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The nurse in the labor and delivery area receives a telephone call from the emergency room announcing that a multigravid client in active labor is being transferred to the labor area. The client has been successful care, when the client arrives by stretcher, she says, 'I think the baby's coming ... Help!' The fetal skull is crowning. The nurse should obtain which of the following information first?
- A. Estimated date of delivery.
- B. Amniotic fluid status.
- C. Gravida and parity.
- D. Prenatal history.
Correct Answer: A
Rationale: With crowning, delivery is imminent, and confirming the estimated date of delivery ensures the neonate's gestational age is known for resuscitation planning. Fluid status, gravida/parity, and prenatal history are secondary.
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When performing Leopold’s maneuvers on a primigravid client, the nurse is palpating the uterus as shown below. Which of the following maneuvers is the nurse performing?
- A. First maneuver
- B. Second maneuver.
- C. Third maneuver.
- D. Fourth maneuver.
Correct Answer: C
Rationale: The third Leopold’s maneuver is performed to: Identify the fetal part that is lying just above the inlet of the true pelvis (i.e., what part is presenting). It helps determine if the presenting part (usually the head or buttocks) is engaged, floating, or movable.
A nurse is attempting to resuscitate a neonate. After following the Neonatal Resuscitation Program guidelines, 30 seconds of chest compressions have been completed. The neonate's heart rate remains less than 60 bpm. Epinephrine is to be given. What is the expected outcome for a neonate who has received epinephrine during resuscitation?
- A. Increased urine output.
- B. A normal heart rate.
- C. Pain relief.
- D. Sedation.
Correct Answer: B
Rationale: Epinephrine is used to restore a normal heart rate during resuscitation by stimulating cardiac activity.
A nurse is discussing emergency contraception with a client. Which of the following statements by the nurse is accurate?
- A. Emergency contraception is most effective when taken within 72 hours of unprotected intercourse.
- B. Emergency contraception requires a prescription for all women.
- C. Emergency contraception is 100% effective in preventing pregnancy.
- D. Emergency contraception can be used as a regular method of birth control.
Correct Answer: A
Rationale: Emergency contraception, like Plan B, is most effective within 72 hours of unprotected intercourse. It is available over-the-counter for those 17 and older, is not 100% effective, and is not suitable for regular use due to lower efficacy and side effects.
A multigravid client in active labor at term is diagnosed with polyhydramnios. The physician has instructed the client about possible neonatal complications related to the polyhydramnios. The nurse determines that the client has understood the instructions when the client states that polyhydramnios is associated with which of the following in the fetus or neonate?
- A. Renal dysfunction.
- B. Intrauterine growth retardation.
- C. Pulmonary hypoplasia.
- D. Gastrointestinal disorders.
Correct Answer: D
Rationale: Polyhydramnios is associated with fetal gastrointestinal disorders (e.g., esophageal atresia) that impair amniotic fluid absorption. Renal dysfunction, growth retardation, or pulmonary hypoplasia are more linked to oligohydramnios.
A client asks about the benefits of the copper IUD. Which of the following would the nurse include?
- A. It reduces menstrual bleeding.
- B. It is hormone-free and effective for up to 10 years.
- C. It requires daily monitoring.
- D. It prevents ovulation.
Correct Answer: B
Rationale: The copper IUD is hormone-free and effective for up to 10 years, offering long-term contraception. It may increase menstrual bleeding, does not require daily monitoring, and does not prevent ovulation.