Nokea
The nurse is describing different types of abruptio placenta to a group of students explaining that the incomplete abruptio placenta is
- A. There is massive bleeding in the presence of almost total separation
- B. Separation beginning at the periphery of the placenta
- C. The placenta separates centrally and there can be concealed bleeding
- D. Blood passes between the fetal membrane of the uterine wall and is skipped vaginally
Correct Answer: B
Rationale: In incomplete abruptio placenta, the separation begins at the periphery of the placenta. This results in partial detachment of the placenta from the uterine wall, rather than almost total separation as seen in complete abruptio placenta. This type of abruptio placenta may present with vaginal bleeding depending on the extent of separation and may lead to various degrees of maternal and fetal compromise.
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A 30-year-old woman is considering the use of emergency contraception. Which of the following is true about its use?
- A. It is most effective when used within 72 hours after unprotected sex.
- B. It should be used at least 5 days after unprotected sex to be effective.
- C. It prevents implantation of a fertilized egg into the uterine wall.
- D. It requires a prescription from a healthcare provider.
Correct Answer: A
Rationale: Emergency contraception is most effective when taken within 72 hours of unprotected sex. Choice B is incorrect as it is not as effective after 5 days. Choice C is incorrect because emergency contraception works primarily by preventing ovulation, not by preventing implantation. Choice D is incorrect because most emergency contraception methods are available over the counter.
The nurse is caring for a client in active labor with late decelerations on the monitor. What is the priority nursing intervention?
- A. Reposition the client to her side.
- B. Administer IV fluids.
- C. Apply oxygen via face mask.
- D. Notify the healthcare provider.
Correct Answer: A
Rationale: Repositioning improves blood flow and oxygen delivery to the fetus during late decelerations.
What is the recommended position for a laboring mother with variable decelerations?
- A. Position the mother in a supine position
- B. Encourage the mother to change positions frequently
- C. Advise using a peanut ball to widen the pelvis
- D. Position the mother in a side-lying position
Correct Answer: D
Rationale: Side-lying reduces pressure on the umbilical cord, improving fetal oxygenation.
A nurse is caring for a client who is 14 weeks of gestation. At which the following locations should the nurse place the Doppler device when assessing the fetal heart rate?
- A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis
- B. Left Upper Abdomen
- C. Two fingerbreadths above the umbilicus
- D. Lateral at the Xiphoid Process
Correct Answer: A
Rationale: When assessing the fetal heart rate in a client who is 14 weeks of gestation, the nurse should place the Doppler device at the midline 2 to 3 cm above the symphysis pubis. This is the appropriate location for detecting the fetal heartbeat at this gestational age. Placing the Doppler device too high on the abdomen may result in difficulty in detecting the fetal heart rate due to the position of the uterus and fetal size. Placing it too low may not capture the fetal heartbeat accurately. Therefore, the midline location above the symphysis pubis provides the best chance for accurate assessment of the fetal heart rate at 14 weeks of gestation.
What is the second stage of pathophysiology in an on anticoagulant therapy due to a deep vein throm- amniotic fluid embolism characterized by? bosis, which occurred after giving birth. Which of
- A. Hemorrhage the following instructions should the nurse include?
- B. Hypoxia
- C. Take an herbal supplement such as St. John's wort
- D. Capillary damage to help increase the effect of the anticoagulant.
Correct Answer: A
Rationale: The second stage of pathophysiology in an amniotic fluid embolism characterized by deep vein thrombosis on anticoagulant therapy after giving birth involves the risk of hemorrhage. Anticoagulant therapies such as heparin increase the risk of bleeding since they inhibit the blood's ability to clot effectively. This means that in the event of an injury or surgery, there is a higher likelihood of excessive bleeding. Therefore, it is crucial to monitor for signs of hemorrhage such as bruising, bleeding gums, blood in urine or stool, and low blood pressure. Intervention to manage bleeding may include reducing the dosage of the anticoagulant, administering blood products, and implementing pressure or surgical interventions as necessary.