Nokea
The nurse is caring for a client pregnant with twins. Which statement indicates that the client needs additional information?
- A. Because both of my twins are boys, I know that they are identical.
- B. If my twins came from one fertilized egg that split, they are identical.
- C. If I have one boy and one girl, I will know they came from two eggs.
- D. It is rare for both twins to be within the same amniotic sac.
Correct Answer: A
Rationale: The statement 'Because both of my twins are boys, I know that they are identical' is incorrect because twins can be fraternal and of the same sex. Identical twins result from one fertilized egg splitting, while fraternal twins result from two separate fertilized eggs.
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A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2 min, last 90 sec, and are strong to palpation. The baseline fetal heart rate is 150/min, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over. Which of the following actions should the nurse take?
- A. Decrease the rate of infusion of the maintenance IV solution.
- B. Discontinue the infusion of the IV oxytocin.
- C. Increase the rate of infusion of the IV oxytocin.
- D. Slow the client's rate of breathing.
Correct Answer: B
Rationale: The described scenario suggests the presence of late decelerations, which occur when uteroplacental insufficiency leads to decreased fetal oxygenation. In this case, the late decelerations are evident with each contraction, indicating a potential adverse reaction to the oxytocin infusion. The appropriate action would be to discontinue the infusion of IV oxytocin to prevent further compromise to fetal well-being. Alternatively, the nurse should consider repositioning the mother, administering oxygen via a face mask, and notifying the healthcare provider for further assessment and interventions.
Early PPH is defined as blood loss greater than ____ 24h after delivery
- A. 500 mL 24h after normal delivery
- B. 1000 48h after c/s (lat
- C. 1500 mL after 48hr
- D. 750 mL after 24h vaginal delivery
Correct Answer: D
Rationale: Early postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL within the first 24 hours after vaginal delivery. This definition is crucial because it helps healthcare providers identify and promptly address any excessive bleeding that may occur in the immediate postpartum period. Monitoring postpartum bleeding is essential to prevent complications related to PPH, such as maternal anemia, hypovolemic shock, and even maternal death. By knowing the definition of early PPH, healthcare providers can take timely interventions to manage and treat postpartum hemorrhage effectively.
The nurse knows that contraindication of the induction of labor includes:
- A. Placenta previa
- B. Diabetes mellitus
- C. PROM
- D. Isoimmunization
Correct Answer: A
Rationale: Placenta previa is a contraindication for the induction of labor because the placenta partially or completely covers the cervix. Inducing labor in this situation can lead to complications such as excessive bleeding and compromised blood flow to the baby. Therefore, it is important to avoid inducing labor in cases of placenta previa to ensure the safety of both the mother and the baby.
Which health concern is most likely to be an issue for the older mother?
- A. Nutrition and diet planning
- B. Exercise and fitness
- C. Having enough rest and sleep
- D. Effective contraceptive methods
Correct Answer: A
Rationale: As women age, their nutritional needs may change, and they may require more specific nutrients to support their health. Older mothers may be more susceptible to health concerns related to inadequate nutrition and diet planning, such as osteoporosis or heart disease. Proper nutrition is essential for both the mother's well-being and the health of her child. Therefore, nutrition and diet planning are more likely to be an issue for an older mother compared to exercise, rest, or contraceptive methods, especially during pregnancy and postpartum periods.
A male infant delivered at 28 weeks gestation weighs 2 pounds, 12 ounces. When performing an assessment, the nurse would probably observe:
- A. Wide, staring eye
- B. Transparent, red skin
- C. An absence of lanugo
- D. A scrotum with descended testicles
Correct Answer: B
Rationale: A male infant delivered at 28 weeks gestation, as described, would likely have very underdeveloped skin due to the premature birth. The premature skin is often transparent, allowing the prominent blood vessels underneath to be visible, and may also have a reddish hue due to the skin's immaturity. This characteristic appearance is a common finding in premature infants and is a result of their skin being thinner and more fragile than that of full-term infants. The other options, such as a wide, staring eye, an absence of lanugo, and a scrotum with descended testicles, are not specifically associated with premature birth and are not likely to be observed in this scenario.