Nokea
A woman has been in labor for 16 hours. Her cervix is dilated
- A. The fetal presenting part is not engage
- B. The nurse would expect which malpresentation
- C. CPD (prevents presenting part form becoming engage
Correct Answer: A
Rationale: If a woman has been in labor for 16 hours and her cervix is not dilated, it suggests that the fetal presenting part is not engaged. Engagement refers to the descent of the fetal presenting part (usually the head) into the pelvis. When the presenting part is not engaged, it may lead to a prolonged labor as the fetus needs to descend further for labor to progress effectively. This can result in slower cervical dilation and may require interventions to help facilitate engagement, such as position changes or use of gravity-assisted techniques.
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The laboring person asks the nurse to review the birth plan. What item is on a typical birth plan?
- A. where the patient will be staying after birth
- B. who will be watching their other children
- C. what position they want to birth in
- D. how they will time contractions
Correct Answer: C
Rationale: Birth plans often include preferences for birthing positions to promote comfort and effectiveness.
The nurse received end of shift report in a high-risk maternity unit. Which patient should the nurse see first?
- A. 26 weeks with placenta previa experiencing blood on toilet tissue after bowel movement (placenta is getting lower)
- B. 30 weeks' gestation with placenta previa whose fetal monitor shows late decelerations
- C. 35 weeks' gestation with grade I abruptio placenta in labor who has strong urge to push
- D. 37 weeks' gestation with pregnancy induced hypertension whose membrane ruptured spontaneously
Correct Answer: C
Rationale: The patient who should be seen first is the 35 weeks' gestation with grade I abruptio placenta in labor who has a strong urge to push. Abruptio placenta is a serious condition where the placenta detaches from the uterine wall before delivery, leading to significant bleeding and potential compromise to both the mother and baby. The strong urge to push indicates that the baby is in distress and immediate intervention is required to prevent potential harm. This patient needs urgent assessment and intervention to ensure the safety of both the mother and the baby.
What tion in the FHR that is abrupt and appears to be does the nurse inform this group that they are at in the shape of a W. What is the most likely cause highest risk for? of this?
- A. Sexually transmitted diseases
- B. Compression of the fetal head
- C. Uterine cancer
- D. Compression of the umbilical cord
Correct Answer: D
Rationale: An abnormality in the FHR that is abrupt and appears to be in the shape of a "W" is often indicative of variable decelerations. Variable decelerations typically occur due to compression of the umbilical cord, leading to a temporary decrease in oxygen supply to the fetus. It is important for the nurse to inform this group that they are at the highest risk for compression of the umbilical cord as this can result in fetal distress and potentially lead to serious complications if not promptly addressed.
The newborn's mother is concerned about the shape of the baby's head after delivery. She states that the baby looks like a "cone head." What is the most appropriate response by the nurse?
- A. "You don't need to worry about it. It is perfectly normal after birth."
- B. "It is molding caused by the pressure during birth and will disappear in a few days."
- C. "I will report it to the physician and recommend a diagnostic scan."
- D. "It is a collection of blood related to the trauma of delivery and will absorb in a few weeks.
Correct Answer: B
Rationale: "It is molding caused by the pressure during birth and will disappear in a few days."
The nurse is educating a client about gestational diabetes. What is the best recommendation for managing blood sugar levels?
- A. Avoid all carbohydrates.
- B. Exercise for 60 minutes daily.
- C. Eat balanced meals and monitor blood sugar levels.
- D. Only take insulin when blood sugar is high.
Correct Answer: C
Rationale: Balanced meals and regular blood sugar monitoring are essential for managing gestational diabetes.