it is based on past occurrences. Hypertension (D) is not directly associated with an increased risk of shoulder dystocia.
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What condition is related to an increased risk for fetal demise?
- A. diabetes
- B. migraine headache
- C. spina bifida
- D. thyroid disorder
Correct Answer: A
Rationale: The correct answer is A: diabetes. Diabetes is associated with an increased risk of fetal demise due to complications such as congenital anomalies, macrosomia, and placental insufficiency. High blood sugar levels can lead to adverse effects on the fetus, including stillbirth. Migraine headache (B) and spina bifida (C) are not directly linked to fetal demise. Thyroid disorders (D) can impact pregnancy outcomes but are not specifically associated with an increased risk of fetal demise.
What is a potential sign of intrauterine fetal demise?
- A. increased fetal heart rate
- B. vaginal bleeding
- C. decreased or absent fetal movement
- D. macrosomia
Correct Answer: C
Rationale: The correct answer is C: decreased or absent fetal movement. This is a potential sign of intrauterine fetal demise because it indicates a lack of fetal activity, which could suggest fetal distress or death. Reduced or absent fetal movement may be an early warning sign that the fetus is not receiving enough oxygen or nutrients. It is important to monitor fetal movement regularly to ensure the well-being of the fetus.
Other choices are incorrect because:
A: increased fetal heart rate is more commonly associated with fetal distress, not demise.
B: vaginal bleeding can be a sign of various conditions such as placental abruption or placenta previa, but it is not specific to fetal demise.
D: macrosomia refers to a large baby, which is not indicative of fetal demise.
A gravida 1 para 0 who is 10 weeks pregnant has her first prenatal visit. After performing a history and physical, which test ordered by the physician should the nurse verify with the examiner?
- A. Serological test for syphilis
- B. Rubella vaccine
- C. Clean-catch urinalysis
- D. Abdominal ultrasound
Correct Answer: D
Rationale: The correct answer is D: Abdominal ultrasound. At 10 weeks gestation, an abdominal ultrasound is typically ordered to confirm the viability of the pregnancy, assess fetal development, and determine gestational age. This test allows the healthcare provider to visualize the fetus, placenta, and amniotic fluid. It is essential in monitoring the progress of the pregnancy and identifying any potential complications.
Rationale for other choices:
A: Serological test for syphilis - While this test is important in prenatal care to screen for syphilis, it is usually done as part of routine prenatal blood work and not typically verified immediately after the first visit.
B: Rubella vaccine - Administering the rubella vaccine during pregnancy is contraindicated as it poses a risk to the developing fetus.
C: Clean-catch urinalysis - While urinalysis is a common test in prenatal care to screen for urinary tract infections and other conditions, it is not typically the first test verified following
The patient presenting at 38 weeks' gestation, gravida 1, para 0, vaginal exam 4 cm, 100% effaced, +1 station vertex. What is the most likely intervention for this fetal heart rate pattern?
- A. Continue oxytocin (Pitocin) infusion.
- B. Contact the anesthesia department for epidural administration.
- C. Change maternal position.
- D. Administer Narcan to patient and prepare for immediate vaginal delivery.
Correct Answer: C
Rationale: The correct answer is C: Change maternal position. At 38 weeks' gestation with 4 cm dilation and 100% effacement, the fetal heart rate pattern suggests possible umbilical cord compression due to the +1 station vertex position. Changing maternal position can relieve this compression, improving fetal heart rate. Continuing oxytocin infusion (A) can worsen the situation by increasing contractions. Contacting anesthesia for epidural (B) is not indicated as it doesn't address the immediate concern. Administering Narcan and preparing for immediate delivery (D) is unnecessary and not supported by the given scenario.
What condition do restlessness, cyanosis, nasal flaring, orthopnea, and use of accessory muscles indicate?
- A. liver failure
- B. alteration in oxygenation
- C. preterm delivery
- D. gestational diabetes
Correct Answer: A
Rationale: The correct answer is B: alteration in oxygenation. Restlessness, cyanosis, nasal flaring, orthopnea, and the use of accessory muscles are all classic signs of respiratory distress, indicating a problem with oxygenation. Liver failure (A) would typically present with jaundice, ascites, and coagulopathy, not respiratory symptoms. Preterm delivery (C) is related to early labor signs, such as contractions and cervical changes. Gestational diabetes (D) would manifest with symptoms like increased thirst, frequent urination, and fatigue, not respiratory distress.