Assessment of High Risk Pregnancy NCLEX Questions

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Which technique would provide the best pain relief for a pregnant woman with an occiput posterior position?

  • A. Neuromuscular disassociation
  • B. Effleurage
  • C. Psychoprophylaxis
  • D. Sacral pressure
Correct Answer: D

Rationale: The correct answer is D: Sacral pressure. This technique involves applying pressure to the sacrum to alleviate back pain associated with an occiput posterior position. The pressure helps relieve tension and discomfort in the lower back, providing effective pain relief for the pregnant woman.

A: Neuromuscular disassociation is not specific to addressing the pain associated with the occiput posterior position in pregnancy.
B: Effleurage is a gentle massage technique that may provide some relaxation but may not be as effective as sacral pressure for pain relief in this specific scenario.
C: Psychoprophylaxis is a method of preparing for childbirth through education and relaxation techniques, but it may not directly target the pain caused by the occiput posterior position.

In summary, sacral pressure is the most appropriate technique as it directly addresses the specific pain associated with the occiput posterior position in pregnancy, unlike the other choices.

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A laboring woman, G4 P3003, who was 6 cm dilated 1 hour ago cries, 'Hurry. I have to go to the bathroom to have a bowel movement.' The nurse notes that there is an increase in bloody show. Which of the following actions by the nurse is appropriate?

  • A. Assess cervical dilation.
  • B. Help the woman to the bathroom.
  • C. Ask the woman if she needs pain medicine.
  • D. Check the fetal heart rate.
Correct Answer: A

Rationale: The urge to have a bowel movement and increased bloody show could indicate that the woman is entering the second stage of labor. The nurse should assess cervical dilation to confirm.

The nurse is caring for a client who had a contraction stress test. Which change in assessment requires immediate notification of the health care provider?

  • A. No late decelerations
  • B. Late decelerations with at least 50% of the contractions
  • C. Accelerations with contractions
  • D. No contractions produced
Correct Answer: B

Rationale: The correct answer is B because late decelerations with at least 50% of contractions indicate fetal distress and potential hypoxia. This requires immediate notification of the healthcare provider for further evaluation and intervention. No late decelerations (choice A) are normal. Accelerations with contractions (choice C) are reassuring. No contractions produced (choice D) would indicate an inadequate test and require reevaluation.

A 36-week-gestation client is having an amniocentesis. For which of the following reasons is the test likely being conducted?

  • A. Genetic evaluation.
  • B. Assessment of intrauterine growth restriction.
  • C. Assessment of fetal lung maturation.
  • D. Hormonal studies.
Correct Answer: C

Rationale: Amniocentesis at 36 weeks is often performed to assess fetal lung maturity before delivery.

What does a birth plan help the parents accomplish?

  • A. Avoidance of an episiotomy
  • B. Determining the outcome of the birth
  • C. Assuming complete control of the situation
  • D. Taking an active part in planning the birth experience
Correct Answer: D

Rationale: The correct answer is D because a birth plan allows parents to actively participate in planning their birth experience by outlining their preferences and wishes. It helps them communicate their desires to healthcare providers and ensures their preferences are considered during labor and delivery. Choice A is incorrect as avoiding an episiotomy is a specific medical procedure, not the primary purpose of a birth plan. Choice B is incorrect as determining the outcome of birth is not within the control of parents. Choice C is incorrect as assuming complete control of the situation may not be realistic or safe during childbirth.

A nurse has provided a young woman with preconception counseling. Which of the statements by the woman indicates that the teaching was successful? Select all that apply.

  • A. “As soon as I think I may be pregnant, I should stop drinking alcohol.”
  • B. “It is important for me to see my medical doctor for a complete physical.”
  • C. “I should make sure that my daily multivitamin contains folic acid.”
  • D. “When I go to my dentist for a checkup I should state that I may be pregnant.”
Correct Answer: A

Rationale: All the statements indicate successful preconception counseling, covering topics such as alcohol cessation, medical checkups, folic acid intake, dental care, and dietary precautions.

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