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A nurse is checking postpartum orders, the doctor prescribed bed rest for 6-12 h. The nurse knows this is an appropriate order if the patient had which type of anesthesia?
- A. Spinal
- B. Pudendal
- C. Epidural
- D. General
Correct Answer: C
Rationale: The correct answer is C: Epidural. The rationale for this is that epidural anesthesia is a regional anesthesia that numbs the lower half of the body while allowing the patient to remain conscious. Therefore, prescribing bed rest for 6-12 hours after receiving an epidural is appropriate to ensure the anesthesia wears off gradually and the patient does not experience any complications while regaining sensation and mobility.
Summary of Incorrect Choices:
A: Spinal anesthesia also numbs the lower half of the body, but it typically wears off faster than an epidural, so bed rest may not be necessary for as long.
B: Pudendal anesthesia is specific to numbing the perineum area and does not affect mobility in the same way as epidural anesthesia.
D: General anesthesia does not target a specific area of the body and does not require bed rest for 6-12 hours postpartum.
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A client at 12 weeks' gestation reports nausea and vomiting. What is the best dietary advice?
- A. Eat three large meals a day.
- B. Drink fluids with meals.
- C. Consume small, frequent meals throughout the day.
- D. Avoid protein-rich foods.
Correct Answer: C
Rationale: The correct answer is C: Consume small, frequent meals throughout the day. This advice helps manage nausea and vomiting during pregnancy by preventing an empty stomach, which can worsen symptoms. Eating small, frequent meals helps stabilize blood sugar levels and provides a steady source of nutrients for the developing fetus. It also reduces the likelihood of triggering nausea by avoiding large meals. Drinking fluids with meals (choice B) may exacerbate symptoms by filling up the stomach too quickly. Eating three large meals a day (choice A) can lead to overeating and may worsen nausea. Avoiding protein-rich foods (choice D) is not recommended as protein is essential for fetal development and overall health during pregnancy.
What is the appropriate intervention for a mother with a third-degree perineal tear postpartum?
- A. Apply ice packs to the perineum
- B. Administer stool softeners as prescribed
- C. Encourage the mother to avoid heavy lifting
- D. Provide perineal exercises for faster recovery
Correct Answer: C
Rationale: The correct answer is C: Encourage the mother to avoid heavy lifting. After a third-degree perineal tear, it is crucial to prevent strain on the perineum to promote healing and prevent complications like infection or further tearing. Heavy lifting can increase pressure on the perineum, leading to delayed healing. Ice packs (A) may help reduce swelling initially but do not address the underlying issue. Stool softeners (B) can help prevent constipation and straining during bowel movements but do not directly impact perineal tear healing. Perineal exercises (D) are beneficial for strengthening the pelvic floor muscles in general but should be introduced gradually and not immediately postpartum with a severe tear.
A nurse in a prenatal clinic is caring for a client who is at 39 weeks of gestation and who asks about the signs that precede the onset of labor. Which of the following should the nurse identify as a sign that precedes labor?
- A. Decreased vaginal discharge
- B. A surge of energy
- C. Urinary retention
- D. Weight gain of 0.5 to 1.5 kg
Correct Answer: B
Rationale: The correct answer is B: A surge of energy. This is because an increase in energy is often seen in pregnant women shortly before labor begins, known as the "nesting instinct." This burst of energy can indicate that the body is preparing for labor.
A: Decreased vaginal discharge is not a sign that precedes labor. In fact, an increase in vaginal discharge is more common as labor approaches.
C: Urinary retention is not a sign of labor onset. In late pregnancy, pressure on the bladder may cause frequent urination, but retention is not typical.
D: Weight gain of 0.5 to 1.5 kg is not a specific sign of labor onset. Weight gain can fluctuate throughout pregnancy and is not a reliable indicator of impending labor.
A nurse is planning care for a full-term newborn who is receiving phototherapy. Which of the following actions should the nurse include in the plan of care?
- A. Dress the newborn in lightweight clothing.
- B. Avoid using lotion or ointment on the newborn skin.
- C. Keep the newborn supine throughout treatment
- D. Measure the newborn's temperature every 8hr
Correct Answer: B
Rationale: The correct answer is B: Avoid using lotion or ointment on the newborn skin. Phototherapy is used to treat jaundice by exposing the baby's skin to light. Lotions or ointments can interfere with the effectiveness of the light therapy. Dressing the newborn in lightweight clothing (choice A) is not directly related to the effectiveness of phototherapy. Keeping the newborn supine throughout treatment (choice C) is a general position recommendation and not specific to phototherapy. Measuring the newborn's temperature every 8 hours (choice D) is important but not directly related to phototherapy.
A nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. Which of the following is the correct interpretation of this clinical finding?
- A. The fetal head is in the left occiput posterior position.
- B. The largest fetal diameter has passed through the pelvic outlet.
- C. The posterior fontanel is palpable.
- D. The lowermost portion of the fetus is at the level of the ischial spines.
Correct Answer: D
Rationale: Correct Answer: D. The lowermost portion of the fetus is at the level of the ischial spines.
Rationale:
1. Station 0 indicates the presenting part of the fetus is at the level of the ischial spines.
2. This position is significant as it helps determine the progress of labor.
3. It means the fetus has not descended into the birth canal yet, indicating early labor stages.
Summary:
A: Incorrect. Left occiput posterior position is related to fetal head position, not station.
B: Incorrect. Passing through the pelvic outlet refers to engagement, not station.
C: Incorrect. The posterior fontanel being palpable is not directly related to station.