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The nurse is educating a gravida 1 para 0 who is 28 weeks pregnant. Which educational topics are appropriate for the nurse to discuss with the patient at this prenatal visit? Select all that apply.
- A. Discussion of prenatal classes
- B. Discussion of alcohol use
- C. Discussion of family history for pregnancy-induced hypertension
- D. Discussion of signs and symptoms of preterm labor
Correct Answer: B
Rationale: The correct answer is B, Discussion of alcohol use. This topic is important for prenatal education to ensure the well-being of the mother and baby. Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. The other choices are incorrect because:
A: Discussion of prenatal classes is relevant, but not a priority at 28 weeks.
C: Discussion of family history for pregnancy-induced hypertension is important but not usually discussed at every prenatal visit.
D: Discussion of signs and symptoms of preterm labor is crucial, but typically discussed later in pregnancy.
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What is a potential sign of intrauterine fetal demise?
- A. increased fetal heart rate
- B. vaginal bleeding
- C. decreased or absent fetal movement
- D. macrosomia
Correct Answer: C
Rationale: The correct answer is C: decreased or absent fetal movement. This is a potential sign of intrauterine fetal demise because it indicates a lack of fetal activity, which could suggest fetal distress or death. Reduced or absent fetal movement may be an early warning sign that the fetus is not receiving enough oxygen or nutrients. It is important to monitor fetal movement regularly to ensure the well-being of the fetus.
Other choices are incorrect because:
A: increased fetal heart rate is more commonly associated with fetal distress, not demise.
B: vaginal bleeding can be a sign of various conditions such as placental abruption or placenta previa, but it is not specific to fetal demise.
D: macrosomia refers to a large baby, which is not indicative of fetal demise.
The nurse is aware that there are multiple classifications for cesarean deliveries. Which situations does the nurse classify as an unscheduled cesarean birth? Select all that apply.
- A. Patient had a previous cesarean delivery.
- B. There is evidence of a prolapsed cord with membrane rupture.
- C. The cervix fails to fully dilate after prolonged labor.
- D. Patient has a preexisting cardiac health condition.
Correct Answer: C
Rationale: The correct answer is C because an unscheduled cesarean birth occurs when the cervix fails to fully dilate after prolonged labor, leading to the need for an emergency cesarean section. This situation poses risks to both the mother and the baby, necessitating immediate intervention.
Choice A is incorrect because a previous cesarean delivery does not necessarily mean the current cesarean birth is unscheduled. Choice B is incorrect as evidence of a prolapsed cord with membrane rupture would typically lead to an emergency cesarean delivery but is not the only scenario for unscheduled cesarean birth. Choice D is also incorrect as a preexisting cardiac health condition does not automatically indicate the need for an unscheduled cesarean birth.
What is a potential complication for the neonate due to precipitous labor?
- A. respiratory distress
- B. low birth weight
- C. prelabor rupture of membranes
- D. placenta previa
Correct Answer: A
Rationale: The correct answer is A: respiratory distress. During precipitous labor, the rapid delivery can cause the neonate to experience respiratory distress due to inadequate time for fluid clearance from the lungs, leading to transient tachypnea or respiratory distress syndrome. This complication can result in difficulty breathing and require immediate medical intervention.
Summary:
B: Low birth weight is not directly associated with precipitous labor.
C: Prelabor rupture of membranes is unrelated to the speed of labor.
D: Placenta previa is a condition involving the placenta's position, not typically related to the duration of labor.
What Bishop score describes the most favorable cervix?
- A. 2
- B. 4
- C. 6
- D. 8
Correct Answer: D
Rationale: The Bishop score assesses cervical readiness for labor. A score of 8 indicates a cervix that is most favorable for labor, with characteristics such as cervical dilation, effacement, station of the presenting part, cervical consistency, and cervical position all being favorable for childbirth. A score of 8 signifies a well-prepared cervix for labor, making it the correct answer. Choices A, B, and C (2, 4, and 6) represent scores indicating varying degrees of cervical readiness, but they are not as optimal as a score of 8. A Bishop score of 8 is associated with a higher likelihood of successful induction and progression of labor compared to lower scores.
What newborn complication does type 1 diabetes mellitus cause?
- A. hyperglycemia
- B. fetal macrosomia
- C. group B strep
- D. cyanosis
Correct Answer: C
Rationale: The correct answer is C: group B strep. Women with type 1 diabetes are at higher risk of developing infections, including group B strep, which can be passed to the newborn during childbirth. This can lead to serious complications such as pneumonia, sepsis, and meningitis in the newborn. Hyperglycemia (choice A) is a common complication of maternal diabetes but is not specific to type 1 diabetes. Fetal macrosomia (choice B) is a condition where the baby is larger than average, which can be a complication of diabetes but not specific to type 1. Cyanosis (choice D) refers to a bluish discoloration of the skin due to lack of oxygen and is not directly related to type 1 diabetes complications in newborns.