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The nurse documents a prenatal patient’s GTPAL as G5T2P1A1L4. Which obstetric history is consistent with this assessment?
- A. The woman is currently pregnant, has five living children.
- B. The woman is currently pregnant and had two preterm pregnancies.
- C. The woman is not currently pregnant and has had one abortion.
- D. The woman is currently pregnant and had one set of twins.
Correct Answer: A
Rationale: Rationale:
1. G5 = Gravida 5 (woman has been pregnant 5 times)
2. T2 = Term births 2 (woman has had 2 full-term pregnancies)
3. P1 = Preterm births 1 (woman has had 1 preterm pregnancy)
4. A1 = Abortions 1 (woman has had 1 abortion)
5. L4 = Living children 4 (woman has 4 living children)
Summary:
- Choice A is correct as it aligns with the GTPAL components.
- Choice B is incorrect because it does not match the number of term and preterm births.
- Choice C is incorrect as it does not reflect the number of living children.
- Choice D is incorrect as it does not indicate any preterm pregnancies.
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The nurse is assisting with the preparation of a patient admitted for a planned cesarean birth. The patient has signed the consent form and discussed the elected regional anesthesia with the nurse anesthetist. Which is the most important action for the nurse related to anesthesia?
- A. Verify the patient has been NPO for 6 to 8 hours.
- B. Start an IV line and administer an IV fluid as ordered.
- C. Administer preoperative medications per orders.
- D. Obtain a baseline fetal heart rate monitor strip.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. NPO status is crucial to prevent aspiration during anesthesia administration.
2. Anesthesia guidelines typically require patients to be NPO for 6-8 hours.
3. Failure to verify NPO status can lead to serious complications.
4. Ensuring NPO status is a fundamental safety measure in anesthesia administration.
Summary of why other choices are incorrect:
B. Starting an IV and administering fluids are important but not as critical as verifying NPO status for anesthesia safety.
C. Administering preoperative medications is important, but ensuring NPO status takes precedence to prevent aspiration.
D. Obtaining a fetal heart rate monitor strip is important for monitoring the baby's well-being but does not directly impact anesthesia safety.
Which of the following is theN pUriRorSitIy NinGteTrvBen.tiConO fMor the patient in a left side-lying position whose monitor strip shows a deceleration that extends beyond the end of the contraction?
- A. Administer O at 8 to 10 L/minut
- B. Decrease the IV rate to 100 mL/hour.
- C. Reposition the ultrasound transducer.
- D. Perform a vaginal exam to assess for cord prolaps
Correct Answer: A
Rationale: The correct answer is A: Administer O at 8 to 10 L/minut. In a left side-lying position, this deceleration indicates possible umbilical cord compression, reducing oxygen supply to the fetus. Administering oxygen at 8 to 10 L/min can help improve fetal oxygenation. Decreasing the IV rate (B) wouldn't directly address the fetal distress. Repositioning the ultrasound transducer (C) is irrelevant to the situation. Performing a vaginal exam (D) could worsen the cord compression if the cord is prolapsed.
The nurse evaluates a pattern on the fetal monitor that appears similar to early decelerations. The deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?
- A. This pattern reflects variable decelerations. No interventions are necessary at this time
- B. Document this Category I fetal heart rate pattern and decrease the rate of the
- C. Continue to monitor these early decelerations, which occur as the fetal head is
compressed during a contraction - D. This deceleration pattern is associated with uteroplacental insufficiency. The nurse
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct:
1. The deceleration pattern described, beginning near the acme of the contraction and extending beyond, is associated with uteroplacental insufficiency.
2. Uteroplacental insufficiency indicates a potential problem with oxygen and nutrient delivery to the fetus.
3. This situation requires immediate intervention to improve oxygenation to the fetus.
4. Monitoring alone is not sufficient; action is needed to address the underlying issue.
5. Therefore, the correct nursing action in this situation is to recognize the potential uteroplacental insufficiency and take appropriate measures to address it.
Summary of why other choices are incorrect:
A: This pattern reflects variable decelerations - Incorrect because the described pattern is not characteristic of variable decelerations.
B: Document this Category I fetal heart rate pattern and decrease the rate of the - Incorrect because immediate action is needed in the presence of potential uteroplacental insufficiency.
What is a potential complication when the fetus is footling breech?
- A. prolapsed cord
- B. oligohydramnios
- C. low biophysical profile score
- D. meconium-stained fluid
Correct Answer: A
Rationale: The correct answer is A: prolapsed cord. In a footling breech presentation, the feet or legs of the fetus are positioned to deliver first, increasing the risk of the umbilical cord slipping down before the fetus during labor, leading to a prolapsed cord. This is a serious emergency as it can compromise fetal blood flow and oxygen supply.
Choice B: Oligohydramnios is a decreased level of amniotic fluid and is not directly related to a footling breech presentation.
Choice C: Low biophysical profile score indicates fetal well-being based on specific parameters and is not a direct complication of a footling breech presentation.
Choice D: Meconium-stained fluid can occur due to fetal distress but is not specific to a footling breech presentation.
A nurse is reviewing the record of a woman who has just been told that she is pregnant. The physician has documented the presence of Goodell’s sign. The nurse determines this sign refers to which of the following?
- A. A softening of the tip of the cervix
- B. A soft blowing sound that corresponds to the maternal pulse
- C. Enlargement of the uterus
- D. A softening of the lower uterine segment
Correct Answer: A
Rationale: The correct answer is A: A softening of the tip of the cervix. Goodell's sign is a softening of the tip of the cervix, which is one of the early signs of pregnancy due to increased vascularity and edema. This sign is often used by healthcare providers to confirm pregnancy.
Rationale:
1. Goodell's sign specifically refers to the softening of the cervix, not any other part of the reproductive system.
2. It is an important early sign of pregnancy due to hormonal changes.
3. Enlargement of the uterus (Choice C) typically occurs later in pregnancy, not as an early sign.
4. A blowing sound corresponding to maternal pulse (Choice B) and softening of the lower uterine segment (Choice D) are not associated with Goodell's sign.