Nokea
The nurse practicing in a labor setting knows the woman most at risk for a uterine rupture is:
- A. G4 who had all 4 c/s birth
- B. G5 who had 2 vaginal birth and 2 c/s births
- C. G2 low segment vertical incision for delivery of 10lb infant
- D. G3 who had 2 lower segment transverse c/s birth
Correct Answer: C
Rationale: The correct answer is C because a low segment vertical incision for delivery of a large infant (10lb) puts the woman at the highest risk for uterine rupture. This type of incision weakens the uterine wall, increasing the likelihood of rupture during subsequent pregnancies or labor. Choices A, B, and D involve lower segment transverse c-section births, which are less likely to result in uterine rupture compared to a vertical incision. Additionally, the number of previous births or the mode of delivery does not increase the risk of uterine rupture as much as the type of uterine incision.
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A nurse on a labor and delivery unit is receiving infection control standards with a newly licensed nurse. The nurse should instruct the newly licensed nurse to don gloves for which of the following procedures?
- A. Assisting a mother with breastfeeding
- B. Performing a newborn's initial bath
- C. Administering the measles, mumps, rubella vaccine
- D. Performing umbilical cord care
Correct Answer: D
Rationale: The correct answer is D: Performing umbilical cord care. Gloves should be worn during this procedure to prevent the spread of infection. The umbilical cord stump is a potential entry point for bacteria, so gloves are necessary to maintain asepsis.
A: Assisting a mother with breastfeeding does not require gloves as it is a clean procedure.
B: Performing a newborn's initial bath does not require gloves unless there are open wounds on the newborn.
C: Administering the measles, mumps, rubella vaccine may require gloves, but the primary concern is needlestick safety rather than infection control through glove use.
What is the term for nonmedical factors that influence health outcomes, including conditions in which people are born, grow, work, live, and age, and the wider sets of forces and systems shaping the conditions of daily life?
- A. environmental influences
- B. life circumstances
- C. situational occurrences
- D. social determinants of health
Correct Answer: D
Rationale: The correct answer is D: social determinants of health. Social determinants of health refer to the external factors that impact health outcomes. These factors include socioeconomic status, education, employment, social support networks, access to healthcare, and the physical environment. The term encompasses a broad range of influences beyond individual behaviors or genetics.
A: Environmental influences focus more on physical factors like pollution or climate, rather than the broader societal factors.
B: Life circumstances may include individual factors like personal choices or experiences, but do not encompass the societal influences.
C: Situational occurrences imply random events or temporary situations, rather than the persistent societal factors that shape health outcomes.
What do you give for magnesium sulfate toxicity?
- A. Calcium gluconate
- B. Sodium bicarbonate
- C. Furosemide (Lasix)
- D. Vitamin K
Correct Answer: A
Rationale: The correct answer is A: Calcium gluconate. In magnesium sulfate toxicity, high levels of magnesium can lead to muscle weakness, respiratory depression, and cardiac arrest. Calcium gluconate is given because it antagonizes the effects of magnesium on the neuromuscular system and helps prevent further complications. Sodium bicarbonate (B) is not the correct choice as it is used to treat acidosis, not magnesium toxicity. Furosemide (C) is a diuretic and would not address magnesium toxicity. Vitamin K (D) is used for blood clotting disorders, not for magnesium toxicity.
The nurse would classify a newborn delivered at 39 weeks' gestation, weighing 2400 g ( 5.0 lbs) as being:
- A. Preterm and immature
- B. Small-for-gestational age
- C. Average-for-gestational age
- D. Average-for-gestational age but pre-term
Correct Answer: B
Rationale: The correct answer is B: Small-for-gestational age. A newborn delivered at 39 weeks' gestation and weighing 2400g is considered small-for-gestational age because the weight is below the 10th percentile for the gestational age. This indicates intrauterine growth restriction. Preterm and immature (choice A) would not apply as the baby was delivered at term. Average-for-gestational age (choice C) would not be accurate as the baby's weight is below the normal range for that gestational age. Choice D is also incorrect as the baby is not within the average weight range for the gestational age.
The nurse is educating a client about postpartum warning signs. Which symptom requires immediate medical attention?
- A. Increased lochia after breastfeeding.
- B. Perineal discomfort on day 3 postpartum.
- C. Fever of 101°F and foul-smelling lochia.
- D. Mild fatigue and trouble sleeping.
Correct Answer: C
Rationale: The correct answer is C: Fever of 101°F and foul-smelling lochia. This combination indicates a possible infection like endometritis, which can be life-threatening if not promptly treated. Fever is a sign of systemic infection, and foul-smelling lochia suggests an infected uterus. Immediate medical attention is crucial to prevent complications.
A: Increased lochia after breastfeeding is common and not necessarily alarming unless it is excessive or accompanied by other symptoms.
B: Perineal discomfort on day 3 postpartum is expected due to the healing process and does not typically require immediate medical attention.
D: Mild fatigue and trouble sleeping are common postpartum symptoms but do not indicate a medical emergency unless they are severe or persistent.