Nokea
The client has been in labor for 21 hours. Induction was started 16 hours ago, and she is now dilated 5 cm. She has made little progress, and there has been no fetal descent. The HCP identifies cephalopelvic disproportion (CPD). The nurse should prepare the client for which mode of delivery?
- A. Traditional vaginal delivery
- B. Forceps-assisted delivery
- C. Vacuum-assisted delivery
- D. Cesarean section delivery
Correct Answer: D
Rationale: A fetus diagnosed with CPD is unable to be delivered vaginally and requires a cesarean section birth. A vaginal delivery is contraindicated once CPD has been identified due to the risk of fetal and maternal trauma. Forceps delivery is contraindicated once CPD has been identified due to the risk of fetal and maternal trauma. Vacuum delivery is contraindicated once CPD has been identified due to the risk of fetal and maternal trauma.
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The 22-year-old client, who is experiencing vaginal bleeding in the first trimester of pregnancy, fears that she has lost her baby at 8 weeks. Which definitive test result should indicate to the nurse that the client’s fetus has been lost?
- A. Falling beta human chorionic gonadotropin (BHCG) measurement
- B. Low progesterone measurement
- C. Ultrasound showing a lack of fetal cardiac activity
- D. Ultrasound determining crown-rump length
Correct Answer: C
Rationale: Ultrasound is used to determine if the fetus has died. The lack of fetal heart activity in a pregnancy over 6 weeks determines a fetal loss. Falling BHCG levels do not conclusively diagnose fetal demise. Low progesterone levels do not conclusively diagnose fetal demise. Crown-rump length determines only the fetal gestational age.
Which information about shortness of breath during pregnancy is correct?
- A. It is not common during pregnancy and may indicate a blood clot in the lungs.
- B. It is probably the result of anxiety about the baby's impending delivery.
- C. It is probably caused by the enlarged uterus pressing against the diaphragm.
- D. It is probably caused by decreased oxygen secondary to slow venous circulation.
Correct Answer: C
Rationale: Shortness of breath is common in late pregnancy due to the enlarged uterus pressing against the diaphragm, limiting lung expansion.
Which of the following beverages should be included in the list of unhealthy drinks to avoid? Select all that apply.
- A. Alcohol
- B. Coffee
- C. Tea
- D. Cola beverages
- E. Sports drinks
- F. Orange juice
Correct Answer: A,B,C,D
Rationale: Alcohol is harmful to the fetus, and caffeinated drinks (coffee, tea, cola) should be limited due to potential effects on fetal development.
What information should the nurse also include about the side effects of iron supplementation?
- A. You may notice that your stools will be black.
- B. Your teeth will become stained.
- C. Vomiting is likely to occur.
- D. You may have diarrhea several times per day.
Correct Answer: A
Rationale: Black stools are a common side effect of iron supplements due to unabsorbed iron, unlike the other options.
Which cultural consideration should the nurse include in prenatal education?
- A. Respect client's dietary preferences and beliefs
- B. Ignore cultural practices
- C. Standardize all education materials
- D. Avoid discussing family roles
Correct Answer: A
Rationale: Respecting the client's dietary preferences and cultural beliefs ensures culturally sensitive and effective prenatal education.